There are two different approaches to place the dental implant. The aim of the study is to compare clinically between the flapless technique and the conventional surgical protocol for self-tapping implants when placed and immediately loaded in partially edentulous patients with atrophic healed bony sites. Materials and Methods: This study was conducted on 24 subjects divided into 12 individuals having a missing tooth with 5-6 mm ridge width and will receive self-tapping one-piece implants after conventional surgical protocol and 12 individuals having a missing tooth with 5-6 mm ridge width and will receive self-tapping one-piece implants after flapless technique utilizing tissue punch device, with 3 months and 6 months follow up the following measurements were recorded (BI, PD, PI, WKM), also standardized periapical X-ray films were taken immediately after implant insertion, at 3 months and 6 months post-operatively to detect marginal bone level around the implant and change in bone density around the implant. Digora software was used to evaluate these changes in marginal bone level and bone density around the implant. Results: there was a statistically significant decrease in mean bone height and bone density measurement after 3 months in groups' received implants after conventional surgical protocol. Conclusion: The flapless implant surgery reduces the amount of crestal bone loss and enhancing bone density than the conventional flap technique.