Pre-prosthetic Surgery Flashcards

1
Q

What are the excisional soft tissue surgeries used in pre-prosthetic dental treatment?

A

Frenectomy/frenoplasty

Papillary hyperplasia (related to dentures/candida)

Flabby ridges

Denture induced hyperplasia (Epulis fissuratum)

Maxillary tuberosity reduction

Retromolar pad reduction

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2
Q

What are the types of frenectomy/plasty?

A

Lingual- tongue tie (younger shortly after birth usually)

Labial- recession or issue with OH

Buccal- Risk of damaging mental nerve

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3
Q

Why may maxillary tuborosity reduction be carried out?

A

If it hinders retention of denture or impression taking

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4
Q

What is a vestibuloplasty?

A

ridge extending procedure- deepening of the sulcus

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5
Q

What is an augmentative procedure that can be done in pre-prosthetic surgery?

A

Soft tissue grafting (more useful for perio)

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6
Q

What are the excisional hard tissue surgeries used in pre-prosthetic dental treatment?

A

Removal of retained teeth/roots/pathology
Ridge defect correction (alveoplasty)
Mandibular/ Maxillary tori removal
Maxillary tuberosity reduction
Exostoses- bony lumps
Undercuts
Genial tubercle reduction
Mylohyoid ridge reduction- if denture rubbing

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7
Q

When may genial tubercle reduction be required?

A

If the tubercle (attachment point of geniohyoid and genioglossus) comes closer to the denture bearing surface due to resorption of alveolus

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8
Q

What are the types other hard tissue procedures in pre-prosthetic surgery?

A

Implants (can help retain denture)

IAN relocation

Augementive- bone grafts

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9
Q

What are the different types of grafts?

A

Autografts- Iliac crest bone, rib

Allografts- bone from other humans

Xenografts- from animals (horses and cows), e.g. Bio-Oss

Synthetic grafts- β Tricalcium Phosphate

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10
Q

What are xenografts used for?

A

Provide framework to help bone regenerate

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11
Q

What are the advantages of synthetic grafts?

A

no issue with transfer of infection or cultural/religious belief

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12
Q

Why may IAN relocation be required? How is it achieved?

A

If resorption is so great that mental foramen is at surface
-> Numbness and pain due to denture pressing on it

 Drill deeper channel in body of mandible and run nerve through

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13
Q

Which teeth are commonly retained?

A

Canines, wisdom teeth, lower premolars

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14
Q

How are retained teeth removed?

A

2 sided flap- expose and remove

-> might require bone removal (monguers)/elevation/sectioning

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15
Q

What type of 2 sided flap is selected for retained tooth removal?

A

Crestal with mesial relieving incision

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16
Q

When may retained roots need to be removed?

A

If it comes to surface and disturbs hygiene or denture retention

17
Q

What can be done as an alternative to retained root removal if ridge needs to be preserved?

A

Create root stub with GIC

18
Q

What is a corticated radiolucency in the mandible most likely to be?

A

Residual cyst from apical radicular cyst which formed due to infection of teeth

19
Q

What causes ridge defects to occur?

A

Patient retains teeth in different areas for longer amounts of time

20
Q

What can be done to treat knife edged ridges (serrated appearance)?

A

Take flap and reduce/round off
 Prevent denture pressing and causing pain

21
Q

Where are mandibular tori usually found?

A

premolar region (often not symmetrical)

-> can meet at midline

22
Q

What issues can mandibular tori cause with dentures?

A

Can cause issues fitting denture in lingual flange area in partially dentate patients (resorption)

23
Q

How are tori reduced?

A

Take one sided flap and smooth
-> use plenty of tissue to close flap

24
Q

What are the options when a palatal tori obstructs seating of a denture?

A

Produce horseshoe denture

OR

Remove to allow more standard denture (utilising whole palate for retention)

25
Q

What can cause an enlarge tuberosity?

A

Excess bone

Excess fibrous tissue deposition

26
Q

What is done when tuberosity is enlarged as a result of excess soft tissue?

A

Remove some of mucosa and connective tissue but not all to allow closure (do not remove periosteum)

27
Q

What is the flap design for a buccal exotosis?

A

2 sided flap- then smooth

28
Q

How can a flabby ridge be identified?

A

Twists/moves on pressure

-> Tends to happen in maxilla when patient still has lower natural teeth (combination syndrome)

29
Q

How are flabby ridges reduced?

A

Using a wedge incision (preserve ST)

30
Q

How can denture induced hyperplasia and ulceration appears?

A

White lines

Ulcerations may look cancerous

31
Q

How is denture induced hyperplasia treated?

A

Remove denture and clean

32
Q

In what instances can immediate dentures cause hyperplasia?

A

If patient doesn’t return for definitive treatment

33
Q

How are vestibuloplasties carried out?

A

Deepen sulcus- numb, do long crestal incision, dissect tissues while maintaining periosteum (half-thickness flap), suture tissue higher up in sulcus (leaving exposed area of raw periosteum)

-> Use patients old denture and border mould with compound/greenstick- extend flanges (denture also keeps ST in place while recovering- may be screwed in for a month)

34
Q

When may implants be offered on the NHS?

A

Hypodontia

Major trauma

Oral cancer

-> sometimes for overdentures (sponsored treatment)

35
Q

How do implant retained over dentures work?

A

2 implants are placed in parallel in canine region- they have studs on them which clips onto denture (fixes issues with retention)