PONTILLAS, KYLA MAE D.
DMD 5Y1-1
Chapter 8: Principles of More Complex Exodonta
Principles of fap design.
• Local fap:
- Outlined by surgical incision - Replaced to the original positon
- Carries its blood supply - Oral surgery, peridontc and endodontc procedure
- Surgical access
Design parameters for sof tssue fap
Adequate exposure
Rapid healing.
• Parameters:
- Base of the fap broader than free margins
- Adequate size; visualizaton, access, retracton ithout tension, sharp incisions heals beter than torn incisions.
- Full thickness fap.
- Incisions must be made over intact bone.
- Flap should avoid injury to local vital structures. Mental nerve, palate.
Types of faps
• Enveloped fap • Semilunar fap
• Three-cornered fap • Subgingival fap
• Four cornered fap • Palatal faps
Enveloped flp
• Most common fap
• Sulcular incision.
• Edentulous patents; crest of the ridge, as long as required, refected buccally or lingually.
Three-cornered flp
, • Vertcal releasing incision
• Greater access, shorter envelop fap, apical area, posterior area.
• Prolonged healing, difcult to close.
Four cornered flp
• T o releasing incisions
• Substantal access.
• Rarely needed.
Semilunlr incision or flp
• Root apex
• Avoid trauma to the papillae and gingival margin
• Limited access
Palatal faps
• Y incision
• Pedicle fap
Technique for developing a Muccoperiosteal fap
• Incision; blade 15, scalpel handle no. 3, pen grasp.
• Posterior to anterior, in contact ith bone. One smooth stroke.
• Refecton start at the papilla.
• Muccoperiosteal elevator.
• Retractor.
Principles of suturing
The surgical or open extracton of an erupted tooth is a technique that should not be reserved for the extreme
situltion. A prudently used open extracton technique mly be more conservltive and cause less operltive morbidity
compared ith a closed extracton. Forceps extracton techniques, hich require great force, may result not only in
removal of the tooth but also of large amounts of associated bone and occasionally the foor of the maxillary sinus The
bone loss may be less if a sof tssue fap is refected and a proper amount of bone is removed; it may also be less if the
tooth is sectoned. The morbidity of fragments of bone that may be literally torn from the ja by the “conservatvee
closed technique can greatly exceed the morbidity of a properly done surgical extracton
Indicltions for Open Extrlction
DMD 5Y1-1
Chapter 8: Principles of More Complex Exodonta
Principles of fap design.
• Local fap:
- Outlined by surgical incision - Replaced to the original positon
- Carries its blood supply - Oral surgery, peridontc and endodontc procedure
- Surgical access
Design parameters for sof tssue fap
Adequate exposure
Rapid healing.
• Parameters:
- Base of the fap broader than free margins
- Adequate size; visualizaton, access, retracton ithout tension, sharp incisions heals beter than torn incisions.
- Full thickness fap.
- Incisions must be made over intact bone.
- Flap should avoid injury to local vital structures. Mental nerve, palate.
Types of faps
• Enveloped fap • Semilunar fap
• Three-cornered fap • Subgingival fap
• Four cornered fap • Palatal faps
Enveloped flp
• Most common fap
• Sulcular incision.
• Edentulous patents; crest of the ridge, as long as required, refected buccally or lingually.
Three-cornered flp
, • Vertcal releasing incision
• Greater access, shorter envelop fap, apical area, posterior area.
• Prolonged healing, difcult to close.
Four cornered flp
• T o releasing incisions
• Substantal access.
• Rarely needed.
Semilunlr incision or flp
• Root apex
• Avoid trauma to the papillae and gingival margin
• Limited access
Palatal faps
• Y incision
• Pedicle fap
Technique for developing a Muccoperiosteal fap
• Incision; blade 15, scalpel handle no. 3, pen grasp.
• Posterior to anterior, in contact ith bone. One smooth stroke.
• Refecton start at the papilla.
• Muccoperiosteal elevator.
• Retractor.
Principles of suturing
The surgical or open extracton of an erupted tooth is a technique that should not be reserved for the extreme
situltion. A prudently used open extracton technique mly be more conservltive and cause less operltive morbidity
compared ith a closed extracton. Forceps extracton techniques, hich require great force, may result not only in
removal of the tooth but also of large amounts of associated bone and occasionally the foor of the maxillary sinus The
bone loss may be less if a sof tssue fap is refected and a proper amount of bone is removed; it may also be less if the
tooth is sectoned. The morbidity of fragments of bone that may be literally torn from the ja by the “conservatvee
closed technique can greatly exceed the morbidity of a properly done surgical extracton
Indicltions for Open Extrlction
