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F l a p d e t a c h m e n t a n d r e t r a c t i o n i n p e r i a p i c a l s u r g e r y New perspectives in periapical surgery: Flap detachment and retraction Juan Cervera Ballester,a David Peñarrocha Oltra,b David Soto Peñalozaa & María Peñarrocha Diagob a Faculty of Medicine and Dentistry, University of Valencia, Valencia, Spain b Faculty of Medicine and Dentistry, University of Valencia, Valencia, Spain; Bellvitge Biomedical Research Institute, l’Hospitalet de Llobregat, Spain C o r r e s p o n d i n g a u t h o r : Dr. David Peñarrocha Oltra Unidad de Cirugía Bucal. Clínicas Odontológicas Facultad de Medicina i Odontología Universitat de València Gascó Oliag, 1 46021 Valencia Spain dpenarrocha@gmail.com H o w t o c i t e t h i s a r t i c l e : Cervera Ballester J, Peñarrocha Oltra D, Soto Peñaloza D, Peñarrocha Diago M. New perspectives in periapical surgery: Flap detachment and retraction. J Oral Science Rehabilitation. 2018 Mar;4(1):24–30. Abstract An update is made of the aspects to be taken into account during flap detachment and retraction in periapical surgery as one of the key ele- ments for treatment success. Raising of the flap and traction must be carried out firmly but gently in order to minimize trauma. This requires an adequate mucoperiosteal incision. Retraction separates the flap in order to facilitate access to and visibility of the bone without damaging the flap. The sulcus technique, described in apicoectomy of the mandib- ular premolars, allows safe stabilization of the retractor supported on the bone without harming the surrounding tissue. Such support can be complemented by placing a piece of dressing impregnated with epineph- rine to improve hemostasis and minimize damage to the flap. Adequate soft-tissue management not only results in a better postoperative course, with less pain and inflammation, but also guarantees optimum wound healing. Furthermore, an adequate flap design will produce more efficient surgery with a shorter operating time. K e y w o r d s Periapical surgery, flap detachment, flap retraction. 24 Volume 4 | Issue 1/2018 Journal of Oral Science & Rehabilitation