GINGIVECTOMY
Gingivectomy means excision of the gingiva. By removing the pocket wall, gingivectomy provides visibility and accessibility for complete calculus removal and thorough smoothing of the roots, creating a favorable enviornment for gingival healing and restoration of a physiologic gingival contour.
Indications:
- Elimination of suprabony pockets, regardless of their depth, if the pocket wall is fibrous & firm.
- Elimination of gingival enlargements
- Elimination of suprabony periodontal abscesses.
Contraindications:
- The need for bone surgery
- Situations in which the bottom of the pocket is apical to the mucogingival junction.
- Esthetic consiserations, particularly in the anterior maxilla.
SURGICAL GINGIVECTOMY
Armamentarium:
- Mouth mirror, probe
- Pocket markers, Kirkland and orban interdental gingivectomy knives
- Surgical blades, Bard Parker handle
- Surgical curettes, Gracey curettes, tissue forceps, scissors.
- Peiodontal dressings.
Surgical Technique Steps:
Step 1: The pockets on each surface are explored with a periodontal probe and marked with a pocket marker.
Step 2: The incision is started apical to the points marking the course of the pockets and is directed coronally to a point between the base of the pocket and the crest of the bone.
Step 3: Remove the excised pocket wall, clean the area, and closely examine the root surface.
Step 4: Carefully curette the granulation tissue, and remove any remaining calculus and necrotic cementum so as to leave a smooth & clean surface.
Step 5: Cover the area with a surgical pack.
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Source: Carranza’s Clinical Periodontolgy, 10th Ed
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