Less Bone Loss from Flapless Implant Placement?

Which procedure causes less bone loss: flapless or convention implant placement with flap elevation? A recent study 1, compared the effect of flapless implant insertion on initial bone loss with that of conventional placement after elevation of a mucoperiosteal flap.

The study concluded:

Flapless implant insertion caused less peri-implant bone loss than implant insertion with flap preparation. Therefore, the flapless procedure represents a protective and promising method in implant surgery.

What has been your experience with flapless implant placement vs placement after a flap elevation?

Read the Full Abstract Here

1. Int J Oral Maxillofac Implants. 2016 Jul-Aug;31(4):876-83. Initial Crestal Bone Loss After Implant Placement with Flapped or Flapless Surgery-A Prospective Cohort Study.. Maier FM.

8 thoughts on “Less Bone Loss from Flapless Implant Placement?

  1. Dr Tony says:

    Flapless is a game of luck. Even with a CBCT I get surprises when I raise a flap. If the implant is too close to the buccal or palatal wall you are gonna get remodelling and bone loss regardless. If there is a small dehiscence you may get a failure without knowing the cause whereas a flap
    would have allowed an easy GBR case. You can’t better actual visualisation of the ridge and flaps don’t have to be huge.

  2. Eric Ruckert, DDS says:

    I always flap as I agree that actuality is often different than the X-ray or clinical ‘feel” Could be thick scar tissue, or craters in the site. My flap is only of the ridge (7-8 mm) , with no releasing incisions. So I expose only the actual ridge top, and close with 2 stitches. But it gives you a chance to see what has happened with the healing of the graft and add a very minor amount of graft to any defect. Plus, how deep do you go with flapless? Is the collar of the implant at bone level??? If you see it directly , you know.
    I see no benefit to flapless.

  3. VD says:

    I only raise a flap when I do concurrent grafting. Definitely prefer flapless and have CBCT imaging beforehand (slices spaced 1mm apart). Works very well for me.
    However I have no objection to flap approach. Just do whatever we feel comfortable.

  4. Peter Fairbairn says:

    Agree with Tony and Eric always a flap …… CBCT not the whole picture and have learnt my lesson the hard way 8 years ago…

  5. Dr.Al says:

    I have been placing implants for 20 years with reflecting a flap all the time. I started to use mobile CBCT and guided flap-less approach a year ago. I have to say it is a guessing game. I opened one of my flap-less cases just because I was not sure the guide had a perfect angle. One of my implants was into lingual plate that I had to remove and repair the site. I stopped doing all cases flap-less.Now I place most of my implant cases with flap and subcrestal.

  6. Konstantinos manolarakis says:

    It is always better to see what you are doing. Anyway flapless procedure is only for a few amount of cases…

  7. Dr. Al-Anee says:

    I always prefer to do a flap ,sometimes only crestal incision, as I do believe that even CBCT is not enough to give us the whole picture. Manytimes I open a flap and get a surprise.
    flapless surgery would not give you a direct vision to the field and it might end with a wrong positioning of the implant. inaddition, I don`t see that much of benefit from doing flapless surgery regarding bone resorption and incidence of infection.


Comments are closed.

Posted in Research and News.
Bookmark Less Bone Loss from Flapless Implant Placement?

Videos to Watch:

Lateral Sinus Lift: Perforation, Repair, and Implants

These two videos demonstrate the lateral window sinus technique, and implant placement following the repair[...]

Watch Now!
Single Tooth Replacement with Implants in the Esthetic Zone

Dr. Jack Hahn provides tips and reviews cases for implant placement in the esthetic zone.[...]

Watch Now!
Surgical Consideration for the Flapless Approach

In this video, Dr. Jack Hahn discusses and presents cases to review the surgical considerations[...]

Watch Now!
Bond Apatite: Socket Preservation Cases

These 2 videos show the use of Bond Apatite in socket preservation cases, one with[...]

Watch Now!
3D Guided Implant Placement

The placement of multiple implants in this case was helped thru the use of 3d[...]

Watch Now!
Ridge Splitting Cases in Narrow Alveolar ridge

This videos shows ridge splitting, which when combined with bone expansion, is an effective technique[...]

Watch Now!
Placement of 4 Implants and Cement-Retained Bridge

The treatment plan was to extract the lower incisors, canines, and lower premolar and place[...]

Watch Now!
Failing Bridge Replaced with Dental Implant Supported Bridge

Ahe patient presented with a failed dental bridge from the upper right canine to the[...]

Watch Now!
Lateral Sinus Augmentation with CGF

Following membrane elevation with the lateral approach, and confirmation of an intact sinus membrane, concentrated[...]

Watch Now!
Titanium Mesh for Ridge Augmentation

The use of titanium mesh is a reliable method for ridge augmentation to provide adequate[...]


Watch Now!
Implant Grafting Techniques: Demineralized Sponge Strip and Tunneling

This video reviews several unique grafting and surgical techniques, including the use of demineralized cancellous[...]

Watch Now!
Mandibular Fixed Screw Retained Restoration

This video shows the use of a surgical guide for a mandibular fixed screw retained[...]

1 Comment

Watch Now!