A periodontal surgical procedure based on temporarily lifting the gum to gain direct access to the tooth root surface and the alveolar bone.
Indication
- Periodontal pockets of 6 mm or more that do not respond to non-surgical treatment (curettage)
- Advanced-stage chronic or aggressive periodontitis
- Teeth with furcation (root branching) involvement
- Irregular defects and infrabony pockets in the alveolar bone
- Need for root surface cleaning using the modified Widman flap technique
- Site preparation prior to periodontal regenerative treatment (graft, membrane)
Preparation
- Detailed periodontal examination and pocket-depth charting
- Periapical and panoramic radiographic assessment
- Initial therapy (scaling, curettage) and improvement of oral hygiene
- Systemic conditions (diabetes, heart disease) under control
- Planning the use of anticoagulants and antiplatelet medications with the relevant physician
How it's performed
- Local anesthesia is administered to the surgical site
- Surgical incisions are made along the gum and the flap is gently raised
- The root surface and alveolar bone are cleaned under direct vision; granulation tissue is removed
- Bone reshaping, graft placement, or membrane application is performed when needed
- The gum tissue is repositioned and sutured closed
- Techniques such as the modified Widman flap aim to minimize tissue loss
Post-procedure
- Sutures are removed after 7-14 days
- Avoidance of hard, hot, and spicy foods during the first week
- Use of chlorhexidine mouth rinse as recommended by the dentist
- Gentle oral hygiene at the surgical site for 4-6 weeks
- Periodontal evaluation and maintenance therapy at 3, 6, and 12 months
Risks
- Postoperative swelling, pain, and slight bleeding
- More noticeable gum recession and increased crown length
- Temporary tooth sensitivity (to hot and cold stimuli)
- Infection (rare) and delayed wound healing
- Temporary increase in tooth mobility
FAQ
Is there pain after flap surgery?
Mild to moderate pain may occur once the local anesthesia wears off. It is controlled with the prescribed pain relievers.
How long is the healing period?
Soft-tissue healing occurs within 2-4 weeks, while complete structural healing of the periodontal tissues takes a few months.
Will any teeth be lost?
The goal is to preserve the teeth. However, some teeth with advanced bone loss may require extraction during surgery.
Will the procedure need to be repeated?
With regular oral hygiene and maintenance therapy, repeat treatment is usually not needed. If hygiene is not maintained, the disease may progress.
Related Information
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Periodontal Curettage
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