If you're familiar, I'd like to know what it means to get the "keyhole dental implant" technique. My research shows that it's a way to avoid a gum incision. How is this possible?
What is a Keyhole Dental Implant?
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Keyhole dental implants
As Dr. Timmerman indicated, it is an approach in access, not a type of implant. Although it is nice to have a 'no-incision' or more accurately a 'no-flap' approach, it is not always possible nor recommended. Too often there is some mild resorption of tissue and it is ideal to create an incision and a small flap and use the tissue to augment it around the implant. Punch hole approach removed good tissue that can not be used in this fashion.
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"Keyhole" dental implant or Flapless approach for dental implant
The "Keyhole" or Flapless approach to place the dental implant is a common technique. It is used in the situation when the surgeon is confident about the amount of the underlying bone after CT scan and minimally invasive technique can be used. It allows to avoid extensive incisions, prevent tissue trauma and post-surgical discomfort, eliminate post-operative pain. In order to place the implant small punch is done and implant is inserted under local anesthesia, what usually saves alot of time and discomfort for the patient. This approach is possible in the cases when the patient has enough bone to place the implant, if the site was previously grafted and CT scan data confirms that.
"Keyhole" Dental Implant is Actually a Technique for Placement, Not a Type of Implant
The "keyhole" technique, as mentioned previously, is a tecnique in which a standard tissue flap is not made but instead a small piece of tissue is removed with a tissue punch or a special drill in the area of the implant placement. This theoretically allows for less post op pain, but not always. The surgeon must be confident of the architecture of the underlying bone becasue he/she will not be able to visulaize it during the surgery. The only way to be absoluteley sure is to have a CT scan with a surgical guide made with specialized software based on the CT scan. IT is nice to be able to perform the surgery this way, but it is not always in the patients best interest if the surgeon does not have the experience to do it properly
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Keyhole dental surgery means less cutting, not zero cutting
The idea is a tissue punch, like a dermatologist would use for a biopsy. I small circle of tissue is removed instead of a large flap which can be uncomfortable after the surgery is done and take longer to heal. Many practitioners prefer this approach, but some surgeries simply cannot avoid using a flap.
Keyhole vs. Flap Surgery
I have done both surgical procedures. While it is an easier post operative recovery with a keyhole or flapless surgery more often than not it is not the way to go. By lifting a flap the dentist can better visualize the underlying bony structures and increase the chances of success. A word to the wise is that several dentist that I have spoken to who have just started to do implant surgery only do a keyhole approach because they are not comfortable with handling a flap and sutures.
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