Materials and Methods: Twenty implants were placed ten per group-ten using flapless and ten using with-flap techniques in posterior mandibular edentulous region by one-stage approach with early loading protocol. The change in heights of crestal bone was then measured on standardized digital periapical radiographs taken at 0 week, 6weeks, 12 weeks and 6 months.

Results: The present study showed that on both proximal sides, the mean change from 0 months, 6 weeks, 12 weeks and 6 months for flapless method was significantly lower than with traditional flap method (+0,07 against +0.26 mm on mesial side and +0.15 against +0.33mm on distal side at 6 months).

Conclusions: During the six-month period, reduction of crestal bone height around the implants placed with flapless surgery was not statistically significant, while the reduction of crestal bone height around the implants placed using with-flap surgery was statistically significant. Comparitively, flapless approach showed lesser crestal bone height reduction, which was statistically significant.