The specialty of periodontics has grown in the past 25 years to encompass a variety of surgical techniques that span the scope of dentistry. The advent of predictable implant placement, use of LASER, microsurgery and numerous new bone augmentation techniques has broadened the repertoire of the periodontist to a point where technical developments through research have impacted other specialties, including Orthodontics, Endodontics, Oral and Maxillofacial surgery and Prosthodontics.The focus of periodontal surgical procedures has shifted over from a philosophy based on resection (subtractive) to one of regeneration of lost tissues (additive). This shift has had particular significance in cases of advanced periodontitis. When a patient presents with severe attachment loss, regeneration cannot take place until the etiologic factors have been effectively managed or reversed and the disease progression arrested.