38. Gingivectomy and gingivoplasty

Question 1

Gingivectomy

Answer 1

• Excision of soft tissue=>pathologic periodontal pocket
• Combined w/ recontouring of diseased gingiva to restore physiological form-Gingivoplasty
• Provides visibility and accesibility for complete calculus removal

Question 2

Gingivecotomy procedure

Answer 2

• La
• Incision-15/12 blade buccally and lingually
• Secondary incision to seperate interproximal soft tissue
• Incised tissues removed with curette or scaler
• Gauze placed in interdental areas to control bleeding
• Exposed root surfaces debrided
• Dentogingival regions probed to detect remainning pockets and gingival contour checked
• Wound surface covered by periodontal dressing
• Dressing remains for 10-14 days
• Teeth cleaned and polished after dressing

Question 3

Indications for gingivectomy

Answer 3

• Presence of supra-alveolar pockets
• Elimination of gingival enlargements
• Elimination of periodontal abcesses

Question 4

Contraindications for gingivectomy

Answer 4

• Need for bone surgery
• If bottom of pocket apical to MGJ
• Aesthetic considerations=>anterior maxilla

Question 5

Healing of 12-24 hours after gingivectomy

Answer 5

Epithelial cells at margins of wound begin to migrate over granulation tissue

Question 6

Healing of 24 hours after gingivectomy

Answer 6

Increase in CT cells

Question 7

Healing of 3 days after gingivectomy

Answer 7

Numerous fibroblasts

Question 8

Healing of 5-14 days after gingivectomy

Answer 8

Surface re-epithelialisation complete

Question 9

Healing of 7 weeks after gingivectomy

Answer 9

Complete repair of CT

Question 10

Gingivoplasty

Answer 10

• Reshaping gingiva to create physiologic gingival contour
• Tapering gingival margin=>
• Scalloped margin outline
• Thinning attached gingiva
• Shaping interdental papillae