摘要
二十一世紀牙科治療主要朝向簡單方便與減少侵犯性發展。早期植牙手術多分兩階段進行，且建議在齒槽黏膜(alveolar mucosa)上做切線。二次手術與翻瓣手術常常增加治療時間與患者不適。近年來許多臨床研究發現單階段與兩階段植牙成功率相當。植體設計更推出人工牙根(fixture)與支台體(abutment)一體成型的設計。無翻瓣植牙手術，顧名思義是指不須翻瓣即將人工牙根植入骨中，術後也無須縫合。雖然無翻瓣植牙手術之臨床研究較少，然而在適當條件下，可減輕術後不適，縮短療程，是植牙治療時的另類選擇。一般而言，無翻瓣植牙手術部位需有足夠角化牙齦與骨脊寬度與高度，且需有足夠骨質密度以提供植體初期穩定度。本文將以兩個病例報告說明單體無翻瓣植牙手術的臨床適應症與操作時應注意事項。單體無翻瓣植牙手術的優點是縮短手術時間、減輕術後不適、無需二次手術、減少贗復治療步驟、減少耗材花費與術後照顧；缺點是軟硬組織條件要夠且操作困難度較高。臨床上只要慎選患者，仔細診斷，應是患者接受度較高的術式。無翻瓣植牙手術之長期療效則仍有待更多臨床研究證實。
並列摘要
The mainstream of periodontal therapy in the 21th century is simple, convenient, and minimum invasive. Early treatment modality for dental implant recommended two stage surgery and making incision on alveolar mucosa which increase treatment time and discomfort. Recent studies indicated that the success rate of one stage implant surgery is similar to that of two stage one. One piece implant design was also invented. Flapless implant surgery is to place implant intraosseously without opening a flap and with no needs for sutures. While there are not many controlled clinical documentations, flapless one-piece implant surgery can be a treatment alternative at appropriate condition. In general, it requires enough keratinized mucosa, ridge width and height, and good bone density to provide initial implant stability for flapless approach. Two case reports are presented to demonstrate the indications and treatment procedures of flapless one piece implant surgery. The advantages of single stage, flapless, one piece implant are to reduce surgical time, and post-operative discomfort, eliminate secondary surgery, reduce post-surgical maintenance care, prosthetic works, and treatment cost. However, flapless surgery of one piece implant is more difficult to perform. In case of meticulous patient selection and treatment planning, one piece implant shall be the treatment modality of high patient acceptance. More clinical studies are required to validate the predictability and long-term stability of flapless one-piece implant therapy.