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Introduction: This study aims to advance evidence-based implant dentistry through a meticulous assessment of clinical and radiographic outcomes of two implant techniques, providing valuable insights for clinicians and researchers on their long-term success. Materials and Methods: A 5-year, split-mouth, randomised, double-blind clinical trial with 40 volunteers compared Group A (flapless technique) and Group B (standard flap technique) across 40 sites each. Clinical and radiographic assessments were conducted, and data were analysed using SPSS Version 22.0 with a significance level of P < 0.001. Results: Participants aged 21–49 years showed that Group A (flapless) had higher baseline marginal bone loss but significantly less bone loss from 1 to 5 years compared to Group B (P < 0.001). Group A also had lower Visual Analogue Scale scores and analgesic intake from day 0 to day 5 (P < 0.001). Both groups had a 100% implant survival rate at 5 years, but Group A had higher patient satisfaction (P < 0.001). The diverse cohort of 40 participants included 50% from urban areas and 17.5% with high professional qualifications, all showing good oral hygiene. Discussion: Flapless implant surgery aligns with minimally invasive dentistry, reducing surgical trauma, improving aesthetics, shortening surgery time and enhancing patient satisfaction. It is suitable for various patient groups and represents a strategic shift in practices, especially in sites with favourable soft- and hard-tissue conditions. [ABSTRACT FROM AUTHOR]