2. The periodontal flap is the most commonly
employed procedure for eliminating moderate
and deep periodontal pockets
Accomplish :
Accessibility to root deposits
Eliminate or reduce pocket depth
Perform regenerative procedures
8. THE MODIFIED WIDMAN FLAP
RAMFJORD and NISSLE -- 1974
Establishes an intimate post-operative adaptation
of healthy collagenous CT to tooth surfaces
Provide access for adequate instrumentation
of the root surfaces
9. TECHNIQUE
Step 1: Internal bevel incision 0.5 โ 1 mm away
from the gingival margin โ alveolar crest
Step 2: Gingiva reflected โ periosteal elevator
10. Step 3: Crevicular incision from the bottom of
pocket to the bone
Step 4 : Interdental incision โ flap reflected
โ gingival collar removed
12. Step 6 : Adapt the facial and lingual interproximal tissue
closely so that no interproximal bone is exposed
during suturing
13. Step 7 : Direct sutures are placed
Covered with periodontal pack
14. PAPILLA PRESERVATION FLAP
Step 1: Crevicular incision is made around
each tooth with no incisions across
the interdental papilla
15. Step 2 : Lingual or palatal incision consists of a
semilunar incision across the interdental papilla
at least 5mm from the crest of the papilla
The preserved papilla can be incorporated into
the facial or lingual / palatal flap
Most commonly -- facial flap
16. Step 3 : Orban knife is then introduced into
this incision to sever oneโhalf to two - thirds
of the base of the interdental
papilla
The papilla is then dissected from the
lingual or palatal aspect and elevated intact
with the facial
flap
17. Step 4 :
The flap is reflected without thinning the tissue
18. Step 5: The gingival tissue is placed back in
position and sutured
