J Periodontal Implant Sci.  2013 Aug;43(4):153-159. 10.5051/jpis.2013.43.4.153.

What is the effect of initial implant position on the crestal bone level in flap and flapless technique during healing period?

• Al-Juboori MJ
• Ab Rahman
• Hassan A
• Bin Ismail IH
• Tawfiq OF

• KMID: 2027810
• DOI: http://doi.org/10.5051/jpis.2013.43.4.153

Abstract

PURPOSE
The level of the implant above the marginal bone and flap design have an effect on the bone resorption during the healing period. The aim of this study is to detect the relationship between the level of the implant at the implant placement and the bone level at the healing period in the mesial and distal side of implants placed with flapless (FL) and full-thickness flap (FT) methods.
METHODS
Twenty-two nonsubmerged implants were placed with the FL and FT technique. Periapical radiographs were taken of the patient at implant placement, and at 6 and 12 weeks. By using computer software, bone level measurements were taken from the shoulder of the healing cap to the first bone implant contact in the mesial and distal side of the implant surface.
RESULTS
At 6 weeks, the correlation between the crestal bone level at the implant placement and crestal bone level of the FT mesially was significant (Pearson correlation coefficient=0.675, P<0.023). At 12 weeks, in the FT mesially, the correlation was nonsignificant (Spearman correlation coefficient=0.297, P<0.346). At 6 weeks in the FT distally, the correlation was nonsignificant (Pearson correlation coefficient=0.512, P<0.107). At 12 weeks in the FT distally, the correlation was significant (Spearman correlation coefficient=0.730, P<0.011). At 6 weeks in the FL mesially, the correlation was nonsignificant (Spearman correlation coefficient=0.083, P<0.809). At 12 weeks in the FL mesially, the correlation was nonsignificant (Spearman correlation coefficient=0.062, P<0.856). At 6 weeks in the FL distally, the correlation was nonsignificant (Spearman correlation coefficient=0.197, P<0.562). At 12 weeks in the FL distally, the correlation was significant (Pearson correlation coefficient=0.692, P<0.018).
CONCLUSIONS
A larger sample size is recommended to verify the conclusions in this preliminary study. The bone level during the healing period in the FT was more positively correlated with the implant level at implant placement than in the FL.

Keyword

Bone resorption; Clinical trial; Dental implantation; Oral surgical procedures

MeSH Terms

Bone Resorption
Dental Implantation
Humans
Oral Surgical Procedures
Software

Figure

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  Figure 1 Using the long-cone parallel technique with a Rinn film holder (Dentsply International Inc.).

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  Figure 2 Correlation between the mesial crestal bone level of the full-thickness flap (FT) at implant placement and the mesial crestal bone level of the FT at 6 weeks (mm). There was a significant positive correlation (moderate to good correlation) (r=0.675, P<0.023).

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  Figure 3 Correlation between the mesial crestal bone level of the full-thickness flap (FT) at implant placement and the mesial crestal bone level of the FT at 12 weeks (mm). There was a fair statistically nonsignificant positive correlation (r=0. 297, P<0.346).

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  Figure 4 Correlation between the distal crestal bone level of the full-thickness flap (FT) at implant placement and the distal crestal bone level of the FT at 6 weeks (mm). There was a nonsignificant positive correlation (moderate correlation) (r=0. 512, P<0.107).

• 

  Figure 5 Correlation between the distal crestal bone level of the full-thickness flap (FT) at implant placement and the distal crestal bone level of the FT group at 12 weeks (mm). There was a significant positive correlation (good correlation) (r=0.730, P<0.011).

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  Figure 6 Correlation between the mesial crestal bone level of the flapless (FL) at implant placement and the mesial crestal bone level of the FL at 6 weeks (mm). There was a nonsignificant positive correlation (poor correlation) (r=0.083, P<0.809).

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  Figure 7 Correlation between the mesial crestal bone level of the flapless (FL) at implant placement and the mesial crestal bone level of the FL at 12 weeks (mm). There was a non-significant positive correlation (poor correlation) (r=0.062, P<0.856).

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  Figure 8 Correlation between the distal crestal bone level of the flapless (FL) at implant placement and the distal crestal bone level of the FL at 6 weeks (mm). There was a poor nonsignificant positive correlation (r=0.197, P<0.562).

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  Figure 9 Correlation between the distal crestal bone level of the flapless (FL) at implant placement and the distal crestal bone level of the FL at 12 weeks (mm). There was a good statistically significant positive correlation (r=0.692, P<0.018).

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