gingivectomy

Question 1

what is gingivectomy

Answer 1

excision of the gingiva

Question 2

indications of gingivectomy

Answer 2

-elimination of suprabony pockets, regardless of depth if the pocket wall is fibrous n firm
-elimination of gingivae enlargments
-elimination of suprabony periodontal abcess
-crown lengthening
(anatomical or restorative purposes)

Question 3

contraindications of gingivectomy

Answer 3

• need for bone surgery
• bottom of pocket apical to mgj (mucogingival junction)
• esthetic considerations
• insufficient attached gingivae

Question 4

gingivectomy methods

Answer 4

electrodes
lasers
chemicals
surgical methods-recommend

Question 5

steps to surgical gingivectomy

Answer 5

step1: probing and market of pockets on all surfaces

step2: incisions to facial and lingual surfaces and distal to the terminal tooth in the arch (kirkland knives or goldman 11 for incisions, orban for interdental, bard parker 11,12 and scissors as auxillary instruments)
incision starts from apikal to the markings and directed coronally between base of pocket and crest on the bone, should be as close as possible to the bone without exposing it. bewel should b approx: 45 degrees resembling healthy gingivae

step3: remove the excised pocket clean the area and examine
step4: carefully curette granulation n remove any remaining calculus leavin a smooth clean surface
step5: cover the area with surgical pack

Question 6

healing after surgical gingivectomy

Answer 6

initally: clot formation-granulation
24 h: t cells underlayer of inflammation n necrosis
3d: numerous young fibroblasts
5-14 days surface epithelization complete
complete repair: 7w
max inflammation = max gingival fluid flow =1w

Question 7

what is gingivoplasty

Answer 7

shaping of gingiva to create physiological contours with the sole purpose of recontouring in the absence of pockets
*gingivectomy includes this reshaping

Question 8

types of deformities in the gingiva

Answer 8

gingival clefts n craters
shelf like interdental papilla caused by ANUG
gingival enlargments

Question 9

gingivoplasty can be done with…

Answer 9

peridontal knife
scalpel
rotary coarse diamond stones or electrodes

Question 10

steps of gingivoplasty

Answer 10

tapering of gingival margin
creating scalloped marginal outline
thinning attached gingiva
creating vertical interdental grooves
shaping interdental papilla