Indications and Benefits of Gingivectomy
- Reduction of pocket depths in patients with periodontitis and suprabony pockets
- Conventional gingivectomy is more successful than non-surgical treatments for reducing pocket depths and inflammation
- Removal of suprabony deep pockets allows better visibility and access for calculus removal
- Provides a suitable environment for healing and restoration of gingival contour
- Effective in treating drug-induced gingival enlargement
- Indicated when overgrowth is severe
- Used to treat gingival fibromatosis with good aesthetic results
- Can increase clinical crown height in teeth with inadequate tissue for prosthetic restorations
- Surgical treatment resets the margin while maintaining biological width and clinical attachment
- Can improve aesthetics and restore normal gingival architecture in gummy smiles
- Laser gingivectomy has additional benefits such as reducing bacteria and inflammation, minimal pain, sterilizing infected root surfaces, and minimal post-operative swelling, bleeding, scar tissue formation, and pain
Contraindications and Post-operative Management
- Bone surgery is needed in certain cases
- Aesthetic considerations, particularly in the anterior region of the Maxilla
- Dental/gingival morphologic characteristics and peri-oral variables influence smile frame
- Higher smile lines are more common among females, lower smile patterns among males
- Adequate plaque control and post-operative infection control are important for long-term results
- Regular professional tooth cleaning and visits for monitoring plaque levels are advised
- Electrosurgery can be used for gingivectomy but is not widely used due to cost and lack of information available
Laser Gingivectomy
- Laser types: Nd:YAG (Neodymium: Yttrium Aluminium Garnet) laser, Diode laser
- Laser treatment has good patient acceptance and minimal pain
- Laser treatment sterilizes infected root surfaces and removes plaque, calculus, and smear layer
- Laser treatment results in minimal post-operative swelling, bleeding, scar tissue formation, and pain
- Efficient sterilization of infected root surfaces and pocket microflora
- Curettage of adjacent pocket epithelium
- Removal of smear layer
- Enhanced calculus elimination
- Nd:YAG laser application showed better wound healing response compared to scalpel incisions
- Low energy and frequency parameters lead to better wound healing
- High levels of energy can cause scar formation and delayed wound healing
- Laser treatment allows for a bloodless operating field, better visibility, and ease for the operator
- Laser treatment eliminates the need for post-surgical dressing
- Laser gingivectomy resulted in minimal or eliminated recurrence of drug-induced gingival overgrowth compared to scalpel gingivectomy
- Laser treatment is effective in achieving periodontal health and reattachment of gingival tissues to previously infected root surfaces
- Laser treatment provides better visibility and ease for the operator
- Laser treatment sterilizes tissues and eliminates the need for post-surgical dressing
Comparison to Other Gingivectomy Methods
- Laser treatment is more effective than conventional treatment in achieving periodontal health and reattachment of gingival tissues to previously infected root surfaces
- Conventional treatment does not completely remove plaque and calculus
- Laser treatment provides better visibility and ease for the operator
- Laser treatment sterilizes tissues and eliminates the need for post-surgical dressing
References (not included in the summary)
Gingivectomy is a dental procedure in which a dentist or oral surgeon cuts away part of the gums in the mouth (the gingiva).
Gingivectomy | |
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MeSH | D005890 |
It is the oldest surgical approach in periodontal therapy and is usually done for improvement of aesthetics or prognosis of teeth.
By removing the pocket wall, gingivectomy provides visibility and accessibility for complete calculus removal and thorough smoothing of the roots, creating a favourable environment for gingival healing and restoration of a physiologic gingival contour. The procedure may also be carried out so that access to sub-gingival caries or crown margins is allowed. A common aesthetic reason for gingivectomy is a gummy smile due to gingival overgrowth.
gingiva + -ectomy
gingivectomy (plural gingivectomies)