Osseous surgery, or flap surgery, is usually performed when a pocket around a tooth (or teeth) has not responded to other treatments. The procedure is performed in order to create a clean environment around the tooth so that the tooth can be retained rather than lost. Osseous surgery is generally tried only after other treatments have been explored and tried and usually is performed when the pocket depth has worsened over time.
Before beginning the procedure, the area will be numbed using a 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 buildup.
Next the surface of the bone will be smoothed. Bacteria trapped in the pocket around the tooth will eat away at bone making it uneven and rough. In order to ensure proper healing, smoothing the bone of these rough surfaces is necessary.
After the root of 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
After the procedure you may be prescribed a pain medication. Stitches will be removed in 6-10 days unless dissolving stitches are used. About a month after surgery, an appointment should be scheduled to check on the healing of the area. Because some gum tissue is trimmed during the procedure and because the gums shrink some what during healing, the tooth may appear longer in the mouth. This may cause increased sensitivity to hot or cold. This is handled using desensitization agents.