Pre Prosthodontics surgery Flashcards
What soft tissue excisional procedure may be required to be done before prosthodntics?
- Frenectomy/frenoplasty (labial, buccal or lingual)
- Papillary hyperplasia
- Flabby ridges
- Denture induced hyperplasia (Epulis fissuratum)
- Maxillary tuberosity reduction
- Retromolar pad reduction
What are ridge extension procedures called?
- Vestibuloplasty of either maxillary or mandibular
What is an augmentation procedures needed to be done pre prosthodontics?
- Soft tissue grafting
What excisional procedures of hard tissue might be needing to be done pre prosthodontics?
- Removal of retained teeth/roots/pathology
- Ridge defect correction (alveoplasty)
- Mandibular tori
- Maxillary tori
- Maxillary tuberosity
- Exostoses
- Undercuts
- Genial tubercle reduction
- Mylohyoid ridge reduction
Label this diagram and tell me where the muscles attaches
What augmentation procedures of hard tissues might be required pre prosthodontics? 4 options
- Autografts (Bone from yourself e.g. Iliac crest bone, rib)
- Allografts (Bone from other humans)
- Xenografts (From animals, e.g. Bio-Oss)
- Synthetic grafts (e.g. β Tricalcium Phosphate)
Other than augmentation and excisional procedures name 2 procedures that can be done pre prosthodontics?
- Implants
- Inferior alveolar nerve relocation
What is the procedure steps when you have retained teeth/roots/pathology?
- Alveolar crestal incision with mesial relieving incision
- Flap elevated with Howarths or periosteal elevators and tooth exposed
- Bone trimmed with Rongeurs or Bur
- Root or tooth extracted with upper root forceps
What does this image show?
- Radiograph acceptable showing retained root just below alveolar ridge
What does this image show?
- OPG acceptable
- Shows large well defined unilocular radiolucency right hand side body of mandible close to ramus of mandible
- Residual cyst from apical cyst most likely diagnosis
Waht defect does this image show?
- Large ridge defect anteriorly on the mandibular alveolar ridge
- Can sometimes help with retention but otherwise may need to be removed to retain dentures
What do these images show?
- Knife edge ridge
- Needs to be smoothed before denture can be made otherwise can cause pain on seating of denture
What defect does this image show? is it harmful to pt?
- Enlargement of left mandibular torus
- Only cause issues if pt lost all teeth and required complete denture or required partial denture
What defect does this image show? Will this cause issue for edentulous pt?
- Mandibular tori < left sligthly bigger than right
- This has caused issue due to denture seating
- Cause trauma to buccal sulcus
- Would need to be removed or made smaller
What defect does this image show? Does it cause an issue
- Palatal tori (2 of them)
- Only causes issues if denture needed and horseshoe design was not of adequate retention
What defect does this image show?
- Prominent maxillary tuberosity in right hand side
Describe this surgical technique of removing the maxillary tuberosity?
- Removal of the fibrous tissue overlying the tuberosity
- Want to keep the periosteum overlying the bone and suture so not tugging and slots in nicely
What defect does this image show? How would you manage?
- Bony exostosis (formation of new bone beyond usual smooth surface)
- Won’t usually cause pain but can remove with surgery if needed for dentures
- 2 sided flap , soft tissue elevtaed , bony removed with bur , flap closed and surtured
What defect does this show? What problems can arise if surgical exposure was to occur?
- Prominent buccal fraenum
- Mental nerve risks damage if surgical removal was to be done
What defect is the instrument on this picture showing? How can this occur?
- Flabby ridges in maxilla
- (xs soft tissue)
- Tends to happen in combination syndrome , have lower natural teeth and full upper denture, increased pressure of natural lower teeth cause xs resorption of alveolar bone in maxilla leading to xs soft tissue
- Remove with wedge incision
What does this image show?
- Denture induced hyperplasia
What does this image show?
Denture induced hyperplasia / ulceration
What does this image show, defect?
- Denture induced hyperplasia
What is a vestibuloplasty?
- Surgical procedure in which the vestibule of the mouth is enlarged
- Vestibule is the space between the cheeks and teeth
- Done to deepen the vestibule and create more surface area and space for dentures or implants (deepens the sulcus depth for retention)
Where are implants placed if going to be used for retentative dentures?
- Placed in the canine area
- Not given for many on NHS
- Implant retained overdenture
