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SP 16 - Perio Test 2 > Periodontal Flap Surgery: Basic Concepts > Flashcards

Periodontal Flap Surgery: Basic Concepts Flashcards

1
Q

What are flaps useful for?

A

Gateway to bone and tooth

Important in treating periodontal defects and most crown lengthening procedures

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2
Q

Periodontal flap definition

A

A section of gingiva and/or mucosa is surgically separated from the underlying tissue (typically bone) to provide visibility and access for treatment

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3
Q

What is the difference in incisions between a flap and a gingivectomy?

A 
Flap = internal incision
Gingivectomy = external incision
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4
Q

What is required with an incision for a Full thickness flap?

A

The incision must reach the bony crest

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5
Q

How is a full thickness flap elevated?

A

With blunt dissection between the periosteum and bone

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6
Q

What is included in a full thickness flap?

A

Epithelium
Lamina propria of the CT
Periosteum

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7
Q

What is exposed with a full thickness flap?

A

Alveolar bone - which can lead to resoprtion

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8
Q

How does a full thickness flap compare to a partial thickness flap?

A

Easier
Harsher to the bone - more resorption could occur
Should be avoided in areas of dehiscence with CT attachment only

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9
Q

Partial thickness flap dissection plane

A

Sharply dissects through the CT
Therefore the dissection plane is within the CT
A portion of the CT and periosteum remains connected to the bone

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10
Q

What are the surgical steps for full thickness flaps?

A

1) Anethesia
2) Incision
3) Elevation
4) Debridement
5) Treatment of bony defects
6) Closure
7) Dressing (optional)

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11
Q

What determines the amount of scallop in our incision?

A

Amount of keratinized gingiva
Need for access to bone
PD
Intended position of the flap

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12
Q

What are the most common scalpel blades used in perio flap surgery?

A

BP15

BP15S

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13
Q

What direction do we make our incisions?

A

Distal to Mesial

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14
Q

What do we use to elevate flaps

A

Periosteal elevator

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15
Q

If a flap is going to be apically positioned, how do we elevate it?

A

Elevate it past the mucogingival junction - the elastic nature of the mucosa allows the flap to relax into the vestibule

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16
Q

What can cause potential issues with flap elevation

A

Exostoses
Incision doesn’t reach the alveolar bone
Thin bone of dehiscence
Potential damage to blood vessels and nerves

17
Q

How can exostoses effect flap elevation?

A

Requires a direction of elevation that is almost horizontal

Flap is easy to tear

18
Q

What can help flap elevation if we have a thin bone of dehiscence?

A

Vertical incisions

19
Q

Once the flap is elevated, what does debridement involve?

A

Removal of fibrous CT
Removal of granulomatous tissue at the base of the pocket and in bony defects
Root planing

20
Q

What instrument(s) are used to remove tissue facially and lingually?

A

Hoes

Curettes

21
Q

What instrument(s) are used to remove tissue interproximally?

A

Scaler

22
Q

What instrument(s) are used for final debridement?

A

Gracey Curette

Ultrasonics

23
Q

Treatment of bony defects

A

Done after debridement

Can be treated by resection and regeneration

24
Q

What is the outcome of partial thickness flaps?

A

Facilitates an increase in the width of the keratinized gingiva

25
Q

What are vertical incisions helpful for?

A

Provide access without flap extension into adjacent areas

Help with flap positioning

26
Q

Where should vertical incisions be placed?

A

Interproximally near line angles

NEVER over a root prominence

27
Q

What happens if a vertical incision is placed over a root prominence?

A

It can be difficult to close the flaps

28
Q

What are the different types of flap positions?

A

Replaced
Apically
Coronally
Laterally

29
Q

Replaced flap position

A

Back to original position

For conservative flaps (minimal recession)

30
Q

What are apically positioned flaps used for?

A

Pocket elimination or crown lengthening

31
Q

What are coronally positioned flaps used for?

A

Regeneration or root coverage

32
Q

What are common suture types used to secure flaps

A

Interrupted

Sling sutures

SP 16 - Perio Test 2 (8 decks)

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