Principles of Oral Surgery – Optimal Incision Design
In this latest episode in the ongoing series of presentations on oral surgery for GPs, Dr. John O’Keefe, Director of Knowledge Networks CDA, welcomes back Dr. Keyvan Abbaszadeh to unpack the concept of incision design.
Highlighting the importance of the surgical incision in setting the overall tone for the procedure that follows, Dr. Abbaszadeh walks through a series of case studies and shares his best practices on how to best optimize the cut.
“We need to make sure we do not compromise good surgical work by having an incision that is inadequate or inappropriate.”
Principles of Incision Design
- Extend at least one tooth beyond the tooth you are working on
- Incision should give full visualization
- Broad based design with a good blood supply
- Use full thickness flap
- Incise on sound structure and avoid osseous defects
- Avoid anatomic structures such as the greater palatine bundle and the incisive canal in the maxilla, and the lingual nerve, the long buccal nerve, the submandibular duct and the mental nerve in the mandible.
- Use #15 blade scalpel
- Maintain a firm, continuous stroke – avoid “sawing” motion
- Cut with the belly of the blade
- Incise at 90° to the surface
- Proper placement is key – important to preserve keratinized tissue
- A small flap can be a big mistake - an adequate flap gives good visual field and room to work
- Incise sharply to the bone and avoid papillae and mid-facial gingival margin
We hope you find the conversation useful. We welcome your thoughts, questions and/or suggestions about this post and other topics. Leave a comment in the box below or send us your feedback by email.
Until next time!
CDA Oasis Team