Osseous surgery

Overview 

Osseous surgery is a gum disease treatment performed by periodontists to address moderate to severe periodontitis. Its primary aim is to reduce pockets around the teeth where plaque and bacteria accumulate. 

Gum disease can damage the bone and tissue supporting teeth, leading to problems like gum recession and tooth loss. If left untreated, it can also impact overall health, increasing the risk of conditions such as heart disease, diabetes, and stroke. 

There are two main types of osseous surgery: 

• Traditional osseous surgery: Involves making incisions to access tooth roots, reshaping the bone around teeth to eliminate deep pockets, and suturing the area. 
• Laser osseous surgery: A newer approach that employs laser energy to target and eliminate bacteria around teeth while preserving healthy tissue. This method avoids the need for incisions and sutures but may yield varying outcomes. 

Reasons for undergoing the procedure  

Osseous surgery is a procedure employed by periodontists to address moderate to severe periodontitis. Its primary objective is to diminish the pockets surrounding your teeth, preventing the concealment of plaque and bacteria within them.

Risk 

Osseous surgery has some risks, just like any other surgical procedure. These risks include:  

• Bleeding excessively.  
• Cavities at the root of the tooth.  
• Gum recession.  
• Infection.  
• Sensitive teeth

The patient can receive advice from the periodontist on how to handle these kinds of problems. However, the advantages of osseous surgery usually exceed the disadvantages. 

Before the procedure  

Before undergoing osseous surgery, it is essential for patients to have a discussion with their periodontist to tailor their preparation to their unique circumstances. Here are some important guidelines to follow unless otherwise instructed by your periodontist: 

• Medications: Ensure that you take all prescribed medications exactly as directed by your healthcare provider. 
• Blood thinners: If you are taking anticoagulants like warfarin or aspirin, it may be necessary to discontinue their use before the surgery. The timing for discontinuation should be determined by your healthcare provider. 
• Meal planning: It is advisable to have a nutritious meal before the procedure since you may experience tenderness afterward.  
• Transportation: If you opt for sedation dentistry, arrange for a reliable friend or family member to drive you to and from your appointment. However, if you choose laughing gas (nitrous oxide) or local anesthetic, transportation may not be necessary. 
• Smoking and alcohol: To promote a smooth recovery, avoid smoking or drinking alcohol at least 24 hours before the procedure. It is also recommended to abstain from these activities for 24 hours after the surgery.

During the procedure  

During osseous surgery, a periodontist performs the following procedures: 

• Anesthesia administration: The periodontist administers anesthesia to numb the patient’s gums and teeth. If the patient desires sedation, appropriate medications will also be given before the procedure. 
• Incision: A small incision is carefully made along the gum line. 
• Gum elevation: Gently, the gums are lifted back to expose the roots of the teeth. 
• Root cleaning: The periodontist removes bacteria and dental plaque from the surfaces of the tooth roots. 
• Reshaping and smoothing: Any pockets or damaged areas around the teeth are addressed by reshaping and smoothing the surrounding bone. 
• Bone regeneration: In cases of bone loss, procedures such as applying membranes and dental bone transplants may be performed to regenerate bone. 
• Gum adjustment: The periodontist may adjust or reposition the gums as needed. 
• Closure with stitches: The incisions are closed using stitches. 

The duration of periodontal osseous surgery typically varies, ranging from thirty to sixty minutes, depending on the number of teeth that require treatment.

After the procedure  

The number of teeth treated, the severity of the condition, and the body’s ability to heal itself are some of the factors that affect how long recovery after osseous surgery takes. Recovery often takes two to four weeks. 

Outcome  

Osseous surgery is an effective treatment for gum disease. While this procedure can significantly enhance oral health, patients must maintain good dental hygiene habits to sustain the benefits. This includes regular dental check–ups, daily brushing, and flossing. 

The primary objectives of osseous surgery are as follows: 

• Reducing harmful oral bacteria. 
• Shrinking the gum pockets around the teeth. 
• Enhancing overall oral health. 
• Preventing the return of bacteria and plaque on tooth roots. 
• Reducing the risk of stroke, heart disease, and other conditions associated with gum disease. 

Patients can take specific actions to manage their symptoms and ensure a comfortable recovery: 

• Adhere to prescribed medication instructions. 
• Use an antimicrobial mouthwash to keep the surgical site clean. 
• Avoid using straws for drinking during the first week. 
• Consume soft foods. (For a detailed list of post–surgery dietary recommendations, consult your periodontist.) 

If a patient experiences any of the following symptoms following osseous surgery, they should promptly contact their periodontist: 

• Persistent bleeding. 
• Pain that is not alleviated by medication. 
• Presence of pus or infection at the surgical site.
• Fever with a temperature exceeding 101.1°F (38.0°C).