One of the first surgical procedures used on periodontics, the gingivectomy, consists of removal of part of the gum tissue. This procedure is useful when there has been an overgrowth of tissue as a result of Dilantin hyperplasia, or when a pocket has formed without bone problems. The excess tissue is cut away to remove the pocket to the patient and hygienist can more easily clean the gum and tooth.
The Gingivectomy is only done when the bone does not have to be accessed and when there is adequate “hard gum”. In most cases that are treated by a periodontist the bone itself has become involved and unless that bone is treated, the case is not successful. In these circumstances, the Gingivectomy is not appropriate. In addition, it is necessary to have a margin of hard or keratinized gum (see Gum Recession), and if the Gingivectomy would remove all the hard gum, it should not be used.
The following are some reasons a gingivectomy might be needed:
- Cosmetics: To make the teeth look normal in size when the gum is covering too much of it, making the teeth look longer and more proportional.
- Functional/Esthetics: To remove excess gum tissue (gingival overgrowth) that has formed as a result of certain drugs such as anti-seizure and organ-transplant medications, and certain high blood pressure medications.
- Bone and gum health around the teeth: To shrink deep gum pockets. This procedure might require some bone work as well.
We first will anesthetize the area(s) to be treated. The excess of gum tissue is removed either with a scalpel blade and sometimes some rotary instruments or a laser. In most cases no sutures (stitches) are required. The surgical sites will be sore for 24-48 hours, and medication will be provided to alleviate any discomfort experienced. A week follow-up appointment is usually needed to ensure proper healing.