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Surgical Gingivectomy Procedures
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Surgical Gingivectomy Procedures

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@Dylario

Questions and Answers

Which of the following is NOT a type of gingivectomy?

  • Chemosurgery
  • Cryosurgery (correct)
  • Laser gingivectomy
  • Electrosurgery

    • Which instrument is commonly used for incisions during a gingivectomy?

  • Hematology analyzer
  • Electrocardiogram leads
  • Bard Parker handle (correct)
  • Surgical suction

    • What is one of the key steps in the gingivoplasty procedure?

  • Incising all surfaces equally
  • Creating vertical interdental grooves (correct)
  • Removing all teeth
  • Suturing the gingiva tightly

    • Which phase describes the initial healing response after a surgical gingivectomy?

    <p>Formation of clot</p> Signup and view all the answers

    What is a common complication associated with electrosurgery in gingivectomy?

    <p>Thermal injury to surrounding tissues</p> Signup and view all the answers

    What is the primary purpose of curettage in periodontal therapy?

    <p>To eliminate inflamed granulation tissue</p> Signup and view all the answers

    What should be done after removing the excised pocket wall during gingivectomy?

    <p>Clean the area and check for deposits</p> Signup and view all the answers

    Which of the following is NOT an indication for performing curettage?

    <p>To directly remove large calculus deposits</p> Signup and view all the answers

    In the healing process after a surgical gingivectomy, granulation tissue appears after what initial response?

    <p>Formation of the clot</p> Signup and view all the answers

    What can occur during curettage as a result of the procedure?

    <p>Complete removal of epithelium from the pocket wall</p> Signup and view all the answers

    What is one reason curettage is considered in the presurgical phase?

    <p>It addresses persistent gingival inflammation</p> Signup and view all the answers

    What is the angle at which the incision should be beveled during a gingivectomy?

    <p>45 degrees</p> Signup and view all the answers

    How does curettage affect bacterial presence in the periodontal pocket?

    <p>It reduces the number of bacteria present</p> Signup and view all the answers

    Which of the following is a disadvantage of gingivectomy by electrosurgery?

    <p>It can cause an unpleasant odor.</p> Signup and view all the answers

    What is a primary indication for performing gingivoplasty?

    <p>Removal of gingival enlargements.</p> Signup and view all the answers

    Which of the following laser types is most commonly used for excision of gingival overgrowth?

    <p>Carbon dioxide laser.</p> Signup and view all the answers

    What is a significant complication associated with electrosurgery in gingivectomy?

    <p>Delayed healing.</p> Signup and view all the answers

    Which statement about chemosurgery for gingivectomy is true?

    <p>It uses chemicals such as potassium hydroxide.</p> Signup and view all the answers

    What distinguishes subgingival curettage from other types of gingival curettage?

    <p>It is performed apical to the epithelial attachment.</p> Signup and view all the answers

    What is a disadvantage of performing gingivectomy by chemosurgery?

    <p>It may injure normal tissues.</p> Signup and view all the answers

    What surgical instrument is primarily used in gingival curettage?

    <p>Curette.</p> Signup and view all the answers

    How does the healing process after electrosurgery compare to traditional methods?

    <p>It may result in greater bone injury.</p> Signup and view all the answers

    What condition is NOT indicated for gingivectomy?

    <p>Reduction of teeth sensitivity.</p> Signup and view all the answers

    What is the primary objective of a gingivectomy?

    <p>To eliminate pockets in the gingiva</p> Signup and view all the answers

    Which type of gingivectomy is primarily surgical in nature?

    <p>Surgical gingivectomy</p> Signup and view all the answers

    What is gingivoplasty primarily aimed at?

    <p>Reshaping and recontouring of gingival tissue</p> Signup and view all the answers

    What is NOT a prerequisite for performing a gingivectomy?

    <p>Presence of infrabony defects</p> Signup and view all the answers

    Which factor would contraindicate a gingivectomy procedure?

    <p>Inadequate oral hygiene maintenance</p> Signup and view all the answers

    What is a potential complication of electrosurgery used in gingivectomy?

    <p>Risk of thermal injury to adjacent tissues</p> Signup and view all the answers

    What is the significance of creating bilateral symmetry during gingivectomy?

    <p>To improve aesthetic appearance in the gingival margin</p> Signup and view all the answers

    Which instrument is typically used in surgical gingivectomy?

    <p>Scalpel</p> Signup and view all the answers

    What post-operative care is crucial after gingivectomy to prevent complications?

    <p>Maintaining excellent oral hygiene</p> Signup and view all the answers

    What is one of the primary indications for performing a gingivectomy?

    <p>To eliminate supra-alveolar pockets and pseudo-pockets</p> Signup and view all the answers

    What is the primary purpose of curettage in periodontal treatment?

    <p>To serve as a method of maintenance for recurrent inflammation</p> Signup and view all the answers

    In the basic technique of curettage, where should the cutting edge of the instrument be positioned?

    <p>Against the tissues</p> Signup and view all the answers

    Which procedure is referred to as a definitive subgingival curettage?

    <p>ENAP</p> Signup and view all the answers

    What is done after adequate local anesthesia in the ENAP procedure?

    <p>Make an internal bevel incision</p> Signup and view all the answers

    How are the epithelium and tissue continuity affected in ultrasonic curettage?

    <p>They are disrupted by ultrasonic vibrations</p> Signup and view all the answers

    What crucial step should follow the curettage procedure to ensure thorough cleaning?

    <p>Scaling and root planing</p> Signup and view all the answers

    What is an important factor to retain during the ENAP incision procedure?

    <p>Interdental tissue</p> Signup and view all the answers

    What complication might arise from the use of electrosurgery in gingivectomy procedures?

    <p>Nerve damage</p> Signup and view all the answers

    During subgingival curettage, how should the curette be moved?

    <p>In a scooping motion</p> Signup and view all the answers

    What is the significance of the flushing step after curettage?

    <p>To remove debris from the area</p> Signup and view all the answers

    Gingivectomy can be performed using lasers as one of the methods.

    <p>True</p> Signup and view all the answers

    Surgical curettes are unnecessary instruments for performing a gingivectomy.

    <p>False</p> Signup and view all the answers

    The shaping of interdental papillae during gingivoplasty helps facilitate the passage of food.

    <p>True</p> Signup and view all the answers

    Healing after a surgical gingivectomy is primarily by primary intention.

    <p>False</p> Signup and view all the answers

    Electrosurgery has a higher risk of complications compared to other gingivectomy methods.

    <p>True</p> Signup and view all the answers

    Bard Parker blades are not typically used for incisions during a gingivectomy.

    <p>False</p> Signup and view all the answers

    A key step in the healing process after gingivectomy is the formation of a clot within the first 24 hours.

    <p>True</p> Signup and view all the answers

    Gingivoplasty involves only the removal of tissue without reshaping the gingiva.

    <p>False</p> Signup and view all the answers

    Electrosurgery is beneficial because it eliminates all potential complications associated with gingivectomy.

    <p>False</p> Signup and view all the answers

    The primary lasers used for gingivectomy are carbon dioxide and Nd:YAG lasers.

    <p>True</p> Signup and view all the answers

    Chemicals such as potassium hydroxide can be used in chemosurgery for gingival removal.

    <p>True</p> Signup and view all the answers

    Gingivoplasty specifically involves the removal of gingival enlargements.

    <p>False</p> Signup and view all the answers

    Inadvertent curettage occurs when curettage is performed intentionally during the scaling process.

    <p>False</p> Signup and view all the answers

    Healing after electrosurgery has been reported to cause a greater reduction in gingival height compared to traditional methods.

    <p>True</p> Signup and view all the answers

    Gingival curettage is a technique meant to remove deposits from the surface of teeth.

    <p>False</p> Signup and view all the answers

    The heat generated by electrosurgery can cause tissue damage, resulting in conditions like cemental necrosis.

    <p>True</p> Signup and view all the answers

    Gingivectomy by electrosurgery is indicated for the relocation of frenum and muscle attachments.

    <p>True</p> Signup and view all the answers

    One of the advantages of gingivectomy by electrosurgery is its ability to leave no odor after the procedure.

    <p>False</p> Signup and view all the answers

    Ultrasonic curettage is a type of surgical curettage used for treating periodontal pockets.

    <p>False</p> Signup and view all the answers

    The primary instrument utilized in gingivectomy procedures is a laser.

    <p>False</p> Signup and view all the answers

    A type of gingivectomy that is primarily surgical in nature is known as surgical gingivectomy.

    <p>True</p> Signup and view all the answers

    Gingivoplasty is primarily aimed at reshaping the gingiva rather than removing it.

    <p>True</p> Signup and view all the answers

    Gingivoplasty is primarily aimed at the elimination of periodontal pockets.

    <p>False</p> Signup and view all the answers

    Granulation tissue appears immediately after the initial healing response following a surgical gingivectomy.

    <p>False</p> Signup and view all the answers

    The healing process after a surgical gingivectomy generally includes the formation of granulation tissue after initial tissue response.

    <p>True</p> Signup and view all the answers

    Electrosurgery in gingivectomy is associated with fewer complications compared to traditional methods.

    <p>False</p> Signup and view all the answers

    Electrosurgery used in gingivectomy can lead to complications such as denervation of the surrounding tissue.

    <p>True</p> Signup and view all the answers

    The presence of infrabony pockets is a prerequisite for performing a gingivectomy.

    <p>False</p> Signup and view all the answers

    Surgical instruments used in gingivectomy include retractors and electrocautery devices.

    <p>True</p> Signup and view all the answers

    Gingivectomy procedures can be performed without considering the patient's oral hygiene maintenance.

    <p>False</p> Signup and view all the answers

    Creating bilateral symmetry is a primary goal of both gingivectomy and gingivoplasty.

    <p>True</p> Signup and view all the answers

    Gingivectomy is always performed alone, without the combination of gingivoplasty.

    <p>False</p> Signup and view all the answers

    Electrosurgery is the only method used for gingivectomy procedures.

    <p>False</p> Signup and view all the answers

    Curettage is an elective procedure that does not require local anesthesia.

    <p>False</p> Signup and view all the answers

    Electrosurgery in gingivectomy does not carry any significant complications.

    <p>False</p> Signup and view all the answers

    ENAP stands for Excisional New Attachment Procedure, which is a type of gingivectomy.

    <p>True</p> Signup and view all the answers

    Gingivoplasty primarily aims to reduce pocket depths for better oral hygiene but is not a surgical procedure.

    <p>False</p> Signup and view all the answers

    In the healing process after a surgical gingivectomy, granulation tissue appears after the initial inflammatory response.

    <p>True</p> Signup and view all the answers

    Ultrasonic curettage uses high-frequency vibrations to disrupt tissue continuity and is a non-invasive procedure.

    <p>False</p> Signup and view all the answers

    During curettage, it is essential to follow up with scaling and root planing to remove local factors like plaque.

    <p>True</p> Signup and view all the answers

    The primary surgical instrument used in gingival curettage is the scalpel.

    <p>False</p> Signup and view all the answers

    A common technique used in gingivoplasty is the internal bevel incision.

    <p>True</p> Signup and view all the answers

    The purpose of curettage is to completely eliminate the need for any future periodontal procedures.

    <p>False</p> Signup and view all the answers

    Study Notes

    Gingivectomy Techniques

    • Types of Gingivectomy: Includes surgical, electrosurgery, laser, and chemotherapeutic methods.
    • Surgical Gingivectomy Armamentarium: Requires instruments such as mouth mirrors, periodontal probes, Kirkland and Orban knives, Bard Parker handles, curettes, tissue forceps, scissors, and periodontal dressing.

    Surgical Procedure Steps

    • Step 1: Explore periodontal pockets using a probe; mark sites with a pocket marker.
    • Step 2: Incisions made with periodontal knives; continuous or discontinuous incisions beveled at 45 degrees.
    • Step 3: Excised tissue is removed; root surfaces cleaned for any deposits.
    • Step 4: Remove granulation tissue and calculus for a smooth root surface.
    • Step 5: Cover the area with a surgical pack.

    Gingivoplasty Steps

    • Instruments include scalpel and diamond stones.
    • Involves tapering margins, scalloping outlines, thinning attached gingiva, and shaping papillae for food passage.

    Healing Post-Surgery

    • Healing occurs by secondary intention involving clot formation, granulation tissue, and migration of connective tissue cells.
    • Initial epithelialization takes 5-14 days with complete healing around one month.

    Electrosurgery Advantages/Disadvantages

    • Advantages: Effective tissue contouring and hemorrhage control.
    • Disadvantages: Risks include damage to pacemakers, undesirable odors, potential irreversible tissue damage, and risk of necrosis.

    Indications for Electrosurgery

    • Useful for gingival enlargements, gingivoplasty, relocating attachments, and abscess incisions.

    Laser Gingivectomy

    • Commonly uses carbon dioxide and Nd:YAG lasers; efficacy in periodontal surgery lacks substantial research support.

    Chemosurgery Details

    • Chemicals like 5% paraformaldehyde or potassium hydroxide remove gingiva.
    • Disadvantages include uncontrolled depth of action causing injury to healthy tissue and delayed healing.

    Curettage Definitions & Types

    • Curettage: Scraping of the periodontal pocket wall; targets diseased soft tissue.
    • Types:
      • Gingival curettage removes inflamed tissue.
      • Subgingival curettage performed apical to epithelial attachment.
      • Inadvertent curettage occurs during other procedures.

    Pre-requisites for Gingivectomy

    • Adequate attached gingiva is necessary for function post-excision.
    • Normal alveolar bone structure is required; any loss should be horizontal.
    • Absence of infrabony pockets and defected structures is crucial.

    Indications for Gingivectomy

    • Eliminate supra-alveolar pockets, fibrous enlargements, and blunted margins.
    • Improve aesthetic appearance and access for restorative procedures.
    • Correct gingival craters and achieve bilateral symmetry.

    Contraindications for Gingivectomy

    • Presence of thick alveolar edges, interstitial craters, or pockets reaching the mucogingival junction.
    • Patients with poor oral hygiene, those medically compromised, or those with dentinal hypersensitivity should avoid surgery.

    Additional Techniques

    • ENAP (Excisional New Attachment Procedure): Involves internal bevel incision followed by tissue removal and root surface planing.
    • Ultrasonic Curettage: Uses ultrasonic scalers for tissue detachment and altered fibroblast features.

    Rationale for Curettage

    • Primarily aims to remove chronically-inflamed granulation tissue that may impede new fiber attachment.
    • Successful root planing diminishes bacterial presence, reducing the need for extensive curettage.
    • Utilized as a preparatory step in patients requiring less invasive approaches prior to major surgical procedures.

    Gingivectomy Techniques

    • Types of Gingivectomy: Includes surgical, electrosurgery, laser, and chemotherapeutic methods.
    • Surgical Gingivectomy Armamentarium: Requires instruments such as mouth mirrors, periodontal probes, Kirkland and Orban knives, Bard Parker handles, curettes, tissue forceps, scissors, and periodontal dressing.

    Surgical Procedure Steps

    • Step 1: Explore periodontal pockets using a probe; mark sites with a pocket marker.
    • Step 2: Incisions made with periodontal knives; continuous or discontinuous incisions beveled at 45 degrees.
    • Step 3: Excised tissue is removed; root surfaces cleaned for any deposits.
    • Step 4: Remove granulation tissue and calculus for a smooth root surface.
    • Step 5: Cover the area with a surgical pack.

    Gingivoplasty Steps

    • Instruments include scalpel and diamond stones.
    • Involves tapering margins, scalloping outlines, thinning attached gingiva, and shaping papillae for food passage.

    Healing Post-Surgery

    • Healing occurs by secondary intention involving clot formation, granulation tissue, and migration of connective tissue cells.
    • Initial epithelialization takes 5-14 days with complete healing around one month.

    Electrosurgery Advantages/Disadvantages

    • Advantages: Effective tissue contouring and hemorrhage control.
    • Disadvantages: Risks include damage to pacemakers, undesirable odors, potential irreversible tissue damage, and risk of necrosis.

    Indications for Electrosurgery

    • Useful for gingival enlargements, gingivoplasty, relocating attachments, and abscess incisions.

    Laser Gingivectomy

    • Commonly uses carbon dioxide and Nd:YAG lasers; efficacy in periodontal surgery lacks substantial research support.

    Chemosurgery Details

    • Chemicals like 5% paraformaldehyde or potassium hydroxide remove gingiva.
    • Disadvantages include uncontrolled depth of action causing injury to healthy tissue and delayed healing.

    Curettage Definitions & Types

    • Curettage: Scraping of the periodontal pocket wall; targets diseased soft tissue.
    • Types:
      • Gingival curettage removes inflamed tissue.
      • Subgingival curettage performed apical to epithelial attachment.
      • Inadvertent curettage occurs during other procedures.

    Pre-requisites for Gingivectomy

    • Adequate attached gingiva is necessary for function post-excision.
    • Normal alveolar bone structure is required; any loss should be horizontal.
    • Absence of infrabony pockets and defected structures is crucial.

    Indications for Gingivectomy

    • Eliminate supra-alveolar pockets, fibrous enlargements, and blunted margins.
    • Improve aesthetic appearance and access for restorative procedures.
    • Correct gingival craters and achieve bilateral symmetry.

    Contraindications for Gingivectomy

    • Presence of thick alveolar edges, interstitial craters, or pockets reaching the mucogingival junction.
    • Patients with poor oral hygiene, those medically compromised, or those with dentinal hypersensitivity should avoid surgery.

    Additional Techniques

    • ENAP (Excisional New Attachment Procedure): Involves internal bevel incision followed by tissue removal and root surface planing.
    • Ultrasonic Curettage: Uses ultrasonic scalers for tissue detachment and altered fibroblast features.

    Rationale for Curettage

    • Primarily aims to remove chronically-inflamed granulation tissue that may impede new fiber attachment.
    • Successful root planing diminishes bacterial presence, reducing the need for extensive curettage.
    • Utilized as a preparatory step in patients requiring less invasive approaches prior to major surgical procedures.

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    Description

    This quiz covers various surgical gingivectomy techniques, including electrosurgery, laser methods, and chemosurgery. Explore the essential armamentarium and the step-by-step surgical procedures involved in performing gingivectomy. Test your knowledge on the tools and techniques required for successful dental surgeries.

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