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CLINICAL
TIP
When a Flapless Approach Makes Sense
by
Michael McCracken, DDS, Ph.D
For many dentists who place
implants, the lure of the “perfect
surgery” is almost irresistible.
Picture it in your mind. It starts
with a flapless approach, continues
with a flawless six-minute implant
placement, and ends with the stunned
appreciation of the patient and a
satisfied smile on the face of the
dentist. The fact is, however, that
flapless surgery can present serious
challenges to the beginning surgeon.
In the university residency setting,
a flapless surgery is automatically
categorized as a minimum of 3 on a
4-point scale, just because it is flapless.
These surgeries can be difficult!
I have seen more than one experienced
and proficient surgeon become
embarrassed when demonstrating a
flapless surgical approach.
Clinicians disagree on whether keratinized
tissue is critical for implant
longevity. There is no doubt, however,
that keratinized tissue is generally desirable
because it improves esthetics
Figure 2: Favorable bone architecture
When is a flapless approach reasonable?
Look for three things:
n Abundant keratinized tissue (Fig. 1)
n Favorable bone architecture (Fig. 2)
n Easy access to treatment planning technology (Fig. 3)
Figure 1: Abundant keratinized tissue
– Clinical Tip: When a Flapless Approach Makes Sense – 65