Making a Periosteal Releasing Incision (PRI) for Coronal Advancement of the Buccal Flap

Making a Periosteal Releasing Incision (PRI) for Coronal Advancement of the Buccal Flap

Clinical technique note

A periosteal releasing incision is a surgical technique used to help advance the buccal flap for tension-free closure. This content is intended for trained dental and surgical professionals and should be applied only with proper clinical judgment.

PRI technique overview

  1. Raise the flap: Raise a full-thickness flap on the buccal side to expose the entire defect.
  2. Stabilize the flap: Hold the buccal flap with tissue forceps and apply gentle traction.
  3. Begin the release: Cut the periosteum approximately 1 mm deep using a fresh 15 or 15C blade.
  4. Advance the flap: Make a superficial releasing incision with a continuous brushing movement from distal to mesial. The goal is to allow coronal flap advancement while reducing the risk of flap perforation.

Important surgical reminder

The objective is to gain flap mobility while preserving tissue integrity and avoiding perforation. Technique, incision depth, flap thickness, tissue quality, and defect anatomy should all be evaluated by the clinician during the procedure.

Periosteal releasing incision for buccal flap advancement

Source attribution

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

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