Gingivectomy Flashcards
Gingivectomy is a
Gingivectomy is a simple surgical procedure to excise the enlarged gingiva
Postsurgical management such as bleeding and pain can be a problem
Healing of gingivectomy is
Primary closure of the wound is not possible and healing is by secondary
intention
Indications & Objectives of gingivectomy
Gingival enlargement
Correction of gingival
contour- physiologic tissue
To eliminate fibrous and firm
fibrous pockets
Increase the clinical crown
Contraindication of Gingivectomy
Access to bone required
Esthetics
Systemic condition, Patient with high
post operative risk of bleeding
Narrow zone of Keratinized Gingiva or
Pocket extending beyond muco-gingival
junction
Gingival enlargements pose problems that include
biofilm control,
impaired function (mastication, tooth eruption, and speech), and
aesthetics.
Soft and friable even after scaling and root planing, the
Gingivectomy
If the gingival tissue is firm and fibrotic, preference is given to the
flap
operation, which is always the favorable choice because the healing is by
primary intention
The Treatment of Drug-induced Gingival Enlargement
Possibility of discontinuing the drug or
changing the medication in consultation
with the patient’s physician
The changes instituted with the drug
should always be in combination with
oral hygiene instructions, scaling, and
root Planing
Reevaluation of the gingival enlargement
after the alteration of drug therapy is
necessary before any surgical treatment
is planned.
Based on the medication used and the clinical features of the case
Tumor-like, localized, and severe
inflammatory enlargements can
be treated by gingivectom
Gingivectomy technique to treat patients with
drug induced gingival
enlargement.
Gingivectomy knives
A, Kirkland B, Orban interdental
Gingivectomy by electrosurgery advantages
Advantages; Permits adequate countering of the tissues
and controls hemorrhage.
Gingivectomy electrosurgery disadvantages
Cannot be used in patients who have a
non compatible or a poorly shielded cardiac pacemaker.
Gives an unpleasant odor.
If the electrosurgical point touches the bone, irreparable
damage may be done
Heat generated by injudicious use can cause tissue
necrosis and loss of periodontal support
Electrosurgical gingivectomies may cause delayed healing, and the
surgeon must be careful not to place the electrodes close to the bone
margins because sequestration of bone can occur.
Use of electrosurgery
Limited to superficial procedures such as;
Gingivoplasty,
Gingival enlargement,
Relocation of frenum and muscle attachment
, Incisions of periodontal abscesses and pericoronal flaps.
Reasons for failure
Failure to eliminate pocket or delineate
depth of pocket
Terminating incisions on a papilla
Leaving tissue tags , necrosis, calculus
and loose dressings
Non-elimination of etiological &
predisposing factors.
Un co-operative patient
Gingivoplasty is a
Gingivoplasty is a reshaping of the gingiva to create physiologic gingival
contours, with the sole purpose of recontouring the gingiva.
