Osseous surgery, also known as pocket reduction surgery, is used to treat periodontitis, an advanced form of gum disease. In a healthy mouth, the gums fit snugly around the teeth, forming a seal that keeps bacteria and other debris from entering. The normal depth of the space between the gums and teeth is 1-3 millimeters.
When periodontitis develops, the gum begins to pull away from the teeth, and the depth of space between the gum and tooth increases, creating periodontal pockets. These pockets may become deeper due to inflammation or destruction of the bone that supports teeth. Periodontal pockets provide an ideal environment for bacteria to thrive because they are difficult to clean with brushing and flossing. Osseous surgery is performed to reduce the depth of these pockets and help eliminate the infection.
Purpose of Osseous Surgery
Osseous surgery, also known as pocket reduction or flap surgery, is used to treat moderate to severe periodontitis, where the depth of periodontal pockets exceeds 5 mm. The goal of osseous surgery is to reduce the depth of periodontal pockets and preserve the bone that supports teeth.
Gingivitis is the early stage of gum disease, which is caused by a bacterial infection. It is characterized by inflammation, redness, and bleeding of the gums. The early stage of gum disease can be reversed with professional teeth cleaning and improved oral hygiene habits. If gingivitis is left untreated, it can progress into periodontitis, which is a more advanced stage of gum disease.
Periodontitis causes jawbone destruction, gum recession, and pocket formation. If left untreated, periodontitis can become severe and cause tooth loss. The more severe the infection, the deeper the pockets become and the more bone destruction takes place. These deep pockets are treated with osseous surgery to help eliminate the infection and preserve the jawbone.
How Osseous Surgery Procedure is Performed?
Osseous surgery is performed under local anesthesia by a periodontist, a dentist who specializes in the treatment of gum disease. The procedure begins with an incision in the gum to raise a flap. This exposes the underlying bone and the tooth’s roots.
Then, the periodontist will perform scaling and root planing to remove bacteria, plaque, and tartar from the surface of the teeth and roots. Also, they will smooth out rough spots on the roots to make it more difficult for bacteria to accumulate and promote the reattachment of the gum to the tooth.
The next step in osseous surgery involves reshaping the jawbone. The periodontist will use various instruments like curettes or lasers to reshape and smooth damaged or irregularly shaped bone around teeth. This helps create a smooth surface for the gums to attach and form a tight seal.
In severe cases, the periodontist may need to perform a bone graft to replace the lost bone associated with periodontitis. Finally, the gums are repositioned and sutured back into place to promote healing.
It takes several weeks for osseous surgery recovery, during which time patients should follow their periodontist’s instructions closely to ensure proper healing.
The Procedure Step-by-Step
During osseous surgery, here’s what you can expect:
- The procedure is performed under local anesthesia
- The periodontist will make an incision in the gums to expose the bone
- The damaged or irregularly shaped will be smoothed by instruments like curettes and lasers
- In severe cases, a bone graft may be placed to help build up areas that have been damaged
- The gums will then be repositioned and sutured back into place
- Post-operative instructions will be given, including specific medications to take
Benefits of Osseous Surgery
Osseous surgery can have many benefits for patients suffering from moderate to severe periodontitis. This type of surgery can help to restore the gums, reduce pocket depths between teeth, and improve the esthetics of your smile.
Additionally, osseous surgery helps to reduce bacteria in the mouth, which can lower your risk of developing other diseases caused by oral bacteria.
If you are considering osseous surgery, your periodontist will be able to answer any questions you may have and help you decide if this type of treatment is right for you.
Recovery from Osseous Surgery
After osseous surgery, patients can expect some discomfort or pain that can be managed with prescribed medications. Swelling and minor bleeding are also normal. These side effects should resolve within a few days.
Patients may also find it difficult to eat and drink during the recovery period, so it is important to follow the periodontist’s instructions, including:
- Take the prescribed medications to manage pain and swelling.
- Apply an Ice Pack to your face, over the surgical area, during the first 24 hours after surgery.
- Eat soft foods for the first few days following surgery.
- Avoid smoking because it can delay healing.
- Avoid physical activity for the first few days after your osseous surgery.
- Avoid drinking from straws or spitting forcefully, as this may disrupt the healing process.
- Practice good oral hygiene, especially after osseous surgery, to promote healing. Use a soft-bristled toothbrush and gently brush your teeth twice daily.
- Rinse with warm salt water and anti-bacterial mouthwash after 24 hours.
- Keep follow-up appointments with your periodontist for checkups to ensure that the surgery was successful and that there are no complications.
Do I Need Osseous Surgery?
You may need osseous surgery if your periodontist finds that you have advanced periodontitis that has caused severe damage to the tooth-supporting bone and tissues. However, osseous surgery is just one of several possible treatments for gum disease.
Other treatments may be sufficient depending on the severity of your condition. Your periodontist will be able to assess your needs and recommend a suitable treatment, including:
- Scaling and root planing: This non-surgical procedure removes plaque buildup and smooths the surface of your teeth roots, making it harder for bacteria to re-colonize.
- Antibiotic therapy: Your periodontist may recommend antibiotics in combination with scaling and root planing to eliminate the infection.
- Soft-tissue grafts: If you have receding gums, your periodontist may recommend a soft tissue graft to cover exposed roots and restore gum tissue. You can read more about gum graft recovery.
- Guided tissue regeneration: In cases of severe bone loss, your periodontist may suggest regenerative techniques that stimulate your body’s own healing process to regrow healthy bone and tissue.
- Tooth extraction: If your teeth are too severely damaged to be saved, the periodontist may recommend extracting them and replacing them with dental implants.
When periodontitis develops, the gums begin to pull away from teeth, and the depth of the spaces between teeth and gums increases, creating periodontal pockets. These pockets provide an ideal environment for bacteria to thrive because they are difficult to clean. If left untreated, periodontitis leads to tooth loss.
Osseous surgery, also known as pocket reduction surgery, is a procedure used to treat moderate to severe periodontitis where the depth of periodontal pockets is more than 5 millimeters.
The procedure involves smoothing the damaged or irregularly shaped bone surrounding the affected teeth to reduce the pockets and eliminate areas where bacteria can accumulate. This helps promote healing, eliminate infection, and restore periodontal health.