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    Preprosthetic Surgery PDF

    Uploaded by

    Mohamad Terro
    Patients typically older, and may have significant medical issues. Most can be done w / l.a. Patients are typically older. Most prosthetics can be made without the need for a second surgery.

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    © All Rights Reserved
    Download as PDF, TXT or read online from Scribd

    Preprosthetic Surgery PDF

    Uploaded by

    Mohamad Terro
    218 views7 pages
    Patients typically older, and may have significant medical issues. Most can be done w / l.a. Patients are typically older. Most prosthetics can be made without the need for a second surgery.

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    Preprosthetic Surgery.PDF

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    Patients typically older, and may have significant medical issues. Most can be done w / l.a. Patients are typically older. Most prosthetics can be made without the need for a second surgery.

    Copyright:

    © All Rights Reserved
    Download as PDF, TXT or read online from Scribd
    Download as pdf or txt
    218 views7 pages

    Preprosthetic Surgery PDF

    Uploaded by

    Mohamad Terro
    Patients typically older, and may have significant medical issues. Most can be done w / l.a. Patients are typically older. Most prosthetics can be made without the need for a second surgery.

    Copyright:

    © All Rights Reserved
    Download as PDF, TXT or read online from Scribd
    Download as pdf or txt
    You are on page 1of 7

    Preprosthetic Surgery

    objectives
    Understand the types of procedures utilized
    to facilitate prosthetic reconstruction
    Understand the purpose of the surgical
    procedure
    Understand the potential pitfalls and risks of

    the procedures

    General Considerations for Preprosthetic

    The Ideal Edentulous Mouth

    Surgery
    Most can be done w/ L.A.
    Patients are typically older, and may have significant
    medical issues

    Typically; restorative phase in 4 8 weeks postop


    Prosthetic plan should dictate the surgical plan

    Adequate bone height and width


    Fixed, keratinized gingiva under dentures
    Adequate ridge relationships
    Adequate space between ridges
    Adequate buccal and lingual sulci
    Absence of redundant tissue
    No obstructing frena or scar bands
    No displacing muscle attachments
    Adequate saliva (amount and consistency)

    Implant reconstruction: effect on preprosthetic surgery

    Alveoloplasty

    Simple Alveoloplasty

    Al veolo = al veolus
    P lasty= recontouring
    Goals
    Smo oth ridges to pre vent irritatio n from
    pro sthesis

    Remove un dercuts for path o f draw


    M aintai n ideal ridge co nto ur and
    relationship

    Simple Alveoloplasty

    Intraseptal Alveoloplasty

    Periosteal attachment is
    mainta ined

    Alveolar height is preserved


    Undercut is removed, but labial
    plate is preserved

    Radical Alveolectomy

    Removal of Tori & Exostoses

    Indications
    Chronic irritation
    Inability to construct prosthesis
    Opposing undercuts
    Horizonta l & vertical problems

    Radical Alveolectomy

    Removal of Tori & Exostoses

    Potential pitfa lls/Problems


    Pneumatization of palata l torus
    Thin mucosa over tori

    Postoperative redundant tissue


    Other anatomic issues (floor of mouth contents ,
    greater palatine artery, etc.)

    Removal of Tori

    Removal of Lingual Tori

    Use LA to help balloon thin tissue


    tumescent technique
    Reflecting the flap is the most tedious portion
    tissue is thin and is easily torn
    It is easier to remove tori when ridge is edentulous
    Remove Tori with:
    Surgical drill

    Osteotome and Mallet


    A combination of both
    Assure a dry field and inspect wound before closure

    Lingua l

    Removal of Palatal Tori

    Tori/exostosis removal
    Potential complications
    Lingual tori
    Lingua l plate fracture
    Lingua l nerve damage
    Hematoma
    Damage to floor of mouth structures
    Postop dehiscence

    Maxillary Tuberosity Reduction

    Tori/exostosis removal
    Potential complications:
    P alatal
    Oro-nasal communication/fistula
    Arterial bleeding
    Hematoma
    Dehiscence

    Excess tissue/bone in the maxillary tuberos ity interferes with


    denture construction at area between tuberosity and

    retromolar pad
    Radiographs help delineate whether this excess tissue is soft
    tissue or bony.
    Radiographs also demonstrate pneumatization of the
    maxillary s inus
    Mounted models/surgical guide recommended

    Maxillary tuberosity reduction


    Surgery can consist of
    1. So ft tissue component of tubero sity
    2. Bo ny compo nent of tuberosity
    3. Bo th

    Frenectomy

    Soft Tissue Surgery

    Diamond

    Frenectomy
    Vestibuloplasty
    Papillary hyperplas ia
    Epulis fissuratum

    Frenectomy

    vestibuloplasty
    Z-plasty :

    Goals
    More useful for the
    short vestibule

    To deepen labial, buccal o r ling ual vestibule to


    preve nt dislo dgement of denture
    Repositio n muscle attachments (eg:mylohyo id)
    P reserve/create keratinized m ucosa if possible

    Partial Thickness palatal dissection

    vestibuloplasty

    de-fat the connective tissue side

    Types

    Supraperiosteal dissection on the


    mandible

    Supraperiosteal
    Subm ucosal

    Sew graft mucosa side up

    Laser abl atio n


    Splints or a relieved denture can be

    M ucosal grafting/skin gr afting

    helpful

    Floor of the mo uth lowering

    Palatal papillary hyperplasia

    Palatal papillary hyperplasia

    Secondary to chronic denture irritation

    Treatment Options

    Denture relief and oral antifunga ls can reduce the size

    Large rotary bur

    of the lesion.

    Cryosurgery
    Laser Ablation
    Post op splint or denture w/ liner is very helpful

    Epulis Fissuratum

    Epulis Fissuratum

    Epulis Fissuratum

    Preprosthetic Surgery
    Complex Preprosthetic Surgery has been largely obviated
    by the osseointegrated implant.

    Preprosthetic surgery for implant


    reconstruction

    Preprosthetic Surgery
    Many preprosthetic procedures are done today in support of
    the implant.

    Qu i c kT i m e a n d a
    T IFF (U n c o m p re s s e d ) d e c o m p re s s o r
    a re n e e d e d to s e e th i s p i c tu re .

    Sinus augmentation
    Ridge augmentation
    Soft tissue augmentation/grafting
    Orthognathic surgery
    QuickT ime and a
    T IFF (Uncompressed) decompressor
    are needed to see this picture.

    QuickT ime and a


    T IFF (Uncompressed) decompressor
    are needed to see this picture.

    QuickT ime and a


    T IFF (Uncompressed) decompressor
    are needed to see this picture.

    QuickT ime and a


    T IFF (Uncompressed) decompressor
    are needed to see this picture.

    QuickTime and a
    TIFF (Uncompressed) decompressor
    are needed to see this picture.

    QuickT ime and a


    T IFF (Uncompressed) decompressor
    are needed to see this picture.

    QuickT ime and a


    T IFF (Uncompressed) decompressor
    are needed to see this picture.

    QuickT ime and a


    T IFF (Uncompressed) decompressor
    are needed to see this picture.

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