"Flapless implantology" - Möglichkeiten und grenzen

With the advancement of implant surface processing technology, current implants offer considerably enhanced osseointegration abilities. Using modern radiographic technology, precision of implant site preparation has recently been improved significantly. Now is the time to shift to minimally invasive implant surgery to provide more predictable results, function, esthetics, and comfort. When implants are placed without flap elevation, there is little scar formation in the soft tissue adjacent to the implants, an increase in blood vessels of the peri-implant mucosa, a reduction in the sulcus depth around the implants, and a reduction in peri-implant bone loss. This procedure also improves esthetic results by maintaining the original form and thickness of the mucosa surrounding the implants. One major limitation of this surgery is the lack of visibility of hard tissue contours during the procedure. The present article outlines the surgical procedure and describes how to overcome the limitations of flapless implantation. It also describes how the procedure can be used in challenging cases and difficult bone sites. Visualization of closed surgical sites, in particular of subgingival spaces and internal bone structures, using endoscopic procedures may contribute to the further enhancement of flapless implantology.