ADVANTAGES OF MICROSCOPE-GUIDED FLAPLESS IMPLANT SURGERY: A REPORT OF 2 CASES

Abstract

Extensive surgical flaps in implant surgery were introduced by Branemark in 1970 to expose the underlying bone for better visualization of the surgical field. Over the past four decades, the flap design has undergone several modifications. Although flap reflection in the surgical field may reduce the risk of bone fenestrations and dehiscences, it is also associated with some degree of morbidity and discomfort and requires suturing to close the surgical wound. Recently, the concept of flapless implant surgery has been introduced in order to preserve the vascular supply and existing soft tissue contours with less morbidity. The flapless implant surgery is considered to be a blind technique with many limitations, such as inability to assess the implant site because there is no direct visualization of the bone, the inability to preserve keratinized mucosa, inability to prevent resorption of the facial crestal bone, inability to perform immediate loading, lack of proper drilling depth assessment, and inability to correct peri-implant defects as they are not exposed during surgery. However, despite these drawbacks, the flapless technique also has several potential advantages, including the reduction of morbidity, increased patient comfort, reduction of intraoperative bleeding, reduction of surgical time and minimal disruption of blood supply to the site. The aim of this study was to evaluate the efficacy of microscope-supported flapless surgery for dental implants.