Conventional crestal and intrasulcular incisions followed by full-thickness flap reflection may inevitably induce surgical trauma, resulting in facial contour reduction, mucosal recession, and interdental papilla loss. Flapless implant surgery is the most conservative approach; however, it might create undetectable bone fenestration/dehiscence and subsequent complications. The present clinical study introduces a modified and minimally invasive approach, the palatal access flap (PAF), for placing implants in the esthetic zone. Preliminary data of 15 consecutive cases demonstrated clinically negligible soft tissue contour changes when pre- and postoperative 3D model scans were compared. The PAF technique could be a surgical solution, especially for patients with a high esthetic risk, to maintain facial and interproximal tissue contours for the implant site and adjacent teeth.
