Modified Widman Flap Surgery

Modified Widman Flap Surgery

Widman’s Flap Operation Objective

• To facilitate root instrumentation.
• To remove pocket lining.

Widman’s Flap Operation Indications

• Irregular bony contours
• Deep craters
• Pockets on teeth in which a complete removal of root irritants is not clinically possible
• Grade 2 or 3 furcation involvement
• Root resection/hemisection
• Intrabony pockets on distal areas of last molars
• Persistent inflammation in areas with moderate to deep pockets.

Widman’s Flap Operation Contraindications

• Uncontrolled medical conditions such as:
  • Unstable angina
  • Uncontrolled diabetes
  • Uncontrolled hypertension
  • Myocardial infarction/stroke within 6 months.
• Poor plaque control
• High caries rate
• Unrealistic patient expectations or desires.

Full Thickness Flap

It consists of the complete mucoperiosteum, i.e. surface epithelium, connective tissue and periosteum which are raised by a periosteal elevator. It is also called as mucoperiosteal flap.

• Dissection in full thickness flap is blunt.
• Full thickness flap heals by primary intention.
• Procedure is significantly easy.
• In full thickness flap there is no periosteal retention.
• Blood supply to flap is significant.
• Wide zone of keratinized gingiva is absent with full thickness flap.
• Possibility of elimination or reduction of periodontal pocket is present.
• Bleeding, postoperative swelling and postoperative pain and discomfort is less in full thickness flap.
• Possibility of flap penetration is less with full thickness flap.
• Augmentation of band of attached gingiva is possible by full thickness flap.

Full Thickness Flap Indication

It is used to expose the bone surface in osseous surgery.

Full Thickness Contraindications

• Area where treatment for osseous defect with mucogingival problem is not required.
• Thin periodontal tissue with probable osseous dehiscence and osseous fenestration.
• Area where alveolar bone is thin.