Comparative radiographic and resonance frequency analyses of the peri-implant tissue after dental implants placement using flap and flapless techniques: An experimental study on domestic pigs

Abstract

Background/Aim. Flapless implant surgery has become very important issue during recent years, mostly thanks to computerization of dentistry and software planning of dental implants placements. The aim of this study was to compare flap and flapless surgical techniques for implant placement through radiographic and radiofrequency analyses. Methods. The experiment was made in five domestic pigs. Nine weeks following domestic pigs teeth extraction, implants were placed, on the right side using surgical technique flap, and flapless on the left side. Digital dental Xrays were applied to determine primary dental implant stability quality (ISQ). At certain intervals, not later than three months, the experimental animals were sacrificed, and just before it, control X-rays were applied to measure dental implants stability. Results. Radiographic analysis showed that peri-implant bone resorption in the first 4 weeks following placement implants with flap and flapless surgical techniques was negligible. After the 3 months, mean value of peri-implant bone resorption of the implants placed using flap technique was 1.86 mm, and of those placed using flapless technique was 1.13 mm. In relation to the primary dental implant stability in the first and second week there was an expected decrease in ISQ values, but it was less expressed in the dental implants placed using the flapless technique. In the third week the ISQ values were increased in the dental implants placed by using both techniques, but the increase in flapless implant placement was higher (7.4 ISQ) than in flap implant placement (1.5 ISQ). The upward trend continued in a 4- week period, and after 3 months the dental implant stability values in the implants placed using flap technique were higher than the primary stability for 7.1 ISQ, and in the implants placed using flapless technique were higher comparing to the primary stability for 10.1 ISQ units. Conclusion. Based on the results of radiographic and resonance frequency analyses it can be concluded that the flapless technique in surgical implants placemat, leads to better results.Uvod/Cilj. Implantatna hirurgija flapless postaje aktuelna poslednjih nekoliko godina zahvaljujuci kompjuterizaciji stomatologije i softverskog planiranja ugradnje implantata. Cilj rada bio je da se radiografskom analizom i analizom rezonantne frekvencije uporede hirurske tehnike flap i flapless ugradnje implantata. Metode. Eksperiment je obavljen na pet domacih svinja. Devet nedelja nakon ekstrakcije zuba, svinjama su ugradjeni implantati, sa desne strane hirurskom tehnikom flap, a sa leve hirurskom tehnikom flapless. Uradjeni su digitalni radioloski snimci i izmerena primarna stabilnost implantata (ISQ). U odredjenim vremenskim intervalima do tri meseca, eksperimentalne zivotinje su zrtvovane, a neposredno pre radjeni su kontrolni rendgenski snimci i merena stabilnost implantata. Rezultati. Radiografskom analizom uoceno je da je periimplantatna kostana resorpcija u prve cetiri nedelje bila zanemarljiva kod obe hirurske tehnike. Nakon tri meseca srednja vrednost periimplantatne kostane resorpcije kod flap implantata bila je 1,86 mm, a kod flapless implantata 1,13 mm. U odnosu na primarnu stabilnost implantata, u prvoj i drugoj nedelji doslo je do ocekivanog pada vrednosti ISQ, ali je taj pad kod flapless implantata bio manji. U trecoj nedelji rasle su vrednosti ISQ kod flap i flapless implantata, ali je porast kod flapless implantata bio veci (7,4 ISQ) u odnosu na flap implantate (1,5 ISQ). Tendencija rasta se nastavila i u cetvrtoj nedelji i nadalje, a nakon tri meseca vrednosti stabilnosti implantata kod flap implantata bile su vece u odnosu na primarnu stabilnost za 7,1 ISQ, a kod flapless implantata za 10,1 ISQ. Zakljucak. Na osnovu rezultata radiografske analize i analize rezonantne frekvencije mozemo zakljuciti da hirurska tehnika ugradnje implantata flapless daje bolje rezultate od hirurske tehnike flap.