Pre-prosthetic surgery

Question 1

What are examples of excisional soft tissue pre-prosthetic surgeries

Answer 1

• frenectomy/frenoplasty
• papillary hyperplasia reduction
• flabby ridge reduction
• denture induced hyperplasia (epulis dissaratum) reduction
• maxillary tuberosity reduction
• retromolar pad reduction

Question 2

What is a frenoplasty

Answer 2

modification of the frenum

Question 3

What is the most common frenum that undergoes frenectomy/frenoplasty

Answer 3

labial frenum

Question 4

Why can frenectomy/frenoplasty be risky on the mandibular buccal frenum

Answer 4

proximity of mental nerve

Question 5

What does a lingual frenectomy/frenoplasty correct

Answer 5

tongue tie

Question 6

What is papillary hyperplasia

Answer 6

 Overgrowth of the soft tissue usually seen on the palate

Question 7

What can cause papillary hyperplasia

Answer 7

type 3 denture stomatitis (most severe form)

Question 8

Does papillary hyperplasia always require surgical correction?

Answer 8

 Sometimes can be improved when denture is sorted out but otherwise requires surgery to remove the excess tissue

Question 9

What is a flabby ridge

Answer 9

 This is a superficial area of mobile soft tissue affecting the maxillary/mandibular alveolar ridges
 It can develop when hyperplastic soft tissue replaces the alveolar bone and it is a common finding particularly in the upper anterior region of long term denture wearers

Question 10

Why is a flabby ridge problematic

Answer 10

 It can pose problems as masticatory forces displace the mobile denture bearing area and this leads to an altered denture positioning and loss of peripheral seal

Question 11

When would we reduce a maxillary tuberosity

Answer 11

uncommon
maybe if its too large

Question 12

What are soft tissue ridge extension procedures

Answer 12

vestibuloplasty

Question 13

What is the purpose of vestibuloplasty

Answer 13

it deepens the sulcus without grafting procedures
unpopular

Question 14

What are examples of soft tissue augmentation procedures

Answer 14

soft tissue grafting
done to increase size of the soft tissues

Question 15

What are the hard tissue excisional procedures

Answer 15

• removal of retained roots/pathology/teeth
• ridge defect correction (alveoplasty)
• mandibular tori correction
• maxillary tori correction
• maxillary tuberosity reduction
• exostoses
• undercut reduction
• genial tubercle reduction
• mylohyoid ridge reduction

Question 16

What is exostoses

Answer 16

These are bony lumps in the mouth

Question 17

What is the genial tubercle

Answer 17

 Small round elevations on the lingual surface of the lower jaws on either side near the inferior border of the body of the mandible
 Point of insertion for geniohyoid

Question 18

Why may we reduce the genial tubercle

Answer 18

uncommon
Can become prominent in the floor of the mouth due to alveolar ridge recession
Required sometimes to facilitate denture wearing

Question 19

What is the mylohyoid ridge

Answer 19

 Oblique ridge on the lingual surface of the lower jaw which extends from the level of the roots of the last molar as a bony attachment for mylohyoid muscles which form the floor of the mouth

Question 20

Why may we reduce the mylohyoid ridge

Answer 20

 Sometimes needed when ridge is sharpand denture pressure can cause pain

Question 21

What are hard tissue augmentation procedures

Answer 21

autografts
allografts
xenografts
synthetic grafts

Question 22

What are autografts

Answer 22

 From patient themselves
 Iliac crest bone, rib

Question 23

What are allografts

Answer 23

From other human (cadaver)

Question 24

What are xenografts

Answer 24

Bone tissue removed from animals

Question 25

What are synthetic grafts

Answer 25

 Becoming more popular due to less infection risk
 Can be less accepted by the body
 E.g Beta tricalcium phosphate

Question 26

What are examples of other pre-prosthetic hard tissue surgical procedures

Answer 26

implants
inferior alveolar nerve relocation

Question 27

When would one undergo an inferior alveolar nerve relocation

Answer 27

 Very rare
 Due to ridge resorption resulting in denture pressing onto nerve causing pain and pressure
 Surgery moves the nerve into a channel that has been made
 Risky procedure