Most patients can return to their daily lifestyle in two days. Soft food diets are recommended for a few days post-op
Osseous surgery is used to treat advanced gum disease by removing bacteria and correcting bone damage. In The Grove, near Rosedale, this surgery is highly recommended before starting orthodontic treatment because it stabilizes the teeth. This prevents tooth loss and ensures that your orthodontic investment lasts. Our team at Enamel Dentistry, The Grove in Rosedale, ensures that you have a solid foundation to receive such treatment.
Medical literature supports that osseous surgery is a reliable tool to reach periodontal stability [1] (Aimetti et al., 2025). Osseous surgery reduces the depth of periodontal pockets and is designed to save your natural teeth. When gum disease advances, the bone and tissue that support your teeth are eliminated, creating deep pockets. In these deep pockets, bacteria then reside, causing damage. These areas cannot be reached with a toothbrush. During this procedure, periodontal care specialists clean the pockets and reshape the bone to correct these deep pockets. This creates a clean environment for the teeth to rebound.
Invisalign creates a permanent, straight, and healthy smile. Medical literature supports that clear aligner therapy is safe, effective, and a convenient orthodontic treatment [2] (AlMogbel et al., 2023). However, periodontal disease can hinder the ability of Invisalign. When aligners are worn, they apply pressure to move the teeth. If the bone and ligaments are inflamed, the pressure moves the teeth but can also accelerate the detachment of teeth from the socket.
Furthermore, if you do spend thousands on clear aligners with active gum disease, you can risk the teeth becoming loose. In this case, the value of clear aligners would decrease due to paying for a smile that you are losing. Osseous surgery can increase that value by anchoring the teeth to the unhealthy bone before the first tray is ever placed.
Specific biomarkers are used to determine bone health. Medical literature supports that aMMP-8 is a promising biomarker for early detection. periodontal and peri-implantitis disease [3] (Goyal et al., 2025). Research has identified that 310.5 ng/mL is a threshold for a tissue-destroying enzyme named MMP-8. Medical literature supports that periodontal disease in smokers has higher concentrations of IL-1beta, TNF-alpha, and MMP-8 than nonsmokers [4] (Dhulipalla et al., 2025). When this enzyme level exceeds 310.5 ng/mL, it is a sign of infection. This reveals to our periodontal team that bone loss is occurring at an aggressive pace. This data point allows our team to diagnose the issue. By identifying the level of bone resorption, osseous surgery can be prescribed to stop the destruction of bone before it reaches a point of no return.
Cost is a significant factor when obtaining osseous surgery. Consequently, many patients look to cities like NYC for cost comparisons. In Manhattan, osseous surgery can cost as high as $3,000 per quadrant. In Austin, periodontal care is available at a much lower price point, ranging from $800 to $1,800 per quadrant.
Below is a table that compares service vs. alternatives
Feature | Osseous Surgery | DIY Clear Aligners | Professional Aligners |
Austin Cost | $800 to $1,800 | $2,000 to $2,500 | $3,500 to $6,000 |
Bone impact | Halts bone loss | Risk of tooth loss | Safe tooth movement |
Longevity | Permanent foundation | High failure risk | Results lasting a lifetime |
Pain level | Manageable | High | Moderate |
Medical literature supports that lower salivary pH is present in tobacco users when compared to non-tobacco users [5] (Grover et al., 2016). Smokers undergoing Osseous surgery face greater financial burdens than nonsmokers. Evidence suggests that smoking hampers the body’s ability to heal after surgery, which in turn boosts the likelihood of infections and the need for additional procedures. Research has demonstrated that smokers are significantly more likely to experience failures with implants and grafts. Some studies estimate these failure rates to be two to three times higher than those seen in non-smokers. These complications inevitably lengthen treatment duration and frequently require corrective surgeries, which inflate the total cost of care. Financially, a smoker undergoing osseous surgery could end up spending thousands of dollars on unexpected follow-up treatments that a non-smoker would likely avoid.
ROI is calculated by looking at the cost of inaction.
Typically, for every $1 spent on osseous surgery, patients see an ROI of $6 in future restorative costs. That would be a 600% return on investment.
Most patients can return to their daily lifestyle in two days. Soft food diets are recommended for a few days post-op
Yes. Clear aligners can cause the teeth to fall out if periodontal disease is present. The periodontium should be healthy to support the movement of teeth.
No. Local anesthetics are used to numb the area of interest. Most patients report feeling mild pressure. Afterward, discomfort can be managed with Tylenol or ibuprofen.
Dr. Ravin Chodavadia, DDS, provides comprehensive general and cosmetic dentistry at Enamel Dentistry in Austin, TX. He brings extensive experience in Invisalign, implant care, and cosmetic treatments. Known for his light-hearted, positive energy, he is committed to delivering thoughtful, evidence-based care that keeps patients comfortable and confident at every step.
[1] Aimetti, M., & Carnevale, G. (2025). Osseous Resective Surgery: The Past, the Present and the Future. Journal of periodontal research, 60(8), 743–747. https://doi.org/10.1111/jre.70029
[2] AlMogbel A. (2023). Clear Aligner Therapy: Up to date review article. Journal of orthodontic science, 12, 37. https://doi.org/10.4103/jos.jos_30_23
[3] Goyal, L., Gupta, M., Sareen, S., Aji, N. R. A. S., Sahni, V., Thomas, J. T., Pätilä, T., Penttala, M., Pärnänen, P., Sorsa, T., Gupta, S., Räisänen, I. T., & Leone, P. (2025). Active Matrixmetalloproteinase-8 in Periodontal Diagnosis: A Scoping Review. Diagnostics (Basel, Switzerland), 15(22), 2932. https://doi.org/10.3390/diagnostics15222932
[4] Dhulipalla, R., Vudathaneni, V. K. P., Bodduru, R., Nadella, S. B., Kondapaneni, A., & Boyapati, R. (2025). Assessment of Salivary Biomarkers as Predictors of Periodontal Disease Severity in Smokers and Nonsmokers. Journal of pharmacy & bioallied sciences, 17(Suppl 2), S1820–S1822. https://doi.org/10.4103/jpbs.jpbs_477_25
[5] Grover, N., Sharma, J., Sengupta, S., Singh, S., Singh, N., & Kaur, H. (2016). Long-term effect of tobacco on unstimulated salivary pH. Journal of oral and maxillofacial pathology : JOMFP, 20(1), 16–19. https://doi.org/10.4103/0973-029X.180907
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