By Dr. Cesar Luchetti from Argentina
DDS - National University of La Plata, Buenos Aires, Argentina.
MS in Oral Implantology - National University of La Plata, Buenos Aires, Argentina.
Associate Professor. Department of Implant Dentistry. National University of La Plata, Buenos Aires, Argentina.
Implant dentistry is pushing their limits towards less invasive procedures and with results in a day.
Although this is a valid approach, an adequate diagnosis is necessary to perform these cases in a secure way.
Flapless surgery is usually faster and gives more postoperative comfort to the patient. However, the adequate tridimensional position of the implants must not be sacrificed just to avoid a flap, especially in cases when bone reconstruction is needed.
Long term prognosis is influenced by a good tridimensional positioning of the implants which is determined by the biomechanical requirements of the teeth being replaced.
Immediate loading is useful because the patient retrieves the function instantaneously, but it must be done just in cases with a good initial fixation.
The following video shows a case with a flapless approach.
Implant site development was made with threaded expanders in order to increase bone density allowing a better initial fixation.
The implant used, B&W CIH (Argentina), has an implant carrier who can be adapted as an abutment. A provisory crown was made over it a few moments after surgery.