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BDS4 Oral surgery > pre-prosthodontics surgery > Flashcards

pre-prosthodontics surgery Flashcards

1
Q

types of soft tissue surgery pre-prosthetics

A

excisional
ridge extension procedures
augmentation procedures

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2
Q

what reasons are there for soft tissue excision

A

frenectomy
papillary hyperplasia
flabby ridges
denture induced hyperplasia
maxillary tuberosity reduction
retromolar pad reduction

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3
Q

what frenectomies/frenoplasty can be done

A

labial, buccal or lingual
could be causing a problem with OH, causing recession
lingual frenectomy often modified at birth if a tongue tie

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4
Q

why are buccal frenectomies/frenoplasty risky on the lower

A

because mental nerve is situated there

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5
Q

what is papillary hyperplasia usually in relation to

A

candida infection

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6
Q

why are flabby ridges altered

A

interfering with retention and stability of denture

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7
Q

why would you reduce maxillary reduction

A

sometimes too big to take impressions and make a good fitting denture
not as common now

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8
Q

what is an example of a ridge extension procedure

A

vestibuloplasty = deepening the sulcus

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9
Q

when is augmentation procedures done

A

quite unusual for prosthodontics, more so in perio

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10
Q

what are reasons for hard tissue excisional proceudres

A

removal of retained teeth/roots/pathology
ridfe defect correction
maxillary/mandibular tori
maxillary tuberosity
exostoses
undercuts
genial tubercle reduction - uncommon
mylohyoid ridge reduction

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11
Q

where does the mylohyoid muscle attach

A

along the mylohyoid ridge

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12
Q

where is the genial tubercle

A

where genioglossus and geniohyoid muscles attach = tongue muscles

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13
Q

where is the bone for augmentation procedures from

A

autografts = own bone from iliac crest, rib
allografts = from cadavers
xenografts = bio-oss
synthetic grafts = tricalcium phosphate

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14
Q

where are xenografts usually from

A

usually cows, can be horses
all cellular content is removed and it is just the calcified part which is maintained = provides a framework to help bone regenerate

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15
Q

what is the issue with synthetic grafts

A

no issue of transmission of disease/infections from other human/animals
can be less accepted in the body

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16
Q

what is good about synthetic grafts

A

can be custom made to a desired shape/size

17
Q

other than excisional procedures for hard tissue, what else can be done

A

implants
inferior alveolar nerve relocation

18
Q

when would a IAN relocation be needed

A

when have severe resorption of alveolar process which leads to mental foramen coming to the surface and then can get the IAN being covered only by soft tissue and not by any bone

19
Q

how is a IAN relocation done

A

drill a channel deeper down in the body of the mandible and relocated the nerve to there
risky procedure

20
Q

how to remove retained roots/teeth/pathology

A

crestal incision with mesial receiving incision
flap elevated and tooth exposed
bone trimmed with ronguers (bone nibblers)
tooth extracted with forceps
sometimes need to section teeth to get them out

21
Q

what causes a ridge defect where there is a higher ridge anteriorly

A

patient retained lower anterior teeth for much longer than they retained their posterior so end up with this funny shape ridge where severe resorption posteriorly occurred but no anteriorly

22
Q

what is the problem with knife-edge ridge

A

its shape and when denture presses down on that edge it causes pain
don’t want to take too much away to lose retention, just enough to smooth out to stop pain

23
Q

when can mandibular tori be a problem

A

no an issue unless to has lost all teeth or is wanting a denture to fill the gap then it can be a problem

24
Q

how do mandibular tori usually present

A

often bilateral but not usually symmetrical

25
Q

what kind of flap is made for surgical excision of mandibular tori

A

one-sided flap, no relieving incision

26
Q

if had a palatal tori how could you adapt a denture design to prevent having to remove it

A

create a horseshoe design

27
Q

how to remove palatal tori

A

use very large bur and trim it down until flat enough or criss-cross pattern with a fissure but and cut off square bits of bone until it is flat enough

28
Q

what are the causes of prominent maxillary tuberosity

A

could be large because bone itself is big, or bone could be normal and have lots of fibrous tissue in the area

29
Q

surgical technique for removal of maxillary tuberosity

A

want to take away a bit of the bulk but still need to be able to get primary closure
take a little bit of the underlying CT away as well then pull tissues together and suture

30
Q

what is a bony exostoses

A

projection of extra bone and can cause pain for a patient

31
Q

what flap is raised for bony exostoses

A

2-sided flap

32
Q

what syndrome is associated with flabby ridges

A

combination syndrome

33
Q

what is combination syndrome

A

lost all maxillary teeth and lose all lower teeth other than anteriors
lower natural teeth are opposing full upper denture and the constant pressure can result in excessive resorption of the bone and end up with excess soft tissue

34
Q

what can denture induced hyperplasia/ulceratoin be mistaken for

A

looks like cancer
small white lines is the beginning and get scarring and callous formation

35
Q

how can denture induced hyperplasia occur

A

people get an immediate denture and are told that it is only temporary and will need a new one but they never come back and then when they do they have lots of hyperplasia around the flanges where they have been digging into the soft tissue

36
Q

procedure for vestibuloplasty

A

numb pt up from tuberosity-tuberosity
long crestal incision made (one sided flap_
dissect tissue maintaining periosteum = split thickness flap raised
suture higher up in the sulcus leaving a big area of raw exposed periosteum
fill edges of pts old denture with compound and place in pts mouth while still numb and do border moulding
once got a good fit leave denture in as that is going to hold the soft tissue from coming back down while the new tissue over the periosteum granulates and forms new tissue
pt needs to keep it in for about 1 month
painful for pt

37
Q

why are vestibuloplasty done

A

to deepen the sulcus
very rarely done now

38
Q

how do implant retained dentures work

A

implants placed parallel to each other usually in canine area
pt able to clip denture in and out and retention is great
life-changing for pts

39
Q

who can get implants on the NHS

A

hypodontia pts
pts who have had cancer and lost teeth

BDS4 Oral surgery (7 decks)

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