So where do we make our incisions for our flaps?
What I'm going to do now is, I'm going to show you a video that is going to outline exactly where we make those flaps and I'll be right back with you.
Here we'll discuss the landmarks for surgical extractions in dogs when we’re talking about flaps and sectioning. When we're demonstrating this on these skulls, what we're doing is showing you the outline of where the incision should go. Keep in mind, with the vertical and releasing incisions, they are a continuous incision but when we're working in the sulcus next to those teeth for our envelope incision, those are not continuous. Those are stab incisions about a 15 degree angle under the gum line to hit the bone and once you hit that bone you’re ready to move on to the next little section as you carry that forward or backward.
The first landmark here is that distal aspect of that third premolar right there at the line angle and we’re going to diverge that incision slightly to keep it out of the way of that root and not get too far up into that infraorbital foramen
For the envelope flap again, little stab incisions versus this continuous demonstration. Little stab incisions back starting at that third premolar and stopping there at the mesial aspect of that first molar, just going right on to that first part of that tooth.
Then there's your section for separation in vestibular and distal root.
There’s your section of the palatal root from the vestibular root and when you turn that over you look closely you can see the actual forcation.
There's gum tissue in that in the live patient.
For the canine tooth, the maxillary canine, we start in the diastema between the canine and incisor.
Carry that up and parallel to the tooth about to that level, which is about half the length of the root.
Then for our envelope incision, start right back there where you started the incision for the vertical release, go all the way back to the distal aspect of that third premolar.
That's the same approach for the mandibular canine as well. When you look at that, we start right next to that incisor. Carry that back, again little stab incisions all the way back, 15 degree angle with the scalpel.
We're going to stop this again at that third premolar.
For the mandibular first molar, we’re going to start at the mesial aspect of the fourth premolar there and again, little stab incisions back caudal until you get to the distal root of the second molar.
Then for sectioning, the easiest place to go making sure you're in the furcation, is right here just in front of that distal cusp.