Gingivectomy Important Question And Answers

Gingivectomy Question And Answers

Gingivectomy may be defined as the surgical excision of the gingiva for the elimination of the pocket wall.

Question 1. Describe the indications and contraindications of gingivectomy.
Answer:

Indications Of Gingivectomy: Suprabony fibrotic pockets

1. Gingival enlargement
2. Suprabony periodontal abscess
3. Anterior esthetic enhancement
4. Crown lengthening procedure
5. Implant uncovering as a second-stage procedure.

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Contraindications Of Gingivectomy

1. Infrabony pockets, where there is a need for respective or regenerative therapy
2. Edematous gingiva
3. Decreased attached gingiva or other mucogingival problems
4. Esthetic consideration. Gingivectomy can result in an anesthetic appearance when used as a pocket elimination procedure and is to be avoided in esthetically sensitive areas.

Question 2. Describe the techniques of gingivectomy.
Answer:

Surgical Technique Of Gingivectomy

Step 1: Following administration of anesthesia, the pocket depth is marked, and using a Crane Kaplan pocket marker bleeding points are created.

Step 2: An external bevel incision is made at the base of the bleeding points. A discontinuous or continuous incision may be used. Discontinuous incisions are designed to stop at the mesial or distal line angles of the tooth and this way the bulk of the interdental gingival may be reduced as required.

Step 3: The soft tissue is excised and remnant granulation tissue is removed using curettes and the exposed roots are thoroughly planed.

Step 4: Placement of periodontal dressing.

Healing Occurs Through Secondary Intention

• Electrosurgical Gingivectomy
  • Electrosurgery may be used for gingival tissue excision procedures. This technique can be used for both cauterization and excision depending on the tip that is used.
  • It offers the advantage of good hemostasis and therefore better visibility in vascular lesions.
  • However, its disadvantages are an unpleasant burning odor and the potential for damage to exposed bone and cause cementum.
• Laser Gingivectomy
  • Soft tissue lasers are used for gingivectomy.
  • They offer the advantages of hemostasis, lesser postoperative morbidity, and good wound healing.
  • However, laser-related precautions are to be observed, otherwise, there is potential for damage to both the operator and patient.
• Chemosurgical Gingivectomy: The use of caustic chemicals for gingivectomy is not in vogue as tissue removal is inadequate or unpredictable.

Healing After Gingivectomy: The blood clot that is formed transforms to granulation tissue and epithelialization occurs in the initial 24–48 hour period. Connective tissue repair takes longer and collagen turnover is completed in a few weeks time.

Gingivoplasty: Gingivoplasty is defied as the recontouring of tissue without the elimination of pockets. It is indicated in the treatment of gingival clefts and soft tissue craters following necrotizing gingivitis, or for the correction of soft tissue deformities for esthetic reasons.