Periodontics

Osseous Surgery

Reshape damaged bone to eliminate pockets and rebuild support.

Periodontics

When periodontal pockets are deep, osseous surgery resets the foundation.

Periodontitis is an advanced and serious form of gum disease that damages the gums, periodontal ligaments, and bone tissue that supports the teeth. Unlike early-stage gum disease, periodontitis involves deeper infection and inflammation that can permanently weaken the structures holding the teeth in place. If left untreated, it can lead to gum recession, deep periodontal pockets, bone loss, loose teeth, and eventually tooth loss.

Osseous surgery may be recommended when periodontitis has not responded adequately to nonsurgical treatments (such as scaling and root planing). During this procedure, gum tissue is gently lifted so the periodontist can access and clean the tooth roots, remove bacteria and infected tissue, and smooth or reshape damaged bone. By reducing deep pockets and creating a healthier environment around the teeth, osseous surgery can help gum tissue to heal more securely and can reduce the risk of further periodontal damage.

At Precision Periodontics and Implant Dentistry, our specialty-trained periodontists, our specialty-trained periodontists have years of experience treating a wide range of stages of gum disease and placing dental implants. To learn more about osseous surgery, our clinic facilities, or to schedule an appointment for a procedure, contact our Alexandria, VA office at (703) 823-2422 or our Washington, D.C. office at (202) 296-3360.

The Procedure

What to expect from your treatment.

Here's what your osseous surgery treatment looks like, step by step.

The Procedure

Prior to the procedure, your periodontist will administer a local anesthetic. Once you are properly numbed, a small incision will be made in your gum, and it will be pulled back to access the root of the tooth and surrounding bone. Once these are accessible, your periodontist will scrape off deposits that have formed on the root surface and recontour and trim the bone. For more advanced cases of periodontitis, a bone graft and/or guided tissue regeneration may be placed during this time. Once this is complete, the gum tissue will be reattached, and the healing process can begin.

Pros and Cons of Osseous Surgery

As with any medical procedure, there are pros and cons to having osseous surgery. In some cases, LANAP may be a better treatment option for patients, depending upon their specific circumstances. One of the most common drawbacks that patients who have osseous surgery cite is that their teeth appear to be longer. While osseous surgery will alter the appearance of your smile, your gums will be returned to a natural, healthier state.

The most powerful method for treating advanced periodontal disease
Healthy gum tissue is preserved
Pocket depths are reduced, which decreases the likelihood of bacteria and plaque developing
Patients can brush areas that were inaccessible before
Patients will have fresher breath
Gums will stop bleeding
Significantly reduces the likelihood of a future infection developing, provided the patient follows good oral self-care
Teeth appear longer
Increased likelihood of tooth sensitivity
Longer and more extensive recovery compared to LANAP
Not able to address certain pockets that can only be treated with LANAP

Recovery & Aftercare

A short recovery, a long-term result.

Following osseous surgery, it is important to follow the post-operative instructions. If you are prescribed medication and/or antibiotics, follow the dosage instructions to completion. If you are not prescribed medication but experience discomfort, over-the-counter pain relievers such as Tylenol or Ibuprofen can generally help manage pain. Some swelling is also common, but this can generally be managed with the use of ice packs. If you follow these instructions, your recovery process should be quick, although your periodontist will likely schedule a follow-up appointment within a week to ensure everything looks right.

Once you have completed the recovery process, it will not be necessary to follow special aftercare instructions, although it is important to be aware of the reason this procedure was needed in the first place. Continue practicing good daily oral hygiene practices. Brush and floss twice daily, and schedule regular visits to your periodontist to ensure that your teeth receive regular professional cleanings, which will reduce your risk of developing gingivitis or periodontitis. It may be necessary to schedule these visits with more frequency until you have fully corrected your periodontitis. If you follow these best practices, you will enjoy a bright and healthy smile for many years to come.

Frequently Asked

Common questions about this treatment.

What is a gingival pocket?

A gingival pocket is a shallower form of pocketing (typically 3 mm or less) caused by the gum tissue swelling and pulling away from the tooth, without loss of the underlying bone. It's a warning sign, not yet a surgical problem — usually reversible with a professional deep cleaning and improved home care. The distinction matters for osseous surgery planning: gingival pockets don't require reshaping the bone, but if left untreated they can progress into true periodontal pockets, at which point bone loss is involved and the surgical picture changes. If probing at your appointment shows only gingival pocketing, we'll treat it non-surgically and monitor.

What is a periodontal pocket?

A periodontal pocket is what osseous surgery is designed to eliminate. Once probing depths reach 4 mm or more, the gingival attachment has been destroyed and the underlying bone has typically resorbed into an uneven, cratered contour. Those irregular bone shapes trap bacteria and make the pocket impossible to clean, even with scaling. Osseous surgery accesses the bone directly, smooths the crater and ledge defects, and reshapes the ridge so the gum tissue can reattach at a shallow, cleansable depth. The goal is to close the pocket permanently by fixing the underlying bone architecture, not just cleaning what's on the surface.

Cost & Payment

Money shouldn't stand between you and the care you deserve.

The cost of osseous surgery will vary depending upon a variety of factors, including your dental insurance plan, whether or not additional procedures are required, and the severity of your case. At Precision Periodontics and Implant Dentistry, we are committed to ensuring that money is not a deterrent to our patients receiving the optimal dental health care they deserve. For this reason, we offer a range of payment options regardless of what type of treatment you are having, which our staff will be happy to explain and assist with. Our office insurance coordinators work with other insurance companies to assist patients with their claims.

For your convenience, Precision Periodontics and Implant Dentistry accepts cash, check, debit, and credit cards (Mastercard, American Express, Visa, and Discover). Our clinic also accepts GreenSky Patient Solutions, a financing option for procedures and treatments not typically covered by insurance or when insurance does not cover the entire cost. We are happy to provide an application in our office. You can find out more information about this service at https://www.greensky.com/patient-faq/.

For your convenience, we accept: