Abstract
Aims: To assess the clinical effect of different flap design that used in periapical surgery and theirrelation to untoward postoperative sequel. Materials and methods: Forty five patients were includedin the present study, they were divided randomly into three groups, each comprised of (15) patients. Inthe first group, apicectomy was done using intrasulcular triangular (2–sided) flap. Whereas, in thesecond group, a submarginal (Luebke–Ochsenbein) scalloped 2–sided flap was used. While in the thirdgroup, a new experimental (straight mucogingival) 2–sided flap was tested. Postoperative healing wasevaluated clinically in regard to oedema, alteration of soft tissue colour, recession of marginal gingiva,extent of scarring, and closure of the wound site. Assessment was done at 2, 7, 15 and 30 dayspostoperative intervals. Results: Comparison among the three study groups was performed. Statisticalanalysis revealed significant differences in the results of experimental flap over the other two types inregard to oedema, colour and wound closure with the superiority of the former on the latter flaps. Bothexperimental and Luebke–Ochsenbein flaps showed significant differences from intrasulcular incisionin their effect on gingival recession. In contrast, scarring was less evident in intrasulcular flap followedby experimental flap while in Luebke–Ochsenbein incision, this complication was significant.Conclusion: This study; however, revealed that the experimental flap allows for rapid and recessionfree healing following periapical surgery. In addition, inflammatory changes persist for longer time inthe intrasulcular and submarginal (Luebke–Ochsenbein) incision than in experemintal incision. So itwas concluded that the new flap design could provide an alternative.
Highlights
The ultimate goal in surgical endodontics is the eradication of periapical pathosis using properly designed flaps for the purpose of preserving the periodontal condition of the surrounding area following surgery (1)
Statistical analysis revealed significant differences among all groups with the best result obtained from experimental flap followed by Luebke–Ochsenbein, while intasulcular showed the worst results as shown in Table (3)
The selected modalities of flap design used in this study included two types of oral tissues that differ in their criteria and texture
Summary
The ultimate goal in surgical endodontics is the eradication of periapical pathosis using properly designed flaps for the purpose of preserving the periodontal condition of the surrounding area following surgery (1). Oral surgeons and endodontists always desire to improve methodology of this procedure by means of instrumentation, materials and different approaches to have a better success rate (2 –5)
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