FOLLOW THE FOLLOWING CHART IN EVERY PERIODONTOLOGY CASE:
A. Nonsurgical debridement. IN EVERY CASE
B. Systemic antimicrobial therapy. WHERE MECHANOTHERAPY AND
SURGICAL PROCEDURES FAIL OR AS A
COVER IN CERTAIN CASES OR WHERE
THERE IS FEVER AND LYMPHADENOPATHY
OR CELLULITIS.
C. Extraction. IN COMPROMISED AND HOPELESS TEETH
D. Open flap debridement alone. The MWF is indicated for the treatment of all types
of periodontitis, but is especially effective with
pocket depths of 5–7 mm
E. Open flap debridement with It can be used for both pocket eradication as well as
apically positioned flap.
widening the zone of attached gingiva
F. Coronally positioned flap. To correct shallow gingival recession when an
adequate band of attached gingiva ( 3 mm or
greater) is present apical to the site of recession.
The major advantage of a coronally positioned
flap is predictable correction of gingival
recession (mainly because the flap has an intact
blood supply).
G. Laterally positioned flap. To widen an inadequate zone of attached
gingiva
To repair an isolated area of gingival recession
H. Free (autogenous) gingival In All Cases Where Root Coverage is Required and
graft. Esthetics is not a Major Concern.
I. Subepithelial connective tissue A lack of adequate donor tissue for a lateral sliding
graft. flap
The presence of root recession
The presence of isolated wide recession
The presence of multiple root recession
The presence of recession adjacent to an edentulous
area requiring ridge augmentation
The presence of recession in an area where
esthetics is often great concern
J. Guided tissue regeneration. One Tooth Recession, Three Walled Defects are the
Ideal Cases
K. Bone graft. Implants
Infrabony Defects
Furcation Involvement
Surgical Defects after Removal of Cysts
Segmental Bone Defects
L. Gingivectomy/gingivoplasty. Elimination of periodontal pocket 3-5 mm
Elimination of gingival enlargement
Asymmetrical or unaesthetic gingival
topography
Suprabony pockets which need access for
restorative dentistry
M. Distal wedge. For Removal of Excessive Soft Tissue Distal to the
Terminal Tooth in a Quadrant
N. Gingival curettage. Curettage can be performed in moderately deep
infrabony pockets located in accessible areas
where a type of ‘closed surgery’ is deemed
advisable.
Done to reduce inflammation prior to pocket
elimination using other methods or in patients in
whom surgical techniques are contraindicated
Shrinkage of localized areas of gingiva,
particularly interdental papillae which are
bulbous and lead to plaque retention and
accumulation
Curettage is frequently performed on recall
visits as a method of maintenance treatment for
areas of recurrent infection.