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Oral Surgery Final > Pre-prosthetic Surgery > Flashcards

Pre-prosthetic Surgery Flashcards

1
Q

Preprosthetic Surgery - Bony surgery

A

Alveoloplasty
Torus Reduction
Tuberosity Reduction

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2
Q

Preprosthetic Surgery - Soft tissue surgery

A

Inflammatory papillary Hyperplasia

Inflammatory fibrous hyperplasia

Frenal attachments/release

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3
Q

Edentulism Long term results

A

Loss of bony alveolar ridge

Increased inter-arch space

Increase influence of surrounding soft tissue

Decreased stability and retention of prosthesis

Increased discomfort from improper prosthesis adapation

Increased risk of spontaneous mandibular fracture

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4
Q

Preprosthetic surgery

A

Surgical preparation in anticipation of removable prosthesis

Tissue supported hypothesis

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5
Q

Evolution of preprosthetic surgery

A

Implant supported prosthesis

Implant is integrated w/ osseous tissue = anchorage for fixed or removal prosthesis

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6
Q

Tissue-supported hypothesis optimal results

A

Good height, width and contour of denture base

No Retentive undercuts

No undercuts impeding path of insertion

Evenly distributed masticatory forces

Adequate vestibular base

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7
Q

Anatomical Factors

A

Ridge form

Osseous Prominences

Tuberosity Form

Vestibular Depth

Adjacent Vital Structures

Inter-arch distancce

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8
Q

Anatomical Factors - Ridge form

A

Height

Width

Contour

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9
Q

Anatomical Factors - Osseous Prominences

A

Tori

Exostosis

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10
Q

Anatomical Factors - Vestibular Depth

A

Frenum and muscle attachments

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11
Q

Anatomical Factors - Adjacent Vital Structures

A

Mental Nerve

Sinus

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12
Q

Anatomical Factors - Interarch Distance

A

Material volume of prosthesis

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13
Q

Preprosthetic Surgery Instrumentation

A

Rongeur - workhorse, clips bone to desirable height

Bone file - smooths bone

Burs - rotatory, reduce large boney prominences

Chisel/osteotome - really large piece removal

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14
Q

Preprosthetic Surgery begins with?

A

Extraction (surgical or non-surgical)

Preserve buccal plates especially for maxillary molars and canine eminences

Retain maximum bone height

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15
Q

Alveoloplasty

A

Recontouring/removing alveolar bone irregularities

Provides best possible tissue contour for prosthesis, retain as much tissue as possible

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16
Q

Timing of alveoloplasty

A

Goal is to do it immediately at time of extraction.

Or

Delay after bony healing of sockets (6-10 weeks). Makes contouring easier but requires additional surgery

17
Q

Types of Alveoloplasty

A

Digital compression - Compressing socket site

Intraseptal - get rid of intraseptal bone (if loose or fractured)

Surgical

18
Q

Surgical Alveoplasty

A
  1. Full thickness mucoperiosteal flap (good exposure, releasing incisions)
  2. Expose osseous structure
  3. Reduction/recontouring (burs, rongeur, bone file)
  4. Reposition flap, palpate, recontour
  5. Close with running stitch
19
Q

Exostosis

A

Overgrowth of bone on buccal surface of maxilla or mandible

Technique same as alveoloplasty

20
Q

Reduction of exostosis - Buccal

A

Less common than maxillary or mandibular torus.

Usually at maxillary molar areas

Reduce when interferes with stability/retention of denture or chronic traumatic ulceration

21
Q

Mandibular Torus

A

Bony protuberances on lingual aspect of mandible

May prohibit denture fabrication

More difficult to remove then buccal exostosis

22
Q

Mandibular Tori Removal Technique

A
  1. Lingual mucoperiosteal flap reflection (crestal?)
  2. Undermine the tori with fissure bur.
  3. Remove tori with chisel
  4. Use bone file as needed
  5. Soft tissue closure
23
Q

Maxillary Torus

A

Bony protuberances of palate

May interfere with fabrication or fit of RPD or CD

Very thin soft tissue

Carefully elevate and dissect soft tissue flap

Naso-palatal fistula may occur if using chisel

24
Q

Maxillary Torus Excision Technique

A
  1. Expose edges of tori
  2. May reduce by fissure bur and chisel or acrylic bur
  3. Close up

Consider protective post-op stent.

Y incision

25
Q

Maxillary Tuberosity Reduction

A

Horizontal and/or vertical excess interference w/ denture

Result of excess soft tissue and/or bone - remove

At least 2-3 mm of vertial sulcus height distal to tuberosity = denture stability

26
Q

Inflammatory Papillary Hyperplasia causes

A

Caused by: mechanical irritation, ill-fitting dentures, poor oral hygiene, fungal infections

27
Q

Inflammatory Papillary Hyperplasia Treatment

A

Non-surgical: proper denture adjustment, antifungals (usual)

Surgical excision (rare)

Abrasion of superficial layer of palatal mucosa (rare)

28
Q

Inflammatory Fibrous Hyperplasia (Epulis Fissuratum) Cause

A

Denture irratation from bad fitting.

Allergic or chemical to denture material

29
Q

Inflammatory Fibrous Hyperplasia Treatment

A

Correction of denture

Electrocautery (if small)

Surgery (if big)

Submit excised tissue for histology!

30
Q

Inflammatory Fibrous Hyperplasia Post-Op

A

Denture w/ adequate flange extension or stent.

Reline w/ soft liner

Maintain in place for 7 days, where denture after

31
Q

Abnormal Labial/lingual frenum problems

A

Diastema, speech problem, edentulous denture displacement

32
Q

Abnormal Labial/lingual frenum Treatment

A

Simple excision, Z-plasty

Oral Surgery Final (5 decks)

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