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Principles of suture and flap design

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A lecture for 4th stage dentistry college (oral and maxillofacial surgery department )

Veröffentlicht in: Gesundheit & Medizin
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Principles of suture and flap design

  1. 1. principles of suture and flap design Dr.Mohammed rhael Tikrit dentistry college
  2. 2. Tips for Surgical skill  Knowledge of the basic principles of surgery  Knowledge of anatomy  training
  3. 3. Incision vs flap
  4. 4. Basic principles of incision in oral surgery  Use new sterilized blade ( number 15 )  Scalpel grasped in a pen grasp for maximum control and tectile sensetivity  The incision should be made at right angle to the undelying bone  The scalpel should moved in single constant firm movement
  5. 5. Basic principle of flap design Avoid anatomical structures The base wider than the apex Adequate width for maximum visualization The flap should be wider than anticipitaed bony defect Delicate handling of flap without tension Vertical releasing incision should start at buccal vestibule and end at the interdental papilla not at the buccal or labial surface .
  6. 6. Sites where vertical releasing incision contraindicated Transveres incision in palate Lingual incision of the mandible Canine eminence Between lower premolars
  7. 7. Three sided flap (trapezoidal flap)
  8. 8. Semilunar flap
  9. 9. Flap for palatal tori removal
  10. 10. Flap for oro-antral fistula closure
  11. 11. suturing
  12. 12. • Monofilament , multifilament • Absorbable , non absorbale • Natural ,synthetic
  13. 13. Absorbable sutures • Plain cutgut • Chromic cutgut • Polyglactin (vicryl) • Polydioxanone (PDS)
  14. 14. Non –absorbable sutures • Silk • Nylone • Polypylene (prolene )
  15. 15. Needles • Needle of 18 -26 mm in length are the suitable for oral surgery • According to suture side of the needle • Eyed , eyeless • According to the tip of the needle ¼ circle , ½ circle , 3/8 circle , 5/8 circle
  16. 16. • According to the cross section of needles • Needle with round or oval cross section • Needles with triangular cross section 9 cutting or reverse cutting )
  17. 17. Needle holder , tissue forcepse
  18. 18. Needle holder vs mosqueto
  19. 19. Basic principles of suturing • Non touch technique • Fewer number of suture as possible • From mobile to fixed tissue • 3-5 mm from margin and needle should enter at right angle to the mucosa • Avoid over tightening , overlapping of the wound • Undermine the incision to facilitate insertion of the needle and decrease tension • Suture removed after 5-7 days
  20. 20. Suture techniques • Simple interrupted suture • Continous suture ( locking or non locking) • Mattress suture • Figure of eight suturing
  21. 21. Video
  22. 22. Thank you for listening

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