Oral Surgery · single question
When designing an incision for a flap to surgically remove an impacted mandibular third molar (tooth #17), which principle is most important?
Show answer and explanation
Correct answer: A. The incision line must be supported by underlying bone (not over a void)
A fundamental principle of surgical flap design is that incision lines must rest on intact underlying bone when sutured. If the incision line is placed over a bony defect or void (such as the extraction socket), the wound margins are unsupported and may dehisce (break down), leading to poor healing, infection, and complications. For third molar surgery, the envelope incision along the external oblique ridge, with or without a mesial releasing incision (directed toward the buccal, not the tongue, to avoid lingual nerve injury), is designed so that margins rest on intact bone after the tooth is removed. A distal releasing incision is not routinely needed for #17 removal.