Fugazzotto PA. The full-thickness mucoperiosteal flap procedure is the same as that described for the buccal and lingual aspects. Two types of horizontal incisions have been recommended: the internal bevel incision. Periodontal pockets in areas where esthetics is critical. The main disadvantage of this procedure is that healing in the interdental areas takes place by secondary intention. In this flap procedure, all the soft tissue, including the periosteum is reflected to expose the underlying bone. This approach was described by Staffileno (1969) 23. 61: Periodontal Regeneration and Reconstructive Surgery, 63: Periodontal Plastic and Esthetic Surgery, 55: General Principles of Periodontal Surgery, 30: Significance of Clinical and Biologic Information. The undisplaced (unrepositioned) flap improves accessibility for instrumentation, but it also removes the pocket wall, thereby reducing or eliminating the pocket. In the present discussion, we shall study in detail, the current concepts and advances in various periodontal flap surgeries. Pocket depth was initially similar for all methods, but it was maintained at shallower levels with the Widman flap; the attachment level remained higher with the Widman flap. Fibrous enlargement is most common in areas of maxillary and mandibular . As discussed in, Periodontal treatment of medically compromised patients, antibiotic prophylaxis is must in patients with medical conditions such as rheumatic heart disease. The local anesthetic agent is delivered to achieve profound anesthesia. The crevicular incision is then placed from the bottom of the pocket till the alveolar crest. Tooth movement and implant esthetics. ), Click to share on Twitter (Opens in new window), Click to share on Facebook (Opens in new window), Click to share on Google+ (Opens in new window), on 59: The Flap Technique for Pocket Therapy, Several techniques can be used for the treatment of periodontal pockets. Possibility of exposure of furcations and roots, which complicates postoperative supragingival plaque control. Contents available in the book .. The primary objective of the flap surgeries is to gain access to the root surfaces and bone defects so that the deposits on the root surfaces can be eliminated and the granulation tissue can be removed. After it is removed there is minimum bleeding from the flaps as well as the exposed bone. One incision is now placed perpendicular to these parallel incisions at their distal end.