Flap techniques Flashcards
What are the commonly used flap techniques?
Modified Widman flap
Undisplaced flap
Apically displaced flap
True/False:
Indications for using flap techniques for periodontal pocket therapy includes pockets greater than 4mm after phase 1 therapy
False!
Pockets must be greater than 5mm after phase 1 therapy
What are the Indications for using flap techniques
Pockets greater than 5mm persisting after phase 1 therapy
Bony pockets and interdental craters
Furcation areas
Need for crown lengthening
Deep, narrow pockets where access is impossible
True/False:
Contraindications for flap techniques include aesthetic concerns
True!
Which flap technique is best recommended when aesthetics is a concern?
Modified Widman flap
Which flap technique requires a sufficient amount of attached gingiva?
Undisplaced flap
True/False:
One of the flap techniques is based on shifting the mucogingival junction coronal to the teeth
False!
Which flap technique is considered as the “Internal Bevel Gingivectomy”? And why?
The Undisplaced flap
Because the pocket wall is removed with the initial incision
Which flap technique uses a continuous sling suture to secure facial and lingual flaps?
The Undisplaced flap
Which flap technique increases the width of the attached gingiva?
The Apically displaced flap
True/False: Modified Widman flap technique uses vertical incisions
False!
Modified Widman technique uses horizontal incisions only and vertical releasing incisions are not needed.
Which flap technique uses bleeding pocket marks?
The Undisplaced flap technique
True/False: The Apically displaced technique uses sling sutures only
False!
It uses the sling sutures for full-thickness flap, and the partial thickness flap is sutured to the periosteum
True/False:
Full thickness flaps need a sharp dissection with a periosteal elevator
False!
Full thickness flaps need a BLUNT dissection with a periosteal elevator
Which flap technique is used to remove the pocket wall and increase the width of the attached gingiva?
The Apically displaced technique
Which flap technique does not eliminate the pocket?
The Modified Widman technique
Which flap technique heals with a short junctional epithelium?
None
True/False: The modified Widman technique heals with a long junctional epithelium
True
What are the advantages of the Modified Widman flap technique?
1) Removes the inflamed pocket wall
2) Provides access for root debridement
3) Preserves maximum amount of periodontal tissue
4) Indicated when aesthetics are of main concern
What are the reasons for using flap techniques for periodontal pocket therapy?
1) Increase visibility of the root surface and deposits
2) Improved access for oral hygiene & supportive periodontal therapy
3) Eliminate or reduce the pocket depth by removal of the pocket wall
4) Expose area to perform regenerative methods
5) Allow more accurate determination of the prognosis
What are the contraindications of using flap techniques for periodontal pocket therapy?
1) Shallow Supra alveolar pockets that can be accessed with conventional SRP
2) Areas where aesthetics may be compromised if flaps are to be raised
What are the contraindications of using flap techniques for periodontal pocket therapy?
1) Shallow Supra alveolar pockets that can be accessed with conventional SRP
2) Areas where aesthetics may be compromised if flaps are to be raised
List the steps of the Modified Widman flap
Step 1) Initial internal bevel incision to alveolar crest, 0.5-1mm away from gingival margin (follow scalloping of margins)
2) Reflect gingiva with periosteal elevator 2-3mm from bone
3) 2nd sulcular incision
4) 3rd incision in interdental spaces coronal to bone - remove gingival collar
5) Remove tissue tags & granulation tissue with curette - SRP if needed
6) Bone architecture only corrected if prevents good tissue adaptation to the necks of teeth
7) Adapt the facial and lingual inter proximal tissue with no bone exposure at time of suturing
- use interrupted direct sutures
Which flap techniques removes the pocket wall with the initial incision
Undisplaced flap
Which flap techniques removes the pocket wall with the initial incision
Undisplaced flap
Which flap technique preserves the length of the attached gingiva
None!
Apically displaced flap preserves/INCREASES the WIDTH of the attached gingiva
T/F: Full thickness flap uses sharp dissection with a periosteal elevator
False!
Full thickness flap uses BLUNT dissection with a periosteal elevator
T/F: the flap edge of the Undisplaced flap should rest on the root-bone junction
True!
What are the reasons for using flap techniques for periodontal pocket therapy?
Increase visibility of the root surface and debris
Improve access for oral hygiene and supportive therapy
Eliminate or reduce pocket depth by removal of pocket wall
Expose area for regenerative methods
Allow for accurate determination of prognosis
Which technique does not eliminate the depth of the pocket itself
Modified Widman
What are the contraindications of using flap techniques
Shallow Supra alveolar pockets that can be accessed with conventional scaling and root planing
Areas where aesthetics may be compromised if flaps are to be raised
What are the contraindications of using flap techniques
Shallow Supra alveolar pockets that can be accessed with conventional scaling and root planing
Areas where aesthetics may be compromised if flaps are to be raised
