Gingivectomy and gingivoplasty
What is the difference?
There are many techniques within periodontal treatment. Some of them are aimed at easing the effects of periodontal disease, such as surgical procedures that seek to repair, maintain and support the tissue holding the teeth in place, so that the mouth in general, and the teeth in particular, have the healthy appearance of a healthy mouth.
A gingivoplasty is a simple procedure, carried out under local anesthetic, to reshape the gums with the aim of improving their contour without altering their height. It is generally carried out in combination with a gingivectomy for esthetic reasons or as part of treatment for periodontitis. A gingivoplasty is a simple procedure for solving a gummy smile, carried out under local anesthetic, to reshape the gums with the aim of improving their contour without altering their height. It is generally carried out in combination with a gingivectomy for esthetic reasons or as part of treatment for periodontitis.
Getting down to it, two of these procedures are the gingivectomy and the gingivoplasty, which often cause confusion because the differences between them are not well known. In this post we are going to unpick the subject. They are similar but have different purposes; we are going to explain what they involve, what their objectives are and what has to be done beforehand for them to be effective.
Gingivectomy step by step
What a gingivectomy is
A gingivectomy is periodontal surgery focused on the gums. It involves removing gum tissue in order to eliminate or reduce periodontal pockets when the bone is not affected. The damaged gum tissue is excised and removed. Local anesthetic is used for this procedure.
How a gingivectomy is carried out, step by step
Once the anesthetic has been applied, a probe is used to locate each periodontal pocket. They are assessed to determine how deep they are and then marked.
A first incision is made down to the mark, but without exposing the supporting bone. A second incision is made to separate the diseased tissue, which is then removed very carefully, taking everything away until the root is completely clean. Various instruments are used to remove all the tissue and leave the tooth surface smooth and visible.
The treated area is then covered with a periodontal dressing to help it heal. That usually stays on for one to two weeks. The tissue is completely repaired in around two months.
What a gingivectomy is used for
This periodontal surgery is commonly used to treat patients with gum inflammation that causes the tissue to grow. It may also be needed in people who have had root canal treatment and have an enlarged periodontal pocket.
Contraindications and side effects
Complications can arise in cases where there is too little gum, when the pockets have reached the mucosa or when bone surgery is clearly needed. In those cases this kind of procedure would not be recommended.
There may be some immediate adverse effects, such as tears in healthy tissue or in the nerves near the gums that cause injury. There can also be complications some time later, such as an infection, bleeding or a more general health problem.
Advantages and drawbacks
A gingivectomy is a straightforward procedure with predictable results. It heals well and offers a clear esthetic improvement.
However, since recovery is somewhat painful in the short term, the esthetic effects will not be visible immediately. The risk of exposed bone or gum loss can cause tooth sensitivity and, as we have said, there may be bleeding afterwards.
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Gingivoplasty
What a gingivoplasty is
A gingivoplasty is periodontal surgery very similar to a gingivectomy, although its aim is different. Here what the clinician is trying to do is restore the contour of the gum once the periodontal pocket has gone. This procedure is often carried out alongside the previous one, at the same time and to complement it.
How a gingivoplasty is carried out
A gingivoplasty is performed with a scalpel by hand, with mechanical instruments or with electrodes, depending on each patient’s needs.
The first step is to smooth the edges of the gums to give them the shape we want. The margins are then contoured to reduce the size of the gum and leave more tooth surface on show, which is where the esthetic side comes in. Finally the teeth are shaped so that they have the appearance we are after.
The effects of a gingivoplasty
This periodontal procedure has a clear esthetic aim. The result is a more beautiful smile thanks to correcting the size of the gums, which sometimes show too much when we smile and make people self-conscious. A gingivoplasty gives the teeth greater brightness and a cleaner look.
Before having periodontal surgery
Before having this kind of surgery, a professional needs to assess each individual case. Both Dr. Marta Peydro and Dr. Diego Peydro can give a diagnosis on this.
In either case, before surgery we may be given a pre-treatment to remove as much plaque and tartar as possible. That makes the area to be treated more accessible.
After the procedure we should follow the Peydro doctors’ recommendations closely. That way we will avoid problems later on, keep good oral hygiene and preserve our smile for life.
