When pocket depth is greater or equal to 5mm, non-surgical treatment (deep cleaning) is no longer effective.  Cleaning instruments cannot reach the bottom of the pocket to completely remove plaque and calculus that are on the root surface.  In this situation, periodontal surgery is necessary.

Osseous surgery consists of cutting gum and pulling the gum away from the teeth and bone so that the periodontist has a direct view of and access to the diseased bone and the root surfaces. Having the direct view also allows the periodontist to thoroughly remove plaque and calculus from the root surfaces.

Then the gum is sutured back purposely at a position lower than the pre-surgical level.  Unfortunately, due to this gum placement, the teeth will appear longer and the roots will be exposed.  Patients may experience sensitivity to cold and hot.

The following diagrams are illustration of the Osseous Surgery procedure.