This document discusses gingivectomy and gingivoplasty periodontal procedures. Gingivectomy involves excising soft tissue from periodontal pockets to eliminate them, while gingivoplasty reshapes gingiva that has lost its normal contours without removing pockets. Surgical gingivectomy involves making incisions and removing pocket walls with knives and nippers. Laser and electrosurgery are alternative techniques. Gingivoplasty reshapes gingiva through thinning, tapering, and sculpting to create a scalloped margin. Both procedures aim to develop healthy tissue and contours, though gingivectomy is rarely used now due to inability to visualize bone and greater post-op discomfort compared to flap surgery.

1. GINGIVECTOMY
GINGIVOPLASTY
- MURALI, CRI

2. GINGIVECTOMY:
An excision of the soft tissue wall of the periodontal pocket
GINGIVOPLASTY:
Recontouring (reshaping) of gingiva that has lost its
physiologic gingival contoursI

3. OBJECTIVES:
GINGIVECTOMY:
Pocket elimination by gingival resection
Development of physiologic tissue
GINGIVOPLASTY:
Recontouring of gingiva in the absence of
pockets

4. GINGIVECTOMY
INDICATIONS
•Elimination of suprabony
pockets
•Elimination of gingival
enlargements
•Exposure of additional
clinical crown for
restorative and esthetic
purposes
•Pericoronal flap
CONTRAINDICATIONS
• Procedures involving bone
surgery or examination of
shape and morphology
• When the bottom the
pocket is apical to the
MGJ, which will leave an
inadequate width of
gingiva
• Anterior teeth -esthetic
zone

5. DRAWBACKS
• Wound healing occurs by secondary intention
• Dentin hypersensitivity
• Alveolar bone defects cannot be treated adequately
• Compromised attached gingiva
TYPES:
1. Surgical gingivectomy
2. LASER gingivectomy
3. Electrosurgical gingivectomy
4. Chemical gingivectomy

6. SURGICAL GINGIVECTOMY
ARMAMENTARIUM:
1. Pocket markers: Goldman-fox, Crane Kaplan
2. Kirkland knife
3. Orban knife
4. BP blade – 11,12,15
5. Tissue nippers

7. PROCEDURE
STEP 1: #Administration of LA
# Pockets are examined and marked with pocket
marker parallel to the root surface
# Bleeding points are marked on both buccal and
lingual surfaces
# Pinpoint perforation depth of the pocket
STEP 2: # Discontinuous or continuous incision is given
from the distal surface using Kirkland knife
# External bevel incision is given at an angle 45
apical to base of the bleeding point/pocket
# Orbans knife – to the free the tissue
interproximally

8. STEP 3: # Remove the excised pocket wall
# Remaining tissue tabs are removed
with tissue nippers
# Gingival margins must be thin and
bevelled
STEP 4 : # Scaling and root planning to be done
to remove the calculus and necrotic debris
STEP 5 : # Bleeding is controlled
# Cover the area with periodontal
dressing
# Postoperative instructions to be
given

9. LASER GINGIVECTOMY:
• Completely dry, bloodless surgery.
• Uses carbondioxide (CO2) & Neodymium-doped : yttrium-aluminium-garnet
(Nd:YAG)
• Reduced postoperative pain, swelling and scarring
• Faster healing due to least mechanical trauma
• High cost and technique sensitive

10. ELECTROSURGICAL GINGIVECTOMY:
INSTRUMENTS: Needle electrode 0.0075inch – 0.015inch
PROCEDURE: 1. Area must be slightly moist
2. Blended cutting and coagulating current is used
3. Electrode must be in constant motion to prevent heat
build-up
4. Debris should be cleaned with isopropyl alcohol from
the electrode for each motion
CONTRAINDICATION:
Cardiac pacemakers.

11. CHEMOSURGICAL GINGIVECTOMY:
5% Paraformaldehyde or Potassium hydroxide is used.
The depth of the chemical action cannot be controlled
Re-epithelialization of junctional epithelium and re-
establishment of alveolar crest fiber occurs in a slower rate
POST-OPERATIVE HEALING – 3 TO 5 weeks
2nd DAY – Clot formation
4th DAY – Clot replaced by granulation tissue
6th DAY – Wound is covered by stratified squamous epithelium
16th DAY – Epithelium and connective tissue appear
21st DAY – Gingiva clinically appears normal

12. GINGIVOPLASTY (Goldman)
Reshaping of gingiva to create physiologic contours in the
absence of pockets
INDICATIONS:
Correcting the grossly thickened gingival margin
Correction of deformities like craters, clefts, gingival
enlargements.
Varying levels of gingival margins
INSTRUMENTS:
Periodontal knife, scalpel, rotary coarse diamond electrodes

13. PROCEDURE:
Tapering the gingival margin
Creating a scalloped margin outline
Thinning the attached gingiva
Shaping the IDP to provide embrasure for the passage of food
Scrapping – shaving of the surface

14. CONCLUSION
Gingivectomy is rarely used to treat periodontitis and gingival
hyperplasia because the underlying bone cannot be visualized thus flap
surgery is preferred and it does not satisfy certain criteria like
conservation of keratinized gingiva, esthetics, minimal bleeding and
discomfort.

15. REFERENCES
Textbook of periodontology, ELEEY
Clinical periodontology, CARRANZA
Textbook of clinical periodontics , Shalu bhatla

16. THANK
U