**6.10 Partial-thickness flaps for ridge expansion**

This is a minimally exposed osteoperiosteal flap to overcome the limitation of full-thickness flap for the wide edentulous area when the resulting vascularity may jeopardize the outcomes (**Figure 22**).

Advantages


Limitations

**6.8 Double papilla preservation**

• More aesthetic results

good amount of tissues may be required

*Double papilla preservation with two vertical releasing incisions.*

*Mesially papilla preserved incision for implant bed preparation.*

• Vascularity may be compromised in the narrow space

aspect.

**214**

**Figure 21.**

**Figure 20.**

*Oral Diseases*

Advantages

Limitation

This flap is designed to preserve both mesial and distal papilla at the defect area. Two vertical incisions are performed and connected with lingual or palatal crestal incision, thus allowing the release of the mucoperiosteal flap toward the buccal

• Suitable for the second stage of implant surgery where the mobilization of a

• The bone is cut blindly; therefore, the surgeon must have a good conceptualization of the alveolar anatomy to not miss the midpoint of the

**Figure 22.** *Full ridge exposure using the full thickness flap buccally and lingually.*

alveolus. The surgeon should avoid extending to the vestibular depth or palatally directed osteotomy

• It is useful in patients with fixed prosthesis restorations because of less recession of the gingival margin and interdental papillae [17–19]

• It can leave a postsurgical scar if the repositioning sutures are not performed

The semilunar (Partsch) flap is a variant involving a submarginal incision in the

alveolar mucosa to form a crescent- or semilunar-shaped flap (**Figure 24**). The semilunar flap is almost exclusively used for the maxillary canines [21]. Care is

• Flap tension is high due to the presence of muscle fibers, making suturing

This flap involves intrasulcular incision in its triangular and trapezoidal versions and offers perfect access for periapical surgery, with sufficient access to the affected bone and lesion-related roots. The intrasulcular incision may be triangular or trapezoidal (**Figure 25**). The most common intrasulcular flap involves a triangular incision with a single vertical releasing incision located one or two teeth distal to the lesion (**Figure 26**). This flap is characterized by increased tension, and the traction forces increase especially at the fixed extremity. This technique allows for easy flap

difficult and increasing the risk of suture dehiscence [5, 22]

*Submarginal incision and two vertical incisions mesial and distal to the defect area.*

required to avoid performing the incision above the bone defect.

• Small incision suitable for upper canine surgery

• Limited surgical access to the root apex

repositioning after periapical surgery.

Limitation

**7.3 Partsch flap**

Advantage

Limitations

**7.4 Neumann flap**

**Figure 24.**

**217**

adequately [20]

*Flap Techniques in Dentoalveolar Surgery DOI: http://dx.doi.org/10.5772/intechopen.91165*

• Requires extensive flap dissection [17]
