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Osseous surgery, or flap surgery, is usually performed when other treatments have not been successful in combating periodontal pockets around a tooth (or teeth). This procedure is performed to allow a clean environment around the tooth so that it can be retained rather than lost, and is also known as pocket depth reduction.
The area will be numbed with the use of local anesthesia before beginning the procedure. An incision is made in the gum tissue around the area that will be treated. Direct access to the area is granted by lifting the gum away from the tooth and the underlying bone. Any plaque or tartar buildup is then thoroughly cleaned away from the surface of the tooth.
The surface of the bone will then be smoothed. This is done because bone tissue can be destroyed by bacteria trapped in the pockets around the tooth, making it rough and uneven. Smoothing of these rough surfaces of the bone is necessary in order to ensure proper healing. In the event of defects in the bone, which are required to be filled, bone grafting procedures are sometimes performed.
After smoothing the bone and cleaning the root of the tooth, the gum tissue is then stitched into place after being trimmed to match the new underlying structure. The stiches are placed to hold the gum tissue in the correct position as it heals.
After the procedure, an over-the-counter pain medication may be recommended for any discomfort. Prescription pain medication may be prescribed on a case by case basis. Stitches will be removed in six to ten days, unless dissolving stitches have been used. An appointment should be scheduled about a month after surgery to check on the healing of the area. The tooth may appear longer in the mouth due to the trimming of gum tissue during the procedure. Sensitivity toothpaste may also be used to manage any sensitive reactions to any hot or cold.
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