ORAL HEALTH EVIDENCE-BASED PRACTICE PROGRAM
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Title Crestal Bone Levels Resulting From Flap And Flapless Dental Implant Surgery
Clinical Question In patients requiring implant surgery, does a 3-D planned flapless surgery as compared with a conventional flap procedure result in decreased crestal bone levels?
Clinical Bottom Line Marginal bone levels evaluated radiographically showed similar results for implants placed with flapless surgery and flap surgery.
Best Evidence (you may view more info by clicking on the PubMed ID link)
PubMed ID Author / Year Patient Group Study type
(level of evidence)
#1) 20572830Nickenig/2010785 implants in 417 patients with flapless 459 implants in 227 patients with flap Nonrandomized Clinical Trial
Key resultsFlapless surgery generated mean crestal bone loss of 0.5mm (SD, 0.5; RANGE: -0.70 to 2.40). Flap surgery generated mean crestal bone loss of 0.5mm (SD, 0.7; range -2.0 to 3.0). Effect of smoking on marginal bone levels were statistically significant for the flapless group. The median follow-up interval was 0.42 years.
Evidence Search "Dental Implants"[Mesh] AND flapless surgery AND Flap AND Crestal bone
Comments on
The Evidence
The trial conducted by Nickenig et. al., was a clinical control trial with a 644 subjects. The strongest support for the evidence found in this study is the large sample size, and number of implants placed. Unfortunately the numbers are skewed more towards the study group, and the effect of a small control group on the results is difficult to determine. The study was also not double blind or randomized. The two groups were treated as similar as possible under clinical conditions.
Applicability In an area of implant dentistry, this clinical trial provides initial evidence that there may be no significant difference in resultant crestal bone levels between flapless and flap implant surgery. Further studies with symmetrical, randomized groups would provide more conclusive evidence.
Specialty/Discipline (General Dentistry) (Oral Surgery) (Periodontics) (Prosthodontics)
Keywords Dental Implant, Flap, Flapless, Crestal Bone
ID# 2403
Date of submission: 03/08/2013spacer
E-mail Brockbank@livemail.uthscsa.edu
Author David C. Brockbank
Co-author(s)
Co-author(s) e-mail
Faculty mentor/Co-author Joseph A. Bartoloni, DMD
Faculty mentor/Co-author e-mail bartoloni@uthscsa.edu
Basic Science Rationale
(Mechanisms that may account for and/or explain the clinical question, i.e. is the answer to the clinical question consistent with basic biological, physical and/or behavioral science principles, laws and research?)
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Comments on the CAT
(FOR PRACTICING DENTISTS' and/or FACULTY COMMENTS ON PUBLISHED CATs)
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