OS - Prosthodontics

Question 1

List the types of soft tissue excisional preprosthetic surgeries. (6)

Answer 1

• Frenectomy/frenoplasty - labial, buccal or lingual (complete not used commonly)
• Papillary hyperplasia
• Flabby ridges: can interfere with denture retention
• Denture induced hyperplasia (Epulis fissuratum)
• Maxillary tuberosity reduction – can interfere with impressions/denture retention
• Retromolar pad reduction

Question 2

List the types of soft tissue ridge extension preprosthetic procedures. (1)

Answer 2

• Vestibuloplasty – deepening the sulcus
• Maxillary
• Mandibular

Question 3

List the types of soft tissue augmentation preprosthetic procedures. (1)

Answer 3

• Soft tissue grafting to increase the size of the tissues

Question 4

List the types of hard tissue excisional preprosthetic surgeries. (9)

Answer 4

• Removal of retained teeth (can be buried)/roots/pathology
• Ridge defect correction (alveoplasty): modify the alveolar process
• Mandibular tori: (most common tori) excess bone
• Maxillary tori
• Maxillary tuberosity
• Exostoses – other boney lumps
• Excessive Undercuts – reduced
• Genial tubercle reduction (interferes with denture/rubbing)
• Mylohyoid ridge reduction (interferes with denture/rubbing)

Question 5

List the types of hard tissue augmentation preprosthetic surgeries. (4)

Answer 5

• Autografts – graft taken from the px themselves and taken to another area e.g. Iliac crest bone, rib
• Allografts - Bone from other humans (cadavers)
• Xenografts - From animals, e.g. Bio-Oss
• Synthetic grafts e.g. β Tricalcium Phosphate

Question 6

List the other hard tissue preprosthetic procedures that can be done (2)

Answer 6

• Implants
• Inferior alveolar nerve relocation: used where bone resorbs so much that the denture presses on the mental foramen

Question 7

When do buried/unerupted teeth cause problems with dentures?

Answer 7

if the bone resorbs enough to bring the tooth to the surface

Question 8

What causes knife edge ridges?

Answer 8

• When teeth in one area are kept longer than teeth in other areas (various rates of ridge resorption)

Question 9

Where (in the mouth) are mandibular tori commonly found?

Answer 9

Lower premolar region in lingual region

Question 10

During a surgery to a high buccal frenum on the lower arch what nerve is at risk?

Answer 10

mental nerve

Question 11

Who commonly suffers from a flabby ridge?

Answer 11

(Commonly presents in the maxilla)
affects those with combination syndrome – where px retains lower anterior teeth and loses all other teeth.

Question 12

Describe how a flabby ridge occurs in a px with combination syndrome.

Answer 12

Lower natural teeth apply pressure to a complete upper denture = excessive resorption of the upper arch

Question 13

What is the first tx option in those with denture induced hyperplasia?

Answer 13

Remove the cause
i.e.Commonly caused when px’s wear an immediate denture for prolonged period of time so remove immediate and provide a definitive.

Question 14

When does the NHS provide implants? (3)

Answer 14

• Hypodontia
• Serious accident/major trauma
• Oral cancer px

Question 15

Where are implants placed in an implant retained denture?

Answer 15

parallel implants in the canine region with studs on the coronal part of them – clip denture in and out