Pre prosthetic surgery 1 (nx power lite) /certified fixed orthodontic courses by Indian dental academy


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Pre prosthetic surgery 1 (nx power lite) /certified fixed orthodontic courses by Indian dental academy

  1. 1. INDIAN DENTAL ACADEMY Leader in continuing dental education
  2. 2. Pre Prosthetic Surgery Definition: “Surgery performed to prepare the remaining oral tissues to best support a prosthesis”
  3. 3. Pre Prosthetic Surgery Objectives To provide a comfortable tissue foundation to support the denture Proper jaw relationship in the anteroposterior, transverse and vertical dimensions. Alveolar processes that are as large as possible and of the proper configuration. (The ideal shape of the alveolar process is a broad U-shaped ridge with the vertical components as parallel as possible.
  4. 4. Pre Prosthetic Surgery Objectives No bony or soft tissue protuberances or undercuts. Adequate attached keratinized mucosa in the primary denture-bearing area. Adequate vestibular depth. Adequate form and tissue coverage for possible implant placement
  5. 5. Pre Prosthetic Surgery Patient evaluation & treatment planning History Physical examination – Evaluation of supporting bony tissue Evaluation of supporting soft tissue
  6. 6. Pre Prosthetic Surgery Classification - Corrective Procedures - Ridge extension procedure - Ridge augmentation
  7. 7. Pre Prosthetic Surgery Corrective Procedures • Soft tissue – – – – Frenectomy Excision of flabby ridges Excision of denture induced granuloma Reduction of fibrous tuberosity • Hard tissue – Alveoloplasty – Removal of Tori – Tuberosity reduction
  8. 8. Pre Prosthetic Surgery Bony Recontouring of the alveolar ridges - Simple alveoloplasty associated with multiple removal of teeth - Compression of the lateral walls
  9. 9. Pre Prosthetic Surgery Knife edge
  10. 10. Pre Prosthetic Surgery Intraseptal alveoloplasty Deans technique • Involves removal of the intraseptal bone and repositioning of the labial cortical bone • Done immediately after tooth extraction or in the initial post operative healing period • Technique is best used when the ridges of regular contour and adequate height but presents an undercut to the depth of the labial vestibule
  11. 11. Pre Prosthetic Surgery Advantages Labial prominence of the ridge can be reduced without significantly reducing the height of the ridge
  12. 12. Pre Prosthetic Surgery Intraseptal alveoloplasty • Periosteal attachment to the underlying bone,this reduces the post operative bone resorption and remodeling. • Muscle attachment to the alveolar ridge can be left undisturbed.
  13. 13. Pre Prosthetic Surgery
  14. 14. Pre Prosthetic Surgery Maxillary tuberosity reduction • Horizontal or vertical excess of the maxillary tuberosity area can be due to bone excess soft tissue both Pre operative evaluation • Clinical examination • Radiographic examination to locate the floor of the maxillary sinus
  15. 15. Pre Prosthetic Surgery Objective • To provide adequate interarch space • A firm mucosal base of consistent thickness Procedure for hard tissue
  16. 16. Pre Prosthetic Surgery Procedure for soft tissue
  17. 17. Pre Prosthetic Surgery Mylohyoid ridge reduction
  18. 18. Pre Prosthetic Surgery Genial tubercle • Reduction or augmentation
  19. 19. Pre Prosthetic Surgery Maxillary Tori • • • • Bony exostosis in the palate Origin is unclear Found twice as much in females than in males Single smooth elevation to multiloculated pedunculated mass • Speech problems,ulcers,interferes with prosthesis • Usually present in the midline
  20. 20. Pre Prosthetic Surgery Maxillary tori
  21. 21. Pre Prosthetic Surgery Mandibular tori • • • • Present on the lingual aspect Usually premolar area Gradually increase in size May interfere with speech or tongue movement • Rarely requires surgical intervention when dentition is present
  22. 22. Pre Prosthetic Surgery Mandibular tori
  23. 23. Pre Prosthetic Surgery
  24. 24. Pre Prosthetic Surgery Unsupported hyper mobile tissue • It is caused due to resorption of underlying bone or ill fitting denture • Treatment • augmentation of bone • soft tissue excision • Complication • obliteration of buccal vestibule due to undermining
  25. 25. Pre Prosthetic Surgery
  26. 26. Pre Prosthetic Surgery Inflammatory fibrous hyperplasia • Epulis fisuratum • Commonly caused by ill fitting denture • Treatment • initial stages– denture with a soft liner • significant fibrosis – excision of the hyperplastic tissue electro surgical surgical excision
  27. 27. Pre Prosthetic Surgery
  28. 28. Pre Prosthetic Surgery Inflammatory papillary hyperplasia of palate • Mechanical irritation, poor hygiene, fungal infection • Appears as multinodular projections in the palatal tissue • Treatment • initial stage – denture adjustment with tissue conditioner • Electro surgical excision • Abrade with a rotating hand piece
  29. 29. Pre Prosthetic Surgery
  30. 30. Pre Prosthetic Surgery Labial frenectomy • It is a thin band of fibrous tissue covered with mucosa extending from the lip and cheek to the alveolar periosteum. • Surgical techniques simple excision z plasty localised vestibuloplasty
  31. 31. Pre Prosthetic Surgery
  32. 32. Pre Prosthetic Surgery
  33. 33. Pre Prosthetic Surgery
  34. 34. Pre Prosthetic Surgery
  35. 35. Pre Prosthetic Surgery Expected Questions I. Short Notes a. Alveolectomy b. Torus palatinus c. Frenectomy II. Classify pre-prosthetic surgical procedures & your procedure to increase the depth of lingual sulcus III. Define pre prosthetic surgery. Write your technique for lingual sulcus extension
  36. 36. Thank you For more details please visit