Gingivectomy and Gingivoplasty

Hamad Alzoman, BDS, M.S.Diplomate, The American Board of Periodontology

Gingivectomy• The excision of a portion of the

gingiva; usually performed to reduce the soft tissue wall of a periodontal pocket

Glossary of Periodontal Terms 4rth Edition. The American Academy of Periodontology.

Gingivoplasty• A surgical reshaping of the gingiva.

Glossary of Periodontal Terms 4rth Edition. The American Academy of Periodontology.

Gingivectomy Gingivoplasty

Indications• Elimination of periodontal pocket 3-5

mm• Elimination of gingival enlargement • Asymmetrical or unaesthetic gingival

topography• Suprabony pockets which need access

for restorative dentistry

• Elimination of periodontal pocket 3-5 mm

X X

Indications

Indications• Elimination of gingival enlargement

Localized Generalized

IndicationsAsymmetrical or unaesthetic gingival

topography

Indications• Suprabony pockets which need access

for restorative dentistry

Contraindications

• Presence of intrabony defect• Pockets extending to or beyond the

mucogingival junction or when there is minimal attached gingiva

• Esthetic consideration• High caries rate • Severely inflamed tissue

Contraindications

• Presence of intrabony defect

Contraindications• Pockets extending to or beyond the

mucogingival junction or when there is minimal attached gingiva

Instruments

Instruments

Instruments

Local anesthesia injection

Technique

Pocket Marking

Technique

Uninterrupted bevelled incision with Krickland knife

Technique

Technique

Use of Orban papilla knife

Technique

Excised tissue

Technique

Scaling and root planing

Technique

Smoothing Sharp edges

Technique

Periodontal dressing

Six months after GV

Technique

Internal Beveled GV

Technique Examples

Elimination of periodontal pocket 3-5 mm

Technique Examples

Technique Examples

Technique Examples

• Elimination of gingival enlargement

Technique Examples

Technique Examples

Technique ExamplesAsymmetrical or unaesthetic gingival topography

Pre-Tx Post-Tx

Need of access for restorative dentistry

Technique Examples

Diagnostic Wax-up

Healing following gingivectomy

• Clot formation begins immediately after surgery

• 12-24 hours, migration of epithelial cells from the margin of the wound

• 5-14 days for complete epithelialization ( 0.5 mm per day )

• 10-30 days for connective tissue healing

Gingivectomy and Gingivoplasty GingivectomyGingivoplasty Gingivectomy GingivoplastyIndicationsSlide Number 6Slide Number 7Slide Number 8Slide Number 9ContraindicationsSlide Number 11Slide Number 12InstrumentsSlide Number 14Slide Number 15TechniqueSlide Number 17Slide Number 18Slide Number 19Slide Number 20Slide Number 21Slide Number 22Slide Number 23Slide Number 24Slide Number 25Slide Number 26Internal Beveled GVSlide Number 28Slide Number 29Slide Number 30Technique ExamplesSlide Number 32Slide Number 33Slide Number 34Slide Number 35Slide Number 36Technique ExamplesTechnique ExamplesSlide Number 39Slide Number 40Slide Number 41Slide Number 42Pre-TxPost-TxSlide Number 44Slide Number 45Slide Number 46Slide Number 47Slide Number 48Slide Number 49Diagnostic Wax-upSlide Number 51Slide Number 52Slide Number 53Slide Number 54Slide Number 55Slide Number 56Slide Number 57Slide Number 58Healing following gingivectomy