Flapless implant surgery to overcome anatomic challenges in the anterior mandible for overdenture therapy: A clinical report

摘要

Implant surgery in the atrophic anterior mandible presents a number of anatomic challenges owing to the vascular and neurologic structures related to this region. Flapless implant surgery is known to be a conservative surgical approach that has a number of advantages and disadvantages for both the clinician and the patient. This clinical report describes the use of flapless implant surgery for a 2-implant overdenture in an 89-year-old patient with a severely atrophic mandible and significant anatomic constraints. The insertion of the sublingual artery into the lingual cortex close to the level of the crest of the ridge and the presence of the mental foramen at the ridge crest precluded conventional flap surgery. To overcome these anatomic challenges, a conventional surgical guide was used with careful preoperative treatment planning for a successful flapless implant surgery and subsequent overdenture therapy. The anatomic challenges, surgical and prosthetic treatment planning, choice of simple versus complex interventions, and indications and contraindications of flapless surgery are discussed.