Periodontal Flap Surgery: Variaitons Flashcards
Palatal Flap Definision
A thinned palatal flap is the method for achieving optimal surgical tissue contours and flap adaptations through internal incisions that are extending apical to the crest of bone on the palate
How do probe depths effect the scalloping of incisions for palatal flaps?
More depth = more scalloping
How do gingival contours effect the scalloping of incisions for palatal flaps?
If architecture is flat, more scalloping is needed?
What are palatal flaps used for?
Pocket elimination, regenerative or conservative
What determines the amount of internal thinning with palatal slaps?
Thickness of soft tissue
Thickness of osseous tissue
Distal wedge Definition
Periodontal surgical procedure for removal of excessive soft tissue distal to a terminal tooth
What is the purpose of a distal wedge?
It is designed to treat pockets through internal thinning, while gaining access to bone of the distal aspect of terminal teeth
What are the advantages of a distal wedge?
Close wound permits healing by primary intention
Permits access to bone and furcations
May preserve the zone of keratinized tissue
What are the indications of a distal wedge?
Deep pocket distal to terminal tooth with need to:
- gain access to bone
- gain access to a furcation
- have a wound closure
Deep bony pocket in an area with thin or absent keratinized gingiva
What are the different types of distal wedges?
Square
Triangular
Linear
What are the advantages of a square distal wedge?
Provides the best access
What are the advantages to a triangular distal wedge?
Easier to accomplish
Less invasive
What are the advantages to a linear distal wedge?
Preserves the tissue the best
What is the technique/steps for using a distal wedge?
1) Initial incision
2) Undermining of wedge
3) Removal of wedge
4) Root planing
5) Osseous Surgery
6) Closure (suturing)
What are the objectives for a Conservative Flap Approach
Access to debride roots
Primary Closure
Pocket reduction through the resolution of inflammation and long junctional epithelium
Minimal gingival recession
What are the indications for a Conservative Flap Approach?
Treatment of periodontal pockets where recession must be minimized (esthetic zones/max anterior)
Areas not amenable to a more definitive approach
What are the contraindications for a Conservative Flap Approach?
If a more definitive procedure is feasible
What is an example of a Conservative Flap?
Modified Wideman Flap
Modified Wideman Flap
A scalloped, replaced, mucoperosteal (full thickness) flap
Accomplished with an internal bevel incision
Provides access for root planing
What is the technique/step for a Modified Wideman Flap?
Initial incision is located 0.5-1.0mm from FGM or intrasulcular
Flap is elevated approx. 2-3 mm from the alveolar crest
Intrasulcular incision free margin tissue is to be removed
Interdental incisions free interproximal tissue to be removed
Soft tissue removal
Root planning
Flap adaptation
Primary closure via sutures
