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Flapless implantology Guidelines on the selection of technique for flapless implants

The choice of a soft tissue punch technique or a mini-incision technique is dependent on bone quality and primary implant stability.

Guideline 1: select the soft tissue punch technique for a one-stage approach

The soft tissue punch technique is used for a one-stage surgical approach, whereas the mini –incision technique is used for either a one – stage or a two – stage surgical approach. The two – stage surgical process places the implant body below the soft tissue until bone healing has occurred. It is prudent to use the two – stage surgical approach when implants are not adequately stabilized or if the patient wears a soft tissue-borne partial denture.

Guideline 2 : the mini-incision technique is preferred in areas with insufficient amounts of keratinized mucosa

The amount of keratinized tissue should be adequate, and ideally patients need at least 1.5 mm of keratinized tissue to the facial aspect of the healing abutment. The mini-incision technique is beneficial in saving the keratinized mucosa. Therefore, the soft tissue punch technique must be used in cases where at least 1.5mm of keratinized tissue is left on the buccal side to this incision line of the punch.

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