Flap versus Flapless Ridge Preservation: A Double-blinded Clinical Study

Abstract Introduction: Loss of crestal bone is a common consequence in the post-extraction area, posing considerable hardships for dental professionals in making a decision regarding the best method for the extraction. The literature comparing flap versus flapless techniques often reports conflicting results, creating doubt. This research is important for defining and illustrating a successful ridge preservation technique. Materials and Methods: Twenty patients were included in this study and were divided into groups of flap and flapless. Group A (flap): Flap elevation, extraction of the tooth, debridement of the socket, graft/biological barrier placement and suturing. Group B (flapless) were performed in a similar manner by omitting the step of a loose flap elevation. We systemically prospectively documented the post-operative clinical and radiographic results. Results: The flapless method was significantly more effective for bone preservation than the conventional flap techniques. This was reflected in the mucosal height reductions, which were significantly less for the flapless approach, with less vertical bone loss being observed, thus showing its importance in preserving crestal bone height. Conclusions: Bone resorption occurred with both surgical modalities; however, the flapless approach had a consistent advantage with improved results. This suggests that there is some inevitable bone resorption, but that with the non-invasive technique, there was a significant reduction ( P < 0.05) in the amount of bone resorption compared to its alternative.