Comparison of flapped and flapless implant surgery in terms of tissue healing and patient comfort

Dental implants have been used in dentistry for years to edentulism. For treatment success, the implants must be placed at the appropriate position and angle. Technological developments increased the expectations of patients and physicians. Without compromising on technical sensitivity, new techniques have been developed to provide a comfortable process for patients during and after surgery. In this clinical study including computer aided methods, implant planning was performed in virtual environment with data obtained from CBCT in patients with bilateral tooth deficiency. In the laboratory stage, resin screening prostheses containing 10% barium sulfate were prepared. CBCT images were obtained while these prostheses were in the patient's mouth. StentCad implant planning software was used for 3D implant planning. Implants were placed on one side of the patients using surgical guides. On the other side, implants were placed by conventional method. The distribution of the toothless areas in the groups and the operation sequence were determined randomly. Implant-supported prostheses were delivered 3 months after surgery. Postoperative soft and hard tissue changes and patient comfort data were compared. In our study, no significant difference was found between pain, edema, ecchymosis, total analgesic number, marginal bone loss, periodontal index and gingival index. However, the operation time was shorter in the flapless surgery group. In terms of patient comfort, Oral Health Impact Profile-14 (OHIP-14) and General Oral Health Assessment Index (GOHAI) parameters were lower in the flapless group compared to flapped group on the 1st and 3rd days. As a conclusion, flapless implant surgery for single tooth had no significant effect on postoperative clinical and radiological findings compared to conventional implant surgery, however it had a significant positive effect in terms of patient comfort during postoperative 1st and 3rd days. Key Word: Dental implant, Flapless surgery, Minimally invasive surgery, Surgical guide,