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[[File:Gingivoplasty step 1.jpg|thumb|200px|right|Gingivoplasty - step 1]]

[[File:Gingivoplasty step 1.jpg|thumb|200px|right|Gingivoplasty - step 1]]

[[File:Gingivoplasty step 2.jpg|thumb|right|200px|Gingivoplasty - step 2]]

[[File:Gingivoplasty step 2.jpg|thumb|right|200px|Gingivoplasty - step 2]]

Gingivoplasty is the '''removal of gingival pockets''' by excision of the gingiva, or recontouring the gingiva to its proper anatomical form. It is indicated for the management of [[Gingival Hyperplasia|gingival hyperplasia]]. In this situation the excessive gingival tissue should be excised, leaving a normal depth of healthy gingiva.

Gingivoplasty is the '''removal of gingival pockets''' by excision of the gingiva, or recontouring the gingiva to its proper anatomical form. It is indicated for the management of [[Gingival Hyperplasia|gingival hyperplasia]]. In this situation the excessive gingival tissue should be excised, leaving a normal depth of healthy gingiva.

#Pocket depths are measured with a graduated [[Periodontal Probe|periodontal probe]]. The probe is withdrawn from the pocket and held against the outer surface of the gingiva to show the depth of the pocket and a bleeding point made. This is repeated along the circumference of the tooth.   

#Pocket depths are measured with a graduated [[Periodontal Probe|periodontal probe]]. The probe is withdrawn from the pocket and held against the outer surface of the gingiva to show the depth of the pocket and a bleeding point made. This is repeated along the circumference of the tooth.   

#A beveled incision, using either a scalpel blade (No. 11 or 15) or electrosurgery is made, joining the bleeding points and recreating the scalloped edge of the normal gingival anatomy. The beveled incision is directed towards the base of the pocket or to a level slightly coronal to the apical extension of the junctional epithelium. When using electrosurgery the operator should allow for a 1 mm slough postoperatively. The electrode should be activated at the minimal effective setting in cut mode and stroked across the [[gingiva]] at the required angle. The cut surface should be pink and not bleeding if the setting is correct. Blanched tissue indicates that the setting is too high and should be reduced. To avoid overheating the tooth the electrode should not be applied to the gingiva around the same tooth for more than 5 seconds.

#A beveled incision, using either a scalpel blade (No. 11 or 15) or electrosurgery is made, joining the bleeding points and recreating the scalloped edge of the normal gingival anatomy. The beveled incision is directed towards the base of the pocket or to a level slightly coronal to the apical extension of the junctional epithelium. When using electrosurgery the operator should allow for a 1 mm slough postoperatively. The electrode should be activated at the minimal effective setting in cut mode and stroked across the [[gingiva]] at the required angle. The cut surface should be pink and not bleeding if the setting is correct. Blanched tissue indicates that the setting is too high and should be reduced. To avoid overheating the tooth the electrode should not be applied to the gingiva around the same tooth for more than 5 seconds.

#The incised tissues are removed using  a curette or a scaler. Remaining tissue tags are cut with a curette or a pair of scissors.

#The incised tissues are removed using  a [[Dental Scaling Equipment|curette or a scaler]]. Remaining tissue tags are cut with a curette or a pair of scissors.

#Hemorrhage is controlled with gauze swabs and digital pressure. The crown and exposed root surfaces are then scaled and polished.

#Hemorrhage is controlled with gauze swabs and digital pressure. The [[Enamel Organ#Crown|crown]] and exposed [[Enamel Organ#Root|root]] surfaces are then scaled and polished.

The postoperative phase is uncomfortable and analgesics are indicated for the first few days. The healing of a gingivoplasty wound is similar to that of a simple soft tissue wound. Plaque control is important to ensure adequate healing.  

 

The postoperative phase is uncomfortable and [[Analgesia for Oral Disease|analgesics]] are indicated for the first few days. The healing of a gingivoplasty wound is similar to that of a simple soft tissue wound. Plaque control is important to ensure adequate healing.

 

These animals are unlikely to accept [[Tooth Brushing|toothbrushing]] immediately postoperatively, so [[Anti-Plaque Agents|chemical plaque control]] is indicated. Apply chlorhexidine gluconate gel on a piece of gauze twice daily for the first week, then once-daily in combination with toothbrushing for the second week.

Plaque control by means of daily toothbrushing and removing any predisposing causes if possible, e.g. cyclosporine administration, are necessary to prevent recurrence.

Plaque control by means of daily toothbrushing and removing any predisposing causes if possible, e.g. cyclosporine administration, are necessary to prevent recurrence.