Operculectomy (dental circumcision)

operculectomy before and after procedure
operculectomy before and after procedure © Ho Dental Office

In Dentistry, an operculum is a piece of gum tissue partially covering over a newly erupted tooth, usually a third molar or wisdom tooth.

It is derived from the same word operculum which is usually known as the flap covering the gills of fishes.

Operculectomy is the dental procedure to excise or surgically cut-out said piece of gum tissue.

examples of operculum located on lower third molars

Possible consequences of leaving an operculum intact includes, but not limited to:

    • pericoronitis - inflammation of the gum specific to the area on top of the dental crown, maybe due to food debris becoming stuck and uncleanable
    • dental cavities - due to food debris becoming stuck and uncleanable underneath the operculum
    • traumatic contact - the operculum may be bitten by opposing tooth, causing injury

Indications of operculectomy:

    • gum tissue covering a fully erupted third molar or wisdom tooth, that is in normal position, and may not be needed to be extracted in the future
    • gum tissue covering any other fully erupted tooth in normal position, that may not be needed to be extracted in the future

Limitations of operculectomy: 

    • operculum may or may not grow back
    • the third molar / wisdom tooth may need extraction if gum persistently regrows
    • other unexpected complications arises, such as premature contact with opposing tooth or orthodontic requirements

Described below is our recent case of operculectomy, carried out using electrosurgery / electrocautery.

operculum covering the far edge of the lower right third molar

After administering local anesthesia, the operculum was cut out using electrosurgery. Peripheral bleeding after cutting was also arrested using electrosurgery. (Note: traditional instruments such as a scalpel blade may also be used.)

commonly used electrocautery tips - wire and circle (for cutting), ball (for hemostasis)
wound site after excision

Patient was advised to use 1% Povidone-Iodine mouthwash after toothbrushing as home-care.

Patient was recalled after two weeks, and the wound site shows very good healing!

wound site 2 weeks after excision

Thank you for reading!

 

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