Flap extension attained by vertical and periosteal-releasing incisions: a prospective cohort study

Objectives: To evaluate the effect of vertical and periosteal‐releasing incisions (PRI) on the extension of the buccal flap in a trapezoidal flap design. Material and methods: Thirty patients scheduled for implant surgery accompanied by bone augmentation were recruited. The amount of flap extension pulled with a minimal tension of 5 g using a dynamometer was measured before and after the first and the second vertical incisions (VI) and PRI. The results were compared based on gender, surgical site and operator's experience. Results: The first VI extended flap length by 1.1 ± 0.6 mm, 113.4% more compared with the original flap length. The second VI increased flap length by 1.9 ± 1 mm (124.2%), and the PRI significantly extended flap length by 5.5 ± 1.5 mm (171.3%) (P