In case of significant bone and clinical attachment loss,and when tartar is located deep under the gum, open curettage is required. The procedure involves dissecting the gum in order to make the root visible and remove (using special curettes) tartar and other deposits created as a result of an inflammation. After this stage, rootplaning is performed in order to scale the top surface of the root, which may be affected by bacteria. The flap of the gum is sewed back in place. Naturally, this procedure is carried out under local anaesthesia. It saves the tissues surrounding the tooth and does not affect the overall condition of the patient.

Flap procedures are applied in case of advanced periodontitis, when extensive damage to the bone tissue covering the roots of the teeth occurs asa result of the progression of the disease. Flap surgery allows for the removal of the focus of infection after gaining access to the bone. There is also the option of filling the bone cavity with special materials that support bone tissue regeneration.