Periosteal Releasing Incision for Successful Coverage of Augmented Sites. A Technical Note
The periosteal releasing incision (PRI) is very common in intraoral surgical procedures, especially when flap advancement is indicated, that is, when vertical or horizontal augmentations take place. This technical note describes the surgical skills for sufficient flap advancement. Complications due to improper PRI are also discussed.Abstract
(a) Flap tension after augmentation before periosteal releasing incision. (b) Periosteal releasing incision. (c) Muscle release for a better flap advancement. (d) Coverage of the augmented site and wound closure. (e) Flap suturing.
(a) Surgical site in the posterior mandible. Observe the mental foramen. (b) Decortication of the mandible and lingual fixation of a collagen membrane. (c) Augmentation with BioOss and membrane fixation with tags. (d) Periosteal releasing incision of the buccal flap for flap advancement.
(e) Release of the mylohyoid muscle using the finger in the lingual area for sufficient closure. (f) Tension free closure immediately after augmentation. (g) Radiograph 3 months after surgery. (h) Clinical situation 3 months after surgery. Complete closure without any complications.
(a) Preoperative situation. (b) Flap elevation and access of the bony defect. (c) Augmentation with BioOss (big granules and autogenous bone), coverage with a collagen membrane and Gore-Tex membrane. Fixation with titanium tags. (d) Flap advancement and closure. (e) Lateral aspect of the advanced flap after suturing. (f) Excellent soft tissue without dehiscence 4 weeks after surgery.
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