Periodontics › Surgery
General Principles of Periodontal Surgery
High-yield revision notes with linked practice questions, written for dental students and candidates preparing for the ADC and other licensing examinations.
High-yield notes
Patients is asked to quit or stop smoking for a minimum of 3 to 4 weeks after the surgical procedure.
The most common emergency is syncope, and the most common cause is fear and anxiety.
The most reliable means of providing painless surgery is the effective administration of local anesthesia.
Root planing falls under both phase I and phase II therapy.
Arteries vulnerable to damage during surgery/ incision are posterior mandible (lingual and inferior alveolar arteries) and the posterior, midpalatal regions (greater palatine arteries)
Minor areas of persistent bleeding from capillaries can be stopped by applying cold pressure to the site with moist gauze (soaked in sterile ice water) for several minutes.
Absorbable gelatin is absorbed in 4 to 6 weeks.
Oxidized cellulose is absorbed in 1 to 6 weeks.
Thrombin is intended for topical use only because it is applied as a liquid or powder. Thrombin should never be injected into tissues because it can cause serious, even fatal intravascular coagulation.
Fragments of calculus delay healing post surgically.
Tooth mobility is increased immediately after surgery, but it diminishes below the pretreatment level by the fourth week.
A common source of postoperative pain is overextension of the periodontal pack onto the soft tissue beyond the mucogingival junction or onto the frena.
Kirkland knife is kidney-shaped.
Electrosection, also known as electrotomy or acusection, is used for incisions, excisions, and tissue planing.
Electrosurgery is contraindicated for patients who have incompatible or poorly shielded cardiac pacemakers.
Larger and heavier curettes and sickles are often needed during surgery for the removal of granulation tissue, fibrous interdental tissues, and tenacious subgingival deposits. E.g. Prichard curette
Back-action chise (Rhodes chisel) is used with a pull motion, whereas the straight chisel (e.g., Wiedelstadt, Ochsenbein #1-2) is used with a push motion.
Practice questions
Select an option to check your answer. Answers are shown below each question.
Aim of scaling and root planing before periodontal surgery is
- Aeliminate some lesions entirely
- Brender the tissues more firm and consistent, thus permitting a more accurate and delicate surgery
- Cacquaint the patient with the office and the operator and assistants, thereby reducing the patient's apprehension and fear.
- DAll of the above
Prophylactic use of antibiotics in patients who are otherwise healthy
- AIs required for subgingival scaling
- BIs required for curettage procedures and root planing
- CIs required for bone grafting procedures
- DIs not required.
Periogard is
- ADiagnostic tool to detect microorganisms
- Bchlorhexidine gluconate
- Cused to measure GCF
- Dperiopack used to protect the gingiva after surgery
The simplest, least invasive method to alleviate anxiety in the dental office is
- ANitrous oxide and oxygen inhalation sedation
- BMidazolam sedation
- CLocal anesthesia
- DBenzodiazepine
Swelling after surgical procedures
- AThe swelling generally begins 1 to 2 hours after the operation and subsides gradually in 3 or 4 days.
- BThe swelling generally begins 1 to 2 days after the operation and subsides gradually in 3 or 4 days.
- CIf occurs, never apply moist heat over the operated area.
- DIs a warning sign of surgical failure.
Post surgical sensitivity to percussion is caused by
- ADeficient pack
- BExtension of inflammation into the periodontal ligament
- CTrauma to the periodontal ligament
- DAll of the above
True about Root hypersensitivity is
- Ahypersensitivity may increase the level of plaque
- Bplaque accumulation increases hypersensitivity
- Cboth are true
- Dnone
anesthesia of choice in hospital periodontal surgery is
- AGeneral Anesthesia
- BLocal Anesthesia
- CConscious sedation
- DOpioids
Interdental incision is given with
- AScalpel
- BKirkland knife
- CBP blade
- DMerrifield knife
electrosurgery or radiosurgery uses electrical (radio) currents in the range of
- A1.0-1.5 million cycles per second, or megahertz
- B10.5-17.5 million cycles per second, or megahertz
- C8.5-9.5 million cycles per second, or megahertz
- D1.5 to 7.5 million cycles per second, or megahertz
Loop electrodes in periodontal electrosurgery is used for
- AIncising
- BExcising
- CPlaning tissue
- DCoagulation procedures
Curettes used in surgery have
- ANarrower blades than those used for conventional scaling and root planing.
- BLess surface area than those used for conventional scaling and root planing
- CWider blades than those used for conventional scaling and root planing
- DNo blades.
These notes are compiled from standard periodontology texts for study purposes. They are a revision aid, not a substitute for your own reading or current clinical guidelines. If you spot an error, please leave a comment.