Lesson 1Setting selection rationale: criteria for office, ambulatory surgery centre, or hospital operating room useOutlines reasons for picking clinic, day surgery centre, or hospital theatre, looking at patient health issues, numbing needs, infection chance, tools available, and emergency readiness for safe, smooth care.
Office setting indications and limitationsWhen to use an ambulatory surgery centerHospital operating room indicationsAssessing medical risk and ASA statusEmergency preparedness and equipment needsLesson 2Flap design options for mandibular molar surgery: envelope, triangular, and vertical releasing incisions with pros/consAnalyses flap making rules for lower back tooth surgery, comparing envelope, triangle, and side release cuts, stressing blood flow, reach, pull control, and how each affects after-surgery pain and ridge keeping.
Biologic principles of mucoperiosteal flapsEnvelope flap indications, pros, and consTriangular flap design and clinical usesVertical releasing incisions and limitationsFlap tension management and repositioningLesson 3Anaesthesia level decision: indications for local anaesthesia alone, local with IV sedation, or general anaesthesiaReviews patient, procedure, and body risk factors guiding numbing choice, comparing local alone, local with vein calming, and full sleep, including watch needs, airway care, and legal records.
Assessing patient anxiety and medical comorbiditiesIndications for local anesthesia aloneWhen to add IV sedation to local anesthesiaCriteria for choosing general anesthesiaMonitoring, recovery, and documentation needsLesson 4Formulating the final diagnosis: chronic periapical infection with buccal cortical thinning and proximity to inferior alveolar nerveExplains combining clinic, X-ray, and 3D scan data to confirm long-term root tip infection, check cheek bone thinning, and assess link to lower jaw nerve for safe surgery planning and outlook.
Key clinical signs of chronic periapical infectionRadiographic and CBCT features of cortical thinningMapping proximity to the inferior alveolar nerveDifferential diagnosis and endodontic vs surgical careRisk stratification and prognosis documentationLesson 5Ridge preservation techniques: socket graft materials (autograft, allograft, xenograft, alloplast), membrane types, and choice considerations given infection and cortical defectsExamines ridge keeping after infected tooth pull, comparing socket fill materials and cover types, timing with infection and bone gaps, and choice paths to keep bulk for later implants.
Assessing socket walls and defect morphologyAutograft, allograft, xenograft, and alloplast choicesResorbable versus nonresorbable membranesTiming of grafting in infected extraction sitesStrategies to maintain ridge width and heightLesson 6Tooth sectioning strategies: root separation patterns for mandibular molars, instrumentation, and minimising torque on nerveCovers root shape check, best split lines for lower back teeth, tool choice, controlled cutting steps, and ways to cut twist pass and machine stress near lower jaw nerve.
Radiographic evaluation of root morphologyDesigning root separation patterns by molar typeInstrumentation choice for precise sectioningTechniques to minimize torque on the nerveManaging fractured roots and difficult segmentsLesson 7Bone removal and access techniques: osteotomy planning, use of rotary instruments vs piezoelectric surgery, minimising cortical lossDetails pre-cut bone design, picking and ordering spinning vs vibration tools, water cooling, and ways to cut bone shell loss while getting good reach and sight for safe tooth removal.
Principles of osteotomy design and planningChoosing rotary versus piezoelectric devicesHandpiece control, irrigation, and heat reductionPreserving buccal and lingual cortical platesIntraoperative assessment of access and visibilityLesson 8Debridement of periapical lesion: curettage technique, removal of granulation tissue, culture/biopsy indicationsDescribes orderly cleaning of root tip lesions, scraping method, clearing growth tissue, handling cyst-like spots, and when to take samples or biopsies to guide germ-killing drugs and tissue checks.
Instrumentation for periapical curettageStepwise removal of granulation tissueHandling cystic and fibrous lesionsIrrigation protocols and hemostasisIndications for culture and biopsy samplingLesson 9Managing proximity to the mandibular canal during extraction: gentle traction, controlled apical curettage, and use of intraoperative CBCT or navigationFocuses on spotting high-risk canal nearness, using soft pull and wiggle, controlled root tip scraping, and signs for during-surgery 3D scans or guides to dodge nerve harm and handle surprise canal show safely.
Preoperative mapping of the mandibular canalAtraumatic luxation and traction techniquesControlled apical curettage near the canalUse of intraoperative CBCT and navigationManagement of suspected nerve exposureLesson 10Soft tissue management and closure: primary closure vs open healing, use of collagen membranes, suturing techniques to maintain ridge contourAddresses gum handling around pull and fill spots, comparing direct close vs open heal, collagen covers, gum stretch, and stitch methods that guard fills and keep ridge shape and tough gum.
Criteria for primary closure versus open healingFlap advancement and releasing techniquesUse of collagen membranes for coverageSuture selection and tension controlPostoperative soft tissue remodeling review
