Effects of flapless versus flap implant surgery on tissues surrounding implants in esthetic zone

Objective To evaluate the effects of flapless versus flap implant surgery on the tissues surrounding the implants in the esthetic zone. Methods A controlled study was conducted in 20 patients with a single implant in the anterior esthetic zone, as compared with the flapless and traditional flap implant placement. 6 and 12 months after the implant ation, the vertical reduction of labial and lingual bone were assessed by cone beam computed tomography (CBCT); 6 and 12 months after the crowns restoration, the peri-implant soft tissues were examined by probing depth (PD), modification sulcus bleeding index (mSBI), papillary index (PPI) and evaluated by pink esthetic score (PES) standard. Results The vertical reduction of the flapless labial and lingual bone was lower than that of the flap, in which the change of labial bone was statistical differences at 6 months after implant surgery between groups (P<0.05). The differences of PES between two groups were not statistically significant, although PES increased over time in both groups, which the flapless group had a significantly change in PES from crown placement to 12 months (P<0.05). Conclusions A flapless implant surgery in sufficient bone support may provide a better short-term esthetic result, whereas the long-term effects need further studies. Key words: Esthetic zone; Flapless; PES; Single-tooth implant