The flap should be minimally reflected in order to expose the entire grafted site (Only one vertical cut should be performed no more than 2-3 mm into the mobile mucosa). Do not perform any horizontal periosteal dissection for release.
Prepare the site for grafting
Cement application
Apply the cement and press firmly for 3 seconds to adapt to the defect using sterile dry gauze.
If needed, apply an additional layer to obtain the desired volume (slightly overfill).
Press firmly with the dry sterile gauze for 3 seconds after each layer.
Press again with a periosteal elevator in order to compact and compress the cement well.
Flap Closure
Reposition the flap by stretching it directly above the cement for maximal closure (up to 2-3 mm of graft exposure is fine but not more than that).
Suture first the mesial corner, then distal, in between, and lastly the vertical aspect.
