Non-surgical periodontal therapy or conventional flap surgery
Pockets of less than 6 mm probing pocket depth (PPD) may lose clinical attachment as a result of a surgical therapy . Thus, a regenerative approach with an open flap is generally not indicated. While shallow pockets (PPD ≤ 3.5 mm) favor scaling and root planing without access flap, a surgical debridement for pockets of 4 - 6 mm PPD may be indicated in order to reduce pocket depth [2, 3].
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 Heitz-Mayfield et al. J Clin Periodontol. 2002;29 Suppl 3:92-102; discussion 160-2.
 Caffesse et al. J Clin Periodontol. 1986 Mar;13(3):205-10.
 Heitz-Mayfield and Lang Periodontol 2000. 2013 Jun;62(1):218-31.