Gingivectomy

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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Gingivoplasty

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
Continue reading Gingivoplasty

Digital Dentistry

Digital dentistry refers to the use of dental technologies or devices that incorporates digital or computer-controlled components to carry out dental procedures rather than using mechanical or electrical tools. The use of digital dentistry can make carrying out dental procedures more accurate, efficient than using mechanical tools, both for restorative as well as for diagnostic purposes.

Digital dentistry can be use for:

  • Fabricating a veneer, crown or bridge in just ONE DAY. So, patient can have a crown done and cemented in his/her mouth on the same day, without the need of 2 visits or multiple injections or temporary prosthesis.
  • Planning of teeth movement in orthodontic patient. After planning, a series of teeth models will be printed out where the vacumme-formed aligners will be fabricate for patient to wear. This aligners will move the teeth as planned and achieve final result.
  • Planning and creating a new smile for patient in digital smile design. By changing the teeth colour and alignment in the computer, both clinician and patient can immediately appreciate the outcome of the smile design. From there, clinician can give several treatment options for the patient to achieve the final result.
  • Surgical guide for implant placement – making implant surgery safe and precise

Digital dentistry basically involved 3 basic steps:

  • data acquisition
  • data manipulation and analysis; and finally
  • output

Data Acquisition

We need to collect data or information from patient to start the outflow in the digital dentistry, for example:

  • Dental and Face images. Good image of the teeth or oral cavity region, patient’s smile or portrait picture of patient are essential data for planning digital smile design (DSD). These information can be obtained using a SLR Camera in the Photo Studio environment.
  • Intra-oral 3D scan. With a Intra-oral scanner (such as 3hape scanner), 3D images of the oral cavity region can be record and save in the computer.
  • CT-scan or 3D image of the teeth and jaw bone of patient mouth. Cone Beam CT (CBCT) is the radiograph unit acquire the data. With CT-scan