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SURGICAL TECHNIQUE
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1. Creation of mucoperiosteal flap.
2. Removal of bone / Tooth division.
3. Delivery of tooth / root portion.
4. Wound debridement or wound toilet.
5. Wound closure / Packing.
6. After care.
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ARMANTARIUM
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Incision and flap reflection
Different designs Envelope & 3 corner.
Anterior limb, posterior limb and middleportion.
Objectives are good exposure to operativefield, broad based with good blood supplyand close on sound bone rather on bonydefect.
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Commonly used Flap Designs
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Bone removal
Balanced but not un necessary.
Occ:, buccal & distal aspect.
Down to cervical line of imp tooth butvaries according to angulations, depth andmorphology of roots.
Bone should not removed from lingualaspect as danger to lingual nerve.
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Tooth sectioning
Depends on;
Direction of delivery of imp. tooth.
Angulations, depth and root pattern
(divergent roots).
Mesio angular, vertical, horizontal or distoangular.
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Wound toilet and closure
Debriment.
Bone trimming / filing
irrigation. Hemostasis bleeding points & brisk
ooze.
Flap approximated back and closed onsound bone.
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Post operative morbidity
Swelling.
Pain.
Limitation of mouth opening.Complications:
Secondary bleeding.
Dry socket.
Nerve damage.