Comparative Study Between Two Flaps—Trapezoidal flap (TZF) and Ocshenbein-Leubke Flap (OLF) in Periapical Surgeries

Abstract

The ultimate goal in surgical endodontics is not only the eradication of periapical pathosis but also preservation of periodontal tissues using suitable surgical techniques. Treatment outcomes are no longer acceptable without considering the esthetic consequences of all involved dentoalveolar structures. It is critical that incisions and tissue elevations and reflections are performed in a way that facilitates healing by primary intention. The large variety of flaps available for periapical surgeries reflects the number of variables to be considered before choosing an appropriate flap design. In this study; Ocshenbein-Leubke (OL) and trapezoidal (TZ) flaps have been compared in terms of their efficacy and comfort. Twenty patients of ASA category I, between the age group of 12-40 years were randomly selected to undergo periapical surgery by utilizing one of two flaps. All the subjects were free of periodontal disease. Demographic variables were found to be statistically similar. OL flap was found to be better than TZ flap with respect to time of flap reflection, accessibility, duration of surgery and post-operative pain. The OL flap takes less time for reflection with nearly the same accessibility, less post-operative pain and less complication as compared to TZ flap. We conclude that OL flap gives better results when compared to TZ flap.

Six-Month Soft Tissues Healing after Lower Third Molar Extraction: Comparison of Two Different Access Flaps

“…Based on these considerations, and distinctly from the previous two-month follow-up study [12], indexes of gingival inflammation, especially BOP, seem to assume importance for longer follow-up evaluations, as confirmed by other authors [16]. In this regard, BOP was demonstrated to increase more in the first molar site with TRAP, while more in the second molar site with DETP: this can be related to eventual excessive tissue manipulation in the first molar site in the case of the mesial-releasing incision of the TRAP design [28] to allow for easier flap mobilization.…”

“…As shown by this investigation, which presents a one-month and six-months analysis of data related to the periodontal indexes of PPD, VPI, BOP, REC, PPD, and CAL, regular and proper monitoring of soft tissue conditions [27] can represent an easy and non-invasive measure in disclosing and thus reducing the incidence of the abovementioned complications. Studies in the literature describing methods to avoid possible soft tissue inflammation are heterogeneous [25][26][27][28][29], evidencing the great interest of clinicians in improving patients' post-operative care.…”