Purpose: To explore and evaluate the clinical outcome of delayed flapless implant placements after bone powder grafted immediately in postextraction sockets.
Methods: 23 patient requiring dental implants after postextractions were selected for this study. The fresh sockets with at least 3 walls (3 or 4 walls) were immediately grafted and filled with artificial bone powders (Bio-oss and demineralized bone powders), covered by ultra-thin titanium membranes. Bone graft got to or 2-3mm higher than the top level of the sockets. 3 months later, the alveolar bone heights were checked by routine X-ray examination. And alveolar bone ridge widths were measured by bone-width gauges. The alveolar bones were confirmed sufficient to accommodate the implant with at least 4.0mm in diameter and 9mm in length. Then flapless implant placements were performed. The primary stability of the implants was measured. The implants were followed up and success rate of implant was evaluated.
Result: The alveolar bone height and width were basically maintained without depression and atrophy through clinical observation and X-ray examination. Flapless implant placements were performed with minor local reaction. The primary stability of 36 implants all attained to 30N. Failure did not happen during a followed up period of by 6-62 months.
Conclusion: After bone powder grafted immediately in postextraction sockets, sufficient alveolar bone volume for implants can be preserved. Flapless implant placements in sufficient bone support can effectively simplify the preoperative examination and surgical procedures, reducing local reaction. Delayed flapless implant placements after bone powder grafted immediately in postextraction sockets is an effective design and method of dental implantation.