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OS 3 > Minor Preprosthetic Oral Surgery Procedures > Flashcards

Minor Preprosthetic Oral Surgery Procedures Flashcards

1
Q

Pre-prosthetic Surgery is the

A

surgical improvement of the denture bearing area and
surrounding tissues (Hard and Soft) to support the best possible prosthetic
replacement.

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2
Q

The goal of pre-prosthetic surgery is to establish a

A

functional biologic platform for
supportive or retentive mechanisms that will maintain or support prosthetic
rehabilitation.

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3
Q

Tooth Loss starts an immediate change in the —.

A

jaws

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4
Q

— is the primary cause for this resorption

A

Lack of functional stress from teeth and periodontal ligament following extraction

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5
Q

— begins to resorb after extraction and this process is unpredictable from one
patient to another

A

Bone

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6
Q

n some patient’s, the bone loss stabilizes and in others it continues to include a
total loss of

A

alveolar and underlying basal bone.

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7
Q

Resorption is accelerated by

A

denture wearing

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8
Q

— denture wearers affected more than — denture wearers

A

Mandibular
maxillary

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9
Q

Resorption affects the mandible more severely because
(2)

A
  • Decreased surface area
  • Less favorable distribution of forces
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10
Q

Factors Responsible for Enhanced Bone Resorption
Systemic factors
(2)

A

– Nutritional abnormality e.g. Calcium and Vitamin D deficiency
– Systemic bone disease

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11
Q

– Systemic bone disease
(3)

A
  • Osteoporosis
  • Endocrine dysfunction e.g. Diabetes, Hyperthyroidism, Hyperparathyroidism
  • Other conditions that affect bone metabolism e.g. Osteomalacia, Renal Osteodystrophy
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12
Q

Factors Responsible for Enhanced Bone Resorption
Local factors
(3)

A
  • Surgery (Alveoloplasty, Some form of bone removal in the alveolar ridge)
  • Denture wearing
  • Low mandibular plane angle
    – Can generate greater bite force
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13
Q

The Challenge of Edentulism
With loss of teeth, there is
significant resorption leading to
— in the jaws.
However, the —
still remain in the same place.

A

bone atrophy
muscle attachments

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14
Q

Bone Loss following Dental Extractions
Long Term Results
(6)

A
  • Loss of bony alveolar ridge
  • Increase in intra-arch space
  • Increase influence of surrounding soft tissue
    – Tongue expansion
  • Decrease stability and retention of prosthesis
  • Increased discomfort from improper prosthesis adaptation
  • Severe resorption of the mandible can make the patient susceptible for a fracture
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15
Q

Evaluation of Supporting Bone
(4)

A
  • Inspection
  • Palpation
  • Radiographic Examination
  • Models Evaluation
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16
Q

Characteristics of the Ideal Alveolar Ridge
(4)

A
  • Proper Jaw Relationship.
  • Proper Configuration of the Alveolar Process (broad U-shaped ridge with Vertical components
    as Parallel as possible).
  • No Bony or Soft tissue protuberances or undercuts.
  • Adequate attached Keratinized mucosa in the primary denture bearing area.
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17
Q

Characteristics of the Ideal Alveolar ridge
(6)

A
  • Adequate Vestibular Depth (Buccal and Lingual sulcus)
  • Adequate bone height and width
  • “Fixed Tissue” under dentures
  • Absence of redundant tissue
  • No obstructing frena or scar bands
  • No displacing muscle attachments
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18
Q

Principles of Patient Evaluation and Treatment
Planning
(3)

A
  • Understand clearly the desired design of final prosthesis.
  • Develop a detailed treatment plan based on a thorough clinical examination.
  • Define and outline the Problem. (Is it with the Soft tissue/ Hard Tissue OR Both
19
Q

AFTER THIS MAKE A DECISION FOR THE TYPE OF

A

PREPROSTHETIC
SURGICAL PROCEDURE

20
Q

Pre-prosthetic Surgical Procedures
(3)

A
  • Pre-prosthetic surgical procedures span a spectrum from very simple to quite
    complex:
  • Minor Pre-prosthetic Surgery
  • Advanced Pre-prosthetic Surgery
21
Q

General Considerations for Minor Pre-prosthetic Surgery
(4)

A
  • Most can be done with L.A.
  • Advanced forms of pain control/ I.V sedation are helpful in Patients who are anxious
    and cases that need more elaborate pre-prosthetic surgery.
  • Patients are often old, and require detailed workup and monitoring.
  • Restorative phase in 4 – 8 weeks postop
22
Q

Minor Pre-prosthetic Surgical procedures
* Many Minor Modifications of the alveolar ridge and vestibular areas can
greatly improve

A

denture stability and retention.
* Hard Tissue(Osseous) surgery
* Soft Tissue Surgery

23
Q

Bony Recontouring of Alveolar Ridges
(4)

A
  • Simple alveoloplasty (Multiple Teeth Extraction).
  • Intraseptal alveoloplasty.
  • Maxillary tuberosity reduction.
  • Buccal exostosis and extensive undercuts.
24
Q

Tori Removal
(2)

A
  • Maxillary tori.
  • Mandibular tori.
25
Q

Alveoloplasty

A
  • Alveoloplasty is “ the recontouring or reduction of a portion of the alveolar
    process”
26
Q

Goals of alveoloplasty:
(3)

A
  • Eliminate bony projections that result in undercuts
  • Improve the path of insertion of the prosthesis
  • Eliminate bony sources of irritation
27
Q

Types of Alveoloplasty
(3)

A
  • Simple alveoloplasty
  • Simple alveoloplasty with buccal or labial cortical reduction
  • Intraseptal alveolectomy and cortical plate in-fracture
28
Q

Intraseptal Alveoloplasty and cortical plate in-fracture
(3)

A

*Periosteal attachment is maintained
*Alveolar height is preserved
*Alveolar width is lost

29
Q

Disadvantages of Alveoloplasty
(3)

A
  1. Accelerates bone loss
  2. Increased post-operative pain
  3. Potential Complications:
    - Oral-antral communication(Maxilla)
30
Q
  1. Accelerates bone loss
    (2)
A
  • Buccal/labial cortical alveoloplasty (most long term loss)
  • Intraseptal alveolectomy (significantly less)
31
Q

Maxillary Tuberosity (Osseous) Reduction
(4)

A
  • Determine if it is excess bone /excess soft tissue or combination of two.
  • Examine pre-op x-ray (Panoramic X-Ray necessary)
  • Locate floor of the sinus
  • Reasons for removal
    – Increase intra-arch space
32
Q

Surgical Removal of Palatal Tori
Clinical Examination:
(3)

A
  • Size of the Torus (How large is it ?)
  • How far has the palatal torus extended posteriorly?
  • Is the overlying mucosa on the top of the torus
    traumatized?
33
Q

Indications for Removal
(5)

A
  • Chronic irritation
  • Inability to construct prosthesis
  • Presence of deep undercuts
  • Interference with normal speech
  • The torus poses psychological problems (e.g., malignancy phobia)
34
Q

Surgical Removal of Tori & Exostoses
(3)

A
  • Use L.A.
  • Raising the thin flap is the most tedious portion of the surgery.
  • Assure hemostasis before wound closure.
35
Q
  • Remove Tori with:
    (3)
A
  • Surgical drill and fissure bur
  • Osteotome and Mallet
  • A combination of both
36
Q

Minor Pre-prosthetic Soft Tissue Surgical Procedures
(4)

A
  • Maxillary tuberosity reduction..
  • Inflammatory Fibrous hyperplasia.
  • Labial Frenectomy.
  • Lingual Frenectomy
37
Q

Epulis fissuratum (Inflammatory Fibrous Hyperplasia)
* Etiology:

A

This is an inflammatory fibrous hyperplasia of oral mucosa caused by an over-extended
denture border.

38
Q

Epulis fissuratum (Inflammatory Fibrous Hyperplasia)
* Treatment:

A

Surgical excision of the lesion and reduction of the denture border

39
Q

Frenectomy
(3)

A

Labial frenectomy
* Buccal frenectomy
* Lingual frenotomy

40
Q

Labial frenectomy
(4)

A

– Simple labial frenectomy (Diamond Shaped)
– Z-plasty
– V-Y plasty
– V - Diamond plasty (Modified V-Y plasty)

41
Q

indications For Frenectomy
(2)

A
  • When speech is impaired due to Ankyloglossia (Tongue tie) – Lingual Frenum
  • To improve denture seating and stability
42
Q

Z-Plasty Technique For Maxillary Frenum
Main advantage of this method
is

A

Minimal Scar tissue formation

43
Q

V-Y plasty can be for

A

lengthening the
localized area

44
Q
A

OS 3 (14 decks)

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