Comparison of flap and flapless procedures for the stability of chemically modified SLA titanium implants: An experimental study in a canine model

Background: Flapless implant surgery has been shown to accelerate recovery and increase the vascularity of the peri-implant mucosa after implant placement. Objective: The aim of this study was to compare dental implant stabilization patterns between flap and flapless implant surgeries over the first 8 weeks after implant placement. Study design: In 6 mongrel dogs, bilateral, edentulated, and flat alveolar ridges were created in the mandible. After 3 months of healing, 2 implants (Straumann SLA-active) were placed in each side of the mandible using either a flap or flapless procedure. The implant stability quotient (ISQ) that was obtained from Osstell Mentor was measured at the time of implantation and weekly over the first 8 weeks after implant placement. Results: Implants stabilized more quickly without flap elevation than with flap elevation. For flapless implants, an increase in stability occurred after 2 weeks without a period of decreasing stability. However, for flap implants, a shift in implant stability from decreasing stability to increasing stability occurred after 2 weeks. Conclusion: In the canine model, flapless surgical placement of implants may increase the initial stability of implants compared with implants placed after the reflection of the mucoperiosteal flap.