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Osseous surgery, or flap surgery, is usually performed when periodontal pockets around a tooth (or teeth) have not responded to other treatments. Also known as pocket depth reduction, this procedure is performed in order to create a clean environment around the tooth so that it can be retained rather than lost. The goal of osseous surgery is to reduce or eliminate periodontal pocketing. Osseous surgery is generally recommended after other treatments have been explored and attempted, and is usually performed when pocket depths have worsened over time or have not responded to other therapies.
Before beginning the procedure, the area will be numbed using local anesthesia. An incision is made in the gum tissue around the area that will be treated. The gum is then lifted away from the tooth and the underlying bone so that there is direct access to the area. The surface of the tooth is then thoroughly cleaned of any plaque or tartar buildup. Next, the surface of the bone will be smoothed. Bacteria that are trapped in the pockets around the tooth can destroy bone tissue, making it uneven and rough. In order to ensure proper healing, smoothing the bone of these rough surfaces is necessary. Bone grafting procedures are sometimes performed if defects in the bone need to be filled.
After the root of the tooth has been cleaned and the bone smoothed, the gum tissue is then trimmed to match the new underlying structure and stitched into place. The stitches are placed to hold the gum tissue in the correct position as it heals.
After the procedure you may be prescribed a pain medication. Stitches will be removed in six to ten days unless dissolving stitches are used. About a month after surgery, an appointment should be scheduled to check on the healing of the area. Since some gum tissue is trimmed during the procedure, the tooth may appear longer in the mouth. This may cause increased sensitivity to hot or cold which can typically be managed through the use of sensitivity toothpaste.