Gingivectomy: Types, Procedures

 Gingivectomy Treatment

Gingivectomy means excision of the gingiva.

By removing the pocket wall gingivectomy provides visibility and accessibility for complete calculus removal and thorough smoothening of the roots, creating a favorable environment for gingival healing and restoration of a physiologic gingival contour.

Rationale of Gingivectomy

• To provide the good visibility and accessibility for the complete calculus removal and thorough smoothening of the roots.
• To facilitate gingival healing by creating a favorable environment.
• To restore a physiological gingival contour.

Types of Gingivectomy

• Surgical gingivectomy
• Electrosurgical gingivectomy
• Laser gingivectomy
• Chemosurgical gingivectomy

Electrosurgical Gingivectomy

In this technique electric current is used for giving the incisions.

It uses high frequency current of 1.5 to 7.5 million cycles per second.

Here three classes of electrodes are used i.e.

• Single wire electrodes for both incising and excising
• Loop electrodes for planning the tissues
• Heavy bulkier electrodes for the coagulation.

Four Types of Electrosurgical Techniques are Present i.e.

• Electrosection: This is used to perform incising, excising and planning
• Electrocoagulation: This is used to prevent hemorrhage
• Electrofulguration: This uses high voltage current. This has limited usage in dentistry.
• Electrodessication: It uses the dehydrating current and is least used as dangerous technique. It is used in dermatological and the cancer surgeries.

Gingivectomy Procedure

• In gingivectomy, needle electrodes are supplemented by ovoid loop or diamond-shaped electrodes. In this fully rectified cutting and coagulation current are used.
• Activate the electrode and move it in the shaving motion.
• A needle electrode is used for giving the incision for drainage.
• Ball electrode should be used for hemostasis.

Laser Gingivectomy

• CO₂ laser and Nd: YAG Laser are commonly used for the excision of gingival growths.
• In laser gingivectomy, healing is delayed as compared to surgical gingivectomy technique.
• Laser offers dry and bloodless surgery.

Chemosurgical Gingivectomy

• 5% paraformaldehyde or potassium hydroxide are the chemicals used to perform chemosurgical gingivectomy.
• This technique is not used now because of various disadvantages such as:
  • Depth of chemical action cannot be controlled.
  • Gingival remodeling cannot be accomplished effectively.
  • Epithelialization and reformation of junctional epithelium, re-establishment of the alveolar crest fiber system are slow in chemically treated gingival wounds than in those produced by scalpel.