The presentation will focus on the rationale and the techniques available to perform periodontal surgery. In particular a focus on the regenerative techniques with the objective of change the prognosis of the teeth will be the main topic. Periodontal regeneration and reconstruction is a well renown and predictable surgical technique in the periodontal armamentarium. The techniques that are available nowadays have been increasing the prognosis of severely compromised teeth and improve tooth survival. Yet the predictability and the indications or periodontal regenerative surgery are mainly focusing on intrabony defects. Intrabony defects are supportive defects providing a positive environment for blood clot stability. Nevertheless, intrabony defects constitute the minority of the periodontal bony defects as horizontal suprabony defects, dehiscence, endo-periapical and furcation defects are the ones that are often frequent and draw the attention of the clinicians.