Diversity of incision and flap design in periodontal regenerative surgery: clinical practice
10.3760/cma.j.cn112144-20250103-00003
- VernacularTitle:牙周再生手术切口与翻瓣设计的多样性和临床实践
- Author:
Zhen HUANG
1
;
Qingxian LUAN
1
Author Information
1. 北京大学口腔医学院·口腔医院牙周科 国家口腔医学中心 国家口腔疾病临床医学研究中心 口腔生物材料和数字诊疗装备国家工程研究中心 口腔数字医学北京市重点实验室，北京100081
- Publication Type:Journal Article
- Keywords:
Periodontitis;
Periodontal surgery;
Periodontal regeneration;
Papilla preservation technique
- From:
Chinese Journal of Stomatology
2025;60(8):846-856
- CountryChina
- Language:Chinese
-
Abstract:
This article reviews the recent advancements in incision and flap design for periodontal regenerative surgery, with a particular focus on the application of minimally invasive surgical techniques and non-crestal approaches. When applied to periodontal regeneration, traditional flap designs, such as the modified Widman flap, present disadvantages including wound dehiscence and gingival recession, compromising regenerative outcomes. To address these issues, researchers have developed a series of novel techniques, including papilla preservation techniques, minimally invasive techniques, and single-flap techniques. However, these techniques usually involve horizontal or oblique incisions near the interdental papilla adjacent to the intrabony defect, which may still lead to wound dehiscence, limiting periodontal regeneration. Also they may cause gingival recession and reduction in papilla height, resulting in "black triangles". In recent years, a series of new techniques utilizing non-crestal approaches have emerged, altering incision placement to preserve the interdental papilla. Examples include the entire papilla preservation technique using a lateral incision approach, non-incised papilla surgical approaching by an apical incision, and apically incised coronally advanced surgical technique. By placing incisions away from the papilla, these methods achieve complete papilla preservation and provide greater space for regeneration, effectively promoting the regeneration of both intrabony and suprabony periodontal tissues. This article systematically analyzes the key surgical points, indications, and clinical efficacies of different incision designs in periodontal regenerative surgery. Detailed case presentations illustrate the step-by-step procedures of these techniques, demonstrating their favorable outcomes in treating intrabony defects. The aim is to encourage future clinical studies to validate the effectiveness and safety of these novel techniques.
