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