title: Flap advancement: practical techniques to attain tension-free primary closure.
abstract: BACKGROUND
  Primary and tension-free closure of a flap is often required after particular surgical procedures (e.g., guided bone regeneration). Other times, flap advancement may be desired for situations such as root coverage.
  
  
  METHODS
  The literature was searched for articles that addressed techniques, limitations, and complications associated with flap advancement. These articles were used as background information. In addition, reference information regarding anatomy was cited as necessary to help describe surgical procedures.
  
  
  RESULTS
  This article describes techniques to advance mucoperiosteal flaps, which facilitate healing. Methods are presented for a variety of treatment scenarios, ranging from minor to major coronal tissue advancement. Anatomic landmarks are identified that need to be considered during surgery. In addition, management of complications associated with flap advancement is discussed.
  
  
  CONCLUSIONS
  Tension-free primary closure is attainable. The technique is dependent on the extent that the flap needs to be advanced.
authors.affiliation: Department of Periodontology and Implant Dentistry, New York University College of Dentistry, New York, NY.
authors.forename: Gary
authors.initials: G
authors.lastname: Greenstein
authors.forename: Benjamin
authors.initials: B
authors.lastname: Greenstein
authors.forename: John
authors.initials: J
authors.lastname: Cavallaro
authors.forename: Nicholas
authors.initials: N
authors.lastname: Elian
authors.forename: Dennis
authors.initials: D
authors.lastname: Tarnow
mesh_terms: D000700:Analgesics / Q000627:therapeutic use; D000900:Anti-Bacterial Agents / Q000627:therapeutic use; D000891:Anti-Infective Agents, Local / Q000627:therapeutic use; D000925:Anticoagulants / Q000627:therapeutic use; D003238:Connective Tissue / Q000637:transplantation; D004848:Epithelium / Q000637:transplantation; D005881:Gingiva / Q000637:transplantation; D006085:Graft Survival; D006801:Humans; D008334:Mandible / Q000473:pathology; D008437:Maxilla / Q000473:pathology; D009061:Mouth Mucosa / Q000637:transplantation*; D010159:Palate / Q000473:pathology; D010347:Patient Care Planning; D010521:Periosteum / Q000637:transplantation; D011183:Postoperative Complications; D019106:Postoperative Hemorrhage / Q000209:etiology; D019651:Plastic Surgery Procedures / Q000295:instrumentation / Q000379:methods*; D013524:Surgical Flaps / Q000145:classification / Q000473:pathology; D013536:Suture Techniques; D014945:Wound Healing
chemical_list: D000700:Analgesics; D000900:Anti-Bacterial Agents; D000891:Anti-Infective Agents, Local; D000925:Anticoagulants