Flap Surgery

 All the questions have been directly picked from Carranza 11th edition


 1.      The first incision in a periodontal flap surgery is

a.       Interdental incision

b.      Crevicular incision

c.       Reverse bevel incision

d.      Releasing incision

 

 


  Hint
✅🔑 

Ans: C

·         Internal bevel incision has also been termed the first incision because it is the initial incision in the reflection of a periodontal flap after crevicular (second) and interdental (third) incisions,

·         Internal bevel incision has also been termed as reverse bevel incision because its bevel is in the reverse direction from that of the gingivectomy incision.

·         The first three are also called a horizontal incisions.

 

2.      Not an objective of The internal bevel incision

a.       It  removes the pocket lining

b.      It  conserves the relatively uninvolved outer surface of the gingiva, which, if apically positioned, becomes attached gingiva

c.       It produces a sharp, thin flap margin for adaptation to the bone-tooth junction.

d.      It preserves papilla for esthetic purposes.

 

 


  Hint
✅🔑 

Ans: D

·         The 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

 

3.      An interdental incision is given with

a.       Kirkland knife

b.      #15 BP blade

c.       Orbans knife

d.      Periosteal elevator

 

 

 


  Hint
✅🔑 

Ans: C

·         Kirkland knife is used to give incision on the facial and lingual aspects of the teeth as well as the distal portion of the distal-most tooth.

·         Orbans knife is used for the interdental incision

·         The periosteal elevator is used for blunt dissection i.e. reflection of the full thickness mucoperiosteal flap.

 

 

4.      In case of an envelope flap

a.       An interdental incision is not made

b.      A crevicular incision is not given

c.       The interdental incision is given with orbans knife.

d.      Vertical releasing incisions are given.

 

 

 


  Hint
✅🔑 

Ans: C

If vertical incisions are not made, the flap is called an envelope flap.

 

 

 

5.      Not true about Vertical releasing incision

a.       Blood supply is compromised

b.      Should not extend beyond the mucogingival line

c.       If a single releasing incision is given, the flap is called a triangular flap and if two releasing incisions are given, the flap is called a rectangular flap.

d.      Vertical incisions in the lingual and palatal areas are avoided.

 

 

 


  Hint
✅🔑 

Ans: B

Vertical incisions must extend beyond the mucogingival line, reaching the alveolar mucosa, to allow for the release of the flap to be displaced.

 

 

 

6.      3 mm of alveolar bone is to be recontoured where the alveolar crest is located 3 mm below the crest of the gingiva. Which type of flap is recommended?

a.       Partial thickness flap

b.      Full thickness flap

c.       Combination of both

d.      Gingivectomy

 

 

 


  Hint
✅🔑 

Ans: C

A combination of full-thickness and partial-thickness flaps may be indicated to obtain the advantages of both. The flap is started as a full-thickness procedure, then a partial-thickness flap is made at the apical portion. In this way, the coronal portion of the bone, which may be subject to osseous remodeling, is exposed while the remaining bone is protected by the periosteum.

 



7.      Which of the following clinical findings has the greatest effect on the type of incision to be given in periodontal flap surgery?

a.       Frenal attachment

b.      Depth of the vestibule

c.       Amount of attached gingiva

d.      Probing depth

 

 

 


  Hint
✅🔑 

Ans: C

 



8.      Open flap curettage refers to

a.      Modified Widman flap

b.      Laterally displaced flap

c.       Apically repositioned flap

d.      Palatal flap

 

 

 


  Hint
✅🔑 

Ans: a Modified Widman flap

 



9.      Crater formation doesn’t occur with

a.      Papilla preservation flap

b.      Conventional flap

c.       Apically repositioned flap

d.      Modified Widman flap

 

 

 

Hint✅🔑 

Correct answer: a . Papilla Preservation flap

 

 

 

10.  The workhorse of periodontal therapy is

a.      Double papilla flap

b.      Apically repositioned flap

c.       Coronally displaced flap

d.      Laterally repositioned flap

 

 

 


  Hint
✅🔑 

Ans: b Apically repositioned flap

An apically displaced flap has a high degree of predictability and is known as the ‘’Workhorse ‘’ of periodontal therapy.

 

 

11.  Apically positioned flap is placed

a.      1mm coronal to crest of alveolar bone

b.      2mm apical to the crest of alveolar bone

c.       At crest of alveolar bone

d.      5mm coronal to the crest of alveolar bone

 

 


  Hint
✅🔑 

Ans: 2mm apical to the crest of alveolar bone

 

 

 

12.  The most frequently performed type of periodontal surgery is

a.      Modified Widman Flap

b.      undisplaced flap

c.       Apically displaced flap

d.      papilla Preservation flap

 

 


  Hint
✅🔑 

Ans: b. undisplaced flap

 

 

 

13.  Periodontal flap surgery is most difficult in

a.      Incisors (Facially)                

b.      Incisors(Lingually)

c.       Second molars (Facially)                               

d.      Second molars (distally)

 

 


  Hint
✅🔑 

Ans: d. Second molars (distally)

 

 

14.  Flap surgeries are mainly done to

a.      Correct mucogingival inadequacies

b.      Remove diseased granulation tissue

c.       Provide access to instrumentation

d.      Add bone support where it has been lost

 

 


  Hint
✅🔑 

Ans: C. Provide access to instrumentation

·         Flap technique provides adequate visibility and accessibility to root deposits.

 

 

 

15.  Which incision is not followed in flap surgeries?

a.      Crevicular

b.      Interdental

c.       Internal bevel

d.      External bevel

 

 


  Hint
✅🔑 

Ans: d External bevel

·         External bevel is given during gingivectomy.

 

 

 

16.  Which of the following must be performed first in the elimination of periodontal disease

a.      Mucogingival surgery

b.      Infrabony pocket therapy

c.       Gingivoplasty

d.      Apically repositioned flap

 

 


  Hint
✅🔑 

Ans: b Infrabony pocket therapy

 

 

 

17.  Periodontal surgery can be best performed

a.      One month after completion of the hygienic phase

b.      4weeks after completion of occlusal adjustments

c.       8 weeks after completion of the restorative phase

d.      Immediately after completion of the hygienic phase

 

 


  Hint
✅🔑 

Ans: a. One month after completion of the hygienic phase

 

 

18.  Which of the following flap does not reduce the pocket depth?

a.      Modified Widman flap

b.      Undisplaced flap

c.       Apically displaced flap

d.      Palatal flap

 

 


  Hint
✅🔑 

Ans: A

·         The modified Widman flap facilitates instrumentation for root therapy.

·         It does not attempt to reduce the pocket depth, but it does eliminate the pocket lining.

·         It is not intended to eliminate or reduce pocket depth, except for the reduction that occurs in healing by tissue shrinkage.

 



19.  Which of the following flap increases the width of the attached gingiva?

a.      Modified Widman flap

b.      Undisplaced flap

c.       Apically displaced flap

d.      Palatal flap

 

 


  Hint
✅🔑 

Ans: C

·         It preserves or increases the width of the attached gingiva by transforming the previously unattached keratinized pocket wall into attached tissue.

·         This increase in the width of the attached gingiva is based on the apical shift of the mucogingival junction, which may include the apical displacement of the muscle attachments.

 



20.    Internal bevel incisions for modified Widman flap is

a.       initiated at or near a point just coronal to where the bottom of the pocket is projected on the outer surface of the gingiva and directed apical to the crest of the bone.

b.      made as close to the tooth as possible, 0.5 to 1.0 mm and directed to crest of alveolar bone

c.       made 1 to 2 mm from the teeth and directed apical from the crest of the bone

d.      made 1 to 2 mm from the teeth and directed to the crest of the bone

 

 

 


  Hint
✅🔑 

ans: D

·         option A is for undisplaced flap

·         option B is for apically displaced flap

·         option C is a distractor for option D

 

 

 

21.  Modified Widman flap was given by

a.       Robiscek et al

b.      Ramfjord and Nissle

c.       Newmann

d.      Widman

 

 

 


  Hint
✅🔑 

Ans: B

·         1974 by Ramfjord and Nissle gave the “modified Widman flap

 

 

 

22.  Modified Widman Flap differs from the original one as

a.       No vertical releasing incision is given in the original one

b.      Osseous re-contouring is done in a modified Widman flap

c.       Blood supply is compromised in the original flap design

d.      Tooth Sensitivity is higher in the case of the modified Widman flap.

Ans: C

  Hint✅🔑 

Difference between Widman and modified Widman flap:

 


 

23.  The incision in the undisplaced flap

a.       Is similar to the modified Widman flap in that the soft tissue pocket wall is not removed with the initial incision in the undisplaced flap

b.      Is similar to the modified Widman flap in that the soft tissue pocket wall is removed with the initial incision in the undisplaced flap

c.       differs from the modified Widman flap in that the soft tissue pocket wall is removed with the initial incision in the undisplaced flap

d.      differs from the modified Widman flap in that the soft tissue pocket wall is not removed with the initial incision in the undisplaced flap.

 

 

  Hint✅🔑 

Ans: C

·         Hence may be considered an “internal bevel gingivectomy.”

·         The incision is usually carried to a point apical to the alveolar crest, depending on the thickness of the tissue.

·         The thicker the tissue is the more apical the ending point of the incision

 

 

 

24.  Not a use of apically displaced flap

a.       Widen the zone of keratinized gingiva

b.      Removal of the pocket wall

c.       Access to instrumentation

d.      Root coverage

 

 

 

  Hint✅🔑 

Ans: D

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