Histologic Evaluation of Implants Following Flapless and Flapped Surgery: A Study in Canines
Bibliographic record
Abstract
BACKGROUND: Flapless surgery requires penetration of the alveolar mucosa and bone without reflection of mucoperiosteal flaps. Do these techniques force gingival tissue or foreign materials into osteotomies? If so, do such tissues or materials interfere with osseointegration? A proof-of-principle study using a canine model attempted to answer these questions. METHODS: Five young adult Hound Labrador mongrel dogs received implants with a moderately roughened surface by anodic oxidation using flapless or conventional one-stage (control) surgery in contralateral jaw quadrants. The implants were placed into the osteotomies, and the international stability quotient (ISQ) was recorded using resonance frequency analysis. These measurements were repeated following a 3-month healing interval when the animals were euthanized, and implants and surrounding tissues were retrieved and processed for histologic analysis. RESULTS: The implants were stable upon insertion and demonstrated increased stability at 3 months without significant differences between surgical protocols. The histologic evaluation showed high bone-implant contact (flapless surgery: 54.7% +/- 8.4%; control: 52.2% +/- 13.0%; P >0.05) without evidence of gingival tissue or foreign body inclusions. There were no significant differences in marginal bone levels between the surgical protocols. Post-insertion and at 3 months, ISQ values depended on the amount of torque delivered. Immediately post-insertion, for every 1-unit increase in torque value, the ISQ increased by 0.3 (95% confidence interval: 0.1 to 0.4; P = 0.0043). Three months postoperatively, for every one-unit increase in torque the ISQ value decreased 0.2 (95% confidence interval: -0.4 to -0.1; P = 0.0012). The effect of torque on ISQ values was independent of treatment effects and remained significant after adjustment for treatment. CONCLUSIONS: The results suggest that implants placed without flap reflection remain stable and exhibit clinically relevant osseointegration similar to when implants are placed with flapped procedures. Greater torque at implant placement resulted in less implant stability at 3 months.
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How this classification was reachedexpand
Full frame machine prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. The Gemma side is a direct model label for every work in the frame, read from the title-only record. The Codex side is a classifier learned from the 10,348 direct Codex labels and calibrated to design-weighted sample rates; fields without enough sample support carry no Codex call. Candidate is the union of the two sides; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels.
Distilled classifier scores by category (both heads)
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.001 | 0.001 |
| Meta-epidemiology (narrow) | 0.000 | 0.001 |
| Meta-epidemiology (broad) | 0.001 | 0.001 |
| Bibliometrics | 0.001 | 0.001 |
| Science and technology studies | 0.000 | 0.001 |
| Scholarly communication | 0.000 | 0.000 |
| Open science | 0.000 | 0.000 |
| Research integrity | 0.001 | 0.000 |
| Insufficient payload (model declined to judge) | 0.001 | 0.000 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one source (direct Gemma or distilled Codex), not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".