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Gingivectomy Approaches: a Review ISSN: 2469-5734 Peres et al. Int J Oral Dent Health 2019, 5:099 DOI: 10.23937/2469-5734/1510099 Volume 5 | Issue 3 International Journal of Open Access Oral and Dental Health REVIEW ARTICLE Gingivectomy Approaches: A Review Millena Mathias Peres1, Tais da Silva Lima¹, Idiberto José Zotarelli Filho1,2*, Igor Mariotto Beneti1,2, Marcelo Augusto Rudnik Gomes1,2 and Patrícia Garani Fernandes1,2 1University Center North Paulista (Unorp) Dental School, Brazil 2Department of Scientific Production, Post Graduate and Continuing Education (Unipos), Brazil Check for *Corresponding author: Prof. Idiberto José Zotarelli Filho, Department of Scientific Production, Post updates Graduate and Continuing Education (Unipos), Street Ipiranga, 3460, São José do Rio Preto SP, 15020-040, Brazil, Tel: +55-(17)-98166-6537 gingival tissue, and can be corrected with surgical tech- Abstract niques such as gingivectomy. Many patients seek dental offices for a beautiful, harmoni- ous smile to boost their self-esteem. At present, there is a Gingivectomy is a technique that is easy to carry great search for oral aesthetics, where the harmony of the out and is usually well accepted by patients, who, ac- smile is determined not only by the shape, position, and col- cording to the correct indications, can obtain satisfac- or of teeth but also by the gingival tissue. The present study aimed to establish the etiology and diagnosis of the gingi- tory results in dentogingival aesthetics and harmony val smile, with the alternative of correcting it with very safe [3]. surgical techniques such as gingivectomy. The procedure consists in the elimination of gingival deformities resulting The procedure consists in the removal of gingival de- in a better gingival contour. Usually, surgical removal of 1 formities resulting in a better gingival contour, it can be to 2 millimeters of gingival tissue solves most cases of the performed in the removal of the inserted, papillary and gingival smile. The surgical technique has the possibility to perform the incision with a conventional scalpel, electrosur- marginal gingiva when there is an absence of periodon- gery (electric scalpel) and there are also the high-frequency tal disease [4]. lasers, being a choice obtained during the treatment plan and in patient-professional harmony, for each case. The lit- However, it may be indicated for clinical crown aug- erature review was carried out through the selection of arti- mentation or remodeling of thick margins, removal of cles related to etiology and diagnosis of gingival smile and hyperplasias caused by a variety of factors, or even re- periodontal surgery, focused on gingivectomy. With this, it moval of supra-bony periodontal pockets [5-7]. is concluded that, based on technical and scientific knowl- edge, gingivectomy promotes essential visibility and access The present study aimed to establish the etiology to a complete removal of superficial irritant deposits and and diagnosis of the gingival smile, with the alternative perfect root straightening. of correcting it with very safe surgical techniques such Keywords as gingivectomy. Gingivectomy, Gingival hyperplasia, Periodontics, Peri- odontal health Methods Study design Introduction Following the criteria of literary search with the use Many patients seek dental offices for a beautiful, har- of the Mesh Terms that were cited in the item below monic smile to boost their self-esteem [1,2]. At present, on “Search strategies”, a total of 34 papers that were there is a great search for the buccal aesthetics, where submitted to the eligibility analysis were collated and, the harmony of the smile is determined not only by the after that, 24 studies were selected Figure( 1). shape, position, and color of the teeth, but also by the Citation: Peres MM, Lima TS, Filho IJZ, Beneti IM, Gomes MAR, et al. (2019) Gingivectomy Approaches: A Review. Int J Oral Dent Health 5:099. doi.org/10.23937/2469-5734/1510099 Accepted: September 06, 2019: Published: September 08, 2019 Copyright: © 2019 Peres MM, et al. This is an open-access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited. Peres et al. Int J Oral Dent Health 2019, 5:099 • Page 1 of 4 • DOI: 10.23937/2469-5734/1510099 ISSN: 2469-5734 Records identified through database Additional records identified through other searching (n = 24) sources (n = 10) n o i t a c i f i Records after duplicates removed (n =34) t n e d I Records screened Records excluded (n = 30) (n = 04) ng i Full-text articles excluded, with en Full-text articles assessed for reasons e eligibility cr (n = 06) S (n = 24) y t i l Studies included in qualitative bi i synthesis ig l (n = 24) E Studies included in quantitative synthesis (Systematic Review) ed (n = 24) ud l Inc Figure 1: Flow chart. Search strategy and sources of information giene is one of the most common complications in re- lation to gingival increases since the accumulation of In general, as an example, the search strategy in biofilm from food remains causes the proliferation of MEDLINE/Pubmed, Web Of Science, Science Direct inflammatory cells and pathogenic bacteria, causing the Journals (Elsevier), Scopus (Elsevier), OneFile (Gale) gingiva to present edematous, color reddish, loose and followed the following steps:-Search for mesh terms: with chances of spontaneous bleeding [3]. Gingivectomy, Gingival Hyperplasia, Periodontics, Peri- odontal Health, and use of the bouleanos “and” be- There are risk factors that may predispose to gingi- tween mesh terms and “or” among historical findings. val hyperplasias, such as the use of orthodontic appli- ances or medications, but their development is directly Literature review and discussion linked to deficient hygiene, causing space for dental The healthy gingiva is represented by specific clini- biofilm installation, which is the etiological agent of the cal features such as pink-pale color, matte and dotted great majority of periodontal problems [4]. surface, firm and resilient consistency, volume-depen- The implantation of dental appliances facilitates gin- dent shape and gingival contour being the thin margin gival inflammation and has great influence on the oral and ending against the tooth like a knife blade. When microbiota, but these conditions are subjects of rever- subjected to the periodontal probe, its depth may vary sion in people who have an adequate oral hygiene [5]. from 1-3 mm and should not present bleeding to this examination [8]. The presence of periodontal pockets is detected through the depth of probing. To do this, the clinical Hyperplasia resulting from the failure of oral hy- insertion level of each patient is measured to analyze Peres et al. Int J Oral Dent Health 2019, 5:099 • Page 2 of 4 • DOI: 10.23937/2469-5734/1510099 ISSN: 2469-5734 the periodontal biological space, which includes gingi- Carbon dioxide laser stimulates blood clotting in val sulcus (0.69 mm), junctional epithelium (0.97 mm), small blood vessels, allowing it to work in a controlled that is, taking into account that in the natural state it area, being indicated for very vascular areas and in pa- presents from 2 to 3 millimeters of healthy structure tients in whom infection control is critical, since the la- that extends from the alveolar bone crest to the gingi- ser has the capacity to transform an area contaminated val margin [6]. or infected in a sterile wound [19,20], also inhibiting the After gingival hyperplasia is observed, surgery is formation of abnormal cells, by the lining of lymphatic usually indicated for treatment, the ideal is always to vessels, in addition to little contraction, scar formation, be associated with basic periodontal therapy, and af- usually does not require surgical cementation, nor su- ter performing scaling and root planning, the adequacy ture and the pain remains for only a few seconds after of the buccal environment, with elimination of all the surgery, generating little discomfort in the postopera- outbreaks of infection seeking to awaken the patient tive period allowing the patient to return to normal ac- through the instructions of oral hygiene, care and con- tivities [21,22]. cern with oral health, being this phase more important The first step in establishing a correct diagnosis is to of the treatment to obtain a healthy gingival condition properly classify the gingival level, taking into account [9]. variables such as gender, age and periodontal health In general, surgical removal of 1 to 2 millimeters of [3,12,13]. The causes defined for gingival growth can gingival tissue resolves most cases of a gingival smile, be characterized by numerous factors (orthodontic rea- but when gingiva at a height is very significant, more sons, maxillary growth, drug-induced, pathologies) and complex surgery should be performed [7]. aggravated according to factors such as age, gender, hygiene and systemic condition of the affected patient While performing the surgical technique, one has the [14]. possibility to perform the incision with the conventional scalpel or elect electrosurgery (electrosurgical scalpel), Conclusion although the former is the most used and most pref- After the literature review in this study, it can be erably among the professionals, both reach the same concluded that gingivectomy promotes essential visi- satisfactory aesthetic results, being a choice obtained bility and access to a complete removal of irritating su- during the treatment plan and in patient-professional perficial deposits and perfect root straightening. One of harmony, for each specific case [9]. the great advantages that gingivectomy provides is the After the preparation of the surgical field and oral transformation of a periodontal pocket of difficult hy- antisepsis, local infiltrative anesthesia is performed and giene into an easily hygienizable gingival sulcus. Contra- bleeding points are marked, both buccally and lingually.
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