What to Expect from Gingivectomy

What to expect from Gingivectomy?

Gingivectomy is one of the most common surgeries performed nowadays. It is used for various reasons:

To remove benign tumors or growths (benign ossification)

To reduce the size of benign tumors (bone metastases)

In some cases it may be necessary to remove cancerous tissue, such as lymph nodes. For example, if there are small lumps in your neck that do not respond well to radiation therapy. Sometimes surgery is needed because of a tumor that has spread into other parts of the body.

Some patients with cancer have been treated successfully without any treatment at all. Other times surgery is required to treat their condition. Some procedures are done under general anesthesia, while others require sedation. Most of these operations are usually done in the operating room of a hospital.

What is Gingivectomy?

The word “gingivectomy” is a combination of three words: gingiva, which is the name of your gum tissue;ectomy, which means cutting out a part; and ctomy, which means to remove. In general, the surgery removes excess gum tissue around the teeth (gingival hyperplasia). This procedure can be done for cosmetic reasons or because the gums are infected or diseased.

The Procedure

Your surgeon will numb your gums before starting the surgery. After cleaning the area, he will make a horizontal incision across the gums. Then, the surgeon will cut slits around tooth’s root to prevent hemorrhaging, after which he’ll lift the tissue up and cut it free from the tooth. Afterwards, he will suture (sew) the tissue back into place and pack it with a healing agent to keep the area clean.

Recovery Time

You will probably need to take 2-3 weeks off work after this procedure. You will most likely have to change your daily habits, such as brushing and flossing your teeth more regularly. You may have some temporary numbness, but it should go away in time. It is important that you care for the wound by rinsing with salt water and applying an antibiotic ointment as your doctor has instructed.

Making the Most out of your procedure

While healing from your surgery, there are some things you can do to speed up the process and make your experience as easy as possible.

Do not smoke or chew tobacco. If you do this, the nicotine and other chemicals in the cigarettes and chewed tobacco will slow down the healing process. Also, smoke irritates the wound and makes it harder to heal.

Rinse your mouth out after each meal. Saliva is a good thing for wounds, but food left stuck in your teeth can rot and become infected.

Do not over-brush or use an abrasive toothpaste on your teeth. Again, this can irritate or harm your wound.

Moist wound dressings are preferable to dry ones.

Get enough rest and avoid strenuous activity while your gums heal.

These steps will make the recovery easier and faster for you. If you have any questions, be sure to contact your doctor.

What is an Alveolotomy?

An alveolotomy (al-vee-o-to-mee) is a minor surgical procedure in which a small incision is made on the gum tissue surrounding the bottom of the teeth. The purpose of this procedure is to provide more room for the teeth to come into proper position. It may be done with or without local anesthetic and takes about thirty minutes to complete.

The Procedure

Traditionally, an alveolotomy is done under a local anesthetic. The surgeon will make a small incision in the gums and cut away a small portion of bone to give more room to move the teeth. After this, sutures (stitches) are applied to stop any bleeding and the opening in the gum heals over naturally within two weeks.

Recovery Time

After the procedure you can expect to have a little pain in your gums and some bleeding for several days. It will be sore for about a week, but most people are able to eat normally right away. Your surgeon will apply a healing agent to the incision site and give you guidelines on how to take care of it. You will also be given an antibiotic to take at regular intervals to stop infection in the incision site.

A full recovery is made within three months and most people notice an improvement within one month.

Making the Most out of your procedure

There are a few things you can do to get the best results from your alveolotomy.

Eat a soft, bland diet for a week or so. Avoid chewing on the affected side.

Do not smoke, drink through a straw or eat sticky substances for at least a week.

Follow all instructions given to you by your surgeon. They are there to help you get the best results.

There is no guarantee that this procedure will work for you. Some people do not respond well to an alveolotomy, but most find it helpful. Be sure to discuss your plan with your dentist and doctor to make the decision that is right for you.

Implant Restoration Options

All of your teeth do not have to be removed in order for an implant to be placed. The following pages discuss some of the options you have if some of your natural teeth are still present.

Dental Implant Bridge

A dental bridge is a false tooth supported by crowns on neighboring natural teeth. This bridge can be connected to one or more artificial teeth. It can be used to fill a gap created by missing teeth, and the replacement teeth will look and feel like natural teeth.

With the loss of one or more teeth, your bite can change. The muscles in your jaw will begin to shift, which causes other teeth to be unsupported and prone to decay or other dental issues. A dental bridge keeps the surrounding teeth from changing position by using them to support replacement teeth. It also keeps your natural teeth from having to support excessive weight, which reduces the risk of them suffering from fractures or dental decay.

The bridge will be attached to two crowns that support replacement teeth on each side. The artificial teeth are shaped like your real ones and are strong enough to chew with.

Dental implants can last a lifetime when cared for properly. With proper cleaning and flossing, you will be able to keep the implant site(s) healthy so that bacteria cannot accumulate around the area.

The Procedure

The first step is to remove all of the teeth on one side of your mouth so that the implants can be placed in the jaw bone. The implants will fuse to the bone over a period of 4 to 6 months and will act as anchors for the new teeth. After the implants have fused into place, the crowns will be attached to them. The tooth replacement process is then complete and you should be able to eat and speak as normal.

If you have untreated dental problems such as infected gums, missing teeth or poorly aligned teeth, these issues should be taken care of before placing the implants. Doing so will reduce the risk of post-operative infection that could affect the implant’s success rate.

Once the implants are in place, you will most likely need to wear a denture or part of a denture until the gums have healed and the implant anchor is secure. Once this has happened, your dentist can make a full denture, bridge or a single crown for each implant. You may also choose to have several implants fitted with mini implants to support one large denture that covers the entire mouth.

The entire process can take up to 1 – 2 years to complete.

Advantages

The success rate of dental implants is very high, with many lasting a lifetime. Once the implants are fitted you will be able to eat and speak as normal. They also look and feel completely natural so nobody will know that you have false teeth.

Disadvantages

The cost of the procedure may be expensive and many people are not able to get dental insurance to help with the cost. The surgery and implants can also only be fitted to people with healthy, intact teeth and sufficient jaw bone volume. If you have severe tooth decay or damage to the jawbone, you may not be suitable for implants and should seek a different solution.

Dental implants require special aftercare that some people find excessively difficult. However, studies have shown that people with implants actually clean their teeth more regularly than others due to the increased maintenance required. If you are concerned about keeping your new implants clean, ask your dentist for advice or buy a good quality electric toothbrush to make the process easier.

Dental implants are not suitable for everyone. It is important that you speak with your dentist or surgeon to find out if you are a suitable candidate for implants and if so, decide which type of implant will work best for you.

Sources & references used in this article:

Surgical treatment of cyclosporine A‐and nifedipine‐induced gingival enlargement: gingivectomy versus periodontal flap by A Pilloni, PM Camargo, M Carere… – Journal of …, 1998 – Wiley Online Library

Indications, Technique, and Post‐Operative Management of Gingivectomy in the Treatment of the Periodontal Pocket by B Orban – The Journal of Periodontology, 1941 – Wiley Online Library

Thermal Modeling of Tissue Ablation During Pulsed CO2 Laser Gingivectomy for Gum Reshaping and Reduction by R Bender, M Gross, W Luo, E Tess – 2014 – ecommons.cornell.edu

Presurgical management of a patient receiving anticoagulant therapy: report of case by NJ Tomasi, JE Wolf – The Journal of the American Dental Association, 1974 – Elsevier

Bilateral symmetrical lymphangiomas of the gingiva: A case report by P Josephson, CW van Wyk – Journal of Periodontology, 1984 – Wiley Online Library

Therapy and treatment with a high-energy laser in case of a periodontal disease treatment instead of physiotherapy or low-level laser treatment by FR Buerger – Laser Applications in Medicine and Dentistry, 1996 – spiedigitallibrary.org

Scaling and root planing vs. conservative surgery in the treatment of chronic periodontitis by DE Deas, AJ Moritz, RS Sagun Jr… – Periodontology …, 2016 – Wiley Online Library

New uses for Lasers in soft tissue dental surgery by W Allen – Laser Medicine and Surgery News and Advances, 1987 – liebertpub.com

Dental Laser Applications: Periodontal Treatment and Intra-Oral Surgery by P Wilder-Smith – Applied Laser Medicine, 2003 – Springer