Comparison of clinical performance of flapless implant surgery and conventional flap elevation: a systematic review and meta-analysis
Statement of problem: Clinicians prefer Branemark’s conventional flap elevation approach for implant placement and flapless implantation is still considered a blind procedure with questionable outcomes. Purpose: The purpose of this systematic review was to compare the clinical performance of flapless implant surgery with conventional flap elevation.
Material and Methods: A systematic search of Medline/PubMed and Google scholar databases for articles published before June 2020 was performed by 2 independent reviewers. A manual search of articles was also conducted. Studies published in English that evaluated the survival rate in patients with implant prosthesis were included. The Cohen kappa method was used to calculate inters reviewer agreement.
Results: Twenty three studies were included. Failure rate of dental implants was affected by different insertion technique with a RR of 1.55 (flapless placement vs flap surgery; 95% CI: 0.94 to 2.57; P=0.09) which was not found to be significant.
Conclusion: Flapless surgery can be a possible alternative as it has comparable outcomes with the conventional flap elevation technique. Clinical Implications: Flapless technique should be given consideration in patients whenever appropriate conditions pertaining to the alveolar bone and soft tissue are available as it has comparable clinical performance with conventional flap elevation technique of implant placement.