What Is Gingivectomy?

A Gingivectomy removes or forms loose gum tissue to get rid of gingival pockets and gums. If you have gum disease, a dentist may recommend Gingivectomy to prevent further gum damage and help your dentist to have easier access to teeth for cleaning. A dentist may also recommend the procedure if you have gingivitis, a bacterial infection or gum injury. For severe gum disease or periodontitis, surgery may be necessary if it cannot be cured with antibiotics, root gouging or scaling. A gum specialist, periodontist or oral surgeon will perform the operation.

Gingivectomy Before And After

Underneath you can find some before and after pictures of clients that have undergone a Gingivectomy procedure.

Gingivectomy Procedure

Your dentist may recommend this procedure if he discovers a gum disease during an examination or cleaning and wants to stop its progression. Gum disease causes an opening in the upper part of the teeth. This leads to a build-up of plaque, bacteria and hardened plaque known as tartar. This accumulation can lead to further damage. A Gingivectomy for cosmetic reasons is also optional. Talk to a dentist about this and be aware of the advantages and disadvantages of this procedure.

It is a good idea to contact your insurance provider before planning a Gingivectomy so that you understand your benefits. When this procedure is performed, the post-operative pain of the patients is minimal. If pain occurs after the procedure, it usually subsides after a few days and is controlled with pain relief medications.

The most common Gingivectomy are laser Gingivectomy, advances in laser technology continue to make these tools cheaper and easier to use. However, laser procedures are more expensive and require more training than scalpel procedures, so your dentist may offer a scalpel Gingivectomy if they are not trained properly or do not have the right equipment. If you have health insurance, your plan may not cover laser surgery, but scalpel dentistry may be covered as it is cheaper. Lasers are more precise, enable faster healing and have a lower risk of infection than possibly contaminated metal tools.

Your dentist injects a local anaesthetic into the gums to numb the area. Then he or she cuts a piece of gum tissue with a scalpel or laser tool. After the tissue is cut, your dentist will use a laser tool to vapourize the remaining tissue to form the gum line. During the procedure, the dentist assistant holds a suction tool in the mouth to remove excess saliva.

A Gingivectomy can take between 30 minutes to 2 hours, depending on how much gum tissue your dentist removes. Minor procedures involving a single tooth or several teeth may require less time. Major gum removal and reshaping can require multiple visits, as your dentist will want one area to heal before moving on to the next. After the procedure, the dentist will apply a soft ‘putty’ feeling substance on your gums to act as a bandage and to aid the healing process.

what is gingivectomy
‘Gummy smile’ correction with Gingivectomy

Aftercare Of Gingivectomy

Adequate plaque control is important to ensure the long-term results of surgery. It is vital to ensure the level of post-operative infection control is maintained, so that the patient can maintain a healthy periodontium. Patients are advised not to rub against or get food near the area where the operation was performed during the initial healing phase. The outcome of the Gingivectomy is influenced by other general factors such as the systemic status of the patient.

After the procedure, the patient is advised to rinse with appropriate anti-plaque agents. If the patient is struggling with self-fulfilling oral hygiene after the procedure due to pain or discomfort, regular visits to a specialist for dental cleaning are advisable. If a patient does not maintain adequate oral hygiene during postoperative treatment, it is possible that the gum disease will return.

You may experience some minor bleeding in the gums, so any bandages used should be replaced often and the area kept clean. Your dentist will advise you on post-care instructions, if you are confused or unsure about something then you should call the dentist. You may be asked to go back for a follow-up check.

In the early stages of healing, the use of an interdental brush is not recommended due to possible damage to the tissue.

You may experience some pain in your jaw once the anaesthetic has worn off. You can take an ibuprofen or acetaminophen to manage your pain. A cold compress or ice pack also can help, and a salt-water mouth rinse can help reduce risk of infection. Avoid harsh mouthwash solutions and anti-septic as these will irritate the open wound.

You should also avoid smoking, as this can cause infection and slow down the healing process. Sugary foods should also be avoided.

Electrical Surgery

Electrical surgery has been used in dentistry for more than 60 years. It is defined as the deliberate passage of a high frequency waveform (current) through tissues of the body to achieve a controllable surgical effect. Electrosurgery is not widely used due to several factors, including the cost and lack of available information about the procedure.

The basic types of electrosurgical techniques are clotting, dehydration, fulguration, electrosection and cutting. The majority of clinical operations are performed by electrosection. By changing the mode of activation of the current, electro-surgery can be used to cut and coagulate soft tissue. It is crucial that a circuit is present in the surgical unit to allow the current to flow. There are two main types of electrosurgical units: monopolar and bipolar.

In a monopolar unit, separate electrodes must form an indifferent plate for the patient. The current starts in the electro-surgical unit and flows via a wire to a secondary electrode to the oral site. Heat is generated when there is contact with the oral tissue and an incision occurs. With bipolar devices, there are two electrodes at their cutting point and the current travels from one to the other, rendering the indifferent plate superfluous. Bipolar devices can also be manufactured with a wider cut.

Results of studies on the healing of electro-surgical wounds vary compared to scalpel wounds, but electro-surgical devices have been found to minimize bleeding and most patients have little or no post-operative pain after surgery.

laser gingivectomy
Here you can see the immediate difference of tooth display

Laser Gingivectomy

Laser gingivectomy is a light enhancement that stimulates the emission of radiation, including ND (YAG), neodymium, yttrium, aluminum garnet laser, CO2 laser and diode laser. It has been suggested that lasers can significantly reduce bacteria such as Actinobacillus and Actinomycetemcomitans aa, reducing inflammation and facilitate the healing process.

Advantages of a laser Gingivectomy include:

  • less bleeding
  • no-contact surgery means less chance of infection and contaminatin
  • sterilization of the surgical site
  • faster healing time
  • minimal post operative pain
  • less time to perform the surgery than traditional scalpel technique

It has also been suspected that laser treatment leads to minimal post-operative swelling and scar tissue formation. It seems to have good patient acceptance and patients report minimal pain. The YAG laser can be used to curettage pocket epitheliums and causes little or no damage to the underlying tissue.

One study found that recurrence was minimal or eliminated in patients with drug-induced gingival overgrowth compared to laser Gingivectomy and scalpel Gingivectomy. Animal studies have shown that rat skin (ND / YAG ) responds better to laser applications after a scalpel cut, but this is only true when energy and frequency parameters are low, as high energy levels can lead to scarring and delay wound healing. Ablation and coagulation lasers sterilize tissue, eliminating the need for a postoperative bandage.

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