Pocket Reduction Surgery

Bacterial plaque (the film on your teeth) can always be found on the surface of your teeth. If left undisturbed, this plaque has been shown to cause inflammation and destruction of the gum and bone around your teeth (“Periodontal Disease”).

Additional factors have also been shown to influence the development of periodontal disease such as smoking, diabetes, and autoimmune diseases.

In order to preserve a healthy tooth foundation, a small distance must be maintained in the space between the gum tissue and bone. Normally, this small space does not permit the pooling of more aggressive bacteria, which may destroy the bone supporting the teeth. As we lose bone, a deep space develops below the gum line called “Pockets”.  Deep “pockets” allow pooling of bacteria and formation of tartar, that is almost impossible to remove and reach via dental cleanings. In this case, the undisturbed bacteria may change to a more aggressive form that can destroy the gum and bone foundation around the tooth.  

Pocket Reduction Surgery is utilized to return the space between the gum and bone (around teeth) to a healthy distance. The overall goal of this type of therapy is to help stop the progression of the disease process and prolong the lifespan of your teeth.

Osseous (Bone) Surgery


Once the deeper “Pockets” have developed around the teeth, it is no longer possible for your dental professional to fully clean (remove the plaque and tartar around) the teeth.  In this scenario, although a patient may feel fresh after a dental cleaning, only the superficial areas have been cleaned, while the more active bacteria are left undisturbed. These bacteria have been shown to release toxins that destroy the gum and bone around the teeth.

Osseous Surgery is performed to reduce the “pockets” around the teeth to healthy depths. Once this is achieved, your dental professional is able to clean your teeth properly. The intent of this treatment is to prevent the disease process from continuing and prolong the life of the teeth. Some teeth may not be suitable for this type of therapy. Dr. Cohen will review all the possible treatment options with you based on your individual needs.


After anesthesia is achieved around the treatment area, the infected gum tissue will be removed, the teeth fully cleaned, and the uneven bone tissue re-contoured. Dissolvable sutures are typically placed that last a few days. Unless sedation is utilized for this type of procedure, patients can typically return to work the same day.

Bone Regeneration (Grafting) – Guided Tissue Regeneration


The traditional approach to treating deep “pockets” or periodontal disease involves eliminating the infected gum tissue and recontouring the uneven bone (as described in the Osseous Surgery section). Although this is still an effective way of treating periodontal disease, new and more sophisticated procedures are available today.

Bone regeneration procedures involve utilization of bone materials (powders) that come in a variety of forms including donor and synthetic. These powders can be used along with osseous surgery to minimize the distance between the gum and bone. The graft material is placed into the periodontal sites during Osseous Surgery to help stimulate your body to grow important supportive bone around your teeth. Grafts typically become incorporated into your newly formed bone or are completely replaced by it.

In many cases, a barrier or “Membrane” is used to help keep the graft in place during the healing period. This “membrane” is placed over the graft material and the gum tissue is then closed over the entire area.

Research has shown that certain types of bone loss respond best to bone regeneration therapy. Dr. Cohen will provide you with in depth information regarding the type of bone loss you may have and if this is an appropriate treatment option for you.


During osseous surgery, after all infected tissue is removed and the uneven bone recontoured, a graft material is placed in the appropriate locations (similar to filling an empty cup with powder). Typically a dissolvable “membrane” is placed over the grafted site to keep it in place (similar to a lid on the cup). The gum tissue is then closed and sutures are used during healing. This type of procedure takes approximately 1 hour. Unless sedation is utilized for the procedure, patients typically can return to work the same day.