Dentaltown September 2021 - 54

by Dr. Samuel B. Low
Dr. Samuel B. Low was named vice president, dental
and clinical affairs, and chief dental offi cer of Biolase in
October 2016. He is professor emeritus at the University
of Florida College of Dentistry and an associate faculty
member of the Pankey Institute, with 30 years of private
practice experience in periodontics, lasers and implant
placement. He is also a diplomate of the American Board of
Periodontology and past president of the American Academy
of Periodontology.
Dueling Lasers
A gingival treatment case study and a look at today's laser options
While it may be diffi cult to determine when the fi rst gingivectomy was performed in the oral
cavity, some suggest it was performed by the French dentist Etienne Bourdet, who in 1757 created a
V-shaped incision between a patient's teeth to the bottom of the pocket. However, the gingivectomy
did not truly become highlighted in the discipline of periodontics until the mid-1940s. Major
periodontal icons such as Goldman, Glickman, Beube and Hirschfeld all describe the gingivectomy
as a major " go-to " in managing periodontal pockets. With the advent of the fl ap procedure in the
1950s, the gingivectomy slowly became less popular because of patient complaints of discomfort
and the signifi cant recession as the result of the blade excisions.
Traditional defi nitions for the gingivectomy can be convoluted, but still should be differentiated
from the gingivoplasty. Defi nitions of each can be found below:
Gingivectomy: Excision of gingiva by removing the diseased pocket wall, thereby exposing tooth
surface to provide the visibility and accessibility that are essential for the complete removal of irritating
surface deposits and thorough smoothing of the roots. Benefi ts include:
* Diseased tissue is removed.
* Pocket depth is reduced.
* Periodontal disease is controlled.
* Patient has improved ability to maintain good hygiene.
Gingivoplasty: A surgical reshaping of the gingiva for a more ideal physiologic contour, including
sculpting gingivae for aesthetic reasons. Benefi ts include:
* Reducing a gummy smile.
* Fixing uneven gingival contours.
With the advent of the fl ap creating excellent visualization for access to both teeth and osseous
structures, the gingivectomy should be utilized more frequently as a monotherapy for the management of
periodontal disease. It is an excellent procedure for excisional removal of supragingival (pseudo-pocket)
tissue to gain access for multiple objectives, from orthodontics to restorative. It indeed is an angular
excision to the tooth structure with the resulting collar removed for exposure. Therefore, the new,
more modern defi nition of gingivoplasty would be contouring existing gingiva without a complete
dissection of the connective tissue and more sculpting of the gingivae.
54 SEPTEMBER 2021 // dentaltown.com

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Dentaltown September 2021

Table of Contents for the Digital Edition of Dentaltown September 2021