non-surgical periodontal treatment including root-planing, deep scaling, irrigation of periodontal pockets and subgingival curettage and all necessary scaling and polishing;

surgical periodontal treatment, including gingivectomy, gingivoplasty or removal of an operculum;

surgical periodontal treatment, including raising and replacement of a mucoperiostal flap, curettage, root planing and bone resection;

free gingival grafts;

sealant restorations;

pulpotomy;

apicectomy;

transplantation of teeth;

oral surgery including surgical removal of cyst, buried root, unerupted tooth, impacted tooth or exostosed tooth and alveolectomy;

soft tissue surgery in relation to the buccal cavity and lips;

frenectomy, frenoplasty and frenotomy;

relining and rebasing dentures including soft linings;

addition of tooth, clasp, labial or buccal flange to dentures;

splints (other than laboratory fabricated splints) in relation to periodontally compromised teeth and in connection with external trauma;

bite raising appliances (other than laboratory fabricated appliances);

permanent fillings in amalgam, composite resin, synthetic resin, glass ionomer, compomers, silicate or silico-phosphate, including acid etch retention, if delivered to less than 3 teeth in single course of treatment;

extraction of one or two teeth; and

endodontic treatment of any retained deciduous teeth.

permanent fillings in amalgam, composite resin, synthetic resin, glass ionomer, compomers, silicate or silico-phosphate, including acid etch retention, if delivered to 3 or more teeth in single course of treatment;

endodontic treatment of any permanent teeth, excluding molar teeth; and

extraction of three or more teeth.