The distal wedge procedure is a flap procedure for the treatment of periodontal pockets in the distal middle of the last molar. The distal wedge procedure can eliminate the overgrown gingival tissue, eliminate the periodontal pocket, trim the bone tissue, and avoid the formation of excessive gingival wounds to facilitate tissue healing. Liang Zhaozhong, Department of Special Oral Surgery, Urumqi Stomatological Hospital I. Indications It is suitable for the distal mesial pocket of the last molar, and also for the proximal and distal mesial pockets in the gap of the missing tooth area, especially those with bone subpockets. Because the lesion in the distal middle area of the affected tooth is often connected with the posterior pad of the molar, the tissue is looser and softer, and the effect is better if there are some attached gingiva on the buccal and lingual side. It should be noted that all the deep pockets in the distal middle of the second molar must be X-rayed before surgery to make sure that there is no low obstructed third molar in the distal middle. Surgical method 1. Conventional sterilization and anesthesia. 2. Based on the internal oblique incision, a wedge-shaped incision is made in the distal middle of the molar to form a triangular flap with the bottom edge on the distal middle surface of the last molar and the tip facing the distal middle end of the posterior pad of the molar, and the incision reaches the bone surface. The width and length between the incisions depend on the depth of the pocket, the width of the keratinized gingiva, and the distance from the distal mesial surface of the tooth to the posterior pad of the molar. The deeper the pocket, the greater the distance between the two incisions. 3. Separate the wedge-shaped lesion from the underlying bone tissue with a scalpel, hold and slightly lift the incised and peeled wedge with tissue forceps or hemostats, and remove it in its entirety, right to the bone surface. Remove the inflammatory granulation tissue and pocket epithelium from other areas and level the root surface. 4. Deep periodontal pockets in the distal molar are usually accompanied by wide and deep vertical bone resorption, and the angular resorbed bone profile must be modified to make it flat to facilitate elimination of periodontal pockets. 5. Reset the buccal and lingual flaps that have been turned over, cover the alveolar bone surface, trim the edges of the gingival flaps, avoid overlapping of the buccal and lingual flaps, and make it just right for the buccal and lingual flaps to dovetail and fit closely with the bone surface, suture and fix, and anchor suture in the far middle. A periodontal plugging agent was placed. After one week, the plugging agent was removed and the sutures were removed.