Podcast
Questions and Answers
Which of the following is NOT a type of gingivectomy?
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?
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?
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?
Which phase describes the initial healing response after a surgical gingivectomy?
What is a common complication associated with electrosurgery in gingivectomy?
What is a common complication associated with electrosurgery in gingivectomy?
What is the primary purpose of curettage in periodontal therapy?
What is the primary purpose of curettage in periodontal therapy?
What should be done after removing the excised pocket wall during gingivectomy?
What should be done after removing the excised pocket wall during gingivectomy?
Which of the following is NOT an indication for performing curettage?
Which of the following is NOT an indication for performing curettage?
In the healing process after a surgical gingivectomy, granulation tissue appears after what initial response?
In the healing process after a surgical gingivectomy, granulation tissue appears after what initial response?
What can occur during curettage as a result of the procedure?
What can occur during curettage as a result of the procedure?
What is one reason curettage is considered in the presurgical phase?
What is one reason curettage is considered in the presurgical phase?
What is the angle at which the incision should be beveled during a gingivectomy?
What is the angle at which the incision should be beveled during a gingivectomy?
How does curettage affect bacterial presence in the periodontal pocket?
How does curettage affect bacterial presence in the periodontal pocket?
Which of the following is a disadvantage of gingivectomy by electrosurgery?
Which of the following is a disadvantage of gingivectomy by electrosurgery?
What is a primary indication for performing gingivoplasty?
What is a primary indication for performing gingivoplasty?
Which of the following laser types is most commonly used for excision of gingival overgrowth?
Which of the following laser types is most commonly used for excision of gingival overgrowth?
What is a significant complication associated with electrosurgery in gingivectomy?
What is a significant complication associated with electrosurgery in gingivectomy?
Which statement about chemosurgery for gingivectomy is true?
Which statement about chemosurgery for gingivectomy is true?
What distinguishes subgingival curettage from other types of gingival curettage?
What distinguishes subgingival curettage from other types of gingival curettage?
What is a disadvantage of performing gingivectomy by chemosurgery?
What is a disadvantage of performing gingivectomy by chemosurgery?
What surgical instrument is primarily used in gingival curettage?
What surgical instrument is primarily used in gingival curettage?
How does the healing process after electrosurgery compare to traditional methods?
How does the healing process after electrosurgery compare to traditional methods?
What condition is NOT indicated for gingivectomy?
What condition is NOT indicated for gingivectomy?
What is the primary objective of a gingivectomy?
What is the primary objective of a gingivectomy?
Which type of gingivectomy is primarily surgical in nature?
Which type of gingivectomy is primarily surgical in nature?
What is gingivoplasty primarily aimed at?
What is gingivoplasty primarily aimed at?
What is NOT a prerequisite for performing a gingivectomy?
What is NOT a prerequisite for performing a gingivectomy?
Which factor would contraindicate a gingivectomy procedure?
Which factor would contraindicate a gingivectomy procedure?
What is a potential complication of electrosurgery used in gingivectomy?
What is a potential complication of electrosurgery used in gingivectomy?
What is the significance of creating bilateral symmetry during gingivectomy?
What is the significance of creating bilateral symmetry during gingivectomy?
Which instrument is typically used in surgical gingivectomy?
Which instrument is typically used in surgical gingivectomy?
What post-operative care is crucial after gingivectomy to prevent complications?
What post-operative care is crucial after gingivectomy to prevent complications?
What is one of the primary indications for performing a gingivectomy?
What is one of the primary indications for performing a gingivectomy?
What is the primary purpose of curettage in periodontal treatment?
What is the primary purpose of curettage in periodontal treatment?
In the basic technique of curettage, where should the cutting edge of the instrument be positioned?
In the basic technique of curettage, where should the cutting edge of the instrument be positioned?
Which procedure is referred to as a definitive subgingival curettage?
Which procedure is referred to as a definitive subgingival curettage?
What is done after adequate local anesthesia in the ENAP procedure?
What is done after adequate local anesthesia in the ENAP procedure?
How are the epithelium and tissue continuity affected in ultrasonic curettage?
How are the epithelium and tissue continuity affected in ultrasonic curettage?
What crucial step should follow the curettage procedure to ensure thorough cleaning?
What crucial step should follow the curettage procedure to ensure thorough cleaning?
What is an important factor to retain during the ENAP incision procedure?
What is an important factor to retain during the ENAP incision procedure?
What complication might arise from the use of electrosurgery in gingivectomy procedures?
What complication might arise from the use of electrosurgery in gingivectomy procedures?
During subgingival curettage, how should the curette be moved?
During subgingival curettage, how should the curette be moved?
What is the significance of the flushing step after curettage?
What is the significance of the flushing step after curettage?
Gingivectomy can be performed using lasers as one of the methods.
Gingivectomy can be performed using lasers as one of the methods.
Surgical curettes are unnecessary instruments for performing a gingivectomy.
Surgical curettes are unnecessary instruments for performing a gingivectomy.
The shaping of interdental papillae during gingivoplasty helps facilitate the passage of food.
The shaping of interdental papillae during gingivoplasty helps facilitate the passage of food.
Healing after a surgical gingivectomy is primarily by primary intention.
Healing after a surgical gingivectomy is primarily by primary intention.
Electrosurgery has a higher risk of complications compared to other gingivectomy methods.
Electrosurgery has a higher risk of complications compared to other gingivectomy methods.
Bard Parker blades are not typically used for incisions during a gingivectomy.
Bard Parker blades are not typically used for incisions during a gingivectomy.
A key step in the healing process after gingivectomy is the formation of a clot within the first 24 hours.
A key step in the healing process after gingivectomy is the formation of a clot within the first 24 hours.
Gingivoplasty involves only the removal of tissue without reshaping the gingiva.
Gingivoplasty involves only the removal of tissue without reshaping the gingiva.
Electrosurgery is beneficial because it eliminates all potential complications associated with gingivectomy.
Electrosurgery is beneficial because it eliminates all potential complications associated with gingivectomy.
The primary lasers used for gingivectomy are carbon dioxide and Nd:YAG lasers.
The primary lasers used for gingivectomy are carbon dioxide and Nd:YAG lasers.
Chemicals such as potassium hydroxide can be used in chemosurgery for gingival removal.
Chemicals such as potassium hydroxide can be used in chemosurgery for gingival removal.
Gingivoplasty specifically involves the removal of gingival enlargements.
Gingivoplasty specifically involves the removal of gingival enlargements.
Inadvertent curettage occurs when curettage is performed intentionally during the scaling process.
Inadvertent curettage occurs when curettage is performed intentionally during the scaling process.
Healing after electrosurgery has been reported to cause a greater reduction in gingival height compared to traditional methods.
Healing after electrosurgery has been reported to cause a greater reduction in gingival height compared to traditional methods.
Gingival curettage is a technique meant to remove deposits from the surface of teeth.
Gingival curettage is a technique meant to remove deposits from the surface of teeth.
The heat generated by electrosurgery can cause tissue damage, resulting in conditions like cemental necrosis.
The heat generated by electrosurgery can cause tissue damage, resulting in conditions like cemental necrosis.
Gingivectomy by electrosurgery is indicated for the relocation of frenum and muscle attachments.
Gingivectomy by electrosurgery is indicated for the relocation of frenum and muscle attachments.
One of the advantages of gingivectomy by electrosurgery is its ability to leave no odor after the procedure.
One of the advantages of gingivectomy by electrosurgery is its ability to leave no odor after the procedure.
Ultrasonic curettage is a type of surgical curettage used for treating periodontal pockets.
Ultrasonic curettage is a type of surgical curettage used for treating periodontal pockets.
The primary instrument utilized in gingivectomy procedures is a laser.
The primary instrument utilized in gingivectomy procedures is a laser.
A type of gingivectomy that is primarily surgical in nature is known as surgical gingivectomy.
A type of gingivectomy that is primarily surgical in nature is known as surgical gingivectomy.
Gingivoplasty is primarily aimed at reshaping the gingiva rather than removing it.
Gingivoplasty is primarily aimed at reshaping the gingiva rather than removing it.
Gingivoplasty is primarily aimed at the elimination of periodontal pockets.
Gingivoplasty is primarily aimed at the elimination of periodontal pockets.
Granulation tissue appears immediately after the initial healing response following a surgical gingivectomy.
Granulation tissue appears immediately after the initial healing response following a surgical gingivectomy.
The healing process after a surgical gingivectomy generally includes the formation of granulation tissue after initial tissue response.
The healing process after a surgical gingivectomy generally includes the formation of granulation tissue after initial tissue response.
Electrosurgery in gingivectomy is associated with fewer complications compared to traditional methods.
Electrosurgery in gingivectomy is associated with fewer complications compared to traditional methods.
Electrosurgery used in gingivectomy can lead to complications such as denervation of the surrounding tissue.
Electrosurgery used in gingivectomy can lead to complications such as denervation of the surrounding tissue.
The presence of infrabony pockets is a prerequisite for performing a gingivectomy.
The presence of infrabony pockets is a prerequisite for performing a gingivectomy.
Surgical instruments used in gingivectomy include retractors and electrocautery devices.
Surgical instruments used in gingivectomy include retractors and electrocautery devices.
Gingivectomy procedures can be performed without considering the patient's oral hygiene maintenance.
Gingivectomy procedures can be performed without considering the patient's oral hygiene maintenance.
Creating bilateral symmetry is a primary goal of both gingivectomy and gingivoplasty.
Creating bilateral symmetry is a primary goal of both gingivectomy and gingivoplasty.
Gingivectomy is always performed alone, without the combination of gingivoplasty.
Gingivectomy is always performed alone, without the combination of gingivoplasty.
Electrosurgery is the only method used for gingivectomy procedures.
Electrosurgery is the only method used for gingivectomy procedures.
Curettage is an elective procedure that does not require local anesthesia.
Curettage is an elective procedure that does not require local anesthesia.
Electrosurgery in gingivectomy does not carry any significant complications.
Electrosurgery in gingivectomy does not carry any significant complications.
ENAP stands for Excisional New Attachment Procedure, which is a type of gingivectomy.
ENAP stands for Excisional New Attachment Procedure, which is a type of gingivectomy.
Gingivoplasty primarily aims to reduce pocket depths for better oral hygiene but is not a surgical procedure.
Gingivoplasty primarily aims to reduce pocket depths for better oral hygiene but is not a surgical procedure.
In the healing process after a surgical gingivectomy, granulation tissue appears after the initial inflammatory response.
In the healing process after a surgical gingivectomy, granulation tissue appears after the initial inflammatory response.
Ultrasonic curettage uses high-frequency vibrations to disrupt tissue continuity and is a non-invasive procedure.
Ultrasonic curettage uses high-frequency vibrations to disrupt tissue continuity and is a non-invasive procedure.
During curettage, it is essential to follow up with scaling and root planing to remove local factors like plaque.
During curettage, it is essential to follow up with scaling and root planing to remove local factors like plaque.
The primary surgical instrument used in gingival curettage is the scalpel.
The primary surgical instrument used in gingival curettage is the scalpel.
A common technique used in gingivoplasty is the internal bevel incision.
A common technique used in gingivoplasty is the internal bevel incision.
The purpose of curettage is to completely eliminate the need for any future periodontal procedures.
The purpose of curettage is to completely eliminate the need for any future periodontal procedures.
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.
