Comparison of the minimally-invasive roll-in envelope flap technique to the holding suture technique in implant surgery: A prospective case series.

[OBJECIVE] The peri-implant soft tissue phenotype plays a role in the long-term success of dental implants, thus, creating the need for the application of different techniques for the management of its adjacent soft tissues. The aim of this case series was to describe and evaluate the clinical outcomes of the microsurgical roll-in-envelope flap (RIE) approach, in comparison with a more commonly used method for manipulation of the peri-implant soft tissues, namely the holding-suture flap (HS) technique.

[MATERIALS AND METHODS] 10 posterior dental implants in 10 healthy individuals were selected and randomly assigned treatment by each of the mentioned groups relative to the flap design. Mucosal thickness was measured at the time of the surgery and at 6 and 12 weeks, serving as the main outcome.

[RESULTS] The healing was uneventful at all sites without any patient drop-outs. The comparison of two groups revealed a three-fold reduction in the mucosal thickness in HS group compared to RIE.

[CONCLUSIONS] In presence of sufficient periimplant supporting tissues and when indicated, the RIE flap seems to yield superior outcomes reducing pain/discomfort compared to connective tissue grafts.