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Oral Surgery · single question

Regarding incision flap design for removal of tooth #17 (lower left third molar), which is correct?

  1. Must end in bone (on attached gingiva)
  2. Must always use vertical incision
  3. Mesial incision towards tongue
  4. Incision should end in alveolar mucosa
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Correct answer: A. Must end in bone (on attached gingiva)

  • A. For a third molar surgical flap, the RELEASING INCISION must end in BONE (over attached gingiva/alveolar bone) — not in soft tissue mucosa. If the incision ends in unattached or mobile mucosa, it tears poorly and heals poorly. The envelope flap plus a mesial or distal releasing incision placed over bone provides the best access and healing.
  • B. Not all third molar extractions require a vertical releasing incision — the envelope flap (crestal/sulcular) is sometimes sufficient.
  • C. The mesial releasing incision for lower third molar extraction should extend BUCCALLY (not toward the tongue/lingual aspect). A lingual incision risks injuring the lingual nerve.
  • D. Ending in alveolar mucosa (unattached) causes tearing and poor healing. The incision must end on attached gingiva over bone.

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