All surgical intervention begins with the incision of the lining tissues, in the oral cavity the intervention begins with the removal of soft tissues or the completion of a flap to address the jaws.
The incision consists in opening the most superficial tissues to see the deepest ones, by means of mechanical procedures (such as the scalpel or scissors) or thermal procedures (such as the electrosurgery or the laser).
A flap is a portion of tissue, with its own vascular contribution, that the surgeon has designed to be able to comfortably access the operative field and because, once at rest, heal without difficulty. In the oral cavity, the most frequently used flaps are those of total thickness, that is, mucoperiosstics.
The incisions must be made with discharges, that is, with other vertical incisions, side and side, and distally to achieve a good flap irrigation and so that it does not tear.
The incisions to be made are conditioned by the anatomical characteristics, the type of pathology present and the approach.
What Types of Incisions Exist in Oral Surgery?
Depending on the layout of the incisions, the following flaps are distinguished:
- Sulcular incision
- Gingival or enveloping incision
- Triangular incision (partial Neumann)
- Trapezoidal Incision (Neumann)
- Adhered gum incision
- Modified Semilunar Incision
- Semilunar incision
- Linear incision
The sulcular ares incisions consist of making the incision in the area of the dental groove. This can be of three different types. The first, the gingival incision, consists in making the incision following the scalloped path of the gingival groove and the dental necks, without any discharge. The second, the triangular incision is also known as a partial Neumann incision, consists of making only one discharge per vestibular. Finally, the third type of incision, the trapezoidal incision or also called the Neumann incision , being the same as the previous one but in the trapezoidal incision two discharges are made by vestibular, one to mesial and another distal to the main incision.
The incisions in the gum attached are made in such a way that the incision is 2 millimeters above the gingival ridge, in the gum attached. A modified semilunar incision can be made which consists of a wavy horizontal incision in the gum attached or in the border area with the oral mucosa (2-4 millimeters from the gingival flange). The semilunar incision is made concavely towards the apical area. This can be done at any level of the mucosa, depending on the existing pathology. Finally, the linear incision, as the name implies, the incision is horizontal along the path of a straight line.