1. LATERAL PEDICAL GRAFT

15. 3. V – shape incision is made About the exposed root With No. 15 scalpel blade 4. V – shaped incision removed. give a beveled incision on the opposite side Of the donor area to permit Overlap of flap

16. 5.coronal portion of pedicle Flap begun Preparation of donor site 6. Final dissection of the Pedicle is in apicoocclusal direction

17. Preparation of pedicle flap 7.flap is released & reflected, Exposing the underlying periosteum 8. If a full thickness flap were Raised the underlying bone Would have been exposed

18. 9. Tension is placed on the pedicle when the positioning is attempted 10. a releasing incision is made

19. 11. In partial thickness pedicle is sutured with periosteum Covering bone 12.cover aluminum foil And place a soft perio pack. Remove the pack and the suture after one week

22. preop Postop

24. B. suturing after rotation of the flap lip is retracted to immobilize the graft

25. For multiple teeth Tooth are easier to stabilize because of the increase size of the flap.(better blood supply )

26. Common reasons for failure 1.Tension at the base of the distal incision , corrected by use of releasing incision 2. Too narrow pedicle flap, care to be taken to have the Donor flap should be 1 1/2 Times wider

27. 3. Bone exposed resulting in the dehiscence, 4. Excessive movement because of poor stabilization

29. 2. V shaped incision over exposed root begun 3. V shaped beveled incision completed & partial thickness flap begun

30. Partial full thickness portion completed

31. Flap is sutured with overlap of the beveled incision

32. VARIANT TECHNIQUES Obliquely placed flap

34. CONCLUSION New techniques are constantly being developed and are slowly incorporated into periodontal practice. Critical analysis of newly presented techniques should guide our constant evolution towards better clinical methods.