Osseous surgery, also known as pocket reduction surgery, is a dental procedure designed to treat advanced gum disease. It involves reshaping the bone that supports the teeth and removing infected gum tissue. The primary goal of this surgery is to eliminate deep spaces, often called pockets, that form between the teeth and gums where harmful bacteria can accumulate. By reducing the depth of these pockets, osseous surgery helps create an environment conducive to better oral hygiene and gum health.
Why Osseous Surgery Is Needed
Osseous surgery becomes necessary when gum disease, specifically periodontitis, has progressed beyond non-surgical treatment. Periodontal disease begins with gingivitis, an inflammation caused by plaque buildup. If untreated, gingivitis can advance to periodontitis, where bacterial infection spreads below the gum line, destroying supporting bone and tissues.
This progression forms periodontal pockets, deepened spaces between teeth and gums. These pockets are difficult to clean, creating a breeding ground for bacteria that further damage bone and connective tissues. Continued bone loss can lead to loose teeth and eventual tooth loss. Osseous surgery addresses these deep pockets and bone irregularities, preventing further disease and preserving affected teeth.
Performing Osseous Surgery
Osseous surgery is performed by a periodontist, a dental specialist focusing on gum health and supporting tooth structures. The procedure begins with local anesthesia to numb the area, ensuring patient comfort. Once numb, the periodontist makes small incisions along the gum line, gently lifting the gum tissue from the teeth and underlying bone. This provides direct access to the tooth roots and bone.
Next, the root surfaces are thoroughly cleaned to remove plaque, tartar, and diseased tissue. The periodontist then reshapes the bone around the teeth, known as osseous recontouring, to eliminate bone defects and shallow gum pockets. This reshaping creates a more even bone contour, hindering bacterial accumulation. If significant bone loss has occurred, bone grafting material may be placed to encourage new bone growth. Finally, the gum tissue is repositioned over the reshaped bone and secured with sutures.
Life After Osseous Surgery
Following osseous surgery, mild discomfort, swelling, and minor bleeding are common in the treated area. These symptoms typically peak within 24 to 48 hours and then gradually subside. Pain can be managed with prescribed or over-the-counter pain relievers, and ice packs can reduce swelling during the initial 24 to 36 hours.
Patients should consume a soft diet for the first few days, avoiding hot, spicy, or hard foods. Strenuous physical activity should be limited for at least a week to prevent increased bleeding and promote healing. Oral hygiene around the surgical site requires gentle care, often with a prescribed mouth rinse, while other areas can be brushed normally. Following all post-operative instructions, including follow-up appointments, is important.
Long-Term Results of Osseous Surgery
The primary long-term outcome of successful osseous surgery is a significant reduction or elimination of periodontal pockets. This reduction makes it easier to maintain effective oral hygiene at home, as plaque and bacteria have fewer deep spaces to hide. Reshaping the bone helps stabilize teeth and prevent further bone loss, reducing the risk of tooth mobility and eventual tooth loss.
Patients often experience improved gum health, with reduced inflammation, bleeding, and swelling. This creates a healthier oral environment and can enhance gum appearance. To preserve these positive results, diligent daily oral hygiene, including brushing and flossing, is essential. Regular professional dental cleanings, known as periodontal maintenance, are also crucial for ongoing monitoring and bacterial removal, ensuring the procedure’s long-term success.