Gingivectomy is a dental surgical procedure involving the removal of gum tissue. It is often performed to treat gum disease (periodontitis or gingivitis affected) or excess gum tissue as it compromises proper hygiene.
Gingivoplasty focuses on reshaping and contouring gum tissue, primarily for cosmetic reasons. It enhances the appearance of the gums without necessarily removing a significant amount of gum tissue. Both procedures contribute to improved oral health and aesthetics.
Gingivectomy vs. Gingivoplasty: When to have, and why?
As both of the procedures are pretty similar to each other, so are their indications.
For Gingivectomy:
- Gingival Hyperplasia: It is the common treatment for abnormal increases in gum tissue, which can happen in gum diseases, injury or infection, pregnancy, and hormonal imbalances. Even some drugs, like anti-epileptics (phenytoin) and immunosuppressants, can cause this.
Gum overgrowth, if not treated, can cause bleeding of the gums as they are easily damaged.
- Pocket Reduction: These pockets form when your gums detach from teeth, creating spaces that can host bacteria and become infected. Gum pockets are caused by plaque buildup, causing inflammation and periodontal disease.
- Cosmetic reshaping: Reshaping of the uneven gum-line and the correction of a gummy smile for aesthetically pleasing look.
- Repositioning of the teeth: The procedure also helps expose more of the tooth structure, allowing for better alignment of teeth and easier application of braces or other dental appliances.
- Crown Lengthening: Removing excess gum tissue exposes more of the tooth’s surface. This provides better access for placing restorations like crowns or fillings and improves the tooth’s structure and aesthetics.
- After tooth extraction: It is important to remove excess gum tissue that can interfere with healing. It prevents infection, ensures proper gum contouring, and prepares the site for future dental implants or prosthetics, promoting better oral health and function
- Treatment of Gum Disease: Removal of diseased gum tissue in cases of advanced periodontitis (involving soft tissue and bone around teeth).
- Biopsy: To obtain sample of gum tissue for examination of oral cancer or benign growths.
- Trauma or Lesion Removal: Reshaping or removing damaged gum tissue due to trauma or lesions.
For Gingivoplasty:
- Cosmetic Improvement: Gingivoplasty is primarily performed to enhance the aesthetics of the smile. It can help create a more balanced appearance in the following ways:
- Gummy Smile Correction
- Uneven Gum Line Correction
- Crown Lengthening
- For better aesthetic looks after orthodontic treatment.
- Functional Reasons: Improving oral hygiene access by reshaping gum tissue makes it easier for individuals to clean their teeth effectively. It can also help cover exposed tooth roots to address gum recession.
Gingivectomy vs. Gingivoplasty: Procedure comparison
For Gingivectomy:
- Initial Examination: The dentist will carefully check your gums and teeth to assess the condition.
- Numbing the Area: Before starting, the dentist will apply a local anesthetic (Lidocaine) to make sure you don’t feel any pain during the procedure.
- Marking the Area: The dentist then marks the spots on your gums where they need to remove the extra tissue.
- Making Small Cuts: The dentist makes precise cuts with a scalpel or laser along the marked lines to remove the excess gum tissue.
- Removing Extra Gum Tissue: The dentist then takes away the extra gum tissue that’s causing
- Smoothing Things Out: Special tools can be used to smooth and shape your gums so they look natural and heal properly.
- Putting in Stitches (if needed): They ensure that the cuts heal nicely.
- Taking Care Afterward: The dentist will give you instructions on how to take care of your gums as they heal. This includes how to brush and floss gently and any medicines and irritants to avoid (smoking).
- Follow-Up Visit: You’ll probably need to come back for a check-up to make sure your gums are healing well and to take out any stitches that need to be removed.
For Gingivoplasty:
The procedure is very much identical to gingivectomy, but it usually involves minimal removal of healthy gum tissue. The dentist sculpts and shapes the pre-existing tissue for a more even and aesthetically pleasing gumline.
Stitches may or may not be needed.
Gingivectomy vs. Gingivoplasty: Procedural Techniques
They both share the same techniques for gum removal and reshaping. These techniques include
Scalpel (Traditional Surgery):
Gingivectomy often involves using a surgical scalpel for precise tissue removal. This is exceptionally suitable for gums with variable tissue thicknesses. It is a widely available technique but is less efficient than new and much efficient ones.
Laser Technology:
The best method of gingivectomy. Erbium and diode lasers provide precision, reduce bleeding, and minimize post-operative discomfort. It usually takes about 14–16 minutes and may require little to no anesthesia.
Electrosurgery:
Electrosurgical units use electric current to cut and shape soft tissue. This provides control over bleeding, precise tissue removal, and simultaneous coagulation to minimize bleeding.
Gingivectomy vs. Gingivoplasty: Specific Postoperative Care
Gingivectomy:
- Bleeding Management: You might experience some bleeding immediately after the procedure. Apply gentle pressure to control it.
- Apply ice packs: Applying ice packs to the outside of your face helps reduce swelling and discomfort during the first 24 hours.
- Use of Antiseptic Mouthwash: The use of chlorhexidine mouthwash will reduce the risk of infection and promote healing. 1 Salt water gargle is also recommended 3-5 times a week.
- Suture Care: Your dentist will recommend special care when sutures are used. Some sutures may need to be removed at a follow-up visit, while others may dissolve on their own.
- Activity Restrictions: Limiting physical activity is necessary as it may lead to bleeding or swelling in the treated area.
Gingivoplasty:
- Swelling and discomfort: Swelling is typically less pronounced, and ice packs are also recommended here. Antiseptic mouthwash and saltwater gargles enhance the recovery.
- Reshaping Assessment: Monitor the reshaped gum line for any irregularities or issues and report them to your dentist during follow-up visits.
Healing and Recovery
Healing typically takes about 2-3 weeks for a gingivectomy procedure. This can depend on the extent of the procedure and the individual’s healing capacity. For gingivoplasty, however, the healing time is usually shorter.
Effectiveness and Success Rates:
Gingivectomy and gingivoplasty are both highly effective procedures. Gingivectomy gives over 90 % success in controlling periodontal disease and cosmetic reshaping when paired with good oral hygiene
Gingivectomy vs. Gingivoplasty: Cost Comparison
- Ginigvetomy usually costs about $200–300 per tooth in many states of the US and depends upon the clinic you choose. 2, whereas a gingivoplasty costs around $50 to $350 per tooth.
- Your dental insurance may cover most of it if it is done for dental health purposes (gingivectomy). However, your insurance provider may be hesitant if you go for a cosmetic reason.
- Never forget to ask your dental insurance provider for details about how much is covered.
- For gingivectomy, long-term success depends on maintaining good oral hygiene practices and regularly visiting your dentist to prevent the recurrence of gum disease.
- In gingivopalsty, results can be long-lasting if proper measures are taken. Regular oral hygiene routines and periodic visits to the dentist are necessary for maintaining the results. However, factors such as aging, gum recession, or changes in gum tissue over time may influence the durability of cosmetic improvements.
Gingivectomy vs. Gingivoplasty: Factors effecting the results
- Oral Hygiene: Consistent brushing, flossing, and routine dental cleanings are crucial for preventing plaque buildup and avoiding pockets.
- Diet and Lifestyle: Avoiding habits like smoking and maintaining a balanced diet contribute to overall oral health and can impact the longevity of gum tissue.
- Underlying Conditions: Diabetes or immune disorders are the most common illness-related factors affecting healing and gum health.
- Age and Genetics: Natural aging processes and genetic predispositions can affect how gum tissue responds to treatment and changes over time.
Gingivectomy vs. Gingivoplasty: Conclusion
Both procedures can significantly benefit patients by promoting better oral hygiene and a more attractive smile. However, it’s important to follow post-operative care instructions carefully. Visit your dentist regularly for better monitoring of your procedure. Consulting with your dentist will definitely help you determine the best treatment approach tailored to your specific needs and goals.
References
Elsevier. Gingivectomy – an overview [Internet]. [undated]. Available from: https://www.sciencedirect.com/topics/medicine-and-dentistry/gingivectomy
Romero-Olid MN, Bucataru E, Ramos-García P, González-Moles MÁ. Efficacy of Chlorhexidine after Oral Surgery Procedures on Wound Healing: Systematic Review and Meta-Analysis. Antibiotics (Basel). 2023 Oct 20;12(10):1552. doi: 10.3390/antibiotics12101552. PMID: 37887254; PMCID: PMC10604691.
Boston Dental Group. (2023, September 21). What is laser therapy for gums? [Blog post]. Retrieved June 17, 2024, from https://www.bostondentalgroup.com/blog/what-is-laser-therapy-for-gums/