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26/Jul/2020

This procedure is conducted to remove excess gum tissue that may be overgrown on the teeth to provide a better aesthetic result and a better area to clean the teeth.

Gingiva Overgrowth

Several reasons why there is an overgrowth of gum:

Inflammatory-induced:

  • Biofilm (bacteria) and the host response, resulting in familiar forms of periodontal disease such as gingivitis and periodontitis. Swelling, erythema, and bleeding are signs of these diseases.
  • Usually due to poor oral hygiene, orthodontic appliances 

Some mediation might trigger the growth of the gum tissue, such as:

  • Anticonvulsants (phenytoin, phenobarbital, lamotrigine, vigabatrin, ethosuximide, topiramate, and primidone)
  • Antihypertensives (calcium channel blockers such as nifedipine, amlodipine, and verapamil)
  • Immunosuppressant (cyclosporine)

Systemic diseases such as:

  • Pregnancy or puberty and vitamin deficiencies (mostly vitamin C) are some of the more common causes in this category.
  • Benign neoplasms—such as giant cell granuloma, papillomas, and fibromas—can cause enlargement of the gingiva.
  • Other more serious causes of gingival enlargement include leukemias, malignant neoplasms/carcinomas, as well as many forms of granulomatous diseases.

All these gum overgrowth can be corrected by reduce the cause factors or gum surgery (gingivectomy)

A case of Gingivectomy

A young lady complained that she didn’t have great smile. On examination, we found out that she had a very short teeth. Oral hygiene just moderate.

Using a dental chi gauge, it was confirmed that the patient had a short crown height

Dental scaling was done to improve oral hygiene

After taken radiograh to determain the bone height and biological width, surgical excision of 2mm of gum tissue above the gingiva margin.

Immedate post surgery
2 days after surgery

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26/Jul/2020

Gingivoplasty

A procedure to correct the gum shape and contour thus improve the smile line. Gingivoplasty surgery is usually done on the upper front teeth (can be up to the premolar region) where the gums here can be seen when smiling.

Most of these gum defects are usually caused by gum diseases (eg. periodontitis). However, in certain cases, the gum recedes due to over brushing or probably just because the gum itself is thin (thin biotype).

In gingivoplasty, a gum graft can be done where the tissue is taken from the roof of the mouth (this is called a graft) and then stitched into place on either side of the tooth that is recessed.

Here, is a case of a young male presented with receded gum due to over brushing…

He didn’t like his teeth and gum for a few aesthetic

reasons:

  • The teeth are uneven
  • The gums on his left are simply too high!!

We found out that he was a right-handed person, using his toothbrush to brush his left teeth too hard!! That causing the gum to shrink upwards.

Secondly, his gums were thin biotype and the previous dentist had over-filled his abrasion cavity  with composite preventing the gum from ‘coming down’

Objectives of treatment:

Correct his over-brushing technique

  • Modified the over-filled composite restoration
  • Correct the Shape of his teeth
  • Gum surgery to thicken his thin biotype gum and bring his gum down at the same time

Final Result

Before Treatment
After Treatment


20/Feb/2011

Gum surgery sometimes needed to correct the gum defect caused by gum disease (such as periodontitist) or gum recession usually due extensive brushing. Gum surgery will helps to impove the gum aesthetically but most importantly, it enable the patient to clean his teeth better.

Different Types of Gum Surgery

There are certain  types of gum surgery that usually the dentist will perform depend on the condition of the patient’s gum:

  • Pocket reduction (Gingiva Flap Surgery) This procedure is indicated for patient with deep pocketing on his gum as the result of gum disease (periodontitist). In this procedure, dentist or periodontist (gum specialist) will reflect the gum to expose the root of deep cleaning and then reposition the gum slightly lower in order to reduce pocket. Thus, this allows the patient to clean his teeth more efficiently.

 

  • Regeneration (Guided bone regeneration GBR) When there is excessive bone lost to a single or few teeth in the mouth, the dentist/periodontist might try to ‘re-grow’ the bone back around the tooth. The procedure can be done only after the gum disease ceased. Dentist/periodontist folds back the gums and removes disease-causing bacteria, then inserts bone grafts, membranes, or tissue-stimulating proteins (or any combination of the three) to encourage your gum tissues to regenerate and fit snugly around the teeth again.

 

  • Crown lengthening This procedure is done to lengthen the crown of the tooth for restoration later (Example: porcelain crowns or fillings). In cases where the tooth breaks down badly, sometimes, up to the gum level; crown lengthening is performed before restoration. The gum around the tooth will be removed to expose the root. This can be done with laser or electrocautery under local anesthetic. Once the gum healed, the tooth finally will be restore with filling or porcelain crown.

 

  • Removing excessive gum (Gingivectomy) In certain conditions where overgrowth of gum covering the teeth (gingiva hyperplasia), gingivectomy can be performed to reduce it. Gingiva hyperplasia usually cause be irritation to the gum, or certain medication patient taking causing the gum grows excessively or can be unknown reason. Basically, gingivectomy improves the teeth aesthetically and reduce plaque accumulation around them.

 

  • Soft tissue graft (Gingivoplasty)This procedure is performed on the gum that is thin and receded due to over-brushing. Dentist will take a tissue from elsewhere in your mouth (usually on the palate) and attaches it to your gums to replace gum tissue that has receded or has been removed due to gum disease. This procedure is often used for cosmetic purposes as well as to treat gum disease because it covers areas where the root is becoming exposed and improves the appearance of the teeth.

Is Gum Surgery Painful?

Most people will have only mild to moderate pain after surgery that can be managed with pain relievers. If the is moderate swelling on the gum, cold pack can be used to reduce it. Usually the dentist will give instructions on managing the wound after surgery.

More info

 

Treatments of gum disease:

 


20/Feb/2011

Introduction

Cosmetic gum surgery – It is a type of surgery used to reshape healthy gum tissue around the teeth to make them look better. If a person has tooth recession where the gum is pushed away from the tooth, a gingivoplasty surgery can be done. Basically to ‘bring’ back the gum to cover the expose root surface of a tooth:

Before cosmetic gum surgery (gingivoplasty surgery) – receding gum especially on patient’s left side
After cosmetic gum surgery (gingivoplasty surgery)

To read more on the gingivoplasty procedure click here.

On the other hand, if there is excessive gum covering the teeth, then the procedure is to remove some part of the gum covering the teeth (gingivectomy surgery) to show more of the tooth thus reduce gummy smile and improve smile line.

Before gingivectomy
After gingivectomy

To read more on the gingivectomy procedure click here.

After gum surgery, it is important that the periodontist or dental hygienist inform you how to clean the teeth and gum tissue with a toothbrush and an antimicrobial fluoride toothpaste, floss and antibacterial mouth rinse. Please consult your periodontal specialist or dentist for more information of how to care for your gum tissue and teeth after gum surgery.

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