2. Another name for gingivectomy: gingivectomy.
Classification of stomatology/Oral and maxillofacial tumor surgery/Oral and maxillofacial benign tumor surgery
4 ICD code 24.3 10 1
5. Summarize the application of gingivectomy in the treatment of gingival tumors. Gingivoma is not a real tumor, but an inflammatory reactive growth originating from gum, periodontal ligament or alveolar periosteum, which has tumor-like properties. Local inflammation, mechanical chronic * * * and endocrine influence are directly related to its pathogenesis. Clinically, it can be divided into four types according to the characteristics of its organizational structure.
Fibrous gingival tumor is mainly fibrous tissue; Granular gingival tumor is mainly inflammatory granulation tissue; Giant cell gingival tumor is characterized by a large number of multinucleated giant cells, abundant blood vessels and hemosiderosis (some scholars listed it as peripheral giant cell repair granuloma); Pregnancy-induced gingival tumors occur in women during pregnancy and grow rapidly. There are many blood vessels in the tumor tissue, which can atrophy or stop growing after delivery. Some scholars classify the particularly rich blood vessels as vascular type, and classify pregnant gingival tumors as this category.
Indications Gingival tumors, regardless of their types, should be surgically removed as soon as possible. In order to avoid regeneration or recurrence, the operation should be thorough, remove its local factors and eliminate inflammation. Gingivoma in pregnancy should be treated symptomatically during pregnancy, such as anti-inflammatory and hemostasis, and postpartum surgery as needed.
7 contraindications There are no special contraindications for the resection of gingival tumors. Only pregnant gingival tumors should be operated after childbirth.
8 preoperative preparation only needs to know the general situation, check blood routine and coagulation time.
9 anesthesia and * * * use local infiltration anesthesia or block anesthesia. Surgery * * * take more sitting position, supine position is also ok.
10 operation steps 10. 1. Make a circular or rectangular incision on the normal tissue at the edge of the gingival tumor or 3mm around the pedicle (figure 10.4.2.7 1).
10.2 2. tumor resection: cut the mucosa along the incision and reach the bone surface with a scalpel or electrotome, peel off the mucoperiosteum, and completely remove the gingival tumor. In order to avoid recurrence, in addition to the pregnancy-induced gingival tumor, the operation should simultaneously remove the teeth affected by the pedicle of the gingival tumor, and remove the base, periosteum and alveolar bone of the gingival tumor (Figure 10.4.2.72).
10.3 3. wound treatment: bite off and flatten the hyperosteogeny (fig. 10.4.2.73). Smaller wounds are tightly closed by suture or transfer and sliding mucosal flap (Figure 10.4.2.74). For wounds with large wounds or bone tissue defects that cannot be tightly sutured, iodoform gauze is used to cover them. After granulation tissue grows, mucosal epithelium heals itself after migration.
1 1 Precautions during operation: There is no special danger in gingivectomy. Attention should be paid to prevent recurrence and enlarge resection during operation.
Postoperative treatment/After Kloc-0/2 gingivectomy, the following treatments were performed:
1. Antibiotics, mouthwashes and painkillers are routinely administered.
2. Eat liquid or semi-liquid food within 1 week after operation.
3. After 7 ~ 7 ~ 10d, the iodoform gauze was replaced, the granulation tissue stopped growing and the wound healed itself.
13 complications