Meta-Analysis
Copyright ©The Author(s) 2020. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Clin Cases. Mar 26, 2020; 8(6): 1087-1103
Published online Mar 26, 2020. doi: 10.12998/wjcc.v8.i6.1087
Long-term clinical performance of flapless implant surgery compared to the conventional approach with flap elevation: A systematic review and meta-analysis
He Cai, Xing Liang, Dong-Yuan Sun, Jun-Yu Chen
He Cai, Xing Liang, Dong-Yuan Sun, Jun-Yu Chen, Department of Prosthodontics, State Key Laboratory of Oral Diseases, National Clinical Research Center for Oral Diseases, West China Hospital of Stomatology, Sichuan University, Chengdu 610041, Sichuan Province, China
He Cai, Botnar Research Centre, University of Oxford, Windmill Road, Oxford OX3 7LD, United Kingdom
Jun-Yu Chen, Kennedy Institute of Rheumatology, University of Oxford, Roosevelt Drive, Oxford OX3 7FY, United Kingdom
Author contributions: Cai H made a substantial contribution to study planning, study screening, data extraction, data analysis and interpretation, drafting and revising the manuscript; Liang X provided methodological advice for this study and contributed to study planning, data acquisition, analysis, interpretation, and revising the manuscript; Sun DY contributed to data interpretation, drafting and revising the manuscript; Chen JY made a substantial contribution to conception of the study, study planning, acquisition and analysis of data, drafting and revising the manuscript; All authors read and approved the final version of the manuscript.
Supported by the Graduate Student's Research and Innovation Fund of Sichuan University, No. 2018YJSY108; the China Postdoctoral Science Foundation Funded Project, No. 2018M640931; the Science and Technology Key Research and Development Program of Sichuan Province, No. 2019YFS0142; the National Natural Science Foundation of China, No. 81901060.
Conflict-of-interest statement: The authors deny any conflict of interest.
PRISMA 2009 Checklist statement: The authors have read the PRISMA 2009 Checklist, and the manuscript was prepared, revised, and checked according to the PRISMA 2009 Checklist. The PRISMA 2009 Checklist has been submitted with the manuscript.
Open-Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
Corresponding author: Jun-Yu Chen, MD, PhD, Lecturer, Department of Prosthodontics, State Key Laboratory of Oral Diseases, National Clinical Research Center for Oral Diseases, West China Hospital of Stomatology, Sichuan University, No. 14, Section 3, South Renmin Road, Chengdu 610041, Sichuan Province, China. junyuchen@scu.edu.cn
Received: October 21, 2019
Peer-review started: October 21, 2019
First decision: November 11, 2019
Revised: November 13, 2019
Accepted: December 6, 2019
Article in press: December 6, 2019
Published online: March 26, 2020
Core Tip

Core tip: This is the first systematic review and meta-analysis to compare the long-term clinical performance after flapless implant surgery to that of the conventional approach with flap elevation over a follow-up of three years or more. Interestingly, we found that the flapless implant surgery and conventional approach had comparable implant survival rates, marginal bone loss, and complication rates over the follow-up period. Moreover, guided or free-hand implant insertion does not affect the long-term effects of flapless surgery. Thus, the flapless technique can be considered a promising alternative to the conventional implant approach without significantly compromising the long-term outcomes of implant treatment.