It is obvious from the foregoing that there are many technical approaches to periodontal surgery. The mere presence of a periodontal pocket of a cerain depth as the major indicator for surgery is not as steadfast as once believed. Other criteria such as hemorrhage and exudate must also be used in evaluating the need for surgery. The decision on which approach to use remains with the therapist and the individual situation which he/she is faced. However, in the past decade it has become increasingly clear that the need for so-called more advanced surgical procedures is not as important to the control of periodontal diseases as was once thought. Regardless, it is also clear that some form of surgical intervention, as defined by this paper, is still necessary to interrupt the sequence of events that make up the pathogenesis of periodontal disease that leads to eventual tooth loss. This paper has reviewed and evaluated some of the current procedures available to the therapist in the surgical approach to therapy.
Laparoscopic surgery also referred to as minimally invasive surgery describes the performance of surgical procedures with the assistance of a video camera and several thin instruments. During the surgical procedure, small incisions of up to half an inch are made and plastic tubes called ports are placed through these incisions. The camera and the instruments are then introduced through the ports which allow access to the inside of the patient.
The camera transmits an image of the organs inside the abdomen onto a television monitor. The surgeon is not able to see directly into the patient without the traditional large incision. The video camera becomes a surgeons eyes in laparoscopy surgery, since the surgeon uses the image from the video camera positioned inside the patients body to perform the procedure.
The human hand performs many functions during surgery that are difficult to reproduce with laparoscopic instruments. The loss of the ability to place the hand into the abdomen during traditional laparoscopic surgery has limited the use of laparoscopy for complex abdominal surgery on the pancreas, liver and bile duct.