Removal of bacteria and necrotic tissue from the periodontal wound occurs predominantly during which phase of healing?

Correct answer: D. Inflammatory phase

• A. Incorrect. Haemostasis (minutes) is clot formation via platelet aggregation and the coagulation cascade — it seals the wound but does not remove bacteria.
• B. Incorrect. The proliferative phase (days 3–21) is characterised by fibroblast migration, collagen deposition, angiogenesis and epithelial migration — the wound is already clean by this point.
• C. Incorrect. Remodelling (weeks to months) converts type III collagen to type I and reorganises fibres along functional lines. No bacterial clearance occurs here.
• D. Correct. The INFLAMMATORY phase (roughly days 0–3) is when neutrophils and then macrophages migrate into the wound and phagocytose bacteria, debris and necrotic tissue. This debridement must be completed before the wound can progress. Clinically this is why scaling and root planing is the debridement step that initiates periodontal healing.