{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,3,16]],"date-time":"2026-03-16T14:59:09Z","timestamp":1773673149261,"version":"3.50.1"},"reference-count":24,"publisher":"Wiley","issue":"1","license":[{"start":{"date-parts":[[2007,10,23]],"date-time":"2007-10-23T00:00:00Z","timestamp":1193097600000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Clinical Oral Implants Res"],"published-print":{"date-parts":[[2008,1]]},"abstract":"<jats:title>Abstract:<\/jats:title><jats:p><jats:bold>Introduction: <\/jats:bold> Some implant companies advocate that flapless surgery is easy to perform and beneficial for aesthetics and patients morbidity. However, studies objectively analyzing the position in the bone of implants installed with this approach are lacking. This <jats:italic>in vitro<\/jats:italic> model study was performed to analyse deviations in position and inclination of implants placed with flapless surgery compared with the ideally planned position and to examine whether the outcome is affected by experience level.<\/jats:p><jats:p><jats:bold>Methods: <\/jats:bold> Identical radio\u2010opaque resin models were developed with a silicon lining mimicking the soft tissues and six edentulous single tooth spaces. Eighteen clinicians (six periodontists, six general dentists and six students) drilled four implant sites each (Straumann AG, Basel, Switzerland) with a flapless approach. Corresponding CT\u2010scan images of the models were available. A virtual implant program (Simplant, Materialise NV, Leuven, Belgium) was used to plan the ideal position and to compare this with the implant angulation and position of the test implants.<\/jats:p><jats:p><jats:bold>Results: <\/jats:bold> There were no significant differences between the experience groups for all parameters except for global deviations between dentist and students, angle deviations between dentists and students and horizontal deviations between specialists and students.<\/jats:p><jats:p>In incisor sites, specialists and students deviated significantly more in global deviation and depth than dentists. In premolar and molar sites, there were no significant differences except for horizontal deviations between specialists and dentists in molar sites. As a consequence of the malpositioning, perforations were seen in 59.7% (43\/72) of the implant occasions when the artificial mucosa was removed from the model.<\/jats:p><jats:p><jats:bold>Conclusion: <\/jats:bold> The three\u2010dimensional location of implants installed with flapless approach differs significantly from the ideal, although neighbouring teeth were present and maximal radiographical information was available. Within the limitations of this <jats:italic>in vitro<\/jats:italic> model study it seems necessary to point out that these deviations would in a clinical situation lead to complications such as loss of implant stability, aesthetical and phonetical consequences. The outcome is not influenced by the level of experience with implant surgery. This points out that more precise measurements of soft tissue <jats:italic>in situ<\/jats:italic> or additional use of guiding systems are recommendable.<\/jats:p>","DOI":"10.1111\/j.1600-0501.2007.01423.x","type":"journal-article","created":{"date-parts":[[2007,10,25]],"date-time":"2007-10-25T05:42:12Z","timestamp":1193290932000},"page":"66-72","source":"Crossref","is-referenced-by-count":80,"title":["A model study on flapless implant placement by clinicians with a different experience level in implant surgery"],"prefix":"10.1111","volume":"19","author":[{"given":"Tommie","family":"Van de Velde","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Fadi","family":"Glor","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Hugo","family":"De Bruyn","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"311","published-online":{"date-parts":[[2007,10,23]]},"reference":[{"key":"e_1_2_7_2_1","doi-asserted-by":"publisher","DOI":"10.1034\/j.1600-0501.2002.130307.x"},{"key":"e_1_2_7_3_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1708-8208.2005.tb00071.x"},{"key":"e_1_2_7_4_1","first-page":"73","article-title":"Consensus statements and recommended clinical procedures regarding esthetics in implant dentistry","volume":"19","author":"Belser U.","year":"2004","journal-title":"International Journal of Oral & Maxillofacial Implants"},{"key":"e_1_2_7_5_1","first-page":"43","article-title":"Optimizing esthetics for implant restorations in the anterior maxilla","volume":"19","author":"Buser D.","year":"2004","journal-title":"International Journal of Oral & Maxilofacial Implants"},{"key":"e_1_2_7_6_1","first-page":"271","article-title":"Flapless implant surgery","volume":"17","author":"Campelo L.D.","year":"2002","journal-title":"International Journal of Oral & Maxillofacial Implants"},{"key":"e_1_2_7_7_1","first-page":"92","article-title":"Intraoperative computerized navigation for flapless implant surgery and immediate loading in the edentulous mandible","volume":"20","author":"Casap N.","year":"2005","journal-title":"International Journal of Oral & Maxillofacial Implants"},{"key":"e_1_2_7_8_1","first-page":"883","volume-title":"Computer Assisted Radiology","author":"Demey S.","year":"1999"},{"key":"e_1_2_7_9_1","doi-asserted-by":"publisher","DOI":"10.1902\/jop.2005.76.4.503"},{"key":"e_1_2_7_10_1","first-page":"886","article-title":"Reliability of preoperative planning of an image\u2010guided system for oral implant placement based on 3\u2010dimensional images","volume":"18","author":"Fortin T.","year":"2003","journal-title":"International Journal of Oral & Maxillofacial Implants"},{"key":"e_1_2_7_11_1","first-page":"298","article-title":"Effect of flapless surgery on pain experienced in implant placement using an image\u2010guided system","volume":"21","author":"Fortin T.","year":"2006","journal-title":"International Journal of Oral & Maxillofacial Implants"},{"key":"e_1_2_7_12_1","doi-asserted-by":"publisher","DOI":"10.1563\/1548-1336(2000)026<0300:PDIPIB>2.3.CO;2"},{"key":"e_1_2_7_13_1","first-page":"268","article-title":"The accuracy of dental radiographic techniques used for evaluation of implant fixture placement","volume":"15","author":"Gher M.E.","year":"1995","journal-title":"International Journal of Periodontics and Restorative Dentistry"},{"key":"e_1_2_7_14_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1600-0501.2004.01058.x"},{"key":"e_1_2_7_15_1","first-page":"21","article-title":"Vollprothetische Versorgung des atrophierten Problem\u2013Unterkiefers mit Hilfe von CBS Implantaten","volume":"12","author":"Ledermann Ph.D.","year":"1977","journal-title":"Quintessenz"},{"key":"e_1_2_7_16_1","doi-asserted-by":"publisher","DOI":"10.1034\/j.1600-0501.1992.030404.x"},{"key":"e_1_2_7_17_1","doi-asserted-by":"publisher","DOI":"10.1034\/j.1600-0501.1992.030202.x"},{"key":"e_1_2_7_18_1","unstructured":"Mimics 9.0 Reference Guide (2000) Materialise NV 480 pp."},{"key":"e_1_2_7_19_1","unstructured":"Molly L.(2005) Deviations from the standard osseointegration protocol in the use of oral implants. 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