What is Pre-Prosthetic Surgery?

Pre-prosthetic surgery is a procedure that is carried out by an oral surgeon to prepare a patient’s mouth before he or she has dentures or prosthetic restorations. To make sure a patient is comfortable when he or she is receiving replacement teeth, there are times when minor oral surgery will need to be performed before the patient receives their replacement teeth. When a patient is receiving dentures, it is crucial the jawbone is the appropriate shape and side because they will sit on the bone ridge. When a patient is preparing for a prosthetic procedure, he or she may need one of the following pre-prosthetic treatments:

• Bone smoothing
• Bone reshaping
• Removable of excess bone
• Removable of gum tissue

In most cases, an oral surgeon will work with a restorative dental professional to make certain the patient’s prosthetic teeth will fit appropriately when administered.

What is Bone Smoothing and Bone Reshaping?

If a patient has teeth extracted, it is possible the underlying bone is serrated and uneven. In order for the prosthetic teeth to fit, a patient’s bone may need to be smoothed or reshaped. When a patient has his or her bone smoothed or re-shaped, it is a procedure called alveoloplasty. There are certain times when this procedure is performed at the same time a patient has teeth extracted. An alveoloplasty is done on a patient to prevent “denture sore spots” that may occur because of jagged and sharp edges that are underneath the new prosthetic teeth or dentures. If a patient has already had his or her teeth extracted, and is having discomfort with new dentures, then an alveoplasty can be a suitable treatment to alleviate pain.

What is Removal of Excess Bone?

Before a dental professional can fit patients for dentures or prosthetic teeth, he or she may need to have excess bone removed. The excess bone that will be removed will vary based on each patient. When the excess bone that needs to be removed is minimal, a patient may not need this procedure because the dentures can be fabricated around the excess bone. When the bone that needs to be removed is moderate to large, a patient will more than likely need to have the excess bone removed prior to denture fitting to ensure the dentures fit properly.

If there is extra bone on cheek and lip side of the ridge, then a patient has exostosis. When patients have exostosis, it is highly likely they will have to have the excess bone removed prior to being fitted for prosthetics. In most cases, the extra bone can be removed at the same time the teeth are removed.

When there is excess bone that is present on the inside of the lower ridge, which is next to the tongue, it is known as a lingual torus. If more than one is present, this it is called a tori. Unless the excess bone is minimal, it will probably need to be removed before before prosthetic teeth are fabricated. Removal of excess bone in this area can be difficult to remove properly, which is why this procedure may be performed after teeth have been extracted.

If the excess bone is present on the roof of the mouth, it is called a palatal torus. In most cases, the extra bone will only need to be removed if it is large or it extends into the soft palate, which will prevent the dentures from sealing. This procedure is complex, so a patient will probably have it performed after teeth are extracted.

What is Removal of Excess Gum Tissue?

There are times when a patient has pre-existing dentures that do not fit properly, which will cause extra folds of gum, lip, and cheek tissue to develop. This is often seen in patients who have worn dentures for a long period and they no longer fit properly. The extra folds of tissue is referred to as epulis fissuratum or hyperplastic tissue. This tissue will have to be removed before fabrication because it will not enable proper fitting. To allow for proper healing, this procedure is performed several weeks before the dentures will be fabricated.

What is Expected Following the Procedure?

After a pre-prosthetic procedure, a patient may feel minor pain and discomfort when the local anesthesia has worn off. To help with pain, patients will be given pain killers. Patients will also be provided with antibiotics and an antimicrobial mouth-wash to prevent infection. The stitches that are present will dissolve on their own in a few weeks. Patients may also experience slight swelling for the first few days following surgery.

If you want to know more about pre-prosthetic surgery, contact us for additional information.