Computer-assisted Flapless Implant Placement Reduces the Incidence of Surgery-related Bacteremia

Objective: Bacteremia--the access of bacterium to the bloodstream--may yield life-threatening complications. The aim of this study was to compare the incidence, duration, and type of bacterium leading to bacteremia with relation to conventional and computer-assisted flapless implant surgery.

Material And Methods: A total of 377 implants were placed in 68 edentulous jaws using the conventional (conventional group) or a computer-assisted stereolithographic (SLA) template-guided surgery technique (flapless group). Bacteremia was monitored from pre- and postoperative blood samples.

Results: The duration of the surgical intervention was significantly shorter in the flapless group (p = 0.3510). Baseline samples were sterile. Following the 15th minute after the placement of the last implant, bacteria were present in 62 and 12 % of the patients in the conventional and flapless groups, respectively (p < 0.0001; relative risk: 3.05). The differences in the incidence of the bacteremia detected at the baseline and 15 min after the last implant placement were statistically significant in the conventional group (p = 0.0001). However, no such statistical significance was present in the flapless group. Staphylocccus epidermidis, Bifidobacterium spp., Streptococcus viridans, Corynebacterium spp., and Streptococcus sanguinis were the isolated bacterium.

Conclusions: Irrespective of the utilized technique, bacteremia may occur upon the placement of four to eight implants to an edentulous jaw. The probability of bacteremia for the patients operated with the conventional technique is, however, 3.05 greater than those operated with the flapless technique.

Clinical Relevance: Flapless implant placement reduces the incidence of surgery-related bacteremia and, therefore, may be beneficial to patients at risk.