Gingivectomy is a surgical procedure that removes gingival pockets by eliminating excess gingiva. It has limited indications for conditions like gingival enlargement or shallow pockets. The procedure involves making continuous incisions at the base of pockets and removing tissue. Disadvantages include pain, healing by secondary intention, and risk of exposing bone. Instruments used include specialized knives and marking forceps. The area is dressed post-operatively to aid healing. Drug-induced gingival overgrowth can also be treated with gingivectomy.

1. GINGIVECTOMY
Date: 2012-12-21
Presenter: R2 鄭瑋之 Instructor: VS 陳娟娟

2. Definition
• A surgical procedure in which gingival
pockets are eliminated by removal of gingiva.

3. Indications
1. Gingival enlargement or overgrowth
2. Idiopathic gingival fibromatosis
3. Pseudopockets
4. Shallow suprabony pockets  modified Widman
5. Areas with difficult access
6. Minor corrective procedures

4. Contraindications
1. Narrow or absent attached gingiva
2. Infrabony pockets
3. Thicking of marginal alveolar bone

5. Advantages
1. Technically simple; good visual access
2. Complete pocket elimination
3. Predictable morphological result

6. Disadvantages
1. Very limited indications
2. Gross wound; postoperative pain
3. Healing is by secondary intention (ca. 0.5
mm/day)
4. Danger of exposing bone
5. Loss of attached gingiva
6. Exposes cervical area of tooth (sensitivity,
esthetics, caries)
7. Phonetic and esthetic problems in anterior area

7. Principle of the Operation
1. Continuous incision at 45° angle at the base of the
pocket
2. Sharp dissection of tissues in the interdental area
3. Smoothing of the incision edge
4. Contouring the gingival surface (GP)
5. Scaling and root planing
6. Wound coverage (periodontal dressing)

8. Instruments
• Size, shape and angulation of the
working tip, and also by the
comfortable handle
• Gingivectomy knife + papilla knife,
singly or doubly angled

9. Pocket marking forceps
• Paired (L & R)
• Use: indicate the location of the base of
the pocket

10. Pocket marking forceps

11. Gingivectomy knives
• GV knife (Kirkland, L & R)
Sharpness! • Papilla knife (Orban, L & R)
Arkansas stone + oil • Universal knife

12. Gingivectomy knives
 45° angle to the tooth long axis
 Anterior area: single-bend
 Less accessible area: double-bend

13. Electrosurgery apparatus and tips
• Use: gingiplasty, papillectomy, smooth out abrupt edges,
expose the margins of a tooth preparation before taking
the impressions or seating a restoration
• Hemostatic effect
• Not recommended for primary gingivectomy  injury to
the root, periosteum or bone

14. Electrosurgery apparatus and tips
 To reduce the bulbous marginal gingival contour

15. Periodontal Dressings
& Tissue Adhesives
• Reduce postaperative pain
• Prevent colonization of plaque
• Left in situ for 7~10 days
• A second dressing may be indicated if
healing is inadequate.
• Only eugenol-free dressings are
recommended.

16. • Peripac: ready-to-use, gypsum base + acrylic,
sets quickly when contacting with saliva, hard
edgesdanger of pressure aphthous ulcer
• Coe-pak: 2 component (zinc oxide + fatty
acids), pliable after setting

17. • CHX power: reduce plaque formation

18. • Tissue adhesives (Cyanoacrylate): Histoacryl,
Bucrylate
• Use: minor GV/GP wounds, instead of sutures
• Applied by plastic tubes, brushes or cannulate

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44. Drug-induced Gingival Overgrowth
Calcium
1 Anti-
convulsants 2 Channel
Blockers
3 Immuno-
suppressants
1. Phenytoin for 1. Antihypertensive 1. Cyclosporin A for
seizure drugs for angina prevention of
2. Valpronic acid, or peripheral transplant
carbamazepine, vascular disease rejection,
phenobarbitone 2. Nifedipine first autoimmune like
rare in early 1980s rheumatoid
3. Vigabatrin new 3. Diltiazem, arthritis 
verapamil limited by renal,
4. Amlodipine, cardiac, and
felodipine rare gingival fibrosis
J Periodontol 2004;75:1424-1431.

45. Prevalence
children
J Periodontol 2004;75:1424-1431.

46. Prevalence
J Periodontol 2004;75:1424-1431.

47. GV/GP - Phenytoin-induced
gingival overgrowth

48. GV/GP - Phenytoin-induced
gingival overgrowth

49. GV/GP - Phenytoin-induced
gingival overgrowth

50. References
1. Color Atlas of Dental Medicine: Periodontology:
Periodontology. Herbert F. Wolf, Klaus H. Rateitschak
2. Informational Paper - Drug-Associated Gingival
Enlargement, J Periodontol 2004;75:1424-1431.

51. MERRY CHRISTMAS~!!