## 4 Discussion
Systemic C-reactive protein (CRP) is a sensitive marker of systemic inflammation and an independent risk factor for CVD (cardiovascular disease) [36; 37]. A pilot study by [PERSON] and [PERSON] [43] conducted on 45 young Canadians (mean age: 18.89 years, SD = 2.62) determined the CRP levels from a saliva sample in active smokers, passive smokers, and nonsmokers. The CRP levels were highest in active smokers, lower in passive smokers, and lowest in nonsmokers. Passive smokers had significantly higher CRP levels than nonsmokers. Interestingly, the difference in CRP levels in the passive and active smokers did not reach significance. In addition, the investigators stated that salivary CRP levels appear to have a similar relationship with tobacco smoke exposure (TSE) as it is a widely used serum biomarker counterpart [44]. A cohort study [19] on 30 patients with oral lichen planus and 30 healthy patients showed that the levels of TNF-\(\alpha\), G-GSF, IL-1\(\alpha\), IL-1\(\beta\), and IL-8 were statistically significantly higher in OLP patients than in the healthy group. [PERSON]'s rank correlation analysis showed that levels of TNF-\(\alpha\), GM-CSF, MIP-1\(\alpha\), MIP-1\(\beta\), IL-1\(\beta\), and IL-6 in saliva were positively correlated with the severity of the OLP lesion, meaning they have great potential as biomarkers for diagnosing and predicting the prognosis of OLP. In implant manufacturing, several concepts have been developed for coating the implant surface and local delivery of agents regarding antimicrobial, bioactive, or therapeutic effects. For example, a coating of bioactive materials (calcium phosphates and hydroxyapatite (HA)) increases the bioactivity of the surface, improving osteointegration. Bisphosphonate coatings are designed to stimulate osteoblasts and inhibit osteoclast activity and bone resorption, and implants coated with gentamicin and polylactic acid have antimicrobial effects [45]. However, bone loss with implants progresses independently of the coatings applied to the implant surface. In the case of reduced alveolar bone, the dehiscence of the full as well as partial-thickness flap consequently leads to a loss of bone mass and increased osteoclast activity [6], which further aggravates the local anatomical conditions [7,8]. Hence, the innovative approach is complimentary implantation, which reduces the invasiveness of the procedure, improves and accelerates the healing process, and reduces the pain sensation of patients, as confirmed in our study. The complementary technique may also lead to less bone loss compared to the traditional technique, as confirmed by a meta-analysis [46]. According to the analysis by [PERSON] et al. [47], computer-assisted flapless implant placement by means of mucosa-supported templates in complete arch restorations can be considered a reliable and predictable treatment choice despite the potential effects that the flapless approach can bring to the overall treatment. Furthermore, on the basis of a comparative analysis of the planning and execution of freehand implant treatment using navigation, it has been shown that dynamic navigation may improve the quality and safety of surgical procedures and reduce the risk of complications compared to freehand implant placement [48]. Dynamic surgical navigation is also used during zygomatic implant placement procedures for the reconstruction of edentulous maxilla among patients whose osseous conditions do not allow for the placing of implants into the alveolar bone of the maxilla. A study by [PERSON] et al. confirmed that free zygomatic implant placement under dynamic navigation guidance represents a technique with minimal surgical complications [49]. Research confirms that surgery with the flapless technique provides a lower temperature for the operated area and bone bed, which contributes to improved healing and reduced likelihood of perioperative complications; this is confirmed by thermographic studies in patients operated on with flapless and classical techniques [50,51].