Periodontal Osseous Surgery

When you have periodontal disease, bone loss causes your gum tissue to become unsupported, creating pockets and gingival recession. As pockets become deeper due to further bone loss, bacteria and decay can destroy the tooth structure. Once the disease passes a certain point, the area can’t be properly cleaned through regular home care or traditional root planing and scaling.  

Inflamed gums before lead to a healthy tooth after osseous surgery

The Procedure

Osseous surgery (also called flap surgery or pocket reduction therapy) removes infected tissue and diseased bone, making the area easier to maintain. It also serves to prevent further damage from periodontal disease while you are under care.

The whole affected area, typically 1-2 quadrants, is treated at one time to minimize the chance of reinfection. During the surgery, the gum flap is lifted to expose the infected area.  As the periodontist inspects the exposed area, they may add bone particles to help regrow the bone structure around the tooth.

We use FDBA (freeze-dried bone allograft), often paired with a resorbable membrane (minimally-manipulated amnion chorion allograft tissue). FDBA offers the best integration of any bone graft material, except for an autograft (where a patient’s own bone is used from a second surgical site). Many dentists and periodontists use bovine (xenograft) or synthetic (alloplast) bone because they are less expensive. However, these materials do not offer the best chance of success or safety.

Gum pockets are reduced by removing the unhealthy bone and contouring the area. This allows the gum tissue to re-adhere to the teeth, making it easier for you and your hygienist to keep the area clean. Often, crown lengthening includes osseous surgery, when bone must be reshaped to expose enough tooth structure for a proper restoration.

What to Expect After Surgery

A side effect of this procedure is that your teeth will appear longer, and some gaps between your teeth may look larger. Sometimes a patient experiences temperature sensitivity following surgery, but this lessens over the healing time. You may be placed on a regular care schedule to return for more frequent cleanings that will prevent further disease and complications from developing. 

Benefits of Osseous Surgery

Periodontal surgery provides several long-term benefits to patients suffering from advanced periodontal disease:

  • Improved Oral Health: By eliminating deep periodontal pockets and diseased tissues, osseous surgery significantly reduces harmful bacteria, lowering the risk of future infections.

  • Easier Maintenance: Shallow gum pockets and reshaped bone structures make home care and professional cleanings more effective, promoting healthier teeth and gums.

  • Preservation of Teeth: By addressing the underlying bone loss and infection, osseous surgery helps prevent tooth loss and the need for future dental implants or prosthetics.

  • Overall Health Impact: Reducing periodontal inflammation can positively influence overall systemic health, potentially lowering the risk for conditions linked to periodontal disease, such as cardiovascular disease and diabetes complications.

  • Aesthetic Restoration: Osseous surgery can restore a more natural gum line by removing inflamed tissue and reshaping bone, improving the appearance of your smile. Tissue grafts or crown lengthening can restore a natural, healthy-looking gumline free of gum recession.

Post-Surgery Care and Maintenance

To ensure the best outcomes after osseous surgery, careful attention to your oral hygiene and follow-up care is essential:

Healthy beautiful smile from periodontal surgery and care

  • Pain and Discomfort: Mild discomfort is common after surgery and can typically be managed effectively with prescribed or over-the-counter pain medication. Applying ice packs intermittently for the first 24-48 hours can help manage swelling.

  • Diet and Lifestyle Adjustments: Initially, soft foods and gentle chewing are recommended to aid healing and prevent irritation at the surgical site. Avoiding smoking is crucial, as it impairs healing and increases infection risk.

  • Enhanced Oral Hygiene Practices: Your dentist or hygienist will instruct you on proper cleaning techniques during the healing phase, such as gentle brushing, using antiseptic mouthwash, and possibly employing special cleaning aids.

  • Regular Follow-Up Visits: Adhering to your prescribed maintenance schedule of professional cleanings and check-ups ensures sustained oral health, preventing the recurrence or progression of periodontal disease.