Types Of Incisions

Write short note on internal and external bevel incisions.
Answer.

Internal Bevel Incision

The internal bevel incision is basic to most of the periodontal flap procedures.
It is also known as first incision as it is the initial incision in reflection of periodontal flap.
It is also known as reverse bevel incision as its bevel is in the reverse direction as compared to external bevel incision.
It is the incision from which the flap is reflected to expose the underlying bone and root.

Objectives of Internal Bevel Incision

It removes the pocket lining.
It conserves the relatively uninvolved outer surface of the gingiva, which, if apically positioned, becomes attached gingiva.
It produces a sharp, thin flap margin for adaptation to the bone-tooth junction.
The #11 or #15 surgical scalpel is used most often to make internal bevel incision.
Internal bevel incision starts from a designated area on the gingiva and is directed to an area at or near the crest of the bone.
The starting point on gingiva is determined by whether the flap is apically displaced or not displaced.

External Bevel Incision

External bevel incision is the choice of incision in surgical gingivectomy technique.
External bevel incision is given at an angle of 45° apical to the base of pocket with the help of Kirkland knife or blade no. 11 or 15 with Bard-Parkar handle no. 3 or angulated Blake’s handle.
The angle in this incision is beveled to 45° to tooth surface and should recreate the normal festooned pattern of gingiva. If in external bevel incision beveling is failed to 45° angle this leaves a broad fibrous plateau which takes more time than required to develop a physiologic contour.
Blade in this incision should pass fully through the tissue to the tooth in coronal direction.
External bevel incision should be as close as possible to the bone without exposing it so as to remove the soft tissue coronal to the bone.

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