Preprosthetic Surgery Flashcards
What is the term for surgical preparation of mouth to facilitate denture construction and retention?
Preprosthetic surgery
What are 5 requirement for ideal ridge for dentures?
- Free from pathology
- Broad U-shaped ridge
- No protuberances or undercuts
- Adequate attached keratinized tissue
- Adequate vestibular depth
What is the term for surgical removal of a portion of the alveolar process but with conservation of the maximum amount of bone consistent with an adequate residual ridge?
Alveoplasty
Why would alveoplasty be done immediately following extractions?
In order to to remove sharp edges that could be painful or delay healing or to remove gross bony undercuts and exostoses
Why would alveoplasty be done other than immediately after extractions?
After period if protracted denture wear to recontour an irregular reabsorbed ridge
What should you do if if you take out 2 or more teeth?
Full thickness mucoperiosteal flap and recontour bone to aide healing
Bone files are used for what type of undercuts: large or small?
Small
End cutting or side cutting Rongeurs are used for what type of undercuts: large or small?
Large
How should the quality of the bone recontouring be checked before flap closure?
Lay flap back over bone and rub finger to check for smoothness
What is an iIncision that is made over the bony crest through mucosa and periosteum to allow you to develop a mucoperiosteal flap?
Crestal incision
What instrument is used to elevate tissue from bone?
Periosteal elevator
How large must flaps be?
Large enough to expose the bone and not tear when retracted
What are 4 benefits of mucoperiosteal surgical flap?
- Expose surgical site
- Improve visability
- Provide access
- Avoid tissue injury
What are 4 areas never to do a releasing incision?
- Over cuspid eminence
- Through muscle attachments
- In area of mental nerve
- On lingual or palatal surfaces
Why must the flap be broad-based?
In order to maintain blood supply
How long must the flap be?
Long enough to retract without tension
Where should a flap be repositioned?
Over sound bone
When is the only time to sacrifice bone to get primary closure?
When the patient is scheduled to undergo radiation therapy
Why are releasing incisions useful?
They help prevent tearing of flap
Which incision heals faster, a long incision or a short incision?
Neither. They both have the same healing time because they heal across and not down their length.
What can cause delay in the healing of an incision?
If the incision was too short and resulted in a tear
Why do you have to reposition a flap over intact bone?
Otherwise unsupported flaps will breakdown and undergo a dehiscence
What are 3 things rongeur and/or bone file are used for?
- Contour bone
- Remove bone excess
- Eliminate undercuts
What are important for healing?
Bleeding edges. But remember raw edges fuse, so in a mouth burn, keep pt open with dentures to avoid their mouth fusing into a small orifice
When is palatal torus surgery indicated?
- If it will be continually traumatized
2. If it will interfere with the palatal seal of a denture prostheses
What should be done for post op healing after a palatal torus surgery?
Surgical stent or denture line with soft tissue conditioner
What are 4 indications for mandibular tori removal?
- Interferes with major connector of partial denture
- Interferes with complete denture
- Trauma
- Interferes with speech
What should you do as you close a flap to avoid a hematoma?
Keep milking the blood
What is the term for when there is a remnant of an embryonic structure connecting the upper lip to the palatine papilla?
Hyperplastic maxillary frenulum
What are 4 indications for surgery on Hyperplastic frenulum?
- Closure of midline diastema
- Maintain integrity of gingival margin
- Aid in maintaining oral hygiene
- Aid denture retention/prevent irritation
What is the procedure for a frenectomy?
- Two hemostats grasping frenulum
- Make scalpel incision above the top hemostat and incision below the bottom hemostat resulting in a diamond shaped incision
- Clean out incision to release tension for primary intention closure
