Pocket reduction surgery (also known as gingivectomy, osseous surgery and flap surgery) is a collective term for a series of several different surgeries aimed at gaining access to the roots of the teeth in order to remove bacteria and tartar (calculus).

The human mouth contains dozens of different bacteria at any given time.  The bacteria found in plaque (the sticky substance on teeth) produce acids that lead to demineralization of the tooth surface, and ultimately contribute to periodontal disease.

Periodontal infections cause a chronic inflammatory response in the body that literally destroys bone and gum tissues once they invade the subgingival area (below the gum line).  Gum pockets form and deepen between the gums and teeth as the tissue continues to be destroyed.

Periodontal disease is a progressive condition which, if left untreated, causes massive bacteria colonization in gum pockets can eventually lead to teeth falling out.  Pocket reduction surgery is an attempt to alleviate this destructive cycle, and reduce the depth of the bacteria-harboring pockets.

Reasons for the pocket reduction surgery

Pocket reduction surgery is a common periodontal procedure which has been proven effective at eliminating bacteria, reducing inflammation and saving teeth.  The goals of pocket reduction surgery are:

• Reducing bacterial spread – Oral bacteria has been connected to many other serious conditions such as diabetes, heart disease and stroke.  Oral bacteria can travel to various parts of the body from inside the bloodstream and begin to colonize.  It is important to decrease bacteria in the mouth in order to reduce the risk of secondary infection.
  
  
• Halting bone loss – The chronic inflammatory response induced by oral bacteria leads the body to destroy bone tissue.  As the jawbone becomes affected by periodontal disease, the teeth lose their rigid anchor.  When the teeth become too loose, they may require extraction.
  
  
• Facilitate home care – As the gum pockets become progressively deeper, they become incredibly difficult to clean by the patient.  The toothbrush and dental floss cannot reach to the bottom of the pockets, increasing the risk of further periodontal infections.
  
  
• Enhancing the smile – An oral cavity that is affected by periodontal disease is not attractive to the eye.  In fact, smiles may be marred by brown gums, rotting teeth and ridge indentations.  Pocket reduction surgery halts the progression of gum disease and improves the aesthetics of the smile.

What does pocket reduction surgery involve?

Osseous "Pocket Reduction" Surgery--Dr. Sherif Warda's Personal Comments...

A “traditional” approach to treating periodontal disease involves reflection of the gum tissues (a flap) and cleansing of the root surfaces affected by plaque biofilms and tartar.  (I use diamond-coated microultrasonic instrumentation designed specifically to accomplish this).  In some cases, uneven bone tissue is reshaped, or bone graft materials are placed to restore a normal contour to the bone.  The tissues are replaced and sutured.   In some cases this approach (osseous surgery) provides the most predictable, long-lasting result in treatment of disease (or when treating teeth with complex problems requiring precise visualization of the root structure).   Literally thousands of studies have proven the benefits of this approach, particularly in patients who are motivated to perform daily home care. 

 Although osseous surgery is an effective way of treating periodontal disease, I invite you to investigate LANAP surgery.  In many cases, LANAP can provide virtually identical results to osseous surgery, with less discomfort and far less “down time”.

If you have any questions about pocket reduction surgery or treatment for periodontal disease, please ask Dr. Sherif Warda.