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Fragiskos
155
Types of Flaps. The types of f laps used are vestibular fold (Fig. 7.103). In rare cases, when
triangular and horizontal: im- paction is deep and a satisfactory surgical
Triangular f lap: field is necessary or when the impacted tooth
The incision for creating the f lap begins at the covers the roots of the second molar buccally, then
max- illary tuberosity and extends as far as the the vertical incision may be made at the distal
distal as- pect of the second molar, continuing aspect of the first molar (Fig. 7.104).
obliquely up- wards and anteriorly (vertical
incision) to the
Fig. 7.103 a, b.
Diagrammatic
illustrations showing
the triangular incision
(a) and ref lection of
the f lap (b), indicated
in certain cases of
extraction of impacted
maxillary third molars
Fig. 7.104 a, b. Variation of the triangular incision of the incision is necessary due to the position of the third
and f lap shown in Fig. 7.103 (the vertical incision extends molar compared to the second molar
as far as the distal aspect of the first molar). The mesial
extension
Fig. 7.105 a,
b. Dia- grammatic
illustra-
tions showing the
horizontal incision
(a) and envelope f
lap (b), for removal
of impacted
maxillary
third molars
Fig. 7.106 a, b. a Radiograph showing a maxillary third molar with distoangular impaction. b Clinical
photograph of the case shown in a
Fig. 7.107 a, b. Triangular incision completed. a Diagrammatic illustration. b Clinical photograph
Fig. 7.108 a, b. Ref lection of the f lap and to protect the tooth from becoming accidentally displaced
exposure of the crown of the impacted tooth. Placement of into the infratemporal fossa or into soft tissues. a
the broad end of the periosteal elevator in the posterior Diagram- matic illustration. b Clinical photograph
position is indicated
Fig. 7.109 a, b. Luxation of the impacted tooth using double-angled elevator. Extraction movements depend
largely upon the relationship between the tooth and the maxillary sinus. a Diagrammatic illustration. b Clinical
photograph
Fig. 7.110 a, b. Final luxation of the tooth. a Diagrammatic illustration. b Clinical photograph
Fig. 7.111 a, b. Surgical field after placement of sutures. a Diagrammatic illustration. b Clinical photograph