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Keyhole / Flapless Implants


What is keyHole/Flapless Implant procedure?

The ‘Keyhole’ or ‘Flapless Implant’ technique is a minimally invasive technique that is performed on patients to place the Dental Implant. A procedure that is beneficial to patients seeking a less traumatic procedure.

This technique is usually recommended for situations where the dental surgeon will know about the amount of the underlying bone through CT scan. It can be done when the bone is more than adequate.

The keyhole / Flapless Dental implant surgery is a procedure where implants are placed without raising the flap (gums). Whereas, conventional implant placement would usually require considerable manipulation of the soft tissues, prior to the Placement of the Implant.

The major drawback of the conventional method is that it takes a minimum of 60 days for complete healing. Minimal invasive flapless surgery is mostly carried out with the use of an image-guided system

Flapless implant techniques can be mainly divided in to:

  • Unaided Flapless Procedure
  • Guided surgery- Flapless Technique

Why is it Recommended?

It is recommended for the following reasons:

  • Avoids extensive incisions,
  • Prevents tissue trauma and post-surgical discomfort
  • Eliminates post-operative pain

The placement of the implant would require a small hole to be punched. Then the implant is inserted under local anaesthesia. This usually saves a lot of time and discomfort to the patient. This approach is only possible in cases where the patient has enough bone to place the implant.

Advantages of Key Hole/ Flapless Implants

The distinct advantages of performing this procedure are given below:

  • Minimal trauma to the soft tissue during the surgical procedure.
  • Blood supply to the surrounding crestal bone is maintained.
  • No sutures required.
  • Less pain, in most cases, no pain
  • Reduced chances of infection
  • Shorter recovery time.
  • Immediate loading of permanent prosthesis.
  • Beneficial for diabetic and hypertensive patients.
  • Improved patient compliance.

The Procedure

The Dentist will first administer local anaesthesia to the patient. Once the effects of local anaesthesia starts, approximately 1 mm of the soft tissue on top of the implant head is removed with a smaller blade, usually 15c.

The size of the hole is increased slowly by firmly by pushing and stretching the soft tissue with a microraspatory. The stretching is done so that the access hole is large enough for the cover screw can be removed and the healing abutment can be placed.

The placement of the healing abutment might result in ischemia of the expanded peri-implant soft tissue due to the pressure created by its size. After the initial healing of the soft tissue, an abutment of greater diameter is placed for further soft tissue expansion and conditioning.

 

Authored by DR.NIRANJAN P

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