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Volume 42 , Issue 6
November/December 2022
Pages 753–759

Periosteum Classification and Flap Advancement Techniques Around the Mental Foramen

Istvan A. Urban, DMD, MD, PhD/Celia Sommer, DMD, MPH, MS/I-Ching Wang, DDS, MS/Hom-Lay Wang, DDS, MSD, PhD

PMID: 36305927
DOI: 10.11607/prd.5921

Various surgical flap advancement techniques for bone regeneration have been described in the literature; however, the clinical challenges of managing tissue that contains scars or embedded foreign materials have not been thoroughly described, especially around metal foramen. Fibrotic and thickened scar periosteum as well as mental foramen restrict the tissue from responding in the same way as native tissue. Therefore, additional considerations and approaches must be considered to achieve tension-free flap closure. This article presents a flap advancement classification that describes three common clinical scenarios based on the periosteum and soft tissue quality and provides surgical approaches for tissue management in each classification, with a focus on flap advancement around the mental foramen.

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