Gingivectomy is a surgical procedure that removes gingival pockets by eliminating excess gingiva. It has limited indications for conditions like gingival enlargement or shallow pockets. The procedure involves making continuous incisions at the base of pockets and removing tissue. Disadvantages include pain, healing by secondary intention, and risk of exposing bone. Instruments used include specialized knives and marking forceps. The area is dressed post-operatively to aid healing. Drug-induced gingival overgrowth can also be treated with gingivectomy.
6. Disadvantages
1. Very limited indications
2. Gross wound; postoperative pain
3. Healing is by secondary intention (ca. 0.5
mm/day)
4. Danger of exposing bone
5. Loss of attached gingiva
6. Exposes cervical area of tooth (sensitivity,
esthetics, caries)
7. Phonetic and esthetic problems in anterior area
7. Principle of the Operation
1. Continuous incision at 45° angle at the base of the
pocket
2. Sharp dissection of tissues in the interdental area
3. Smoothing of the incision edge
4. Contouring the gingival surface (GP)
5. Scaling and root planing
6. Wound coverage (periodontal dressing)
8. Instruments
• Size, shape and angulation of the
working tip, and also by the
comfortable handle
• Gingivectomy knife + papilla knife,
singly or doubly angled
9. Pocket marking forceps
• Paired (L & R)
• Use: indicate the location of the base of
the pocket
11. Gingivectomy knives
• GV knife (Kirkland, L & R)
Sharpness! • Papilla knife (Orban, L & R)
Arkansas stone + oil • Universal knife
12. Gingivectomy knives
45° angle to the tooth long axis
Anterior area: single-bend
Less accessible area: double-bend
13. Electrosurgery apparatus and tips
• Use: gingiplasty, papillectomy, smooth out abrupt edges,
expose the margins of a tooth preparation before taking
the impressions or seating a restoration
• Hemostatic effect
• Not recommended for primary gingivectomy injury to
the root, periosteum or bone
15. Periodontal Dressings
& Tissue Adhesives
• Reduce postaperative pain
• Prevent colonization of plaque
• Left in situ for 7~10 days
• A second dressing may be indicated if
healing is inadequate.
• Only eugenol-free dressings are
recommended.
16. • Peripac: ready-to-use, gypsum base + acrylic,
sets quickly when contacting with saliva, hard
edgesdanger of pressure aphthous ulcer
• Coe-pak: 2 component (zinc oxide + fatty
acids), pliable after setting
50. References
1. Color Atlas of Dental Medicine: Periodontology:
Periodontology. Herbert F. Wolf, Klaus H. Rateitschak
2. Informational Paper - Drug-Associated Gingival
Enlargement, J Periodontol 2004;75:1424-1431.