minor preprosthetic surgery Flashcards
Pre-prosthetic Surgery defined
Pre-prosthetic Surgery is the surgical improvement of the denture-bearing area and surrounding tissues (Hard and Soft) to support the best possible prosthetic replacement.
The goal of pre-prosthetic surgery is to?
The goal of pre-prosthetic surgery is to establish a functional biologic platform for supportive or retentive mechanisms that will maintain or support prosthetic rehabilitation.
Bone Loss following Dental Extractions Facts
* Tooth Loss starts?
* Lack of functional stress from teeth and periodontal ligament following extraction is?
* Bone begins to resorb? predictable?
* In some patient’s, the bone loss? and in others it continues to include?
- Tooth Loss starts an immediate change in the jaws.
- Lack of functional stress from teeth and periodontal ligament following extraction is the primary cause for this resorption.
- Bone begins to resorb after extraction and this process is unpredictable from one patient to another.
- In some patient’s, the bone loss stabilizes and in others it continues to include a total loss of alveolar and underlying basal bone.
Alveolar Bone Resorption
Facts
* Resorption is accelerated by?
* more affected arch?
* why is one arch more affected?
- Resorption is accelerated by denture wearing
- Mandibular denture wearers affected more than maxillary denture wearers
- Resorption affects the mandible more severely because
- Decreased surface area
- Less favorable distribution of forces
systemic factors of enhanced resorbtion
– Nutritional abnormality e.g. Calcium and Vitamin D deficiency
– Systemic bone disease
* Osteoporosis
* Endocrine dysfunction e.g. Diabetes, Hyperthyroidism, Hyperparathyroidism
* Other conditions that affect bone metabolism e.g. Osteomalacia, Renal Osteodystrophy
local factors of enhanced resorb
- Surgery (Alveoloplasty, Some form of bone removal in the alveolar ridge)
- Denture wearing
- Low mandibular plane angle
– Can generate greater bite force
bone loss patterns of both arches
muscular attachments with edentualism
With loss of teeth, there is
significant resorption leading to
bone atrophy in the jaws.
However, the muscle attachments
still remain in the same place
Bone Loss following Dental Extractions Long Term Results
- 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
Evaluation of Supporting Bone
components
- Inspection
- Palpation
- Radiographic Examination
- Models Evaluation
Characteristics of the Ideal Alveolar Ridge
Characteristics of the Ideal Alveolar Ridge
- Jaw Relationship?
- Configuration?
- protuberances or undercuts?
- preferred tissue type?
- 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
Characteristics of the Ideal Alveolar ridge
- Adequate ?
- bone height/width?
- Tissue under dentures?
- Absence of?
- No obstructing?
- No displacing?
Characteristics of the Ideal Alveolar ridge
- 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
Principles of Patient Evaluation and Treatment Planning
* Understand clearly the?
* Develop a detailed treatment plan based on?
* Define and outline the?
AFTER THIS MAKE A?
Principles of Patient Evaluation and Treatment
Planning
* 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
AFTER THIS MAKE A DECISION FOR THE TYPE OF PREPROSTHETIC
SURGICAL PROCEDURE
General Considerations for Minor Pre-prosthetic Surgery
* Most can be done with?
* Advanced forms of pain control/ I.V sedation are helpful in Patients who are? and?
* Patients are often old, and require detailed?
* Restorative phase in ? weeks postop
- 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
Z-Plasty Technique For Maxillary Frenum Main advantage
Main advantage of this method
is Minimal Scar tissue formation
