Gingivectomy And Gingivoplasty

Question 1

Name 6 indications for gingivectomy or gingivoplasty

Answer 1

1. Suprabony pockets coronal to the mucogingival junction
2. No Ossetia defects that require correction by Ossetia surgery or regeneration
3. Gingival enlargements secondary to medications, systemic disease, or the margins and contours of fixed restorations
4. Adequate zone of keratinized gingiva
5. Ample vestibular depth and palatial vaults to permit instrumentation
6. Crown lengthening

Question 2

Name 6 contraindications to gingivectomy and gingivoplasty

Answer 2

1. Inadequate attached gingiva
2. Infra-bony defects
3. Aesthetic compromise
4. Acutely inflamed soft tissue
5. Presence of thick bony ledges and exostosis
6. An alternative, more effective procedure

Question 3

What are the advantages to gingivectomy and gingivoplasty?

Answer 3

1. Relatively easy procedure
2. Access and visualization for root debris event
3. Probing depth decrease
4. Predictable morphology
5. Aesthetic result if properly done

Question 4

What are the disadvantages to gingivectomy and gingivoplasty?

Answer 4

1. Limited application
2. Post operative pain
3. Slow healing
4. Used inappropriately it may:
   - create inadequate attached gingiva
   - give unaesthetic results
   - alter phonetics
   - expose bone

Question 5

What is gingivectomy and gingivoplasty?

Answer 5

Gingivectomy - excision of a portion of the gingiva, usually performed to reduce soft tissue walls of a periodontal pocket

Gingivoplasty - reshaping of the gingiva

Question 6

When does epithelialization occur after a gingivectomy?

Answer 6

It occurs within a few days and completes in 1-2 weeks.

Regeneration of the supra alveolar connective tissue than occurs

Question 7

What angle do you begin your incision for gingivectomy and gingivoplasty? And what instrument is used?

Answer 7

45 degrees angle external bevel incision

The Kirkland or Goldman Fox GV knife (scalpel)

Question 8

Recall the phases of periodontal therapy

Answer 8

Phase I - initial preparation

Phase II - re-evaluation/pre-surgical evaluation

Phase III - periodontal surgery

Phase IV - post-surgical evaluation

Phase V - prosthetic treatment

Phase VI - periodontal maintenance

Question 9

Recall the physiologic contour (architecture) of the tooth

Answer 9

Parabolic, parallels the CEJ, and more pronounced in the incisor region and becomes flatter as you move posterior

Question 10

What is positive and negative architecture? (Recall)

Answer 10

Positive - normal physiologic relationship of interdental and radical are bone heights – radical are bone is apical to inter proximal bone)

Negative - interdental bone is apical to radicular bone

Question 11

In an Osseous defect, what is the gingival morphology? Compared to periodontitis?

Answer 11

Gingival morphology tends to remain parabolic

In periodontitis the bone morphology is changed

Question 12

Is there an increased or decreased probing depth with Ossetia defects?

Answer 12

Increased PD

Question 13

What are some 0 wall defects?

Answer 13

Dehiscences

Fenestrations

Question 14

True or false: you can treat 0 wall Ossetia defects with Osseous surgery?

Answer 14

Probably but it is NOT the treatment of choice

Question 15

What is a 1 wall defect called if the proximal wall is present?

Answer 15

Hemiseptal

Question 16

What is a 1 wall defect called if only the facial or lingual wall is present?

Answer 16

Ramp

Question 17

What is the treatment for a 1 wall defect?

Answer 17

Osseous surgery

Question 18

What factors do you need to consider for Osseous surgery?

Answer 18

1. # of remaining walls
2. Depth of defect
3. Width of defect
4. An anatomic landmarks
5. Predictability