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 mm in depth or greater. During this procedure, after administering anesthetic, the periodontist pushes back the gum tissue and removes 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. The gums are then placed back over the newly shaped bone and sutured in place. Typically no antibiotics are prescribed for this treatment and over-the-counter pain medication is sufficient for any post-operative discomfort.
Case Study 1
This 91 year-old gentleman presented on referral from his general dentist for “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 Dr Weiner
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.
Photos taken one year post surgery (at periodontal maintenance appointment)
These photos, radiographs (“x-rays”), and periodontal charting were taken two 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 after osseous surgery.