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
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
