In some cases there are localized areas that have advanced disease, which unfortunately would not respond through non-surgical therapy. These sites are usually linked to very deep sites, bone loss affecting the bone in between multi rooted teeth, irregular bone loss, soft tissue and tooth irregularities. These sits usually still have pockets of a depth that puts the tooth at risk of progressive disease and even long term loss of the tooth.
In order to limit this risk the option available is the surgical access and cleaning of the area, and managing the irregularity causing the residual pocket. All this involves is directly visualizing by gently lifting the gum out the way and reshaping the irregularities. This leaves an area which is cleansable and shallow enough to be maintained by home care and regular hygiene visits.