Recent Advances In Periodontal Therapy Question And Answers

Recent Advances In Periodontal Therapy Question And Answers

Question 1. Define LASER. Describe its characteristics and classify LASERs.
Answer:

LASER is an acronym for “Light Amplification by Stimulated Emission of Radiation”.

Question 2. Write a note on the properties of lasers.
Answer:

A laser is a device that emits light through a process called stimulated emission, featuring

• Collimated (parallel) and
• Coherent (temporally and spatially constant)

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• Electromagnetic radiation
• Single wavelength.

When it reaches biological tissues, the laser light can be;

• Reflected
• Scattered
• Absorbed
• Transmitted to the surrounding tissues.

Question 3. Describe the types of lasers.
Answer:

• Solid state lasers: Neodymium : yttrium–garnet (Nd:YAG); Erbium:YAG (Er:YAG) laser
• Gas lasers—carbon dioxide (CO₂) laser
• Semiconductor—diode laser.

Question 4. What are the periodontal applications and advantages of laser?
Answer:

Calculus detection—Diode laser, Nd: YAG

Surgery

• Gingivectomy (CO2 laser)
• Frenectomy
• Subgingival debridement and curettage (Diode laser, Nd:YAG)
• Removal of gingival pigmentation (CO2 laser, Diode laser)
• Er: YAG, Er, Cr: YSGG—used for hard and soft tissue.

Advantages of LASERs

• Hemostasis
• Bactericidal effect
• Minimal wound contraction.

Question 5. What are the precautions during Laser use?
Answer:

• Use glasses for eye protection
• Prevent inadvertent irradiation
• Ensure high-speed evacuation
• Use wet gauze packs to avoid reflection from shiny surface.

Question 6. What is microsurgery?
Answer:

• Microsurgery is defined as a refinement in operative technique by which visual acuity is enhanced through the use of a surgical operating microscope.
• The microscope enables clinicians to use smaller needles, sutures, and instruments, and precisely position tissues, and stabilize the mending tissues. An operating microscope offers three distinct advantages to periodontal surgery:

1. Illumination
2. Magnification
3. Increased precision of surgical skills.

A variety of simple and complex magnification systems are available ranging from simple loupes to prism telescopic loupes and surgical microscopes.

Magnifiation Range of Surgical Loupes

• Range of magnifiation from 1.5X to 10X.
• Less than 2.5X is inadequate for the visual acuity necessary.
• More than 4.5X provides an adequate combination of magnification, field of view, and depth of focus.

Question 7. What are the advantages of microsurgery?
Answer:

• Microsurgical instruments minimize tissue trauma and create clean incision that enables wound healing by primary intention with less postoperative inflammation and less pain.
• Microscopy permits easy identification of ragged wound edges for trimming and freshening.
• Microsurgical wound apposition minimizes gaps or voids at the wound edges.

Question 8. Mention some procedures done under magnification.
Answer:

• Mucogingival surgery
• Root preparation
• Crown-lengthening procedures
• Minimally invasive surgery or minimally invasive surgical technique (MIS or MIST) refers to the regenerative surgical techniques using bone replacement grafts etc. that are done under magnification.
• The advantages of the procedure are that greater magnifiation allows for conservative flip elevation and thereby reduces postoperative morbidity.
• At the same time, greater visibility ensures thorough debridement and stable postoperative results. The disadvantages of the procedure are the cost associated with the equipment and the technique-sensitive nature of the procedure.

Question 9. What is piezosurgery? Describe its principle.
Answer:

• Piezosurgery was invented by the professor. Tomaso Vercellotti. Piezosurgery has been developed to overcome the limits of precision and intraoperative safety existing in traditional bone-cutting instruments.
• It enables high predictability and low morbidity in periodontal bone surgery.

Principle of Piezosurgery

• The piezoelectric effect was described by Jean and Marie Curie as certain crystals producing electrical current while under mechanical pressure. In reciprocal effect, the crystals are deformed when under electrical current. This is the effect being used by the Piezosurgery device.
• The principle of piezosurgery is ultrasonic transduction, obtained by piezoelectric ceramic contraction and expansion. In this device, the electrical field is located in the handle of the saw.
• Due to the deformation caused by the electrical current, a cutting—hammering movement is produced at the tip of the instrument. These micro-movements are in the frequency range of 25 to 29 kHz and, depending on the insert, with amplitude of 60 to 210 μm.
• This way only mineralized tissue is selectively cut. For cooling an in-built pump automatically washes the physiological solution to the area being cut, producing the cavitation phenomenon.

Question 10. What are the advantages and applications of piezosurgery in periodontal therapy?
Answer:

Advantages of Piezosurgery

• Selective cutting action—minimum soft tissue damage
• Very thin, precise, and effortless incisions, hence minimum surgical stress
• Acute tactile sense for the operator
• Maximum intraoperative visibility due to cavitation effect
• Limited risk of sinus membrane perforation
• Hemostatic effect
• Excellent tissue healing
• Less postoperative pain.

Indications of Piezosurgery

• Bone harvesting
• Osteotomy-osteoplasty
• Osteogenic distraction
• Ridge expansion (crystal splitting)
• Maxillary sinus lift
• Alveolar nerve decompression.