Flap Design on oral surgery

 Flap Design on dentistry

ochsenbein-luebke flap
indication:

• prosthetic crown present
• periapical surgery: anterior region and longer root
• wide band of attached gingiva

Advantage:

• ease in incision and reflection
• enhanced visibility  and acces
• ease in repositioning
• maintain integrity of gingival attachment: prevent gingival recession, avoid dehiscences, and prevents crestal bone loss

Disadvantage:

• horizontal component disrupts blood supply
• vertical component crosses mucogingival junction and may enter muscle tissue
• difficult to alter it if size of lesion misjudge

Rectangular flap
Indication:

• Periapical surgery: multiple teeth, large lesions and long or short roots
• literally roots repairs: full-length root visualized 

Advantage:

• provides maximum access and visibility
• reduce retraction tension
• facilitates repositioning

Disadvantage:

• Reduce blood supply to flap
• increased incision and reflection time
• gingival attachment violated: gingival recession, crestal bone loss and may uncover dehiscence
• suturing is more difficult

Triangular Flap
Indication:

• midroot preparation repair
•  periapical surgery: posterior areas and short roots  

 Advantage:

• easily modified: small relaxing insicion, additional vertical insicion and extension of horizontal component
• easily repositioned
• maintains integrity of blood supply

Disadvantage:

• Limited acces and vicibility to long roots
• tension is created on retractin
• vertical insicion penetrates alveolar mucosa
• gingival attachment severed

Gingival Flap
Indication:

• cervical resorptive defects
• cervical area perforations
• periodontal procedure

Advantage:

• no cervical insicion
• ease of repositioning

Disadvantage:

•  limited access and visibility
• difficult to reflect and retract
• predisposed to stretching and tearing
• gingival attachment violated