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SURGICAL TECHNIQUE

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1. Creation of mucoperiosteal flap.

2. Removal of bone / Tooth division.

3. Delivery of tooth / root portion.

4. Wound debridement or wound toilet.

5. Wound closure / Packing.

6. After care.

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ARMANTARIUM

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Incision and flap reflection

Different designs Envelope & 3 corner.

Anterior limb, posterior limb and middleportion.

Objectives are good exposure to operativefield, broad based with good blood supplyand close on sound bone rather on bonydefect.

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Commonly used Flap Designs

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Bone removal

Balanced but not un necessary.

Occ:, buccal & distal aspect.

Down to cervical line of imp tooth butvaries according to angulations, depth andmorphology of roots.

Bone should not removed from lingualaspect as danger to lingual nerve.

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Tooth sectioning

Depends on;

Direction of delivery of imp. tooth.

Angulations, depth and root pattern

(divergent roots).

Mesio angular, vertical, horizontal or distoangular.

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Wound toilet and closure

Debriment.

Bone trimming / filing

irrigation. Hemostasis bleeding points & brisk

ooze.

Flap approximated back and closed onsound bone.

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Post operative morbidity

Swelling.

Pain.

Limitation of mouth opening.Complications:

Secondary bleeding.

Dry socket.

Nerve damage.