Traditionally, ”osseous bone surgery” has been used to treat teeth with periodontal disease. It is used much less today because root planning aided by the perioscope can achieve many of the same objectives non-surgically. There are specific times when it is still the therapy of choice. These include areas of the mouth with teeth that still bleed with pockets 5 mm or greater on probing even after perioscope assisted root planning. In osseous surgery, a small incision is made around the neck of the teeth and the roots and supporting bone are exposed. The roots of the teeth are cleaned with some of the same instruments that a registered dental hygienist uses. If there are areas of bone loss that are amenable to regeneration, a bone graft can be placed along with guided regeneration material. The areas are then sutured. The advantage of osseous surgery over root planning is that Dr. Jolkovsky and Dr. Du has direct visual access to remove any calculus deposits that could not be removed by perioscope assisted root planning. The techniques for osseous surgery are much more sophisticated and less invasive than older types of osseous therapy.