Advancing periodontal disease can often leave a patient with deep pockets that, despite the best efforts of the patient to keep them clean, continue to worsen due to inaccessibility. Osseous surgery and pocket reduction are designed to allow the patient the accessibility needed for proper hygiene and maintenance of periodontitis. Osseous surgery is usually performed after diagnosis of periodontitis and following root scaling and planning. As the patient understands the cause and effect of periodontal disease and performs increasingly better home care, pockets that have not responded to therapy and continue to be an issue are most likely the result of inaccessibility and poor boney architecture.
The general procedure involves the use of local anesthetic for patient comfort. An incision is made in the affected area and the deep pockets are exposed. The boney architecture is evaluated for areas that make maintenance difficult. Once these areas are identified, the tissue and bone are “sculpted” to provide for easier access and maintenance. Sutures are placed and an intraoral bandage is positioned for comfort and healing. The sutures and bandage are removed in 7-10 days and complete healing occurs in about eight weeks. With easier access and proper maintenance, the advancement of the periodontal disease should be kept at bay.