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ePaper created 2017-10-13, 10:01:15 | version 1.38.0
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. 10 Fig. 11 Fig. 12 Fig. 13 Fig. 14 Fig. 15 Fig. 10 Clinical view before periapical surgery of tooth #21. Fig. 11 Detachment of a triangular flap with sulcular incision. Fig. 12 Intraoperative view after ostectomy. Fig. 13 Clinical view before periapical surgery of teeth #12 and 22. Fig. 14 Sulcular incision along the gingival margin of the teeth and two vertical releasing incisions distal to the canines. Fig. 15 Detachment of the trapezoidal sulcular flap. especially at the fixed extremity (Figs. 10–12). This technique allows easy flap repositioning after periapical surgery. A modification of this flap involves a trape- zoidal incision where a horizontal incision is made over the interdental papillae and along the neck of the teeth. Furthermore, two vertical releasing incisions are made on either side of the flap (leaving one or two teeth outside the lesion as a safety margin; Figs. 13–15). The important inconvenience of this technique is that post- operative gingival recession can occur—with a strong esthetic impact in the case of surgery of the anterior maxillary segment.3, 5, 8 3 . F l a p w i t h i n c i s i o n a t t h e b a s e o f t h e p a p i l l a e This flap was originally described by Velvart9 and is characterized by a horizontal incision fol- lowing the dental sulcus along the neck of the teeth and extending to the base of the papillae. The latter is left adhered for posterior suturing of the flap. A vertical releasing incision is more- Journal of Oral Science & Rehabilitation Volume 3 | Issue 3/2017 59