Complicated Extraction Flap Operations: Flashcards
When to do a flap
When routine procedures fail
Principle of flap design pertaining to: Prevent ischemia & necrosis of the flap
Broad Based
Principle of flap design pertaining to: Preserve an adequate blood supply
Broad Based
Principle of flap design pertaining to: Attached portion is wider than the detached portion
Broad Based
Principle of flap design pertaining to: Incision should go all the way up to the periosteum
Full Thickness
Principle of flap design pertaining to: Carries all of the layers of flap
Full Thickness
Principle of flap design pertaining to: Flap must be of adequate size for better visualization of the area
Accessibility
Principle of flap design pertaining to: Reflection without tension
Accessibility
Principle of flap design pertaining to: all edges of flap is supported by bone
Made over Sound Bone
Principle of flap design pertaining to: Importance of knowledge of your anatomy: major arteries or blood vessels or nerves
Avoidance of Anatomical Structure
Principle of flap design pertaining to: No (relieving) vertical incision on the lingual side of the mandible
Avoidance of Thin Mucosa
Principle of flap design pertaining to: Avoidance of canine eminence in the maxillary area
Avoidance of Thin Mucosa
Principle of flap design pertaining to: Occupies the space between teeth
Avoidance of Interdental Papilla
Principle of flap design pertaining to: Damaged Papilla
Avoidance of Interdental Papilla
Principles of flap design:
Broad Based
Full Thickness
Accessibility
Made over Sound Bone
Avoidance of Anatomical Structure
Avoidance of Thin Mucosa
Avoidance of Interdental Papilla
Usually in these cases you almost ALWAYS have to open up a flap especially if stable or already hard
Hypercementosis
Most common reason why we open up a flap
Extensive caries
Indication of flap that presents as Absence of PDL space
Ankylosis
Flap extends to 2 teeth anterior and 1 tooth posterior to the tooth that will be extracted
A form of this flap is also used in periodontics
Envelope / Sulcular Flap
Flap extends to 1 tooth anterior and posterior to the
tooth that will be extracted
Triangular / 3-Corner Flap and Trapezoidal / 4-Corner Flap
Type of flap but with 1 relieving incision
Triangular / 3-Corner Flap
flap that Gives most amount of access
Trapezoidal / 4-Corner Flap
Type of flap but with 2 relieving incisions
Trapezoidal / 4-Corner Flap
Flap Used in endodontic or periapical surgeries of a tooth
Semilunar Flap
common filling material during apicoectomy
MTA
A 4-corner flap but with a slight difference:
○ The incisions are made inside the mucogingival junction
Ochsenbein-Luebke Flap
Flap with high tendency of having scar tissue
Alveolar Mucosa Flap
Flap Used in removing tori
Y - Flap
Flaps Used in closure of Oro-Antral Openings or Fistulas
Pedicle Flaps
How to Use Root Tip Pick
- Look for the high edge: where you’ll put the root tip pick.
- Push it away from the wall.
- Root tip rotates out of the socket.
- Take it out with hemostats, cotton pliers, or any fine instrument.
When sectioning a tooth, we cute from ______ to _____, separating the ______ and ______ half
Cut from mesial to distal, separating the Buccal and Palatal half
Width of Bone Removed in difficult extractions:
The Approximate Mesio-Distal Width of the Root
Bur used in removing bone
surgical round bur #4
Length of Bone Removed in difficult extractions:
About 1/2 to 2/3 the Root Length
Needle is held about ________ from the tip
2/3
Needle penetrates ___________ to tissue
perpendicularly
Sutures are Passed from _____ tissue to ______ Tissue
Free tissue to Fixed Tissue
In suturing: Puncture the mucosa from a distance of at least _
mm from the incision line
3 mm
Space each suture about ______ mm apart
3-5 mm apart
When cutting off sutures, should be ____ mm from the
knot
2-3mm
If gut, nylon, or polypropelene, it can be 3-4 mm
