Mental Dental Perio Video 11 Flap

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Questions and Answers

What is the primary characteristic of a full thickness flap?

The flap is repositioned or displaced coronally or laterally

Only the mucosal tissue is raised

The flap is used for papilla management

The flap includes both mucosal tissue and periosteum (correct)

What is the indication for a full thickness flap?

When the alveolar bone is already thin

When you need access to the bone for osseous resection (correct)

For papilla management

When a grafting recipient site is required

What is the contraindication for a full thickness flap?

When papilla management is necessary

When the alveolar bone is already thick

When a grafting recipient site is required

When the alveolar bone is already thin (correct)

What is the primary characteristic of a partial thickness flap?

Only the mucosal tissue is raised, leaving the periosteum intact Signup and view all the answers

What is the purpose of a displaced flap?

To allow for the flap to be moved around Signup and view all the answers

What is necessary for a flap to be displaced?

The attached gingiva must be totally separated from the underlying bone Signup and view all the answers

What type of flap cannot be displaced?

Palatal flap Signup and view all the answers

What is the purpose of vertical incisions in a displaced flap?

To increase the mobility of the flap Signup and view all the answers

What is a displaced flap in dentistry?

When a flap is returned and sutured back in its original position Signup and view all the answers

What is the main advantage of conventional flaps?

It allows for more reflection Signup and view all the answers

What is a papilla preservation flap?

A flap that involves an incision around the papilla to save it Signup and view all the answers

What is the corona lead position flap used for?

To cover a recession defect for one or multiple teeth Signup and view all the answers

What is the main difference between a corona lead position flap and a laterally position flap?

The purpose of the flap Signup and view all the answers

What is the downside of conventional flaps?

It can lead to the formation of black triangles Signup and view all the answers

What is the purpose of the papilla preservation flap?

To save the papilla Signup and view all the answers

What is the laterally position flap also known as?

All of the above Signup and view all the answers

What is the main difference between the corona lead position flap and the papilla preservation flap?

The purpose of the flap Signup and view all the answers

What is the advantage of the papilla preservation flap?

It limits the formation of black triangles Signup and view all the answers

What is the benefit of using the epically positioned flap in Crown Lengthening procedure?

To preserve the attached gingiva without having to cut any off Signup and view all the answers

What is the primary function of the epically positioned flap?

To reduce or eliminate a pocket by atypically positioning the soft tissue wall Signup and view all the answers

What is the modified Widmann flap primarily used for?

To facilitate instrumentation for scaling and root planing therapy Signup and view all the answers

What is the result of using the modified Widmann flap over time?

The pocket shrinkage occurs as everything heals Signup and view all the answers

What is the purpose of the internal bevel or reverse bevel cut in the modified Widmann flap?

To remove the internal pocket lining and conserve the outer gingiva Signup and view all the answers

What is the difference between the undisplaced flap and the modified Widmann flap?

The undisplaced flap removes the entire pocket wall, while the modified Widmann flap does not Signup and view all the answers

What is the purpose of the circular or crevicular cut in the modified Widmann flap?

To make an incision through the base of the pocket to the alveolar crest Signup and view all the answers

Why is the undisplaced flap commonly performed in periodontal surgery?

To temporarily get the soft tissue out of the way in order to clean the root surface Signup and view all the answers

What is the difference between the undisplaced flap and the epically positioned flap?

The epically positioned flap is used for anterior esthetics, while the undisplaced flap is not Signup and view all the answers

What is the purpose of the interdental or interproximal cut in the modified Widmann flap?

To remove the collar of tissue around the tooth Signup and view all the answers

What is the main purpose of a connective tissue graft?

To improve root coverage for recession defects Signup and view all the answers

What is the deciding factor between atypically positioned and undisplaced flap?

The width of attached gingiva Signup and view all the answers

What is the donor site for a connective tissue graft?

The posterior hard palate Signup and view all the answers

What is the purpose of sutures in a grafting procedure?

To immobilize the graft onto the recipient bed Signup and view all the answers

What is the purpose of a semi-lunar flap?

For apico-ectomies and envelope for extractions Signup and view all the answers

What is the purpose of a modified Whitman flap?

To access for good quality scaling and root planing Signup and view all the answers

What is the tissue harvested in a connective tissue graft?

The lamina propria only Signup and view all the answers

What is the recipient bed prepared with in a connective tissue graft?

A split or full thickness flap with dissection beyond the mucogingival junction Signup and view all the answers

What is the main difference between the modified Whitman flap and the undisplaced flap?

The undisplaced flap takes more gingiva away Signup and view all the answers

What is the purpose of the distal wedge procedure?

To reduce the depth of a pocket after a wisdom tooth extraction Signup and view all the answers

What type of flap design is used in the semi lunar flap?

Crescent shaped incision in the alveolar mucosa Signup and view all the answers

What is the main advantage of the envelope flap?

It is quick and easy Signup and view all the answers

What is the purpose of a free gingival graft?

To widen the band of keratinized tissue around teeth Signup and view all the answers

What is the donor site for a free gingival graft?

The posterior hard palate Signup and view all the answers

What is the difference between the undisplaced flap and the modified Whitman flap in terms of technique sensitivity?

The modified Whitman flap is less technique sensitive Signup and view all the answers

What is the term for the site where the tissue is being placed in a grafting procedure?

Recipient site Signup and view all the answers

What is the purpose of measuring the depth of the pocket and the width of attached gingiva before carrying out an undisplaced flap?

To ensure enough attached gingiva is left behind Signup and view all the answers

What is the characteristic of the incisions in the distal wedge procedure in the mandible?

They are made to form a triangle Signup and view all the answers

Study Notes

Flap Classification

Flaps can be classified based on the amount of tissue content: full thickness (Muco-periosteal flap) or partial thickness (split thickness or mucosal flap)
Flaps can also be classified based on final placement: non-displaced or displaced
Papilla management: conventional or preservation

Full Thickness Flap

Also called Muco-periosteal flap
Lifts both mucosal tissue and periosteum
Indicated when access to bone is needed for osseous resection or modifying bone surface
Contraindicated in areas with thin alveolar bone

Partial Thickness Flap

Also called split thickness or mucosal flap
Lifts only mucosal tissue, leaving periosteum intact
Provides vascular bed for grafting recipient site
Used when attached gingiva needs to be preserved

Displaced Flaps

Involve vertical incisions to increase mobility and allow repositioning
Can be full thickness or partial thickness
Attached gingiva must be totally separated from underlying bone
Palatal flaps cannot be displaced due to absence of unattached gingiva

Papilla Management

Conventional: papilla is split between two adjacent teeth
Indicated when interdental space is narrow or extra reflection is needed
Downsides: formation of black triangles
Preservation: involves incisions around papilla to limit black triangle formation

Flap Designs and Applications

Corona lead position flap: displaced flap for covering recession defects
Laterally positioned flap: displaced flap for small single tooth recession defects
Epically positioned flap: displaced flap for pocket reduction and preserving attached gingiva
Modified Widman flap: for instrumentation during scaling and root planing therapy
Undisplaced flap: most commonly performed flap in periodontal surgery for temporarily removing soft tissue during surgery
Semi lunar flap: conservative flap design for apico-ectomies
Envelope flap: most commonly raised flap in oral surgery for tooth extractions
Distal wedge procedure: for reducing pocket depth distal to terminal molar

Grafts

Free gingival graft: used to widen band of keratinized tissue around teeth
Donor site: posterior hard palate
Recipient site: where graft is placed
Connective tissue graft: used to improve root coverage for recession defects
Donor site: posterior hard palate
Recipient site: prepared with split or full thickness flap with dissection beyond mucogingival junction

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Description

This quiz covers the different categories of flaps in oral surgery, including full thickness and partial thickness flaps, and their classification based on final placement and papilla management.