Endodontic flap design: analysis and recommendations for current usage

By Lubow RM, Wayman BE, Cooley RL.

Date: 01/1984
Journal: Oral Surg Oral Med Oral Patho

Summary: 

•Purpose: To correlate the available information about endodontic flaps and to propose the use of a simple, realistic flap design which will provide an esthetic result while adhering to the principles necessary for a successful endodontic flap

•Proposed Flap design:

•Straight-line horizontal incision which follow easily identifiable landmarks at the most apical extent of the facial gingiva.

•This type of incision will leave the maximum amount of interproximal gingiva untouched, directed apically to create a short bevel between the reflected flap and the remaining interproximal tissues.

•The flap is primarily a full thickness flap with dissection to bone.

•Vertical releasing incisions (one tooth away) are used to allow access to the root apex.

•The reflected flap should always be designed so that the apical base is broader horizontally than the coronal margin.

Most highlighted Results: 

Advantages:

1.The interdental papillae remain untouched and are not incorporated into the flap. 

2.The incisions is rapidly accomplished , easy to reflect, and easy to reposition.

3.The primary reflection is via a full thickness dissection.

4.The flap incorporates the maximum amount of surface keratinized tissue available.

5.The beveled incision along the interproximal regions allows a broad area of  flap re-adaptation at the incision line.

Disadvantages:

1.The use of a full thickness dissection with incorporation of the periosteum to the body of the flap will produce fenestrations or dehiscence.

2.The flap design involves the reflection of the gingival margin at the cervical region, there is a possibility that the esthetic result could be compromised at this area.