TOPIC: PERIODONTAL SURGERY

 📌 POINTS TO PONDER 

🔹Causes of excessive bleeding during surgery include laceration of large blood vessels, incomplete removal of granulation tissue, hypertensive patient, bleeding disorder patient and patient on anticoagulant therapy. 

🔹 If the surrounding tissue blanches, however, the suture is too tight, which may cause necrosis because of poor  vascularization. 

🔹 Hemostasis should be achieved before, and not by, the application of a dressing. The only clear indication for a dressing is to achieve tissue stasis, such as with a free mucosal graft, or to protect a clot over bone in the interdental denudation technique. Application of dressing is a matter of individual preference. 

🔹 The possible outcomes of surgical periodontal therapy are: Regeneration, new attachment, long junctional epithelium, root resorption or ankylosis and recurrence of pocket.

📣 Classification of periodontal surgery: 

A. Pocket reduction surgery:

🔺Resective: Gingivectomy, apically displaced flap and undisplaced flap with or without osseous resection.

🔺Regenerative: Flaps with grafts and membranes. 

B. Correction of anatomic/morphologic defects:

🔺Plastic surgery techniques to widen attached gingiva: 

– Epithelial grafts 

– Connective tissue grafts

🔺Esthetic surgery: 

– Root coverage 

– Recreation of gingival papillae

🔺Preprosthetic surgery techniques: 

– Crown lengthening 

– Ridge augmentation 

– Vestibular deepening

🔺Placement of dental implants: