Pre-prosthetic surgery Flashcards
What are examples of excisional soft tissue pre-prosthetic surgeries
- frenectomy/frenoplasty
- papillary hyperplasia reduction
- flabby ridge reduction
- denture induced hyperplasia (epulis dissaratum) reduction
- maxillary tuberosity reduction
- retromolar pad reduction
What is a frenoplasty
modification of the frenum
What is the most common frenum that undergoes frenectomy/frenoplasty
labial frenum
Why can frenectomy/frenoplasty be risky on the mandibular buccal frenum
proximity of mental nerve
What does a lingual frenectomy/frenoplasty correct
tongue tie
What is papillary hyperplasia
Overgrowth of the soft tissue usually seen on the palate
What can cause papillary hyperplasia
type 3 denture stomatitis (most severe form)
Does papillary hyperplasia always require surgical correction?
Sometimes can be improved when denture is sorted out but otherwise requires surgery to remove the excess tissue
What is a flabby ridge
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
Why is a flabby ridge problematic
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
When would we reduce a maxillary tuberosity
uncommon
maybe if its too large
What are soft tissue ridge extension procedures
vestibuloplasty
What is the purpose of vestibuloplasty
it deepens the sulcus without grafting procedures
unpopular
What are examples of soft tissue augmentation procedures
soft tissue grafting
done to increase size of the soft tissues
What are the hard tissue excisional procedures
- 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
What is exostoses
These are bony lumps in the mouth
What is the genial tubercle
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
Why may we reduce the genial tubercle
uncommon
Can become prominent in the floor of the mouth due to alveolar ridge recession
Required sometimes to facilitate denture wearing
What is the mylohyoid ridge
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
Why may we reduce the mylohyoid ridge
Sometimes needed when ridge is sharpand denture pressure can cause pain
What are hard tissue augmentation procedures
autografts
allografts
xenografts
synthetic grafts
What are autografts
From patient themselves
Iliac crest bone, rib
What are allografts
From other human (cadaver)
What are xenografts
Bone tissue removed from animals
What are synthetic grafts
Becoming more popular due to less infection risk
Can be less accepted by the body
E.g Beta tricalcium phosphate
What are examples of other pre-prosthetic hard tissue surgical procedures
implants
inferior alveolar nerve relocation
When would one undergo an inferior alveolar nerve relocation
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
