The Effect of Flapless and Full-thickness Flap Techniques on Implant Stability During the Healing Period
Identifieur interne : 000A42 ( Pmc/Checkpoint ); précédent : 000A41; suivant : 000A43The Effect of Flapless and Full-thickness Flap Techniques on Implant Stability During the Healing Period
Auteurs : Mohammed Jasim Al-Juboori [Malaisie] ; Shafluzan Bin Abdulrahaman [Malaisie]Source :
- The Open Dentistry Journal [ 1874-2106 ] ; 2015.
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DOI: 10.2174/1874210601509010243
PubMed: 26312095
PubMed Central: 4541338
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<record><TEI><teiHeader><fileDesc><titleStmt><title xml:lang="en">The Effect of Flapless and Full-thickness Flap Techniques on Implant Stability During the Healing Period </title><author><name sortKey="Al Juboori, Mohammed Jasim" sort="Al Juboori, Mohammed Jasim" uniqKey="Al Juboori M" first="Mohammed Jasim" last="Al-Juboori">Mohammed Jasim Al-Juboori</name><affiliation wicri:level="1"><nlm:aff id="aff1">Department of Oral Surgery, MAHSA University, Malaysia</nlm:aff><country xml:lang="fr">Malaisie</country><wicri:regionArea>Department of Oral Surgery, MAHSA University</wicri:regionArea><wicri:noRegion>MAHSA University</wicri:noRegion></affiliation></author><author><name sortKey="Abdulrahaman, Shafluzan Bin" sort="Abdulrahaman, Shafluzan Bin" uniqKey="Abdulrahaman S" first="Shafluzan Bin" last="Abdulrahaman">Shafluzan Bin Abdulrahaman</name><affiliation wicri:level="1"><nlm:aff id="aff2">Department of Oral and Maxillofacial Surgery, University Sains Malaysia, 16150, Kelantan, Malaysia</nlm:aff><country xml:lang="fr">Malaisie</country><wicri:regionArea>Department of Oral and Maxillofacial Surgery, University Sains Malaysia, 16150, Kelantan</wicri:regionArea><wicri:noRegion>Kelantan</wicri:noRegion></affiliation></author></titleStmt><publicationStmt><idno type="wicri:source">PMC</idno><idno type="pmid">26312095</idno><idno type="pmc">4541338</idno><idno type="url">http://www.ncbi.nlm.nih.gov/pmc/articles/PMC4541338</idno><idno type="RBID">PMC:4541338</idno><idno type="doi">10.2174/1874210601509010243</idno><date when="2015">2015</date><idno type="wicri:Area/Pmc/Corpus">000407</idno><idno type="wicri:explorRef" wicri:stream="Pmc" wicri:step="Corpus" wicri:corpus="PMC">000407</idno><idno type="wicri:Area/Pmc/Curation">000407</idno><idno type="wicri:explorRef" wicri:stream="Pmc" wicri:step="Curation">000407</idno><idno type="wicri:Area/Pmc/Checkpoint">000A42</idno><idno type="wicri:explorRef" wicri:stream="Pmc" wicri:step="Checkpoint">000A42</idno></publicationStmt><sourceDesc><biblStruct><analytic><title xml:lang="en" level="a" type="main">The Effect of Flapless and Full-thickness Flap Techniques on Implant Stability During the Healing Period </title><author><name sortKey="Al Juboori, Mohammed Jasim" sort="Al Juboori, Mohammed Jasim" uniqKey="Al Juboori M" first="Mohammed Jasim" last="Al-Juboori">Mohammed Jasim Al-Juboori</name><affiliation wicri:level="1"><nlm:aff id="aff1">Department of Oral Surgery, MAHSA University, Malaysia</nlm:aff><country xml:lang="fr">Malaisie</country><wicri:regionArea>Department of Oral Surgery, MAHSA University</wicri:regionArea><wicri:noRegion>MAHSA University</wicri:noRegion></affiliation></author><author><name sortKey="Abdulrahaman, Shafluzan Bin" sort="Abdulrahaman, Shafluzan Bin" uniqKey="Abdulrahaman S" first="Shafluzan Bin" last="Abdulrahaman">Shafluzan Bin Abdulrahaman</name><affiliation wicri:level="1"><nlm:aff id="aff2">Department of Oral and Maxillofacial Surgery, University Sains Malaysia, 16150, Kelantan, Malaysia</nlm:aff><country xml:lang="fr">Malaisie</country><wicri:regionArea>Department of Oral and Maxillofacial Surgery, University Sains Malaysia, 16150, Kelantan</wicri:regionArea><wicri:noRegion>Kelantan</wicri:noRegion></affiliation></author></analytic><series><title level="j">The Open Dentistry Journal</title><idno type="eISSN">1874-2106</idno><imprint><date when="2015">2015</date></imprint></series></biblStruct></sourceDesc></fileDesc><profileDesc><textClass></textClass></profileDesc></teiHeader><front><div type="abstract" xml:lang="en"><p><underline>Purpose</underline> :
When soft tissue flaps are reflected for implant placement, the blood supply from the periosteum to the bone is disrupted. The aim of this study was to compare the effects of the flapless (FL) and full-thickness flap (FT) techniques on implant stability. <italic><underline>Methods</underline> :</italic> Nine patients received 22 implants. The implants were placed using the FL technique on the contralateral side of the jaw; the FT technique was used as the control technique. Resonance frequency analysis (RFA) was performed at the time of implant placement and at 6 and 12 weeks after implant placement. RFA values were compared between the FL and FT groups and between time intervals in the same group. <italic><underline>Results</underline> :</italic> The median (interquartile range [IQR]) RFA values at the time of implant placement were 75.00 (15.00) for the FL technique and 75.00 (9.00) for the FT technique. At 6 weeks, the median (IQR) values were 79 (3.30) for the FL technique and 80 (12.70) for the FT technique. At 12 weeks, the median (IQR) values were 82.3 (3.30) for the FL technique and 82.6 (8.00) for the FT technique. There were no significant differences between the 2 techniques at the time of implant placement, after 6 weeks or after 12 weeks, with p values of 0.994, 0.789, and 0.959, respectively. There were significant differences between the RFA values at the time of implant placement and after 6 weeks for the FL technique (p=0.028) but not for the FT technique (p=0.091). There were also significant differences between the RFA values at 6 weeks and the RFA values at 12 weeks for the FL technique (p=0.007) and for the FT technique (p=0.003). <italic><underline>Conclusion</underline> :</italic> Periosteum preservation during the FL procedure will speed up bone remodeling and result in early secondary implant stability as well as early loading.</p></div></front><back><div1 type="bibliography"><listBibl><biblStruct><analytic><author><name sortKey="Mesa, F" uniqKey="Mesa F">F. Mesa</name></author><author><name sortKey="Mu Oz, R" uniqKey="Mu Oz R">R. Muñoz</name></author><author><name sortKey="Noguerol, B" uniqKey="Noguerol B">B. Noguerol</name></author><author><name sortKey="De Dios Luna, J" uniqKey="De Dios Luna J">J. de Dios Luna</name></author><author><name sortKey="Galindo, P" uniqKey="Galindo P">P. Galindo</name></author><author><name sortKey="O Alle, F" uniqKey="O Alle F">F. 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<front><journal-meta><journal-id journal-id-type="nlm-ta">Open Dent J</journal-id><journal-id journal-id-type="iso-abbrev">Open Dent J</journal-id><journal-id journal-id-type="publisher-id">TODENTJ</journal-id><journal-title-group><journal-title>The Open Dentistry Journal</journal-title></journal-title-group><issn pub-type="epub">1874-2106</issn><publisher><publisher-name>Bentham Open</publisher-name></publisher></journal-meta><article-meta><article-id pub-id-type="pmid">26312095</article-id><article-id pub-id-type="pmc">4541338</article-id><article-id pub-id-type="publisher-id">TODENTJ-9-243</article-id><article-id pub-id-type="doi">10.2174/1874210601509010243</article-id><article-categories><subj-group subj-group-type="heading"><subject>Article</subject></subj-group></article-categories><title-group><article-title>The Effect of Flapless and Full-thickness Flap Techniques on Implant Stability During the Healing Period </article-title></title-group><contrib-group><contrib contrib-type="author"><name><surname>AL-Juboori</surname><given-names>Mohammed Jasim</given-names></name><xref ref-type="aff" rid="aff1">1</xref><xref ref-type="corresp" rid="cor1">*</xref></contrib><contrib contrib-type="author"><name><surname>AbdulRahaman</surname><given-names>Shafluzan Bin</given-names></name><xref ref-type="aff" rid="aff2">2</xref></contrib></contrib-group><aff id="aff1"><label>1</label>Department of Oral Surgery, MAHSA University, Malaysia</aff><aff id="aff2"><label>2</label>Department of Oral and Maxillofacial Surgery, University Sains Malaysia, 16150, Kelantan, Malaysia</aff><author-notes><corresp id="cor1"><label>*</label>Address correspondence to this author at the MAHSA University, Dental Faculty, Block E, 4th floor, pusat bandar damansara, damansara height, 50490, Kuala Lumpur, Malaysia; Tel: (+60)0162417557;
E-mail: <email xlink:href="doctor_mohamed_2006@yahoo.com">doctor_mohamed_2006@yahoo.com</email></corresp></author-notes><pub-date pub-type="epub"><day>31</day><month>7</month><year>2015</year></pub-date><pub-date pub-type="collection"><year>2015</year></pub-date><volume>9</volume><fpage>243</fpage><lpage>249</lpage><history><date date-type="received"><day>29</day><month>4</month><year>2015</year></date><date date-type="rev-recd"><day>26</day><month>5</month><year>2015</year></date><date date-type="accepted"><day>31</day><month>5</month><year>2015</year></date></history><permissions><copyright-statement>© AL-Juboori and AbdulRahaman; Licensee <italic>Bentham Open.</italic></copyright-statement><copyright-year>2015</copyright-year><copyright-holder>AL-Juboori and AbdulRahaman</copyright-holder><license license-type="open-access" xlink:href="http://creativecommons.org/licenses/by-nc/3.0/"><license-p>This is an open access article licensed under the terms of the Creative Commons Attribution Non-Commercial License (<uri xlink:type="simple" xlink:href="http://creativecommons.org/licenses/by-nc/3.0/">http://creativecommons.org/licenses/by-nc/3.0/</uri>) which permits unrestricted, non-commercial use, distribution and reproduction in any medium, provided the work is properly cited.</license-p></license></permissions><abstract><p><underline>Purpose</underline> :
When soft tissue flaps are reflected for implant placement, the blood supply from the periosteum to the bone is disrupted. The aim of this study was to compare the effects of the flapless (FL) and full-thickness flap (FT) techniques on implant stability. <italic><underline>Methods</underline> :</italic> Nine patients received 22 implants. The implants were placed using the FL technique on the contralateral side of the jaw; the FT technique was used as the control technique. Resonance frequency analysis (RFA) was performed at the time of implant placement and at 6 and 12 weeks after implant placement. RFA values were compared between the FL and FT groups and between time intervals in the same group. <italic><underline>Results</underline> :</italic> The median (interquartile range [IQR]) RFA values at the time of implant placement were 75.00 (15.00) for the FL technique and 75.00 (9.00) for the FT technique. At 6 weeks, the median (IQR) values were 79 (3.30) for the FL technique and 80 (12.70) for the FT technique. At 12 weeks, the median (IQR) values were 82.3 (3.30) for the FL technique and 82.6 (8.00) for the FT technique. There were no significant differences between the 2 techniques at the time of implant placement, after 6 weeks or after 12 weeks, with p values of 0.994, 0.789, and 0.959, respectively. There were significant differences between the RFA values at the time of implant placement and after 6 weeks for the FL technique (p=0.028) but not for the FT technique (p=0.091). There were also significant differences between the RFA values at 6 weeks and the RFA values at 12 weeks for the FL technique (p=0.007) and for the FT technique (p=0.003). <italic><underline>Conclusion</underline> :</italic> Periosteum preservation during the FL procedure will speed up bone remodeling and result in early secondary implant stability as well as early loading.</p></abstract><kwd-group><title>Keywords</title><kwd>Flapless</kwd><kwd>full-thickness flap</kwd><kwd>osseointegration</kwd><kwd>periosteum</kwd><kwd>resonance frequency analysis</kwd><kwd>stability</kwd></kwd-group></article-meta></front><floats-group><fig id="F1" position="float"><label>Fig. (1)</label><caption><p>The first step in flap design is a mid-crestal incision on the
alveolar crest of the edentulous area.
</p></caption><graphic xlink:href="TODENTJ-9-243_F1"></graphic></fig><fig id="F2" position="float"><label>Fig. (2)</label><caption><p>The second step in flap design is an intrasulcular incision
to cut the periodontium between the gingiva and the root surface on
the marginal gingiva and the interdental papillae area.
</p></caption><graphic xlink:href="TODENTJ-9-243_F2"></graphic></fig><fig id="F3" position="float"><label>Fig. (3)</label><caption><p>Full thickness flap reflection starts with a crestal incision
using a backward movement to reflect the palatal side. Care should
be taken during flap reflection to ensure that the flap and adjacent
soft tissue are not traumatized.
</p></caption><graphic xlink:href="TODENTJ-9-243_F3"></graphic></fig><fig id="F4" position="float"><label>Fig. (4)</label><caption><p>Raising of the full thickness flap (including the adjacent
papillae) without vertical incision. Sufficient bone is exposed to
evaluate the bone width and to explore any potential bony undercut.
</p></caption><graphic xlink:href="TODENTJ-9-243_F4"></graphic></fig><fig id="F5" position="float"><label>Fig. (5)</label><caption><p>Flapless technique (punch) by cutting the mucosa and
periosteum until the bone.
</p></caption><graphic xlink:href="TODENTJ-9-243_F5"></graphic></fig><table-wrap id="T1" position="float"><label>Table 1.</label><caption><p>Distribution of dental implants in the mouths of patients.</p></caption><table frame="border" rules="all" width="100%"><thead><tr><th rowspan="2" colspan="1">Type of flap</th><th colspan="2" rowspan="1">Maxilla</th><th colspan="2" rowspan="1">Mandible</th></tr><tr><th align="center" rowspan="1" colspan="1">Molar area</th><th align="center" rowspan="1" colspan="1">Premolar area</th><th align="center" rowspan="1" colspan="1">Molar area</th><th align="center" rowspan="1" colspan="1">Premolar area</th></tr></thead><tbody><tr><td align="center" rowspan="1" colspan="1">Flapless</td><td align="center" rowspan="1" colspan="1">1</td><td align="center" rowspan="1" colspan="1">2</td><td align="center" rowspan="1" colspan="1">8</td><td align="center" rowspan="1" colspan="1"> </td></tr><tr><td align="center" rowspan="1" colspan="1">Full-thickness</td><td align="center" rowspan="1" colspan="1">2</td><td align="center" rowspan="1" colspan="1">1</td><td align="center" rowspan="1" colspan="1">5</td><td align="center" rowspan="1" colspan="1">3</td></tr></tbody></table></table-wrap><table-wrap id="T2" position="float"><label>Table 2.</label><caption><p>The median RFA values (ISQ units) at implant placement and at 6-week and 12-week time points for flap and flapless implants.</p></caption><table frame="border" rules="all" width="100%"><thead><tr><th align="center" rowspan="1" colspan="1">Variable</th><th align="center" rowspan="1" colspan="1">Flap<break></break>n=11<break></break>median (IQR)</th><th align="center" rowspan="1" colspan="1">Flapless<break></break>n=11<break></break>median (IQR)</th><th align="center" rowspan="1" colspan="1">Z statistica</th><th align="center" rowspan="1" colspan="1">P value*</th></tr></thead><tbody><tr><td align="center" rowspan="1" colspan="1">RFA (ISQ)<break></break>0 weeks</td><td align="center" rowspan="1" colspan="1">75.00(9.00)</td><td align="center" rowspan="1" colspan="1">75.00(15.00)</td><td align="center" rowspan="1" colspan="1">-0.070</td><td align="center" rowspan="1" colspan="1">0.994</td></tr><tr><td align="center" rowspan="1" colspan="1">RFA (ISQ)<break></break>6 weeks</td><td align="center" rowspan="1" colspan="1">80(12.70)</td><td align="center" rowspan="1" colspan="1">79(3.30)</td><td align="center" rowspan="1" colspan="1">-0.267</td><td align="center" rowspan="1" colspan="1">0.789</td></tr><tr><td align="center" rowspan="1" colspan="1">RFA (ISQ)<break></break>12 weeks</td><td align="center" rowspan="1" colspan="1">82.6(8.00)</td><td align="center" rowspan="1" colspan="1">82.3(3.30)</td><td align="center" rowspan="1" colspan="1">-0.051</td><td align="center" rowspan="1" colspan="1">0.959</td></tr></tbody></table><table-wrap-foot><fn id="T2F1"><label>a</label><p>aWilcoxon signed rank test
</p></fn><fn id="T2F2"><label>*</label><p>Significant difference (p<0.05)</p></fn></table-wrap-foot></table-wrap><table-wrap id="T3" position="float"><label>Table 3.</label><caption><p>The median RFA values (ISQ units) at implant placement (0 weeks) and at the 6-week time point for the flapless and flap techniques.</p></caption><table frame="border" rules="all" width="100%"><thead><tr><th align="center" rowspan="1" colspan="1">Variable</th><th align="center" rowspan="1" colspan="1">RFA (ISQ)<break></break>0 weeks<break></break>median (IQR)</th><th align="center" rowspan="1" colspan="1">RFA (ISQ)<break></break>6 weeks<break></break>median (IQR)</th><th align="center" rowspan="1" colspan="1">Z Statistica</th><th align="center" rowspan="1" colspan="1">P valuea</th></tr></thead><tbody><tr><td align="center" rowspan="1" colspan="1">Flapless</td><td align="center" rowspan="1" colspan="1">75.00(15.00)</td><td align="center" rowspan="1" colspan="1">79(3.30)</td><td align="center" rowspan="1" colspan="1">-2.191</td><td align="center" rowspan="1" colspan="1">0.028</td></tr><tr><td align="center" rowspan="1" colspan="1">Flap</td><td align="center" rowspan="1" colspan="1">75.00(9.00)</td><td align="center" rowspan="1" colspan="1">80(12.70)</td><td align="center" rowspan="1" colspan="1">-1.691</td><td align="center" rowspan="1" colspan="1">0.091</td></tr></tbody></table><table-wrap-foot><fn id="T3F1"><label>a</label><p>Wilcoxon signed rank test</p></fn></table-wrap-foot></table-wrap><table-wrap id="T4" position="float"><label>Table 4.</label><caption><p>The median RFA values (ISQ units) for bone at 6-week and 12-week time points for the flapless and flap techniques.</p></caption><table frame="border" rules="all" width="100%"><thead><tr><th align="center" rowspan="1" colspan="1">Variable</th><th align="center" rowspan="1" colspan="1">RFA (ISQ)<break></break>6 weeks<break></break>median (IQR)</th><th align="center" rowspan="1" colspan="1">RFA (ISQ)<break></break>12 weeks<break></break>median (IQR)</th><th align="center" rowspan="1" colspan="1">Z Statistica</th><th align="center" rowspan="1" colspan="1">P valuea</th></tr></thead><tbody><tr><td align="center" rowspan="1" colspan="1">Flapless</td><td align="center" rowspan="1" colspan="1">79(3.30)</td><td align="center" rowspan="1" colspan="1">82.3(3.30)</td><td align="center" rowspan="1" colspan="1">-2.705</td><td align="center" rowspan="1" colspan="1">0.007</td></tr><tr><td align="center" rowspan="1" colspan="1">Flap</td><td align="center" rowspan="1" colspan="1">80(12.70)</td><td align="center" rowspan="1" colspan="1">82.6(8.00)</td><td align="center" rowspan="1" colspan="1">-2.936</td><td align="center" rowspan="1" colspan="1">0.003</td></tr></tbody></table><table-wrap-foot><fn id="T4F1"><label>a</label><p>Wilcoxon signed rank test</p></fn></table-wrap-foot></table-wrap></floats-group></pmc><affiliations><list><country><li>Malaisie</li></country></list><tree><country name="Malaisie"><noRegion><name sortKey="Al Juboori, Mohammed Jasim" sort="Al Juboori, Mohammed Jasim" uniqKey="Al Juboori M" first="Mohammed Jasim" last="Al-Juboori">Mohammed Jasim Al-Juboori</name></noRegion><name sortKey="Abdulrahaman, Shafluzan Bin" sort="Abdulrahaman, Shafluzan Bin" uniqKey="Abdulrahaman S" first="Shafluzan Bin" last="Abdulrahaman">Shafluzan Bin Abdulrahaman</name></country></tree></affiliations></record>Pour manipuler ce document sous Unix (Dilib)
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