Periodontology

Contraindications and Limitations

Gingivectomy

• Major Contraindication: When pocket bottom is apical to mucogingival junction
• Risk: Inadequate attached gingiva post-surgery

Curettage Protocol

• Prerequisite: Should always be preceded by scaling and root planing
• Rationale: Reduce bacterial load before surgical intervention

GTR (Guided Tissue Regeneration)

Membrane Placement Technique

• Apical Extension: 3-4mm apical to defect margin
• Lateral Extension: 2-3mm laterally beyond defect
• Objective: Exclude epithelial and connective tissue cells

Implant Considerations

Placement Guidelines

• Distance from Mental Foramen: ≥5mm to avoid nerve damage
• Primary Stability: Critical for osseointegration

Micro-movement Tolerance

• Critical Threshold: >150μm causes fibrous tissue formation instead of osseointegration
• Clinical Implication: Importance of proper implant stability