Incisions And Flaps Flashcards
Important rules for incisions
🔸Firm, continuous stroke
🔸Avoid key structures
🔸Adequate flap width
🔸Flap longer than bone deficit
🔸Mucosa and periosteum reflected together
🔸Scar taken into consideration
🔸Excessive pulling, crushing or folding of flap avoided
Importance of firm continuous stroke
🔸Repeated strokes impair healing
🔸Scalpel in constant contact w/ bone
Key structures to avoid during incision
🔸Mental neuro vascular bundle
🔸Palatal vessels
🔸Infraorbital nerve
🔸Lingual nerve
🔸Submandibular duct
🔸Parotid duct
🔸Hypoglossal venous plexus
🔸Buccal artery
🔸Facial nerve, artery and vein
Vertical releasing incisors should begin at
Buccal vestibule and end at interdental papillae
Envelope and semilunar incisions of at least 0.5cm from gingival sulcus are used for
🔸Apicoectomies
🔸Removal of root tips
Elliptic incision use
Excision of various soft tissue lesions
Importance of adequate flap width
🔸Operative field easily accessible
🔸No creation of tension and trauma
Importance of flap being larger than bone defect
🔸Sutured flap margins will rest on healthy intact bone
🔸Prevention of flap dehiscence and tearing
Why excessive pulling, crushing or folding of flap avoided
Blood supply and healing compromised
Types of flaps
🔸Trapezoidal
🔸Triangular
🔸Envelope
🔸Semilunar (Y and X incisions)
🔸Pedicule
Characteristics of trapezoidal flap
🔸п-shaped incision
🔸Horizontal gingival incision and two oblique vertical to buccal vestibule
🔸Base of flap broader than free gingival margin
Vertical releasing incisions in trapezoidal flap extend to
🔸Interdental papilla and never buccal surface
🔸Ensures integrity of gingiva
How satisfactory surgical field is achieved
Incision extends at least one or two teeth either side of area of bone removal
Rational for base of flap being broader than gingival margin
Ensures adequate blood supply
Advantages of trapezoidal flap
🔸Excellent access
🔸Operation on multiple teeth
🔸No tissue tension
🔸Easy approximation
🔸Good healing
Disadvantages of trapezoidal flap
🔸Defect in attached gingiva
Triangular flap characteristics
🔸L-Shaped incision
🔸Gingival horizontal incision and vertical incision
Advantages of triangular flap
🔸Good bloody supply
🔸Good visualisation
🔸Good stability
🔸Good reaproximation
🔸Easily modified
Disadvantages of triangular flap
🔸Limited access to long roots
🔸May cause tension
Envelope flap characteristics
🔸Extended horizontal incision along cervical lines of teeth
🔸Extends along 4 or 5 teeth
Advantages of envelope flap
🔸Avoidance of vertical incision
🔸Good approximation
Disadvantages of envelope flap
🔸Difficult reflection
🔸Tension
🔸Limited visualisation in apicoectomies
🔸Limited access
🔸Defect of attached gingiva
Semilunar flap characteristics
🔸Curved incision
🔸From vestibular fold- bow shaped course w/ convex part towards attached gingiva
🔸Each end extends at least one tooth away from bone removal area
Advantages of semilunar flap
🔸Small incision and easy reflection
🔸No recession
🔸Easy oral hygiene
Disadvantages of semilunar flap
🔸Difficult reaproximation and suturing
🔸Limited access and visualisation
🔸Potential tearing
Uses of trapezoidal flap
Suitable for extensive surgical procedures
Triangular flap uses
🔸Removal of root tips, small cysts and apicoectomies
Envelope flap uses
🔸Apicoectomy
🔸Removal of impacted teeth
🔸Cycts
Semilunar flap uses
🔸Apicoectomy
🔸Removal of small cysts and root tips
