Pre-prosthetic Surgery

Question 1

Aim of pre-prosthetic surgery

Answer 1

Provide an ideal denture-bearing area for the prosthesis/prostho replacements thereby improving its satisfactory stability and retention

Such surgeries are done to help in insertion, retention, stability and function of a removable prosthesis/denture

Involves surgery of the hard and soft tissues oft he jaws, tooth extractions and elimination of pathology in the denture-bearing soft and hard tissues

E.g. removal of impacted teeth, septic/retained roots, malpositioned/nonfunctional teeth, cyst

Question 2

Types of bone contouring procedures

Answer 2

Alveoplasty

Removing/reducing bony protuberances: mylohyoid ridge, torus, bony exostosis, tuberosity, genoid tubercle etc

Atrophic alveolar ridge? Use patient’s bone, osteotomy then encourage bone to grow, but often cannot really target which direction the bone will grow

Question 3

Alveoplasty

Answer 3

Removes hard tissue undercuts or bony spicules that are left behind post-exo

Must be careful of mental nerve when doing lower jaw because premolar area is where mental nerve is

Run finger across to see if bumpy or sharp

Question 4

Removing/reducing bony protuberances

Answer 4

Mylohyoid ridge, torus, bony exostosis, tuberosity, genoid tubercle etc

Big torus with denture? The denture may cause chronic ulcers on the torus which is dangerous esp for elderly due to the risk of malignant transformation.

Case by case basis, if cannot give horseshoe denture and need a wider denture base + torus damn huge then need to do torus removal

Question 5

Types of pre-prosthetic surgery

Answer 5

Bone contouring (ridge correction/reduction) procedures

Jaw/orthognathic surgery

Soft tissue procedures

Implant surgery

Question 6

Jaw/orthognathic surgery

Answer 6

Correct skeletal relationship such that denture will be class 1
Skeletal base osteotomy
Distraction osteogenesis?

Question 7

Soft tissue procedures

Answer 7

Frenectomy - labial/lingual

Excision of hyperplastic tissue
> E.g. inflammatory fibrous hyperplasia

Vestibuloplasty - sulcus deepening
> I.e. ridge is flat then need to deepen sulcus for retention

Question 8

Implant surgery

Answer 8

Used to remove bone for implant surgery
Denture too unstable? Can do implant supported denture