Flap Designs for Implant-Related Surgical Procedures: A Review

Purpose: The objective of this study was to compare the reliability and results of 2 flap techniques, flapless (FL) and full-thickness (FT) flap, during implant placement. Materials and Methods: Online and hand searches of the literature published were conducted to identify studies examining different flap techniques on clinical and histological outcomes. The search terms used, alone or in combination, were "flapless," "full-thickness flap," "crestal bone resorption," "gingival blood circulation," and "biological width." Results: Fifty studies were selected for comparison and to address the points highlighted in this study. Fourteen articles and 1 book were not directly related to flap design but were included for understanding the process of soft tissue healing. Five articles discussed the principles of oral surgery and flap design. Conclusion: This review revealed that the FL technique might be more appropriate in immediate implant loading cases. This specific technique results in shallower biological width, reduced inflammation, less morbidity with guided implant placement, and better esthetics in comparison with the FT technique. The implant survival rates are not significantly different between the 2 flap techniques. With respect to crestal bone resorption in FL and FT, it is inconclusive, depending on the study type (human or animal).