The Impact of Vestibular versus Trapezoidal flap design on immediate implants a randomized clinical trial.

Document Type

Article

Publication Date

4-2026

Abstract

This randomized controlled clinical trial aimed to determine the post-restorative soft tissue changes associated with the minimally invasive vestibular access and conventional trapezoidal mucoperiosteal flap designs, while using an identical guided bone regeneration protocol to augment the defective buccal bone of type II sockets. The outcomes included midfacial mucosal level change, buccal bone plate changes, and the pink esthetic score after 6 months of implant loading with the final prosthetic placement. Twenty-two participants presenting with compromised class II fresh extraction sockets in the maxillary anterior region were treated with immediate implant placement using two flap designs (conventional trapezoidal mucoperiosteal and vestibular access). Peri-implant midfacial mucosal level changes, pink esthetic score, and buccal bone plate changes were evaluated 6 months after final prosthetic placement. Statistically significant differences in midfacial mucosal level change were observed between the groups (p = 0.02), while no statistically significant difference in pink esthetic score was found between the groups (p = 0.07). Regarding buccal bone plate changes, statistically significant gains in width were observed in both groups, with no statistically significant intergroup difference (p = 0.72). Soft tissue stability was statistically and clinically more favorable when using the minimally invasive vestibular access flap design compared with the conventional trapezoidal mucoperiosteal flap.

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