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Flap Design for Minor Oral Surgery
Flap Design for Minor Oral Surgery
Flap Design for Minor Oral Surgery
Flap Design for Minor Oral Surgery
Flap Design for Minor Oral Surgery
Flap Design for Minor Oral Surgery
Flap Design for Minor Oral Surgery
Flap Design for Minor Oral Surgery
Flap Design for Minor Oral Surgery
Flap Design for Minor Oral Surgery
Flap Design for Minor Oral Surgery
Flap Design for Minor Oral Surgery
Flap Design for Minor Oral Surgery
Flap Design for Minor Oral Surgery
Flap Design for Minor Oral Surgery
Flap Design for Minor Oral Surgery
Flap Design for Minor Oral Surgery
Flap Design for Minor Oral Surgery
Flap Design for Minor Oral Surgery
Flap Design for Minor Oral Surgery
Flap Design for Minor Oral Surgery
Flap Design for Minor Oral Surgery
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Flap Design for Minor Oral Surgery

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  • 1. Flap Design for Minor Oral Surgery Presenter: R1 鄭瑋之 Instructor: VS 陳靜容醫師 2012/2/24
  • 2. Stages of Operation
    • Retraction
    • Incision
    • Reflection
    • Bone removal
      • access
      • point of elevation
      • removal of obstruction
    • Tooth section
    • Delivery
    • Clean-up
    • Sew-up
    • Check-up
    • Follow-up
    • Write-up
  • 3. Principles of Flap Design
    • Local flap
      • outlined by a surgical incision
      • carries its own blood supply
      • allows surgical access to underlying tissues
      • can be replaced in the original position
      • can be maintained with sutures and is expected to heal
      • Used in oral surgical, periodontic, and endodontic procedures to gain access.
  • 4. Principles of Flap Design
    • Complications
      • Flap necrosis
      • Flap Dehiscence
      • Flap Tearing
      • Injury to Local Structures
  • 5. Principles of Flap Design
    • Base > Free margin
      • to preserve an adequate blood supply
      • unless a major artery is present in the base
    • Width of Base > Length of Flap*2
      • less critical in oral cavity, but length < width
      • a long, straight incision with adequate flap reflection heals more rapidly than a short, torn incision.
    • An axial blood supply in the base
    • Hold the flap with a retractor resting on intact bone to prevent tension.
    A. Flap necrosis
  • 6. Principles of Flap Design
    • The incisions must be made over intact bone
    • If the pathologic condition has eroded the buccocortical plate, the incision must be at least 6 or 8 mm away from it .
    • The incision is 6 to 8 mm away from the bony defect created by surgery.
    • Gently handle the flap's edges
    • Do not place the flap under tension
    • Do not cross bony prominences, ex: canine eminence
    B. Flap Dehiscence
  • 7. Principles of Flap Design B. Flap Dehiscence
  • 8. Principles of Flap Design
    • Envelope flaps
      • an incision around the necks of several teeth.
      • extends 2 teeth anterior and 1 tooth posterior .
    • If not provide sufficient access…
    • Vertical (oblique) releasing incisions :
      • extends 1 tooth anterior and 1 tooth posterior .
      • started at the line angle of a tooth.
      • carried obliquely apically into the unattached gingiva.
      • If cross the papilla  localized periodontal problems
    C. Flap Tearing
  • 9. Principles of Flap Design
    • Mandible : lingual n. & mental n.
    D. Injury to Local Structures
  • 10. Principles of Flap Design
    • Maxilla : greater palatine a. & nasopalatine n./a.
    D. Injury to Local Structures
  • 11. Principles of Flap Design Summary
  • 12. Types of Mucoperiosteal Flaps
    • Envelope/sulcular incision
    • Envelope with one releasing incision (three-corner flap)
    • Envelope with two releasing incisions (four-corner flap)
    • Semilunar incision
    • Y-incision
    • Pedicle flap
    Full-thickness mucoperiosteal flap
  • 13. Types of Mucoperiosteal Flaps Edentulous: at the crest of the ridge  removal of a mandibular torus 2 teeth anterior 1 tooth posterior 1. Envelope/Sulcular flap
  • 14. Types of Mucoperiosteal Flaps
    • Greater access in an apical direction, especially in the posterior aspect of the mouth
    1 tooth anterior 1 tooth posterior 2. Three-corner flap
  • 15. Types of Mucoperiosteal Flaps
    • rarely indicated
    1 tooth anterior 1 tooth posterior 3. Four-corner flap
  • 16. Types of Mucoperiosteal Flaps
    • to approach the root apex
    • avoids trauma to the papillae and gingival margin
    • useful for periapical surgery of a limited extent.
    • should not cross major prominences, ex: canine eminence
    4. Semilunar incision
  • 17. Types of Mucoperiosteal Flaps
    • removal of a maxillary palatal torus
    5. Y-incision
  • 18. Types of Mucoperiosteal Flaps
    • mobilizes from one area and then rotates to fill a soft tissue defect in another area.
    • closure of oroantral communications
    6. Pedicle flap
  • 19. Examples
  • 20. Examples
  • 21. Reference
    • Contemporary Oral and Maxillofacial Surgery , 4th Edition, Larry J Peterson, DDS, MS, Edward Ellis, III, DDS, MS, James R Hupp, DMD, MD, JD, FACS and Myron R Tucker, DDS
    • Peterson's principles of oral and maxillofacial surgery , Michael Miloro,G. E. Ghali,Peter Larsen,Peter Waite
    • An atlas of minor oral surgery: principles and practice , David A. McGowan
    • Manual of minor oral surgery for the general dentist , Karl R. Koerner
  • 22. Thanks for your attention!

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