Periodontics

Pocket Reduction Surgery in Los Angeles

When the pockets are too deep to clean from above.

Deep cleaning reaches a great deal, and past a certain depth it stops being enough. Flap surgery gives the access. Smile LA Downtown Modern Dentistry uses it where the pockets have gone beyond what scaling can resolve.

Dr. Kourosh Yousefzadeh working under the surgical microscope with an assistant
The access

What the surgery does

Scaling and root planing reaches a great deal, and past a certain depth it stops being enough — not because the technique fails but because the instrument is working blind through a narrow opening. Lifting the gum tissue solves that. The root surfaces and the structures around them can then be cleaned thoroughly and under direct vision, and the tissue is re-contoured before it is closed so that it heals back against the tooth with a shallower pocket than it had. That last part is what makes the result last. A pocket that has been cleaned but left deep will simply refill; one that has been made shallower is a pocket you and we can actually keep clean afterwards.

  • Access The reason for the procedure. A deep pocket cannot be cleaned reliably through its opening.
  • Thorough cleaning Of the root surfaces and the structures around them.
  • Re-contouring So the tissue heals against the tooth with a shallower pocket than before — which is what makes it maintainable afterwards.
Where it sits

Where it sits in the treatment sequence

Usually after scaling and root planing, when the pockets have not responded enough. Where bone has been lost around the tooth, bone grafting or guided tissue regeneration may be done at the same time — the point of getting access is to do everything the site needs while it is open.

Afterwards, the result is held by periodontal maintenance.

Why it is worth doing

Advanced periodontitis affects the bone supporting your teeth and, if left untreated, results in tooth loss. Our methods aim to preserve affected teeth wherever possible, and this is one of them. See gum disease.

A treatment operatory with the original exposed brick wall and an arched window

Pocket Reduction Surgery FAQ

What is flap surgery?
Lifting the gum tissue so the structures underneath can be cleaned thoroughly and the gums re-contoured, which reduces pocket depths.
Why can a deep clean not do it?
Past a certain depth a pocket cannot be cleaned reliably through its opening. The surgery is about access.
Will I need it if I have gum disease?
Not necessarily. It is used where pockets are deep, usually after scaling and root planing has not reduced them enough.
Is anything else done at the same time?
Often. Where bone has been lost, grafting or guided tissue regeneration may be carried out while the site is accessible.
Dr. Kourosh Yousefzadeh seated in the office lobby beside a white Samoyed
Your Dentist
Dr. Kourosh Yousefzadeh, D.D.S.
Founder of the practice, treating patients at the Financial District office.
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