Changes

==Flap Operations With or Without Osseous Surgery==

==Flap Operations With or Without Osseous Surgery==

Flap procedures can be used in all cases where surgical treatment of periodontal disease is indicated. These procedures can be performed with or without osseous surgery. Flap procedures are particularly useful where periodontal pockets extendbeyond the mucogingival junction, the furcation is involved and/or recontouring of bony lesions is required.  

Flap procedures can be used in all cases where surgical treatment of [[Periodontal Disease|periodontal disease]] is indicated. These procedures can be performed with or without osseous surgery. Flap procedures are particularly useful where periodontal pockets extend beyond the mucogingival junction, the furcation is involved and/or recontouring of bony lesions is required.  

 

The advantages of flap operations include:  

The advantages of flap operations include:  

*Existing keratinized gingiva is preserved.

*Existing keratinized [[gingiva]] is preserved.

*There is increased visualization of the defect and enabling thorough debridement of dental deposits and inflamed soft tissues.

*There is increased visualization of the defect and enabling thorough debridement of dental deposits and inflamed soft tissues.

*The marginal bone is exposed, whereby the morphology of bony defects can be identified and the proper treatment carried out.

*The marginal bone is exposed, whereby the morphology of bony defects can be identified and the proper treatment carried out.

*The flap can either be replaced at its original position or shifted apically or coronally, thereby making it possible to adjust the gingival margin to the local conditions.  

*The flap can either be replaced at its original position or shifted [[Dental Terminology|apically or coronally]], thereby making it possible to adjust the gingival margin to the local conditions.  

*The flap procedure preserves the oral epithelium.

*The flap procedure preserves the oral epithelium.

The design of the periodontal flap will depend on the type of pocket. The most common flap used in veterinary oral surgery is usually a full flap, or one with vertical releasing incisions allowing for increased exposure, but considered more invasive. Another commonly used flap for periodontal surgery is the envelope flap. This is created along the arcade, without vertical incisions.

The design of the periodontal flap will depend on the type of pocket. The most common flap used in veterinary oral surgery is usually a full flap, or one with vertical releasing incisions allowing for increased exposure, but considered more invasive. Another commonly used flap for periodontal surgery is the envelope flap. This is created along the arcade, without vertical incisions. Periodontal flaps are typically made full thickness, which means the periosteum is released from the underlying hard tissue and kept with the flap.

Periodontal flaps are typically made full thickness, which means the periosteum is released from the underlying hard tissue and kept with the flap.

====Envelope Flap:====

'''Envelope flap:''' The sulcal incision is different from any other incision used in the oral cavity because the incision not only releases the gingiva from the underlying hard tissues but also excises the diseased pocket epithelium and granulation tissue. Furthermore, the sum of these incisions used to create the flap, creates a sharp marginal edge of the resulting flap, which allows for better apposition when it is replaced.  

The sulcal incision is different from any other incision used in the oral cavity because the incision not only releases the gingiva from the underlying hard tissues but also excises the diseased pocket epithelium and granulation tissue. Furthermore, the sum of these incisions used to create the flap, creates a sharp marginal edge of the resulting flap, which allows for better apposition when it is replaced.  

The extent of the flap should always be determined prior to any incision and all teeth in the area affected and needing treatment should be involved from the beginning to allow for a smooth incision. In most cases, carrying the incision a little mesial and distal of the target tooth is necessary for adequate visualization and access .

The extent of the flap should always be determined prior to any incision and all [[Teeth - Anatomy & Physiology|teeth]] in the area affected and needing treatment should be involved from the beginning to allow for a smooth incision. In most cases, carrying the incision a little mesial and distal of the target tooth is necessary for adequate visualization and access .

   

   

The full flap is created when further exposure is necessary or the flap is to be repositioned (coronally, apically, or laterally). It is a more invasive procedure with increased complication potential (e.g., hemorrhage and dehiscence) and therefore should not be performed when an envelope flap is sufficient.

The '''full flap''' is created when further exposure is necessary or the flap is to be repositioned (coronally, apically, or laterally). It is a more invasive procedure with increased complication potential (e.g., hemorrhage and dehiscence) and therefore should not be performed when an envelope flap is sufficient.