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F l a p d e s i g n i n p e r i a p i c a l s u r g e r y Fig. 4 Fig. 5 Fig. 6 Fig. 7 Fig. 8 Fig. 9 Fig. 4 Initial view before preparation of the triangular submarginal flap for periapical surgery of tooth #12. Fig. 5 Detachment of the triangular submarginal flap. Fig. 6 Clinical view showing the ostectomy for accessing the apex of tooth #12. Fig. 7 Clinical view of tooth #23 before surgery. Fig. 8 Detachment of the semilunar (Partsch) flap. Fig. 9 Intraoperative view after ostectomy to access the apex of tooth #23. The semilunar (Partsch) flap is a variant involv- ing submarginal incision in the alveolar mucosa to form a crescent- or semilunar-shaped flap. It is little used in periapical surgery because it affords limited surgical access to the root apex. Furthermore, owing to the presence of muscle fibers, flap tension is high, making suturing dif- ficult and increasing the risk of suture dehis- cence.6 The semilunar flap is almost exclusively used in application to the maxillary canines (Figs. 7–9).7 Care is required to avoid performing the incision above the bone defect. 2 . N e u m a n n f l a p w i t h i n t r a s u l c u l a r i n c i s i o n This flap offers perfect access for periapical sur- gery, with sufficient access to the affected bone and lesion-related roots.6 The intrasulcular inci- sion in turn may be triangular or trapezoidal. The most common intrasulcular flap involves a tri- angular incision with a single vertical releasing incision located distal and one or two teeth distal to the lesion. This flap is characterized by increased tension, the traction forces increasing 58 Volume 3 | Issue 3/2017 Journal of Oral Science & Rehabilitation