Preprosthetic Surgery

1. PREPROSTHETIC
SURGERY
PRESENTED BY
Dr. AJINS CB

2. Contents
2
• Introduction
• Definition
• Pre prosthetic surgical procedures
• Case report
• Discussion
• Conclusion

3. Introduction
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• Pre-prosthetic surgery is an integral part of Complete denture
Prosthodontics.
• The ultimate goal of pre-prosthetic surgery is to prepare a mouth to
receive a dental prosthesis by redesigning and smoothening the
bony edges, which would otherwise cause hindrance in restoration
of optimum health and function.

4. Definition
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• Preprosthetic surgery is carried out to reform/redesign soft/hard
tissues, by eliminating biological hinderances to receive comfortable
and stable prosthesis – GPT 8

5. Preprosthetic surgical procedures
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Preprosthetic
surgical procedures
Alveolar ridge
correction
Alveolar ridge
extension
Alveolar ridge
correction

6. 6
o Alveoloplasty
o Alveolectomy
o Excision of tori
o Genial tubercle reduction
o Maxillary tuberosity reduction
o frenectomy
Alveolar ridge
correction
o Vestibuloplasty
Alveolar ridge
extension
o Maxillary ridge
augmentation
o Mandibular ridge
augmentation
Alveolar ridge
augmentation
Pre prosthetic surgery

7. Case report
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• An 81 year old male patient reported to the department with the
chief complaint of missing teeth in both upper and lower arch
• A history of total extraction of natural teeth before 3 weeks
• Intraoral examination revealed irregular, bulbous bony ridges with
corrugated appearance
• On palpation, the ridges were tender at some spots

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• The patient was advised gingival massage with a gum astringent,
oral supplementation with multivitamins
• A recall was scheduled after 2 weeks
• On recall, not much improvement was found
• Rx plan:
• Quadrant wise surgical correction of the irregular ridges and bony
prominences to achieve optimum denture foundation
• Surgeries were conducted sequentially from maxillary left quadrant,
maxillary right quadrant, followed by alveoloplasty in mandibular
canine to canine region and lastly in mandibular left posterior
region

9. Surgical procedure
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Sharp bony prominences seen
clinically in maxillary left quadrant
Releasing incision to expose the
bony prominence

10. Surgical procedure – Contd.
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Bony prominence crushed using bone
ronguer and smoothened using bone file
Sutures placed

11. Surgical procedure – Contd.
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Incision over the
ridge of the
maxillary right
quadrant (envelope
flap)
Irregular residual
ridge exposed
Smoothening of
residual ridge with
bone file

12. Surgical procedure – Contd.
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envelope flap was used for mandibular canine
to canine region
Smoothening of irregular ridge carried out
with bone rongeur and bone file

13. Surgical procedure – Contd.
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minimally invasive incision was given in
mandibular left posterior region to expose a
small bony prominence

14. Post operative healing
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15. MM.DD.20XX15
Pre operative view Post operative view

16. Discussion
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• The preparation of the patient’s mouth before the placement of a
denture (or prosthesis) is referred to as preprosthetic surgery.
• A denture sits on the bone ridge, so it is very important that the
bone is of proper shape and size.
• One of several procedures that might be needed to be performed
to prepare the mouth for a denture include bone smoothening and
reshaping, removal of excess bone, and/or removal of excess gum
tissue.

17. 17
• The placement of an incision on the crest of the ridge and elevating
the mucoperiosteum as minimally as possible to maintain the
vestibular depth was the chief concern in the mandibular anterior
region.
• Irregular and sharp bony edges were trimmed to a depth of 1–2
mm with the help of rongeurs, bone files, or burs, and the wound
was closed with silk sutures

18. 18
• Postinsertion problems such as pain, discomfort, sore spots related
to irregular ridges and bony prominences were minimized by
well-planned quadrantwise alveoloplasty procedure that were
carried out in this case.
• Preprosthetic surgery thus served as an adjunct for the
development of a denture foundation that enabled fabrication of a
well-fitting and comfortable prosthesis

19. Conclusion
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• Proper diagnosis of the condition of edentulous ridges, discussing
problems associated about the same with patient and proper
treatment planning are the key determinants for successful
fabrication of complete dentures.

20. Reference
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• Preprosthetic Surgery: An Adjunct to Complete Denture Therapy by
Medha Vivek Bhuskute , Lt. Col Ravi GK Shet
• Textbook of prosthodontics by Deepak Nallaswamy – 2nd edition
• Textbook of Oral and Maxillofacial Surgery by Neelima Malik – 4th
edition

21. THANK YOU
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