the basics of flap surgery

Question 1

reading

Answer 1

1_ chapter 61, periodontal surgical therapy 730-749

Question 2

periodontal flap

Answer 2

1) reduce pocket flap
2) provide access for regenerative procedures

Question 3

different flap incisions

Answer 3

1) internal bevel
2) crevicular or sulcular incision
3) interdental
4) vertical releasing
5) envelope

Question 4

internal bevel

Answer 4

1) starts from the GM and aimed at or near the crestal bone
2) removes the sulcular epithelium
3) sharp thin flap margin for adaptation to the bone tooth junction

Question 5

crevicular incision

Answer 5

1) scalpel inserted into the pocket and goes down until touches bone

Question 6

crevicular with gingiva consevation

Answer 6

1) keratinized gingiva preservation
2) does not start with internal bevel
3) guided tissue regen and CT grafting

Question 7

interdental

Answer 7

1) third incision
2) performed after the flap is elevated
2) separates the collar of ginigva left around the tooth facially, lingually and interproximally

Question 8

optional incision

Answer 8

1) indications
- to allow increased surgical access
- to facilitate flap positioning (must extend beyond mucogingival junction to provide maximum flap mobility (tension release)
2) placement
- over the line angle of a tooth and CONSERVE the papilla!
- blood supply is important in interdental area

Question 9

envelope

Answer 9

1) flap reflected by horizontal incision only

Question 10

mucoperiosteal flap

Answer 10

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Question 11

mucosal flap

Answer 11

1) split the CT
- filet the fish

Question 12

full thickness flap indications

Answer 12

1) for periodontal pocket reduction
2) for direct access to bone
3) for mucogingival osseous procedures

Question 13

partial thickness flap indiciations

Answer 13

1) for free gingival grafts
2) for CT and laterally positioned grafts
3 )for gingival augmentation in apically positioned flaps

Question 14

partial thickness flap contraindications

Answer 14

1) thin tissue
2) osseous problems such as exostoses

Question 15

modified widman flap

Answer 15

1) allows access to roots
2) reduction of probing depths
3) reduction of disease in sulcus

1) internal bevel incision to crest
- interdental papillae retained as much as possible
2) minimal reflection
3) crevicular incision
4) interdental incision
5) remove granulomatous tissue
6) replacement of flaps to attain max interproximal bone coverage

Question 16

ENAP

Answer 16

1) bleeding points made at depth of the pocket
2) crevicular sulcular incision to depth of pocket
3) debridement, no flap reflection

Question 17

flap styles

Answer 17

1) T flap, trolley design
2) wedge or pie shaped mandible
3) incision #2 to crestal bone
4) #3 to release wedge tissue
5) remove wedge tissue in one piece
6) suture and lop off extra tissue gingivectomy (only in keratinized tissue)

Question 18

positional flap

Answer 18

1) placement can be apical, coronal or lateral to original position
2) requires reflection past the MGJ for tension release

Question 19

apically positioned flap

Answer 19

1) for pocket reduction
2) for augmentation of attached ginigva

Question 20

osseous recountouring needle

Answer 20

1) reposition the flap to make a good tooth flap interface to reduce the pocket

Question 21

coronally positioned or advance flap

Answer 21

1) required adequate attached gingiva coronally
2) for root coverage and or gingival augmentation
3) can be used in conjunction with soft tissue - autograft or allograft

Question 22

alloderm

Answer 22

1) derived from cadaver skin

Question 23

lateral pedicle graft

Answer 23

1) requires adequate attached gingiva adjacent to the recipient site
2) for root coverage or gingival augmentation

Question 24

palatal falp

Answer 24

1) attached keratinized tissue does not have elastic properties