Gingivectomy Case Presentation

7/27/2019 Gingivectomy Case Presentation

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Regine Glyza Gepanaga

Darryl John Villar

Case Presentation



- For suprabony pockets which need access forrestorative dentistry, when moderate gingivalenlargements or aberrations are present,

and when moderate gingival enlargements oraberrations are present, and when there isasymmetrical, or unaesthetic gingival

topography.



Patient Picture Name: Jan Michael Cañedo

Address: Calumpang, Iloilo City

Age: 28

Gender: Male

Birthdate: August 19, 1985Civil Status: Single

Occupation: Student

Smoker: Applicable Quantity: 10 sticks per dayDrinking Alcohol: Applicable Quantity: 3 – 5 bottles per week



“ Nag damul liwat akon na gums kg ga sige dugomag tooth brush ko”



10 years PTC, patient suffered from severeswelling of the gingiva. Consulted Dr. Robles andwas diagnose with gingivitis treated with deepscaling.

9 years and 11 months PTC, Patientundergone gingivectomy.

2 months PTC, patient had oral prophylaxis

at IDC–

CDUpon consultation patient presents with a

hyperplastic gingiva with enlarged roundedmargins and covers 1/3 of the clinical crown.



History of hospitalization:

3 years ago patient broke his ankle due to

a sport accident.Systemic Diseases: No known problem

Allergies: None

Medications: None



Frequency of Dental Visits: SeldomPrevious Treatments:

Oral Prophylaxis

Restoration: Tooth # 36 and 46Extraction: Tooth # 28

Gingivectomy (10 years ago)

Odontectomy: Tooth # 38 ( 2 years ago)

Last Dental Visit: September 21, 2013 (Extraction of tooth #28)



Maternal side: Hypertension

Paternal side: Diabetes Milletus



Extraoral Absence of assymetry

Lymph nodes not palpable

Absence of growths and swellings

Medium-sized jaw

Developed muscles of mastication



Intraoral Findings

Medium sized tongue

Reddish gingiva with enlarged rounded margin Presence of composite filling on selected teeth

Gummy smile





Tooth Length 27mm 22mm 23mm 24mm 22mm 27mm

Crown Length 12mm 9mm 11mm 12mm 9mm 12mm

(CEJ)



Periapical and Panoramic Radiographs reveal no bone loss



7mm 7.5mm 9mm 7.5mm

6.5mm 7mm



•Tentative: Hyperplastic Gingiva

•Definitive: Gingival Fibromatosis



Gingivectomy



Help the patient feel calm Check the blood pressure of the patient Have the patient mouthwash or gargle with any antiseptic

agent to reduce the intraoral bacterial count Wash the area around the mouth with an antiseptic solution Dry the area to be anesthetized and apply topical anethesia

for 2 – 3 minutes Anesthetize the area by local infiltration the let the patient

gargle Check if the area anesthetized is already numb Use an electrocautery to recontour or remove excess gingiva Mix ZOE powder and Liquid and apply it to the surgical site

and let it stay for 30 mins. After 30 mins. Remove the ZOE and let the patient gargle



Do NOT eat anything until the anesthesia wears off, as you might bite your lips, cheek, ortongue and cause damage

Slight swelling of the operated area is not unusual even bruising and chapped lips may occur.

A reusable ice bag or a frozen vegetable bag, wrapped in a soft towel, may be applied tothe area of surgery to help minimize the swelling of your face. Alternating 20 minutes on and20 minutes off will usually be adequate during the first 24-48 hours after surgery.

Avoid extremely hot foods for the rest of the day and do NOT rinse out your mouth, as these

will often prolong the bleeding. If bleeding continues, apply light pressure to the area withmoistened gauze or moistened tea bag. Keep in place for 20-30 minutes without looking tosee if bleeding has stopped.

Please follow a soft food diet, taking care to avoid the surgical area(s) when chewing. Chewon the opposite side and do NOT bite into food if the procedure was done in the front of themouth. Avoid sticky, hard, brittle, spicy, highly seasoned, or acidic foods in your diet.

Maintain normal oral hygiene measures in the areas of your mouth not affected by the

surgery Avoid alcohol (even beer and wine) and smoking until after your post-operative

appointment. Smoking is not advised during the 7-14 days following surgery.

Please do NOT play with the surgery area with your fingers or tongue.

Do NOT pull up or down the lip or cheek to look at the area and do not have someone elselook at the area.

Do NOT use a drinking straw, as the suction may dislodge the blood clot.

Avoid extremely hot foods. Cold foods such as ice cream or shake are OK as long as you use aspoon



Initial response-formation of protective clot, underlying tissue hasacute PMN infiltrate and some necrosis.

Clot replaced by granulation tissue.

24 hours increase CT and angioblast below surface layer. 12-24 hours epithelial cells at margin migrate into the granulatin

tissue, beneath the necrotic tissue.

After 5-14 days surface epithelialization is complete butkeratinization is incomplete

Vasodilation and vascularity begin to decrease about the 4th dayand appear normal by about 16 days.

Epithelium grows about 0.5mm per day.

Complete repair of the connective tissue takes about 7 weeks.



Mefenamic acid 500mg # 24 tabs

Sig. Take 1 tablet every 6 hours for 3 days

Chlorhexidine

Sig. Gargle 15ml for 30 seconds twice a day(morning and night)

Gingivectomy Case Presentation

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