Modified Periosteal Releasing Incision for Flap Advancement: A Practical Technique for Tensionless Closure

Primary closure of tensionless flap advancement is required during a guided bone regeneration (GBR) procedure. The periosteal releasing incision (PRI) is a commonly used technique for flap advancement. However, excessive use of the PRI technique to gain major flap advancement has consequences, such as swelling, paresthesia, bleeding, and patient discomfort. This case report describes a novel technique, the modified periosteal releasing incision (MPRI), which involves a shallow incision and lateral stretching approach for flap advancement. Case Presentation: A 63‐year‐old non‐smoking white male presented for implant placement in the posterior mandibular area. Vertical and horizontal bone augmentation using the GBR technique was planned before implant placement because of ridge deficiency. MPRI was used for flap advancement. The flap advancement achieved was >10 mm. Using this technique, a major flap advancement was possible without mental nerve complications. Conclusions: The MPRI technique introduced in this case report was used successfully when major flap advancement was needed to gain primary closure. The technique can be an alternative to the PRI technique when there is a possibility of damaging the nerve or when flap advancement made by PRI is inadequate, particularly around the mental foramen.