Flap Design
Transcript of Flap Design
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Flap Design
Homan Zandi 2004
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Free Gingiva
Attached Gingiva
Mucogingival Junction
Alveolar Mucosa
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Enamel
Connective Tissue
JE
CEJ
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Objective
• The flap should offer adequate access and have an adequate blood supply
• The flap must be of adequate size and fully reflected
• The edges must lie on the sound bone
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Mucoperiosteal Flap
• Mucosa• Connective tissue• Periosteum
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Considerations• The number of teeth involved in the surgery• The length and shape of the roots involved• The dimensions of the lesion• The amount of attached gingiva• The existence and depth of periodontal
pockets• The locations of muscle attachments and
frenums• The height or depth of the vestibule• The location of anatomic structures, such as
the neurovascular bundles and the maxillarysinus
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Techniques
• Gingival flap• Intrasulcular flap (marginal)
– Triangular– Rectangular
• Semilunar flap• Submarginal flap
– Ochsentein-Luebke flap
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Gingival Flap• Indications
– Cervical resorptive defects
– Cervical area perforations
– Periodontalprocedures Homan Zandi
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Intrasulcular Flap(Triangular)
• Indications
– Periapical SugeryPostrerior areas
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Intrasulcular Flap(Rectangular)
• Indications
– Multiple teeth– Large lesions– Long roots
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Semilunar Flap
• Indications
– Esthetic crowns
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Submarginal FlapOchsenbein-Luebke Flap
• Indications
– Prosthetic crowns
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Incision• Tissue should be handled gently
• Sharp dissection should be used
• Careful hemostasis should be attained
• Tension should be avoided
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Homan Zandi
# 11 Scalpel # 15C Scalpel
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# 12 Scalpel
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Most endodontic surgery problems canbe avoided by using the following
incision rules
1. Firm continuous incision
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2) An incision should not cross an underlying bonydefect
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2) An incision should not cross an underlying bonydefect
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2) An incision should not cross an underlying bonydefect
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2) An incision should not cross an underlying bonydefect
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3) The vertical incision should be in the concavitiesbetween bone eminences
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4) The vertical incision should not extend into themuccobuccal fold
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4) The vertical incision should not extend into themuccobuccal fold
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5) The termination of the vertical incision at the gingival crest must be at the mesial or distal line angle of thetooth
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6) The base of the flap must be at least equal to the widthof its free end
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Most endodontic surgery problems can be
avoided by using the following incision rules
1) Firm continuous incision2) An incision should not cross an underlying bony
defect3) The vertical incision should be in the concavities
between bone eminences4) The vertical incision should not extend into the
muccobuccal fold5) The termination of the vertical incision at the
gingival crest must be at the mesial or distal line angle of the tooth
6) The base of the flap must be at least equal to thewidth of its free end