Pre-Prosthetic Surgery

If you need a prosthesis but have sustained gum recession or jawbone atrophy, pre-prosthetic surgery can restore the form of your smile. Pre-prosthetic surgery refers to any form of oral or maxillofacial surgery that helps to prepare your mouth for a dental restoration. Depending upon your needs, treatment may involve rebuilding areas of bone loss or smoothing the gums and alveolar ridge. The goal of surgery is to ensure your denture fits as comfortably and snugly in your smile as possible.

Ridge Augmentation

Ridge augmentation (also called bone grafting) is performed to prepare an atrophied jaw for dental implants.

Candidates for Pre-Prosthetic Surgery

Your dentist or prosthodontist will likely determine your candidacy for pre-prosthetic surgery during your denture consultation. The need for such procedures is based on the shape and contours of your mouth, especially your alveolar ridge and gums. If you have abnormal bone development, a denture may fit loosely. In addition, food and bacteria can more easily accumulate beneath ill-fitting dentures, increasing your risk for gum disease and chronic bad breath. You may also need pre-prosthetic surgery if you have suffered jawbone recession following tooth loss or have excess gum tissue that interferes with your restoration.

You must be healthy enough to undergo surgery in order to qualify. If you have a systemic health condition that compromises your body’s ability to heal, you may not be eligible for treatment.

Preparing for Surgery

When designing your treatment plan, your doctor will take into account:

  • The type of surgery required

  • The techniques used

  • Grafting materials, if applicable

  • Appropriate sedation

Depending upon the extent of your surgery, your doctor may collaborate with a surgeon or prosthodontist.

What You Can Do

In order to ensure a successful treatment, there are several preparatory steps you can take. Smoking can interfere with healing, so you should stop at least three weeks before surgery. Make sure to refrain from smoking for several weeks after surgery as well. You may also need to stop taking certain medications, such as blood thinners. Be prepared to discuss any medications you are taking with your doctor during the consultation.

By improving the fit of dentures, pre-prosthetic surgery can safeguard your oral health.

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.

Ridge Augmentation

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.