Aim: The aim of the study was to evaluate and compare the crestal bone levels surrounding the implants on 0, 90th, and 180th day using the flapless soft tissue punch technique with and without repositioning of the punched soft tissue back at the osteotomy site after the surgery. Flapless implant surgery is a boon to dentistry, which comprises a marginally invasive procedure for the placement of the implant. In recent times, it has been widely used for flapless implant placement either by using a soft tissue punch or a direct drill method. Flapless implant surgery with soft tissue punch has been seen to minimize the crestal bone loss when compared to the direct drill method or conventional technique.
Materials and methods: Seven subjects with bilateral posterior edentulous sites were selected for this study which were segregated into two groups. In group I, placement of implants was done using flapless soft tissue punch technique without repositioning of punched soft tissue back at osteotomy site, and in group II, seven implants were placed using flapless soft tissue punch technique with repositioning of punched soft tissue back at osteotomy site. For measuring the crestal bone height, digital radiographic images were obtained at 0, 90th, and 180th day and changes were evaluated using CorelDRAW software.
Results: On intragroup comparison, there was a significant crestal bone loss seen in both groups I and II, from 0 to 180th days (p = 0.001). On intergroup comparison, no statistically significant difference in crestal bone height measurements was found between groups I and II from 0 to 180th days.
Conclusion: Hence, it is concluded that the flapless soft tissue punch technique with repositioning produced faster healing, less scar formation, and minimal bleeding. However, in terms of crestal bone changes, it showed similar results to the flapless soft tissue punch technique without repositioning.
Clinical significance: The soft tissue punch technique can be implemented as an appropriate protocol, showing clinician's ease, less time-consuming, and improved patient compliance owing to the faster healing and less scar formation with minimal crestal bone loss.
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