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Osseous Surgery

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Osseous surgery is often recommended when pockets are too deep to clean with daily home care and a professional care routine.  Typically this is the case when pockets following scaling and root planning are still 5-6 mm in depth or greater.  During this procedure, after ensuring you are comfortably numb, our periodontist pushes back your gum tissue, allowing direct access to remove disease causing bacteria and calculus.  In most cases, irregular surfaces of the damaged bone are smoothed to limit areas where disease causing bacteria can hide.  This reshaping of the bone allows for the gum tissue to reattach to the tooth after healing at a lower level down the root surface, reducing the pocket depth and improving the health of the affected teeth.  Your gums are then gently placed back over the newly shaped bone and secured using dissolving stitches.  Typically no antibiotics are prescribed for this treatment and over-the-counter pain medication is sufficient for any post-operative discomfort.

Case Study

This 91 year-old gentleman was referred to our periodontist for evaluation of “deep pocket depths that didn’t shrink after scaling and root planing.” Although osseous surgery was completed in all four quadrants of his mouth, we will focus on the upper right quadrant.

Photos and measurements taken at initial appointment with our periodontist.

Osseous surgery was completed to reduce the 5-7 mm pockets and smooth out the defects, or holes, in the bone caused by periodontitis.  The photos below were taken 2.5 months following osseous surgery.  Notice the improved health of the gum tissue and shallower pockets surrounding his teeth.

These photos, x-rays, and periodontal charting were taken 2 years after surgery (at the patient’s periodontal maintenance appointment). Note that all pocket depths have remained less than 5 mm and the vastly improved gum health two years following osseous surgery.