Flapless implant surgery: review of the literature and report of 2 cases with computer-guided surgical approach.

PURPOSE Modern implantology uses techniques that can provide function, esthetics, and comfort with a minimally invasive surgical approach. Flapless implant surgery has been proposed to fulfill these requirements. Traditionally, flapless implant surgery was carried out by using a tissue punch technique, which may be potentially harmful because of the inherent blindness of the technique. The purpose of this article is to introduce a predictable flapless approach for treatment of 2 patients through principles of computer-guided implantology. MATERIALS AND METHODS Using dedicated interactive computer software programs and 3D radiographic techniques such as computed tomography (CT), the precise location of each implant was planned. Using the concept "prosthetic-driven implantology," surgery was carried out for the rehabilitation of 2 patients. RESULTS The procedure of implant planning in this sophisticated technique has potential to yield substantial public health benefits. CONCLUSION Although this modern approach may have many advantages, transferring virtual planning to the patient's mouth has only been developed recently. Further research is required to justify this novel approach for implant rehabilitation.

[1]  Reinhilde Jacobs,et al.  Preoperative radiologic planning of implant surgery in compromised patients. , 2003, Periodontology 2000.

[2]  F. M. Gardner,et al.  Fabrication of a guide for radiographic evaluation and surgical placement of implants. , 1995, The Journal of prosthetic dentistry.

[3]  C M Stanford,et al.  Biomechanical and Functional Behavior of Implants , 1999, Advances in dental research.

[4]  Massimiliano Martignoni,et al.  Immediate loading in the maxilla using flapless surgery, implants placed in predetermined positions, and prefabricated provisional restorations: a retrospective 3-year clinical study. , 2003, Clinical implant dentistry and related research.

[5]  B Rangert,et al.  Bending overload and implant fracture: a retrospective clinical analysis. , 1995, The International journal of oral & maxillofacial implants.

[6]  Henry W K Luk,et al.  Precision surgical template for implant placement: a new systematic approach. , 2002, Clinical implant dentistry and related research.

[7]  Kevin C Kopp,et al.  Predictable implant placement with a diagnostic/surgical template and advanced radiographic imaging. , 2003, The Journal of prosthetic dentistry.

[8]  D M Almog,et al.  Fabrication of imaging and surgical guides for dental implants. , 2001, The Journal of prosthetic dentistry.

[9]  O. Jensen,et al.  Anterior maxillary alveolar distraction osteogenesis: a prospective 5-year clinical study. , 2002, The International journal of oral & maxillofacial implants.

[10]  J. Hobkirk,et al.  The influence of mandibular deformation, implant numbers, and loading position on detected forces in abutments supporting fixed implant superstructures. , 1998, The Journal of prosthetic dentistry.

[11]  A. Sclar.  Soft Tissue and Esthetic Considerations in Implant Therapy , 2003 .

[12]  A B Reiskin,et al.  Implant imaging. Status, controversies, and new developments. , 1998, Dental clinics of North America.

[13]  M. Martignoni,et al.  Immediate loading of Brånemark System TiUnite and machined-surface implants in the posterior mandible: a randomized open-ended clinical trial. , 2003, Clinical implant dentistry and related research.

[14]  H F Morris,et al.  Long-term assessment (5 to 71 months) of endosseous dental implants placed in the augmented maxillary sinus. , 2000, Annals of periodontology.

[15]  D A Kaiser,et al.  Surgical guide for dental implant placement. , 2000, The Journal of prosthetic dentistry.

[16]  P F van der Stelt,et al.  The radiographic assessment of implant patients: decision-making criteria. , 2001, The International journal of oral & maxillofacial implants.

[17]  Reinhilde Jacobs,et al.  Imaging technique selection for the preoperative planning of oral implants: a review of the literature. , 2002, Clinical implant dentistry and related research.

[18]  D A Garber,et al.  The esthetic dental implant: letting restoration be the guide. , 1995, The Journal of oral implantology.

[19]  Gerlig Widmann,et al.  Accuracy in computer-aided implant surgery--a review. , 2006, The International journal of oral & maxillofacial implants.

[20]  Anthony G Sclar,et al.  Guidelines for flapless surgery. , 2007, Journal of oral and maxillofacial surgery : official journal of the American Association of Oral and Maxillofacial Surgeons.

[21]  Alan L Rosenfeld,et al.  Prosthetically directed implant placement using computer software to ensure precise placement and predictable prosthetic outcomes. Part 1: diagnostics, imaging, and collaborative accountability. , 2006, The International journal of periodontics & restorative dentistry.

[22]  Kunal Lal,et al.  Use of stereolithographic templates for surgical and prosthodontic implant planning and placement. Part I. The concept. , 2006, Journal of prosthodontics : official journal of the American College of Prosthodontists.