Submerged flapless technique vs. conventional flap approach for implant placement: experimental domestic pig study with 12-month follow-up

Objectives The aim of our study was to compare osseointegration and peri‐implant crestal bone resorption in submerged flapless and conventional flap surgery over a 12‐month follow‐up. Materials and methods The study used five domestic pigs. Implants were inserted 9 weeks after tooth extraction. Each animal received six implants in the mandible, following a split‐mouth design: one side was treated using a flapless technique using mini‐incisions, while a flap was raised on the other. The animals were sacrificed at 2 weeks, 1, 3, 6 and 12 months after implant placement. Radiographic images were taken to analyze crestal bone loss, and samples were extracted for histopathological and bone‐to‐implant contact (BIC) analyses. Results Significantly, greater crestal bone loss (P = 0.005) was obtained in the flap group compared with the flapless group. The flapless group presented significantly higher percentages of BIC (P