Deep periodontal pockets
Pocket depths greater than 5mm indicate that bacteria have penetrated beyond the reach of non-surgical cleaning. Surgery provides the access needed to fully debride these sites.
Osseous surgery removes infected tissue, smooths irregular bone surfaces, and reduces periodontal pocket depth — stopping the progression of advanced gum disease before teeth are lost.
Osseous surgery — also called bone surgery or flap surgery — is a periodontal procedure used to treat advanced gum disease (periodontitis) where bacteria have eroded the bone and tissue supporting the teeth. When scaling and root planing alone can't eliminate the infection in deep periodontal pockets, surgery provides direct access to the root surfaces and bone.
During the procedure, the gum tissue is gently folded back to expose the tooth roots and bone. Infected tissue is removed, irregular bone surfaces that harbor bacteria are smoothed (a process called osseous recontouring), and pocket depth is reduced. The gums are then sutured into place to promote a tighter, healthier fit around the teeth.
Osseous surgery doesn't just treat the symptom — it addresses the structural environment that allows bacteria to thrive and bone to deteriorate.
Not every case of gum disease requires surgery. Here are the clinical indicators that osseous surgery is the appropriate next step.
Pocket depths greater than 5mm indicate that bacteria have penetrated beyond the reach of non-surgical cleaning. Surgery provides the access needed to fully debride these sites.
Radiographic imaging showing horizontal or angular bone loss confirms that periodontal disease has progressed to the bone-destroying stage. Surgery halts further deterioration.
Scaling and root planing (deep cleaning) is usually the first line of treatment. If bacterial inflammation persists after a healing period, osseous surgery is the appropriate escalation.
Bone craters, ledges, and other irregular surfaces create environments where bacteria accumulate and are impossible to clean. Reshaping these surfaces improves long-term maintenance.
Every step of bone surgery at Minty Smiles is explained to you before it happens. Here's the full process.
The treatment area is thoroughly numbed with local anesthesia. IV sedation is available for patients who prefer a more relaxed experience.
The gum tissue is carefully folded back (a "flap") to expose the tooth roots and the underlying bone, allowing direct visual and physical access to the infection.
Infected soft tissue is removed, root surfaces are cleaned of bacteria and calculus deposits, and any irregular bone contours are smoothed to reduce bacterial harboring sites.
The gum tissue is repositioned and sutured snugly around the teeth. Detailed post-operative instructions and a prescription rinse are provided. A follow-up is scheduled for 1–2 weeks later.
Most patients return to desk work and light activity within 1–2 days. Full tissue healing takes 2–4 weeks, and bone remodeling continues for several months.
Treatments that frequently come up alongside bone surgery.