Endodontic Microsurgery Flap Design and Suture Method: A Review

Abstract

Apical surgery is an integral part of dentistry for saving a tooth with a periapical lesion that has not responded to previous endodontic treatments. Periapical microsurgical steps include local anesthesia, incision and surgical flap design, osteotomy, curettage of the lesion, root resection, staining of the resected root end surface, inspection of the resected root end, and ultrasonic preparation of the root end, retrograde filling of the prepared root end, and suturing. Gingival flap design and suture placement are important steps for surgical success. A full-thickness mucoperiosteal sulcular flap is a commonly used flap design. Singlestrand sutures with a 3/8 reverse triangle needle are recommended for suturing. Intermittent suturing and proximity of the incised gingival edges ensure better healing. In this review, we concentrate on flap design, and suture method to improve the success rate of surgery and prevent surgical complications.