Types of Pre-Prosthetic surgery
To determine the right form of surgery for you, your doctor will assess the root cause of irregularities. Treatment may include bone reshaping, ridge augmentation, or removing excess tissue.
Bone Smoothing and Reshaping (Alveoloplasty)
An uneven alveolar ridge will result in a loose denture. You could also suffer from sore spots, due to uneven pressure from your prosthetic. Ragged bone may be congenital. More often, it is the result of tooth removal, which can leave uneven bone around the extraction site. Your surgeon can carefully reshape the area, trimming away excess tissue. Alveoloplasty can be performed in conjunction with tooth extraction.
Removing Excess Bone
Abnormal bone development in your mouth is not unusual, and it is not typically a cause for concern. Small growths do not always need to be removed, but moderate to large irregularities can significantly affect the fit of your denture. Certain types of growths almost always need to be removed. These include exostoses, found on the outer edge of the alveolar ridge and touching the lips and cheeks, and tori, which are found on the lower alveolar ridge touching the tongue or on the roof of the mouth. Growths on your hard palate may need to be removed if they interfere with an upper denture or cause speech impediments.
Insufficient bone tissue can cause just as many problems as excess tissue. After you lose teeth, your alveolar ridge can start to shrink. This can impact the fit of your denture and lead to more widespread tooth loss, as the bone continues to recede and pull away from the tooth roots. During ridge augmentation, your oral surgeon will place a bone graft to fill the shrunken areas of your alveolar ridge. Your doctor may use your own bone, animal bone, donor bone, or a synthetic material.
Removing Excess Gum Tissue (Excision)
Excess or uneven soft tissue can result in an ill-fitting denture. Fortunately, gum surgery is typically faster and less invasive than treatments that target the bone. In many cases, your doctor can excise tissue with a diode laser. As this device will seal your blood vessels simultaneously, you should experience minimal bleeding and swelling, as well as a quick recovery.
Less commonly, your doctor will recommend vestibuloplasty to build up an insufficient alveolar ridge. During the procedure, your doctor can lower the muscles attached to labial, buccal, and lingual parts of the jaws.
Sometimes, your teeth may keep a denture from fitting correctly, particularly if they are severely misaligned. Impacted teeth, which are not able to erupt fully, can also interfere with the fit of your restoration. As a result, your dentist may need to remove teeth before providing your denture. Some extractions are simple, and others teeth require surgical extraction. To remove an impacted tooth, your doctor will also need to clear away the overlying bone or gum tissue, which requires more complex surgical techniques.