Gingivectomy and Gingivoplasty Procedures

There are two reasons for gingivectomy and gingivoplasty procedures to be performed. One is to correct a periodontal pathology or abnormality and the other is to reshape the gum tissue around a tooth or teeth so that a restoration, usually a crown, can be made.

A gingivectomy is the removal of a portion of the periodontal (gum) tissue. Gingivoplasty is a reshaping of the soft tissue. Although both obviously refer to some soft tissue removal, the gingivectomy involves more tissue reduction. In both cases, there is no alteration of the underlying bone support for the teeth. These procedures might be considered the simplest form of periodontal surgery.

The most frequent reason for a gingivectomy is that bleeding gum tissues still persist even after the teeth have been thoroughly cleaned and polished and oral self-care is excellent. There may be areas where it is impossible for the patient to clean effectively due to different situations. Therefore, the tissue never has a chance to heal and inflammation and infection remain. Removal of some soft tissue helps reposition the gums so the area can be properly cleaned on a regular basis. If the pocket is too deep, unwanted bacteria will colonize the area and cause periodontal infection to persist. Removing the extra soft tissue allows the patient better access for proper oral self-care at that location.

The tissue rarely grows back, unless other medical factors are present or oral self-care is neglected. These procedures can be done with either a laser or scalpel, depending on the extent of the therapy.

While time-consuming to perform, both of these procedures are technically simple to complete. Visibility and access to the surgical sites are usually very good, and results can be predicted with great reliability. 

In brief, a local anesthetic is given, the specific soft tissue is removed, sutures (stitches) are placed, and a periodontal surgical dressing or medicated oral bandage may be used to cover the treated area. The dressing will be removed about 7 days later. Sometimes the dressing may be reapplied for another week. This depends on your healing progress. While the dressing is in place, it is helpful to rinse with an antibacterial mouthrinse and not eat on the side that is being treated. Hard, crunchy foods or chewing gum can displace the periodontal dressing, so beware.

If you are having this procedure done in order to make enough tooth structure available for a crown, final impression for the crown will be delayed for this 4- to 8-week healing period. 

Postoperatively, there may be some discomfort. Anti-inflammatory or pain relief medication may be prescribed for you.

Periodontal tissue is really thin, pink skin. New periodontal tissue will mature and will become stronger and will reach its final healed position around the tooth during the next 4 to 8 weeks.

If you have any questions about gingivectomy and gingivoplasty procedures, please feel free to ask us.