Making Periosteal Releasing Incision (PRI) for coronal advancement of the buccal flap

Step 1: Raise a full-thickness flap on the buccal side to expose the entire defect.

Step 2: Hold the buccual flap with a tissue force and pull gently.

Step 3: Cut the periosteum 1 mm deep with a fresh 15 or 15C blade

Step 4: Make a superficial incision by moving the blade, without stopping, from distal to the mesial direction. The objective is cutting the tissue apically to the muco-gingival junction, to prevent from flap perforation, and coronally to the vestibular fornices. Move your blade with a “brushing movement”

Marco Ronda, M.D., D.D.S., Private Practice, Genova, Italy

Claudio Stacchi, D.D.S., M.Sc., Department of Medical, Surgical and Health Sciences, University of Trieste, Trieste, Italy