Page 44 - MDJ Volume 47 Number 2 ( Jul-Dec 2024)

Sharma, et al.: Gingivectomy via electrosurgery

Figure 8: Post-operative photograph after 10 months (case 2)
Figure 5: Removal of excess gingiva via electrosurgery (case 1)

Figure 9: Post-operative photograph after 10 months (case 3)
Figure 6: Immediate post-operative photograph (case 1)
dIscussIon
IGE is commonly observed in patients undergoing
orthodontic treatment. Primarily, it is induced by the
presence of fixed orthodontic appliances that can
exacerbate plaque accumulation, leading to gingival
inflammation and hyperplasia. Other reasons can
[5]
be the orthodontic appliances’ location leading to
mechanical irritation, exposed cement causing chemical
irritation, wires increasing food impaction and poor oral
hygiene. [6-9] Orthodontic treatment has also been seen to
initiate various other soft tissue discrepancies including
Figure 7: Ten months post-operative photograph (case 1) labial desquamation, multiform erythema and gingivitis.
However, GE is a more common sequela of fixed
orthodontic treatment than other manifestations. [10,11]
Patient motivation and the use of mouth rinses, along
such as 2R/2L and 4R/4L were also used to aid in the with non-surgical periodontal therapy, are the first line of
removal of excess gingival tissue, wherever required. After treatment for GE. However, gingivectomy or gingivoplasty,
the removal of the enlarged tissues [Figure 6], the area which involves the surgical removal of enlarged gingival
was cleared of debris and charred tissues. Haemostasis tissue to eliminate pockets and improve oral health and
was achieved, and the periodontal dressing was placed to aesthetics, is another effective treatment option. We
[11]
assist healing by protecting the tissue in all the patients. managed this case with non-surgical periodontal therapy
The patients were prescribed analgesics for 5 days followed by gingivectomy and gingivoplasty using
(Ibuprofen tablet 400 mg) and post-operatively they were electrosurgery.
instructed to rinse twice daily with 0.2% chlorhexidine
digluconate mouthwash twice a day for 2 weeks. They Electrosurgery has become an invaluable tool in the
were recalled after 10 days for revaluation. All the patients management of IGE induced by orthodontic treatment.
showed significant improvement in gingival contour and This technique leverages high-frequency electrical
reduction in inflammation within 2 weeks. There was no currents to achieve precise cutting and coagulation
evidence of recurrence at a 10-month follow-up, and the of soft tissues, offering numerous advantages over
patient maintained good oral hygiene [Figures 7–9]. traditional surgical methods such as a clear operating

70 Malaysian Dental Journal ¦ Volume 47 ¦ Issue 2 ¦ July-December 2024
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