Crown Lengthening (Gingivectomy)


GINGIVECTOMY is the surgical removal of gingiva (i.e., gum tissue).  A gingivectomy is necessary when the gums have pulled away from the teeth creating deep pockets. The pockets make it hard to clean away plaque and calculus.  Gingivectomy is usually done before gum disease has damaged the bone supporting the teeth. The procedure involves removing and reshaping loose, diseased gum tissue to get rid of pockets between the teeth and gums. By removing the pocket walls, gingivectomy provides visibility and accessibility to remove calculus and thoroughly smooth the tooth roots.  This creates a favorable environment for gingival healing and restoration of the gingival contour.  Although gingivectomy was initially developed to treat periodontal disease, it is now a common cosmetic surgery, also.  It is used to remove overgrown gum tissue and improve the appearance of the gums.

GINGIVOPLASTY is the surgical reshaping of gum tissue around the teeth.  It is often is done simply to make gums look better. They may have an unusual shape or may not be formed normally. The causes can include a person’s genes, disease or trauma. Gingivoplasty reshapes the gums to make them look more natural. It often is done alone, but can be done during or after a gingivectomy. Gingivoplasty also can be done along with a gum graft. This type of surgery adds tissue to the gum line.

What is gingivoplasty used for?

Reshaping your gums through gingivoplasty could make your gums look more natural. The gingivoplasty procedure could be used to correct asymmetrical gums, badly formed gums, diseased gums, genetically malformed gums, trauma, or for purely cosmetic purposes. Gingivoplasty is usually done alone although it can also be done after a gingivectomy or a gum graft. Gum grafts are additions of gum tissue to the gum line.

How do you prepare for a gingivectomy or a gingivoplasty?

Before either of these procedures, our periodontist in Tijuana Surgery Center will have a discussion with you regarding your oral hygiene habits. He will also give you further instructions for preparing properly for the surgery. It is important that before a gingivectomy or gingivoplasty, you get a thorough cleaning. You may have to go through root planing in order to remove the tartar or calculus from the existing pockets.

How is a gingivectomy or a gingivoplasty performed?

A gingivectomy or a gingivoplasty is usually performed using a scalpel. It can also be performed using elctrosurgery units, diamond dental burs, and lasers. Your periodontist may use specialized instruments designed for gingivectomies like angled blades that allow your dentist to work around your teeth.

Before either of these procedures, you will get a local anaesthetic injection that will make your gums numb. A gingivectomy may last for a few minutes to more than an hour. The duration of the surgery will depend on the amount of gum tissue that has to be worked on. Gingivoplasties are usually done in a couple of minutes only.

How should you follow-up your gingivectomy or gingivoplasty?

A periodontal dressing will be placed on your gums after your gingivectomy or gingivoplasty. This periodontal dressing is a type of bandage left in the treated area for about a week or two. You may have to follow a soft diet, avoid spicy foods, and refrain from eating crunchy foods during this healing period. Your dentist may also prescribe some pain medications and chlorhexidine mouth rinse.

You must make it a point to keep your mouth clean during this healing period. Your periodontist will advice you not to brush the teeth in the surgical area while the periodontal dressing is still there. For the rest of your mouth, you can brush normally and floss just like before although you may have to be a little more careful with a periodontal dressing nearby. When this periodontal dressing is removed, you will be able to brush your teeth normally and floss normally as well. You should not be worried if the healing tissues bleed after you floss or brush because this is normal right after the dressing is removed.

You will have the periodontal dressing removed after a week or two. Your gums will start looking natural once again after a month. It may take about three months for your tissues to heal completely.

What are the risks associated with gingivectomy or gingivoplasty?

There are no major risks to gingivectomy or gingivoplasty so infections aren’t common in such procedures. It is possible for your gums to bleed although this is rare as well. The affected area may ooze blood for a day or two but it should eventually subside in time.

When should you call to our office?

You should call to our office if one or more of the following happen to you

  • your gums do not stop bleeding
  • there is excessive pain that can not be remedied by painkillers. Even if people have different thresholds for pain, a gingivectomy should not cause a lot of pain
  • you think that your gums might be infected
  • there is excessive swelling and discharge from the surgical area
  • the periodontal dressing becomes loose
  • the periodontal dressing is displaced
  • the lymph nodes in your lower jaw and in your neck become swollen