Types of flaps

Question 1

Envelope Flap

Answer 1

Extended horizontal incision along cervial line of 4-5 teeth without any vertical or releasing incision

Advantages: Minimal trauma to tissue and quicker healing, easy reapproximation to original position

Disadvantages: Limited access to deeper structures, difficult reflection mainly palatally, great tension with risk of ends tearing, possibility of injuring nerves and vessels

Question 2

Triangular (Three-Cornered) Flap

Answer 2

L shaped incision. Horizonta incision along the gingival sulcus and a vertical or oblique incision.

Vertical incision begins at vestibular fold and extends to interdental papillae of gingiva

Performed labially/bucally to remove:
1) Root tips
2) Small cysts
3) Apicoectomies

Question 3

Trapezoid flap

Answer 3

Horizontal incision along the gingiva with two oblique vertical releasing incisons extending to the buccal vestibule.

Advantages:
1) Excellent acces
2) Surgery can be done on more than one tooth
3) Produces no tension in the tissues
4) Eas y approximation

Disadvantages
1) Gingival recession

Question 4

Semi-lunar flap

Answer 4

Curved incison beginning beneath the vestibular fold with the convex part towards the attached gingiva which should be atleast 0.5 cm from the gingival margin

1) Apicoectomy
2) Removing small cysts
3) Root tips

Question 5

The three main types of Pedicle flaps

Used fo rclosure of an oroantral communication are:

Answer 5

1) Buccal (trapezoidal flap)

2) Palatal

Used in edentulous patients so that the vestibular depth is maintained

3) Bridge flaps

This type of flap is used only on edentulous parts of the alveolar ridge.

Question 6

Halsted’s principles

Answer 6

• Gentle handling of tissue
• Meticulous haemostasis
• Preservation of blood supply
• Strict aseptic technique
• Minimum tension on tissues
• Accurate tissue apposition
• Obliteration of dead space

Question 7

Y-shaped and an X –shaped incisions

Palatal surgery to remove tori

Answer 7

Flap Resulting from Y-shaped Incision.
An incision is made along the midline of the palate, as well as two anterolateral incisions, which are anterior to the canines

X-shaped incision
This type of flap is used in larger exostoses, and is basically an extension of the -shaped incision