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Clinical outcome and bone preservation of single TiUnite™ implants installed with flapless or flap surgery

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Abstract
Background: Flapless, free-handed implant surgery offers advantages for patient comfort, but studies on long-term clinical success based on marginal bone loss are scarce. Aim: The aim of this study was to compare single implants installed with a flap (F) or flapless (FL) surgery with respect to survival and marginal bone preservation after at least 3 years. Materials and Methods: Fifty-three TiUnite (TM) Branemark implants, installed in 49 patients (27 females; 22 males; mean age 53 years) were examined. Then, 25 F and 28 FL were delayed loaded; bone level from the abutment-implant level was measured on intraoral radiographs. From 44 (21 F, 23 FL), 31 (18F, 13FL), and 36 (18 F, 18 FL) implants, radiographs were available at baseline and after 1 and 3 years of function. Results: The overall survival rate was 100% and the overall mean bone loss after an average of 38 months was 1.35 mm (SD 0.91; range 0-3.7). Both F and FL showed increasing bone loss during the first year with a higher bone loss for FL than for F sites (p < .01). Afterward, no further bone loss occurred and both groups were statistically equal (p > .7). On individual implant level, nearly 80% in both F and FL were considered a success showing bone loss between 1.5 and 1.9 mm. Conclusions: Single implants yield an excellent prognosis with stable bone levels irrespective of the surgical technique, and free-handed flapless surgery is a viable alternative to more extensively planned guided surgery. Proper case selection and clinical experience are considered prerequisites for a predictable treatment outcome.
Keywords
flapless surgery, bone remodeling, one-stage surgery, single implant, TiUnite surface, DENTAL IMPLANTS, COHORT, TRIAL

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MLA
De Bruyn, Hugo et al. “Clinical Outcome and Bone Preservation of Single TiUniteTM Implants Installed with Flapless or Flap Surgery.” CLINICAL IMPLANT DENTISTRY AND RELATED RESEARCH 13.3 (2011): 175–183. Print.
APA
De Bruyn, H., Atashkadeh, M., Cosyn, J., & Van de Velde, T. (2011). Clinical outcome and bone preservation of single TiUniteTM implants installed with flapless or flap surgery. CLINICAL IMPLANT DENTISTRY AND RELATED RESEARCH, 13(3), 175–183.
Chicago author-date
De Bruyn, Hugo, Mandana Atashkadeh, Jan Cosyn, and Tommie Van de Velde. 2011. “Clinical Outcome and Bone Preservation of Single TiUniteTM Implants Installed with Flapless or Flap Surgery.” Clinical Implant Dentistry and Related Research 13 (3): 175–183.
Chicago author-date (all authors)
De Bruyn, Hugo, Mandana Atashkadeh, Jan Cosyn, and Tommie Van de Velde. 2011. “Clinical Outcome and Bone Preservation of Single TiUniteTM Implants Installed with Flapless or Flap Surgery.” Clinical Implant Dentistry and Related Research 13 (3): 175–183.
Vancouver
1.
De Bruyn H, Atashkadeh M, Cosyn J, Van de Velde T. Clinical outcome and bone preservation of single TiUniteTM implants installed with flapless or flap surgery. CLINICAL IMPLANT DENTISTRY AND RELATED RESEARCH. 2011;13(3):175–83.
IEEE
[1]
H. De Bruyn, M. Atashkadeh, J. Cosyn, and T. Van de Velde, “Clinical outcome and bone preservation of single TiUniteTM implants installed with flapless or flap surgery,” CLINICAL IMPLANT DENTISTRY AND RELATED RESEARCH, vol. 13, no. 3, pp. 175–183, 2011.
@article{854191,
  abstract     = {Background: Flapless, free-handed implant surgery offers advantages for patient comfort, but studies on long-term clinical success based on marginal bone loss are scarce. 
Aim: The aim of this study was to compare single implants installed with a flap (F) or flapless (FL) surgery with respect to survival and marginal bone preservation after at least 3 years. 
Materials and Methods: Fifty-three TiUnite (TM) Branemark implants, installed in 49 patients (27 females; 22 males; mean age 53 years) were examined. Then, 25 F and 28 FL were delayed loaded; bone level from the abutment-implant level was measured on intraoral radiographs. From 44 (21 F, 23 FL), 31 (18F, 13FL), and 36 (18 F, 18 FL) implants, radiographs were available at baseline and after 1 and 3 years of function. 
Results: The overall survival rate was 100% and the overall mean bone loss after an average of 38 months was 1.35 mm (SD 0.91; range 0-3.7). Both F and FL showed increasing bone loss during the first year with a higher bone loss for FL than for F sites (p < .01). Afterward, no further bone loss occurred and both groups were statistically equal (p > .7). On individual implant level, nearly 80% in both F and FL were considered a success showing bone loss between 1.5 and 1.9 mm. 
Conclusions: Single implants yield an excellent prognosis with stable bone levels irrespective of the surgical technique, and free-handed flapless surgery is a viable alternative to more extensively planned guided surgery. Proper case selection and clinical experience are considered prerequisites for a predictable treatment outcome.},
  author       = {De Bruyn, Hugo and Atashkadeh, Mandana and Cosyn, Jan and Van de Velde, Tommie},
  issn         = {1523-0899},
  journal      = {CLINICAL IMPLANT DENTISTRY AND RELATED RESEARCH},
  keywords     = {flapless surgery,bone remodeling,one-stage surgery,single implant,TiUnite surface,DENTAL IMPLANTS,COHORT,TRIAL},
  language     = {eng},
  number       = {3},
  pages        = {175--183},
  title        = {Clinical outcome and bone preservation of single TiUnite™ implants installed with flapless or flap surgery},
  url          = {http://dx.doi.org/10.1111/j.1708-8208.2009.00200.x},
  volume       = {13},
  year         = {2011},
}

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