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Gum Diseases

Osseous surgery

01/15/2009

Question:

I am in the midst of deciding if I should have the osseous surgery after my deep cleaning. I am afraid when the gum does not reattach well to the tooth may allow more bacteria to get into the teeth. Would deep cleaning be good enough and not having the surgery where the gum is cut through.From what I understand, the gum where the surgery is done will recede.

Answer:

Osseous surgery is indicated when the patient presents residual pockets following deep cleaning. The goal of the surgery is to eliminate deep pockets thus eliminating areas where bacteria can adhere and grow.

Yes, it would cause more gingival recession but the long-term gingival line stays stable if you are well maintained. If you do not have the surgery, the residual pockets will be recultured with pathogenic bacteria in a couple of months and the disease will re-occur. You can have disease recurrence following surgical therapy too if you do not continue with the maintenance phase of the therapy.

Repeating deep cleaning without surgery will not solve the problem. Deep pockets cannot be maintained long term and there is always a higher risk of leaving residual plaque and calculus after deep cleaning compared with surgery. This is because the clinician cannot see the area while he/she is performing deep cleaning.

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Response by:

Binnaz   Leblebicioglu, DDS, MS, PhD Binnaz Leblebicioglu, DDS, MS, PhD
Associate Professor of Periodontology
College of Dentistry
The Ohio State University