Internal vs. External bevel surgical technique in gingivectomy. Literature review.
DOI:
https://doi.org/10.70577/asce.v4i4.463Keywords:
Periodontics; Oral Surgery; Gingivectomy; Internal Bevel; External Bevel; Surgical Technique.Abstract
Introduction: Smiling plays a decisive role in personal perception, relating to both aesthetics and functionality. Gingival alterations that affect this balance require periodontal interventions, such as gingivectomy, which can be performed using internal or external bevel techniques depending on the clinical diagnosis. Objective: To review the internal and external bevel surgical techniques used in gingivectomy, identifying their indications, contraindications, benefits, and clinical applications. Methodology: A documentary and descriptive study with a qualitative approach, based on a critical review of scientific literature indexed in databases such as PubMed and Redalyc, using DeCS/Mesh descriptors and Boolean operators. Inclusion and exclusion criteria were applied to ensure the relevance, accuracy, and consistency of the sources. Results: Comparative analyses showed that both techniques provide satisfactory clinical results when applied correctly; the internal bevel favors the preservation of gingival tissue and aesthetics, while the external bevel is useful in severe enlargements by allowing greater control of the gingival contour. Conclusion: Gingivectomy is an effective therapeutic alternative for the management of gingival enlargements and gingival smiles. Internal and external beveling techniques have particular benefits and should be selected according to the patient's clinical conditions and treatment objectives. Neither is superior; the choice depends on the diagnosis and individualized planning.
Downloads
References
1. Venugopal A, Manzano P, Ahmed F, Vaid NR, Bowman SJ. Gummy smiles: Etiologies, diagnoses & formulating a clinically effective treatment protocol. Semin Orthod. 2024;000. DOI: https://doi.org/10.1053/j.sodo.2023.11.014
2. Lucana Nina MR, Machaca Mamani P. Cirugía Estética Periodontal. Rev Actual CLínica. 2014;48:2546–50.
3. Araújo AL de, Souza TM de, Sá JL de. Cirurgia periodontal para aumento de coroa clínica. Res Soc Dev [Internet]. 2021;10(16):e397101624227. Available from: https://revistas.icesp.br/index.php/RCO/article/view/3840
4. Álvarez Fernández WJ, Chavira Torres MY, Furrer Franco EP, Castillo Álvarez VH, Aguado Arzola MM, Tolentino Luévanos C. Manejo Quirúrgico De Sonrisa Gingival Excesiva. Reporte De Caso. Salud Vida Sipanense. 2022;9(2):1–13. DOI: https://doi.org/10.26495/svs.v9i2.2313
5. Vieira Couto A, Marzagao M, Vilela Junior R de A. Correción de asimetría dentogingival a través de la técnica mínimamente invasiva Flaplees- Estudio de caso clínico. Arch Heal Investig [Internet]. 2020;8(10):606–12. Available from: http://dx.doi.org/10.33448/rsd-v11i6.29171%0ACorreção DOI: https://doi.org/10.33448/rsd-v11i6.29171
6. Lione R, Pavoni C, Noviello A, Clementini M, Danesi C, Cozza P. Conventional versus laser gingivectomy in the management of gingival enlargement during orthodontic treatment: A randomized controlled trial. Eur J Orthod. 2020;42(1):78–85. DOI: https://doi.org/10.1093/ejo/cjz032
7. Souza AN de, Silva ARJ da, Silva EPL. Correción de la asimetría gingival mediante la gingivectomía con osteotomía. Arch Heal Investig [Internet]. 2021;10(6):888–91. Available from: http://dx.doi.org/10.21270/archi.v10i6.4993 DOI: https://doi.org/10.21270/archi.v10i6.4993
8. Ariza Martínez S, Herrera Herrera A, Díaz Caballero A. Gingivecectomia como alternativa estética de la cirugía periodontal. duazary. 2012;9(1):72–4.
9. Seki K, Sato S. A 15-year Follow-Up of a Gingivectomy Procedure for Idiopathic Gingival Fibromatosis: A Case Report and Literature Review. J Clin Pediatr Dent. 2022;46(2):119–24. DOI: https://doi.org/10.17796/1053-4625-46.2.5
10. Mostafa D. A successful management of sever gummy smile using gingivectomyand botulinum toxin injection: A case report. Int J Surg Case Rep [Internet]. 2018;42:169–74. Available from: https://pubmed.ncbi.nlm.nih.gov/29248835/
11. Sangalette BS, Vieira L V, Verri FR, Mestrener LR, Mestrener SR, Gustavo L, et al. Periodontal Surgery Intervention for Gingival Smile Correction - Case Report. Open Dent J [Internet]. 2020;14:27–34. Available from: https://www.sciencedirect.com/org/science/article/pii/S187421062000143X DOI: https://doi.org/10.2174/1874210601913010027
12. Tavares Pereira Filho CR, Rodrigues de Sousa SM, Braz Monteiro LK, Adriano Araújo VM, Alencar e Silva FJ, De Araújo Sales EM, et al. Gengivectomia com finalidade estética: relato de dois casos clínicos. Rev Eletrônica Acervo Saúde. 2020;(42):e2880. DOI: https://doi.org/10.25248/reas.e2880.2020
13. Domínguez Díaz DD, López Flores AI. Tratamiento multidisciplinario mínimamente invasivo de la sonrisa gingival. Rev Científica Odontológica. 2020;8(2):e022. DOI: https://doi.org/10.21142/2523-2754-0802-2020-022
14. Cristóvam AVS, Medeiros JDS, Cruz JH de A, Brito RMLV, Figueiredo KA de, Rodrigues R de QF, et al. Correction of gengival contour for the techniques of conventional and minimally invasive gengivectomy. Arch Heal Investig [Internet]. 2020;8(10):606–12. Available from: http://dx.doi.org/10.21270/archi.v8i10.3800 DOI: https://doi.org/10.21270/archi.v8i10.3800
15. Vicente MSC, Nicole TPA, Ernestina MSM. Gingivectomy in patient with gingival smile and altered passive eruption. Rev Cuba Investig Biomed. 2023;42(2).
16. Padilla-Avalos CA, Marroquín-Soto C. Tratamiento estético de la sonrisa gingival. Rev Estomatológica Hered. 2023;33(1):62–7. DOI: https://doi.org/10.20453/reh.v33i1.4436
17. T M, C S, G S. Surgical correction of gummy smile: An overview. 8(1):9–15.
18. Burgos Fuentes T, Palomino Romero D, Díaz Caballero A. Gingivectomía a bisel externo. Duazary. 2008;5(2):125–8.
19. Díez Pérez R, Costa Berenguer X, Bascones Martínez A. Cirugía plástica periodontal en dientes del sector anterior. Av Periodoncia [Internet]. 2016;28(3):147–54. Available from: http://scielo.isciii.es/scielo.php?script=sci_arttext&pid=S1699-65852016000300005
20. Silberberg N, Goldstein M, Smidt A. Exposición gingival excesiva. Etiología, diagnóstico y modalidades de tratamiento. Quintessence [Internet]. 2011;24(3):133–42. Available from: https://www.elsevier.es/es-revista-quintessence-9-articulo-exposicion-gingival-excesiva-etiologia-diagnostico-X0214098511013352
21. Mostafa D. A successful management of sever gummy smile using gingivectomy and botulinum toxin injection: A case report. Int J Surg Case Rep [Internet]. 2018;42:169–74. Available from: http://dx.doi.org/10.1016/j.ijscr.2017.11.055 DOI: https://doi.org/10.1016/j.ijscr.2017.11.055
22. Lima de Araújo A, Moreira de Souza T, Lopes de Sá J. Periodontal surgery for clinical crown augmentation. Res Soc Dev [Internet]. 2021;10(16):1–11. Available from: https://rsdjournal.org/index.php/rsd/article/view/24227 DOI: https://doi.org/10.33448/rsd-v10i16.24227
23. Manzur Villalobos I, Díaz Rengifo IA, Manzur Villalobos D, Díaz Caballero AJ. Agrandamiento gingival farmacoinducido: Serie de casos. Univ y Salud [Internet]. 2018;20(1):89–96. Available from: http://www.scielo.org.co/pdf/reus/v20n1/0124-7107-reus-20-01-00089.pdf DOI: https://doi.org/10.22267/rus.182001.113
24. Molano Valencia PE, Quisoboni Eguizábal JF, Yepes Ramírez BI. Despigmentación gingival y cirugía de alargamiento coronal en erupción pasiva alterada tipo IA e IB en el mismo tiempo quirúrgico. Univ Odontológica [Internet]. 2015;34(72):19–28. Available from: https://www.redalyc.org/pdf/2312/231242734011.pdf DOI: https://doi.org/10.11144/Javeriana.uo34-72.dgca
25. Narayan S, Narayan T V., Jacob PC. Correction of gummy smile: A report of two cases. J Indian Soc Periodontol [Internet]. 2011;15(4):421–4. Available from: https://pmc.ncbi.nlm.nih.gov/articles/PMC3283946/ DOI: https://doi.org/10.4103/0972-124X.92585
26. Garg K, Aggarwal R, Kalra P, Khunger A, Garg Professor K. Surgical Periodontal Therapy using as a Different Scalpel. Natl Res Denticon. 10(1).
27. Gupta G, Gupta R, Gupta N, Gupta U. Crown Lengthening Procedures-A Review Article. IOSR J Dent Med Sci Ver I [Internet]. 2015;14(4):2279–861. Available from: www.iosrjournals.org
28. Fidyawati D. BIOLOGIC WIDTH CONCEPT IN GINGIVECTOMY (CASE REPORT). J Ilm dan Teknol Kedokt Gigi [Internet]. 2020;16(2):67–72. Available from: https://www.researchgate.net/publication/349561227_BIOLOGIC_WIDTH_CONCEPT_IN_GINGIVECTOMY DOI: https://doi.org/10.32509/jitekgi.v16i2.1086
29. Khatiri MA, Alhaidari AA, Orkouby ZO, Eyad A. Periodontal Surgery and Operative Dentistry. 1(2021):11–7.
30. Razi MA, Debnath S, Chandra S, Hazra A. Biologic Width – Considering Periodontium in Restorative Dentistry. Int J Contemp Med Res [IJCMR]. 2019;6(3):4–11. DOI: https://doi.org/10.21276/ijcmr.2019.6.3.15
31. Almiñana Pastor PJ, Buitrago Vera PJ, Alpiste Illueca FM, Catalá Pizarro M. Hereditary gingival fibromatosis: Characteristics and treatment approach. J Clin Exp Dent [Internet]. 2017;9(4):599–602. Available from: https://pmc.ncbi.nlm.nih.gov/articles/PMC5410686/
32. Proaño L, Reyes J, Camacho D, Medida M. Aumento de corona clínica por planificación guiada. Rev Odontol [Internet]. 2022;2(25):30–6. Available from: https://dialnet.unirioja.es/descarga/articulo/8578565.pdf DOI: https://doi.org/10.29166/odontologia.vol24.n2.2022-e3931
33. Sawai M. Altered passive eruption treated with external and internal bevel gingivectomy. Univers Res J Dent. 2016;6(2):150. DOI: https://doi.org/10.4103/2249-9725.181687
34. Keerthana R, Varghese S s., Chaudhary M. Gingivectomy by different Techniques - A Comparative Analysis. Int J Dent Oral Sci [Internet]. 2019;8(2):11–6. Available from: https://www.researchgate.net/publication/347184732_Gingivectomy_by_different_Techniques_-_A_Comparative_Analysis DOI: https://doi.org/10.19070/2377-8075-SI02-08003
35. García Huerta A, Espinosa Maesse JL, García Huerta P. Gingivectomía como tratamiento para la hiperplasia gingival inducida por ortodoncia. Reporte de caso. Rev Mex Periodontol [Internet]. 2019;10(1–2):18–20. Available from: https://www.medigraphic.com/pdfs/periodontologia/mp-2019/mp191_2e.pdf
36. Tobar Peñaherrera AN, Moya Salazar ME, Morocho Segarra CV, Astudillo Carruyo AJ. La gingivectomía como tratamiento de la hiperplasia gingival. Rev Cuba Investig Biomed [Internet]. 2023;42:1–18. Available from: file:///C:/Users/PERSONAL/Downloads/3350-18487-1-PB (1).pdf
37. Srivastava V, Dwivedi S, Sharma S. Periodontal wound healing: An absolute literature review. J Clin Images Med Case Reports. 2022;3(3):1–5. DOI: https://doi.org/10.52768/2766-7820/1726
38. Kumar P, Rattan V, Sachin R. Comparative evaluation of healing after gingivectomy with electrocautery and laser. J oral Biol craniofacial Res [Internet]. 2015;5:69–74. Available from: https://pmc.ncbi.nlm.nih.gov/articles/PMC4523585/ DOI: https://doi.org/10.1016/j.jobcr.2015.04.005
Downloads
Published
How to Cite
Issue
Section
License
Copyright (c) 2025 Rivas Astudillo Jorge Andrés
This work is licensed under a Creative Commons Attribution-NonCommercial-ShareAlike 4.0 International License.
Eres libre de:
- Compartir : copiar y redistribuir el material en cualquier medio o formato
- Adaptar : remezclar, transformar y desarrollar el material
- El licenciante no puede revocar estas libertades siempre y cuando usted cumpla con los términos de la licencia.
En los siguientes términos:
- Atribución : Debe otorgar el crédito correspondiente , proporcionar un enlace a la licencia e indicar si se realizaron cambios . Puede hacerlo de cualquier manera razonable, pero no de ninguna manera que sugiera que el licenciante lo respalda a usted o a su uso.
- No comercial : no puede utilizar el material con fines comerciales .
- CompartirIgual — Si remezcla, transforma o construye sobre el material, debe distribuir sus contribuciones bajo la misma licencia que el original.
- Sin restricciones adicionales : no puede aplicar términos legales ni medidas tecnológicas que restrinjan legalmente a otros hacer algo que la licencia permite.
