Can surgery be justified for patients with periodontitis?

There is a debate concerning the role that surgical procedures should play in the treatment of inflammatory periodontal diseases. This review details some of the situations in which surgery can be of benefit. Benefits include obtaining shallower probing depths and therefore reducing the areas that are hospitable to pathogenic bacteria associated with disease. Also, removal of tooth-accumulated materials such as plaque and calculus in probing depths greater than 5 mm is more predictable with surgery. In some forms of aggressive periodontitis, elimination of potentially pathogenic bacteria is found more frequently with surgical procedures. Regeneration of lost bone and attachment apparatus are predictable only with surgery.