My recommendation
”Ever since Accesia introduced me to #12 fluted burs, my working time during gingivectomy dramatically decreased and I immediately realised the obvious benefit of good hemostasis during and after the procedure. I definitely would recommend collegues of mine to learn this time saving surgical technique!"
- Magnus Andersson, DVM, Head of Odontology Evidensia Sweden
- Magnus Andersson, DVM, Head of Odontology Evidensia Sweden
GINGIVECTOMY
By Magnus Andersson
Gingival enlargement is a common clinical finding and characterized by an increase in the size of gingiva. Based on etiopathogenesis, enlargements is commonly inflammatory but can also be multifactorial, drug induced, neoplastic, hypertrofic, hyperplastic or associated with systemic conditions and influenced by hereditary factors.
Without real destruction of the underlying periodontal tissues, the pseudo pockets predispose for periodontal disease and in certain situations, gingivectomy is required in order to reduce the gingival pocket depths to a normal 1–3 mm.
As an important part of the professional dental cleaning procedure, excessive gingiva must be excised and even though gingivectomy is a simple form of periodontal surgery, it can nonetheless be very challenging, time consuming and cause profuse bleeding.
Without real destruction of the underlying periodontal tissues, the pseudo pockets predispose for periodontal disease and in certain situations, gingivectomy is required in order to reduce the gingival pocket depths to a normal 1–3 mm.
As an important part of the professional dental cleaning procedure, excessive gingiva must be excised and even though gingivectomy is a simple form of periodontal surgery, it can nonetheless be very challenging, time consuming and cause profuse bleeding.
The use of helical #12 fluted burs for contouring the gingiva can dramatically simplify the gingivectomy prodedure. One of the major advantages is the immediate hemostatic effect and in addition it shortens the working time both when used as single techique and when used in combination with cold steel method.
After planning the procedure by marking bleeding points with Goldman-Fox forceps, the gingiva is contoured using the fluted bur. Hemostasis is immediate and only very mild bleeding occurs compared to cold steel method with a scalpel.
Post surgical treatment with local hemostatic agents is often not necessary, but can be done with aluminum chloride or equivalent preparation with or without local hyaluronic acid gel (Aftaclear) for post operative comfort for the patient. NSAID for 3-5 days post surgery is recommended.
After planning the procedure by marking bleeding points with Goldman-Fox forceps, the gingiva is contoured using the fluted bur. Hemostasis is immediate and only very mild bleeding occurs compared to cold steel method with a scalpel.
Post surgical treatment with local hemostatic agents is often not necessary, but can be done with aluminum chloride or equivalent preparation with or without local hyaluronic acid gel (Aftaclear) for post operative comfort for the patient. NSAID for 3-5 days post surgery is recommended.
HELICAL #12 FLUTED BURS
When faceting the gingiva or working in wide interproximal spaces, the conical bur with a round tip works excellently.
The burs come in different sizes and can be used as needed. Football/Egg-shaped burs serve as "all-round burs" for both dogs and cats and come in various sizes.
The flame-shaped, conical burs are used near the enamel surface and interproximally. It "picks up" hanging loose gingiva without touching the tooth and can be used advantageously for e.g., juvenile hyperplasia in cats.
What do you need?
A suitable selection of spiral burs in various sizes is appropriate to have in your "gingivectomy kit.". In cases where the gingiva is very tissue-rich, excision preferably starts with a scalpel, so handles and blade 15 may also be suitable accessories.
An examination probe and Goldman-Fox forceps (right and left) are necessary.
An examination probe and Goldman-Fox forceps (right and left) are necessary.
