Gingivectomy is the kind of gum disease surgery which involves the removal of the diseased or excessively grown gingiva with the help of special instruments like Orban or Kirkland knife.Such a specialized treatment of gums and surrounding periodontal tissues is performed by Periodontist. Gingivectomy is performed to restore the functionality, aesthetics and physiology of the gums, which may be diseased, or altered in shape or size, in cases such as:
Hyper-plastic (overgrown) gums either increased in size genetically, during pregnancy or due to intake of certain drugs (like anti-seizure or anti-epileptic drugs). Such a condition of gums is known as Gingival Hyperplasia and such gums are difficult for the patient to clean and brush properly.
Fully or partially erupted wisdom tooth, completely or partially covered by gums leading to Pericoronitis. The procedure performed to treat such a condition is known as Operculectomy.
Pocket formation around the teeth leading to food lodgment and infection by microorganisms causing periodontitis.
Alteration in the ratio of the height of visible crown to the extent of gingival tissue covering the cementum and the enamel of the tooth. Such a tooth crown may look smaller in size as compared to gums.
The Gingivectomy procedure
During Gingivectomy one quadrant of mouth is treated at a time. Making the surgical area numb with a local anesthetic is the first step involved in gingivectomy procedure. After the local anesthetic shows its effect, the Periodontist marks the points with a periodontal probe or a periodontal pocket marker on the parts of gums up to which the gingivectomy procedure is to be performed. Bleeding points can also be produced over the gums for an easy identification by the Periodontist. The gingival tissue towards the tooth crown, beyond the bleeding areas is then excised with the help of Kirkland and Orban’s knife. The Kirkland knife is a specialized heart shaped surgical periodontal knife. It is used for primary gingivectomy. On the other hand, the Orban’s knife is used to excise the gingival tissue in between the teeth. After the excessive gingival tissue has been excised to the required extent, the surgical area is packed with an obtundant dressing to promote clot formation, healing and to prevent food lodgment and infection.
Risk Factors associated with Gingivectomy:
Post Operative Bleeding:
Prolonged bleeding may occur after gingivectomy either because of unseating of the periodontal dressing, intake of hot foods or creation of negative pressure in the mouth (like while spitting, rinsing or sipping). The patient must report to the dentist in such a condition. Such a bleeding can be managed by application of pressure on the wound and applying cold packs. The periodontal dressing is then replaced properly after the bleeding is arrested.
The surgical procedure of Gingivectomy is not painful in itself, but sharp pain may occur after the effect of local anesthesia subsides. The patient must take the prescribed medication on proper intervals and also observe proper precautions as advised by the Periodontist to prevent pain.]
In case the surgical wound gets infected after the surgery, a yellowish watery pus discharge may occur a few days after the surgery. This may happen in case the patient does not follow the instructions and continues to smoke or use tobacco products.
The patient must report to the Periodontist till the area completely heals. The patient must report any unusual progression of the surgical wound like prolonged bleeding, pus discharge or prolonged pain.
The Prognosis of Gingivectomy is excellent in case good post operative care is taken by the patient.