Flap Procedures

Periodontal flap procedures may be the most universal and commonly used of all periodontal surgical techniques. A flap is a section of gum tissue that has been freed from its underlying attachment in order to gain direct vision and access to the periodontal structures that are underneath. These periodontal structures are not normally accessible to the patient or dentist. The length and shape of the flap relate to the particular region of the surgery and the nature of the required treatment. An excellent analogy is that the procedure is like lifting the flap of an envelope to look at the contents, then closing the flap when done.

It is important to have healthy gums.  If you think a flap procedure might be for you, contact us soon.

Indications

Flap procedures are indicated in cases of periodontal disease with active or nonresponsive pockets that are too deep to be treated successfully with scaling, root planing, or curettage. The flap may be raised to treat one tooth, a sextant (six teeth), or a quadrant (eight teeth). The advantage of the flap procedure is the shorter treatment time needed due to the improved access to the affected area. The root surfaces can be seen directly for better and more accurate cleaning. Pockets can be selectively reduced, or regeneration of lost tissues can be attempted. Many times the flap procedure is used strictly for correcting soft tissue defects. At other times, when the damage is more severe, the flap is used to gain access to the hard periodontal supporting structures for osseous (bone) surgery. 

Procedures

Preoperative radiographs, clinical observation, and periodontal charting assist in planning which procedures are required during the flap procedure. However, none of these procedures give a direct view of the treatment site. Flap procedures are most often done by a periodontal specialist (a periodontist).  While the periodontist may have a specific treatment plan for treating the diseased areas, when the flap is raised, the method for treating your particular problem may be modified. It may involve regenerative procedures. Bone grafting with natural or synthetic bone may be done. Guided tissue regeneration (GTR) may be attempted. These procedures may be done separately or in conjunction with one another. Other options include direct scaling and root planing of calculus (tartar) that might exist and the reshaping of a bone in a particularly difficult area.

The procedure involves the use of a local anesthetic so there is no pain during treatment. After the procedure is done, there is normally little postoperative discomfort. Prescription medication may be provided to deal with this.  It is uncommon for surgical problems to arise after the flap is closed. Sutures will be used and a periodontal dressing (pack) may be placed for one week. After that time, the pack may be left off or reapplied, depending on your individual healing progress. Flaps normally heal quickly and well. Four to eight weeks after the procedure, the tissue appears normal. If indicated, further dentistry (fillings, crowns, etc.), can then be completed.

If you have any questions about periodontal flap procedures, please feel free to ask us at (512)250-5012.

-          Omni Dental Group