5-4 PERIODONTAL SURGERY Flashcards
What is gingivectomy?
Gingivectomy is the surgical removal of excess gingival tissue
What is the normal attachment of the gingiva?
The gingiva attaches to the tooth at the enamel-cementum junction, with the alveolar bone located 2mm below the gingival attachment, and the gingival crevice ranging from 1-3mm in healthy tissue.
What causes gingival hyperplasia?
Gingival hyperplasia (excess gum tissue) may occur naturally after tooth eruption or as a response to drug therapy, such as phenytoin (for epilepsy) or nifedipine (for hypertension).
Why is gingival hyperplasia problematic?
Hyperplastic tissue can make oral hygiene difficult and increases the risk of periodontal disease due to its difficulty in cleaning and potential for false pocketing.
what is the purpose of a gingivectomy?
The purpose of a gingivectomy is to remove excess gingival tissue that covers part of the crown, creating false pockets and making cleaning difficult.
What are the key steps in performing a gingivectomy?
- Check records, medical history, and obtain consent.
- Administer local anaesthetic.
- Make an incision with a gingivectomy Blake knife and remove the tissue.
- Remove any visible subgingival calculus.
- Apply a periodontal pack (e.g., Coe-pak) to cover the raw surface for one week.
What post-operative instructions should be followed after a gingivectomy?
-Take painkillers (not aspirin).
-Eat a soft diet for one week.
-Avoid spicy food, smoking, and hot food.
-Brush gently with a soft toothbrush.
-Use chlorhexidine mouthwash.
-Return in one week for dressing removal, healing review, and professional cleaning.
What is gingivoplasty?
Gingivoplasty is the re-contouring of the gingivae, typically using electrosurgery or diathermy, which cuts tissue and coagulates blood simultaneously.
What should be avoided during gingivoplasty in certain patients?
Diathermy and electrosurgery should be avoided in patients with cardiac pacemakers.
What causes drug-induced gingival overgrowth?
Certain medications, such as phenytoin (for epilepsy) and nifedipine (for hypertension), can lead to drug-induced gingival overgrowth, causing excessive gum tissue formation.
What is the role of the periodontal pack after a gingivectomy?
The periodontal pack (e.g., Coe-pak) is applied to cover the raw surface of the gingiva after a gingivectomy to protect the tissue and promote healing for about one week.
What are the main indications for a gingivectomy?
Indications for a gingivectomy include excessive gingival tissue (gingival hyperplasia), aesthetic concerns, and difficulty maintaining oral hygiene due to overgrown gum tissue.
How does a gingivectomy improve oral hygiene?
By removing excess gingival tissue, gingivectomy makes it easier to clean the teeth and gums, reducing the risk of plaque accumulation and periodontal disease.
What is the typical recovery time after a gingivectomy?
the recovery time after a gingivectomy is typically about one week for initial healing, during which the periodontal pack is removed, and the gingiva begins to reattach and heal.
What are common complications of gingivectomy?
infection,
bleeding,
pain,
swelling,
delayed healing,
and potential damage to the underlying bone if not performed properly.
What is the difference between gingivectomy and gingivoplasty?
Gingivectomy involves the removal of excess gum tissue, while gingivoplasty is the re-contouring of the gingiva to reshape it, often using electrosurgery or diathermy.
What is the role of chlorhexidine mouthwash after a gingivectomy?
Chlorhexidine mouthwash helps reduce the risk of infection, control plaque, and support healing of the gingiva after the gingivectomy procedure.
Why should aspirin be avoided post-gingivectomy?
Aspirin should be avoided because it is a blood thinner and can increase the risk of excessive bleeding after the gingivectomy procedure.
What should be done if there is discomfort after a gingivectomy?
Discomfort can be managed with analgesics (except aspirin), and the patient should be advised to follow post-operative care instructions to minimize pain and promote healing.
What are the main objectives of performing a gingivectomy?
The primary objectives of a gingivectomy are to improve the aesthetic appearance of the gums, facilitate better oral hygiene, and prevent or treat periodontal disease by removing excessive gum tissue.
Where does the gingiva attach to the tooth?
The gingiva attaches to the tooth at the enamel-cementum junction.
What is the normal range of the gingival crevice?
1-3mm in healthy periodontal tissues.
How far below the gingival attachment is the alveolar bone?
The alveolar bone is 2mm below the gingival attachment.
What can cause gingival hyperplasia?
gingival hyperplasia can occur naturally as a response to tooth eruption or as a result of drug therapy such as phenytoin (for epilepsy) or nifedipine (for hypertension).
