Incidence of Peri-Implantitis, Technical and Biological Complications of Single Implants Placed with Flap or Flapless Surgery-A 10-12-Year Case-Series.

Background: Long-term follow-up of single implants and crowns is scarce, especially when inserted using flapless surgery.

Aim: Evaluate survival, peri-implantitis incidence, and technical/biologic complications of solitary implants/crowns after 10-12 years of function.

Material And Methods: 49 patients with 53 single implants, initially operated with a one-stage flap (F) or flapless (FL) surgery and delayed loading, were recalled. Implant survival, radiographic bone-level changes compared to baseline, peri-implant health, and soft tissue aesthetics were registered. Differences in implant level between and within groups were statistically tested using the Mann-Whitney U-Test and Wilcoxon Signed Ranks Test, respectively.

Results: 36 patients with 40 implants were reassessed, yielding 100% implant and 97.5% crown survival. The bone loss in F ( = 19) was 0.56 mm (SD 0.89; range -0.9-2.02) and -0.85 mm (SD 0.98; range -2.84-0.53) in FL ( = 21), indicative of bone gain in FL ( = 0.003), the latter due to a difference at baseline but bone-level was comparable ( = 0.126). Groups were comparable for probing pocket depth (PPD); (3.32 vs. 3.19 mm), Bleeding Index (BI); (0.15 vs. 0.22), and gingival recession; (0.38 vs. 0.17 mm). According to international criteria, the peri-implantitis incidence was 0%, but 32.5% of the implants/crowns experienced biological or technical complications irrespective of surgical technique.

Conclusions: Solitary implants and crowns show good long-term clinical outcomes and peri-implant health. Flapless surgery is a good alternative to conventional in straightforward cases with sufficient bone volume and proper treatment planning.