Osseous surgery has been the gold standard in periodontal care for the past 20 years. This technique consists of open debridement of periodontally infected teeth, removal of bacterial toxins from root surfaces, and removal of diseased tissue from the teeth and adjacent supporting bone. This is accomplished with small access incisions along the necks of the teeth under a local anesthetic. Sutures and a surgical dressing are typically required. Within the past five years, remarkable breakthroughs have occurred which allow us not only to treat periodontal disease, but in many cases reverse it.