Periodontal surgery
Consider surgery for selected persistent defects or access needs after good non-surgical care. Treatment choice depends on anatomy, prognosis and patient factors.
Understand
Surgery can improve access, reduce pockets or manage selected defects, but the objective and technique depend on anatomy and prognosis. It follows adequate non-surgical care.
Assess
Assess residual sites, morphology, plaque control, smoking, medical risk, aesthetics and tooth value. Consider whether regeneration is biologically plausible.
Apply
Discuss expected benefit, recession, sensitivity and maintenance. A technically successful flap without sustained self-care can still fail clinically.
Key distinctions
Surgical options include access, resective and regenerative approaches, each with different anatomy and trade-offs. Intrabony morphology, furcation class and soft tissue phenotype affect expected benefit. Surgery may improve access but can cause recession and sensitivity. It should follow a clear indication and a maintenance plan rather than serve as a substitute for patient-performed plaque control.
Think through a case
A residual intrabony defect is considered for regenerative surgery. Its anatomy, smoking status and home care affect the chance of a durable result.
The distinction to remember
Do not offer a technique by name without discussing recession, sensitivity, alternatives and long-term maintenance.
Test your recall
Why is plaque control a prerequisite?
Show answer
Poor control undermines healing and long-term stability.