Periodontal Surgery

Question 1

What are the aims of periodontal surgery?

Answer 1

1. Arrest disease by gaining access to complete RSD

2. Regenerate periodontal tissues

Question 2

What are the indications for periodontal surgery?

Answer 2

• Re-evaluation, >4 weeks after completing non-surgical phase
• Pockets >5mm persist
• Excellent OH

Question 3

What surgery is performed?

Answer 3

Open flap curettage (debridement)

Question 4

Outline the procedure

Answer 4

1. Flap design
2. Gingivae incision & flap retraction
3. Granulation tissue removed
4. RSD (hand or [powered)
5. Flap replaced and sutured

Question 5

What are the post-operative instructions given?

Answer 5

• CHX mw 1-2 weeks
• Analgesia
• AB if inficiated
• Remove sutures after 1 week
• Re-evaluate

Question 6

What are the possible bony defects?

Answer 6

aka vertical bone defect, angular bone defect

1. One bone wall
2. Two bone wall
3. Three bone wall

Question 7

How are infrabony defects managed?

Answer 7

1. Closed/ open RSD = healing by repair (re-attach long JE)
2. Pocket elimination wit ossesous resection = removing bone defect and moving gingiva apically
3. Regenerative techniques

Question 8

What are the disadvantages of pocket elimination surgery?

Answer 8

1. Unaesthetic
2. Exposed root sensitivity
3. Removal of supporting bone

Question 9

What is the ‘triad of tissue engineering’?

Answer 9

1. Scaffold
2. Signalling molecule
3. Cells