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Cleaning down to the root and regenerating bone
Periodontal surgery is a form of oral microsurgery indicated when periodontitis reaches an advanced stage, characterised by residual pockets of at least 6 mm following initial cleaning. Performed
under local anaesthetic, it enables deep root surfaces to be thoroughly cleaned, lost bone to be regenerated and the gum tissue to be reconstructed. In Paris, leading practices such as Cabinet Dentaire de la Madeleine (Paris 8th arrondissement) use minimally invasive protocols (access flap surgery, gum grafting, bone grafting and gingivectomy). Average fees in Paris range from €400 to €1,500 depending on the procedure, following a diagnosis and personalised quotation.
Periodontitis is a chronic bacterial infection that destroys the bone supporting the teeth. According to the World Health Organization (WHO), severe forms of the disease affect nearly 19% of adults worldwide. In France, epidemiological data show that 32% of adults are at risk of developing periodontal bone loss.
To halt this damage, practitioners follow a multi-stage treatment protocol endorsed by the European Federation of Periodontology (EFP):
The first stage involves assessing the condition of the gums. The dentist uses a graduated probe to measure the space between the gum and the tooth (the periodontal pocket). An initial non-surgical treatment called root planing is then carried out under local anaesthetic to disinfect the root surfaces.
A reassessment is carried out 6 to 8 weeks after this initial cleaning. If probing shows that periodontal pockets of at least 6 mm persist and continue to bleed, surgery becomes necessary.
At this depth, conventional cleaning instruments can no longer reach the bacteria. Without surgery to open the area and clean it thoroughly, the bone continues to deteriorate, eventually causing the tooth to become loose.
Periodontal surgery has evolved. Today's reconstructive techniques use precision instruments to minimise inflammation.
Common procedures include:
In Paris, some practices, including Cabinet Dentaire de la Madeleine (Paris 8th arrondissement), combine 3D examinations (cone beam imaging) with microsurgical instruments and magnifying loupes to perform these procedures precisely and comfortably.
Without treatment, the infection continues to destroy the bone supporting your teeth.
Microsurgery provides deep cleaning of the root surfaces and helps rebuild lost bone.
In modern dentistry, the gums (pink aesthetics) provide direct biological support for the teeth (white aesthetics).
Dental veneers (E-Max or Lumineers) should not be placed, nor should orthodontic treatment (braces or aligners) begin, while the gums show signs of active infection. An unstable periodontium compromises the longevity of cosmetic treatment. Periodontal surgery to clean or reshape the gums (such as gingivectomy to align the gum line) is an essential preliminary step in creating a healthy, symmetrical environment.
Periodontal surgery, bone grafting and gum grafting are not reimbursed by the French national health insurance system (they are classified as procedures outside the official schedule).
The table below shows the average fees charged by dental practices in Paris equipped with modern clinical facilities:
| Type of periodontal procedure | Average indicative fee in Paris | Billing basis |
|---|---|---|
| Periodontal cleaning surgery (access flap) | €400 – €800 | Per section (sextant) |
| Gum graft (plastic surgery) | €600 – €1,200 | Depending on the number of teeth involved |
| Regeneration with bone grafting | €800 – €1,500 | Per treated site (depending on the volume of biomaterial) |
| Cosmetic gingivectomy | From €300 | Per section |
Most supplementary health insurers offer partial or full reimbursement for these procedures through an annual periodontal treatment allowance. Book an appointment for a full examination. Only a clinical diagnosis supported by 3D imaging can determine the appropriate treatment plan. Contact Cabinet Dentaire de la Madeleine (Paris 8th arrondissement) for a complete periodontal assessment and a personalised quotation to submit to your insurer.
Ask your questions, send a photo of your smile and receive initial guidance from our team, simply by message, wherever you are.
Root planing is a non-surgical treatment carried out beneath the gum to disinfect the root without exposing it. Periodontal surgery is considered only when root planing has not succeeded and 6 mm pockets persist. It involves gently lifting the gum so the area can be cleaned under direct vision.
No. The procedure is performed under local anaesthetic, so you will not feel pain during treatment. Afterwards, microsurgical techniques help minimise inflammation. Some discomfort or mild swelling may occur, but this can be managed with standard painkillers for 48 hours.
The surface gum tissue heals within 7 to 14 days, after which the practitioner removes the sutures if they are not dissolvable. Deeper tissues, such as the bone or the gum attachment to the root, continue to heal over 3 to 6 months.
No. These minimally invasive procedures generally do not require time off work. You can return to work the following day. You should simply avoid strenuous exercise for 3 to 5 days to reduce the risk of bleeding.
Nicotine constricts the blood vessels in the gums, reducing the oxygen supply needed for tissue healing. Regular smokers have twice the failure rate for bone and gum grafts. Complete smoking cessation is required for 2 weeks before and 4 weeks after the procedure.
Recognise the signs of loose teeth and receding gums and explore suitable treatments.
Discover the treatment SurgeryIdentify common causes of bleeding gums and find out when to seek advice.
Discover the treatment SurgeryUnderstand why gums recede and the possible solutions.
Discover the treatment SurgeryRecognise gum inflammation and learn how it can be treated.
Discover the treatment SurgeryRecognise the signs of loose teeth and receding gums and explore suitable treatments.
Discover the treatment SurgeryIdentify common causes of bleeding gums and find out when to seek advice.
Discover the treatment SurgeryUnderstand why gums recede and the possible solutions.
Discover the treatment SurgeryRecognise gum inflammation and learn how it can be treated.
Discover the treatment
Parodontiste
Chirurgie Reconstructive Parodontale
Book an appointment8 Boulevard de la Madeleine, 75009 Paris
