Pocket depth, bleeding and tooth mobility
Periodontal access and debridement
Periodontal flap surgery
A procedure intended to access the roots and the bone when non-surgical treatment is not enough to control certain periodontal pockets.
Duration
60 to 180 minutes depending on the number of teeth and associated procedure
Recovery
Pain, swelling, sensitivity or discomfort possible for several days
Deep cleaning under direct vision
Periodontal flap surgery, also called open flap debridement or access surgery, treats certain areas of periodontal disease that remain difficult to clean despite thorough non-surgical treatment.
The flap gives access to the deposits and to the bone defects. The roots are cleaned, then the tissues are repositioned. A regenerative procedure may be combined with it in selected situations.
- Indicated after reassessment of the initial treatment
- Direct access to the roots and to the defects
- Periodontal maintenance essential after healing
The benefits
- Direct access to roots and bone defects that are difficult to clean
- Some affected teeth can be kept when the prognosis remains favourable
- Possible reduction of certain persistent periodontal pockets
- Area potentially easier to maintain after healing
- Regeneration possible only in certain favourable defects
- Plan adapted to the severity of the disease and the bone anatomy
- Treatment combined with personalised periodontal maintenance
- Prognosis strongly dependent on hygiene and smoking
Contraindications
- Non-surgical treatment and improved hygiene generally required before surgery
- Persistent deep periodontal pockets, bleeding or inflammation confirmed at reassessment
What the practitioner assesses
Shape and extent of the bone loss
Hygiene, smoking, diabetes and response to the initial treatment
The treatment process
Initial treatment and periodontal reassessment
Scaling and root planing, learning interdental cleaning, then reassessment of pockets, bleeding, mobility and bone level. Imaging is chosen according to the area to be treated.
Anaesthesia and surgical access
Under local anaesthesia, an incision allows the gum to be gently lifted to access the roots and the bone in the area concerned.
Debridement and root cleaning
Tartar, plaque and inflammatory tissue are removed. The root surfaces are cleaned and the bone architecture can be reshaped when it prevents proper maintenance.
Possible regeneration and sutures
A biomaterial, a membrane or a regenerative product may be added only when the defect is suitable. The gum is then repositioned and held in place with sutures.
Healing and periodontal maintenance
Sutures are checked or removed after one to two weeks. Cleaning resumes gradually according to the instructions. Regular check-ups and maintenance sessions are essential to preserve the result.
Technology and materials
Periodontal measurements and targeted imaging
Probing, X-rays and photographs make it possible to compare how the situation changes. The outcome also depends on plaque control and on the risk factors.
Frequently asked questions
Does this surgery cure periodontitis definitively?
It can help to control the disease in the areas concerned, but periodontitis requires regular maintenance and long-term management of the risk factors.
Can the gums recede?
Recession or more visible gaps may appear after the inflammation has been reduced and after surgery. This point is explained before treatment.
Related treatments
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