Podcast
Questions and Answers
What aspects should be included in the evaluation when constructing a treatment plan for bony resorption?
What aspects should be included in the evaluation when constructing a treatment plan for bony resorption?
In cases of moderate bony resorption in older patients, which treatment might suffice?
In cases of moderate bony resorption in older patients, which treatment might suffice?
Which factor is NOT critical when planning treatment for alveolar ridge recontouring?
Which factor is NOT critical when planning treatment for alveolar ridge recontouring?
What should be prioritized during treatment planning for an older patient with significant bony resorption?
What should be prioritized during treatment planning for an older patient with significant bony resorption?
Signup and view all the answers
When dealing with hard tissue augmentation, what is a key consideration?
When dealing with hard tissue augmentation, what is a key consideration?
Signup and view all the answers
What is one of the primary uses of CT scans in dental evaluations?
What is one of the primary uses of CT scans in dental evaluations?
Signup and view all the answers
Why is it important to formulate a treatment plan before surgical intervention?
Why is it important to formulate a treatment plan before surgical intervention?
Signup and view all the answers
What specific anatomical features can be more precisely evaluated using CT scans?
What specific anatomical features can be more precisely evaluated using CT scans?
Signup and view all the answers
Which of the following is NOT typically addressed in a treatment plan prior to surgery?
Which of the following is NOT typically addressed in a treatment plan prior to surgery?
Signup and view all the answers
CT scans can provide important data regarding which of the following aspects during treatment planning?
CT scans can provide important data regarding which of the following aspects during treatment planning?
Signup and view all the answers
Study Notes
Preprosthetic Surgery - Hard Tissue
- Preprosthetic surgery involves soft and hard tissue procedures.
- The goal is to create proper supporting structures for prosthetic appliances.
- Preprosthetic treatment begins with a thorough medical history to identify systemic conditions that could affect bone healing.
- A physical examination is necessary, focusing on possible systemic diseases causing bone resorption.
- Laboratory tests assess metabolic problems affecting bone health (calcium, phosphate, parathyroid hormone, alkaline phosphatase).
- Intraoral and extraoral examinations evaluate hard and soft tissues.
- Hard tissue assessment includes occlusal relationships, ridge form and contour, presence of tori and exostosis, and jaw relationships, including soft tissue and bony conditions in the maxilla and mandible.
- The primary denture-bearing area, vestibular area and the area between the external oblique line and mylohyoid ridge are examined.
Radiological Examination
- Lateral and posteroanterior cephalometric radiographs evaluate skeletal discrepancies, ridge relationships, and interarch distance.
- Panoramic radiographs provide an overview of underlying bony structures and potential pathologies.
- CT scans offer detailed cross-sectional views of the maxilla, including ridge form, sinus anatomy, and locations of the inferior alveolar nerve and mental foramina.
Alveoloplasty Associated with Multiple Tooth Removal
- Simple alveoloplasty involves compressing the lateral walls of extraction sockets after single or multiple tooth removal.
- Digital compression can adequately contour the bone if no gross irregularities are present.
- More extensive recontouring may be necessary if multiple irregularities exist.
- The technique is similar for alveoloplasty performed at the time of extraction or later in the healing period.
Incision and Flap
- Incisions are made along the crest of the ridge, with sufficient extension to expose areas requiring recontouring.
- A mucoperiosteal flap is reflected to ensure visualization of alveolar bone and to protect adjacent soft tissue during the procedure.
- Vertical releasing incisions may be necessary if complete flap reflection is not possible to prevent tear in the edges.
- Excessive flap reflection should be avoided to ensure adequate exposure of bony irregularities.
Recontouring the Ridge
- Techniques for recontouring include the use of a rongeur, bone file, mallet (and) osteotome, or a bone bur.
- Copious saline irrigation throughout the recontouring procedure is crucial to avoid overheating and bone necrosis, maintaining a temperature below 47°C.
- Recontouring is adjusted based on the extent and nature of the ridge irregularities.
Suturing
- Tissue margins are reapproximated using interrupted or continuous sutures.
- Resorbable sutures are often used to add tensile strength.
- The body will naturally break down resorbable materials over several days/weeks, eliminating the need for removal.
Maxillary and Mandibular Tuberosity Reduction
- Excess bone or soft tissue in the maxillary tuberosity area is reduced to create better fit for prosthetics.
- Radiographs help determine the extent of bone and soft tissue contributions to the excess and the location of the maxillary sinus.
- Recontouring the area is necessary to address ridge irregularities or create sufficient interarch space (minimum 1cm).
- Procedures involve removing bone using bone files, rongeurs, or rotary instruments, avoiding perforation of the maxillary sinus and ensuring the smooth adaptation to existing oral structures.
- Excessive soft tissue is removed by an elliptical fashioning of the area.
Maxillary Tori Removal
- Maxillary tori are bony exostoses in the palate area.
- Bilateral greater palatine and incisive blocks and local infiltration are used for anesthesia.
- A linear incision in the mid-line of the torus with oblique releases may be necessary to minimize soft tissue tension.
- Interrupted or continuous suturing techniques are used.
Mandibular Tori Removal
- Mandibular tori are bony exostoses on the lingual aspect.
- Bilateral lingual nerve blocks and inferior alveolar injections provide appropriate anesthesia.
- The incision is made along the ridge, roughly 1-1.5cm beyond the torus margins.
- Bone removal techniques and the use of osteotomes and/or burs are necessary for the procedures.
- Readaptation of tissues, including those adjacent to the torus area, is key.
- Interrupted or continuous suturing techniques, together with other procedural techniques, such as using gauze to minimize edema, are involved in the procedure.
Alveolar Ridge Preservation
- This procedure preserves the alveolar bone height and width at the time of tooth extraction.
- Alloplastic and xenogenic materials are used to aid in alveolar ridge reconstruction.
- Atraumatic extractions and maintaining buccal and lingual cortical walls limit bone loss.
- Grafted materials are placed in extraction sockets, compressed to the alveolar crest level, and potentially covered with collagen material.
- Implant placement following alveolar ridge preservation can take place 2-6 months after the procedure.
Intraseptal Alveoloplasty (Dean's technique)
- Intraseptal alveoloplasty involves removing intraseptal bone and repositioning the labial cortical bone to correct undercuts at the time of tooth removal.
- The technique is best suited for ridges with relatively regular contours and adequate height but with undercuts resulting from the ridge configuration.
Studying That Suits You
Use AI to generate personalized quizzes and flashcards to suit your learning preferences.
