Pre Prosthetic Surgery Question And Answers

Pre-Prosthetic Surgery

 

Pre-Prosthetic Surgery Important Notes

1. Types of bone grafts

Preprosthetic SurgeryTypes Of Bone Grafts

2. Vestibular procedures:

Preprosthetic Surgery Vestibular Procedures

3. Lip switch procedure or transpositional flap

  • It is a lingually-based flap
  • First described by Kazanjian
  • In this technique, an incision is made in the labial mucosa, and the thin mucosal flap is dissected from the underlying tissue
  • Flap of labial mucosa is sutured to depth of vestibule
  • Exposed labial tissue heals by secondary Intention

4. Submucous vestibuloplasty:

  • First described by Macintosh and Obwegeser
  • It is a procedure of choice for the correction of soft tissue attachment on or near the crest of the alveolar ridge of the maxilla
  • This technique is particularly useful when maxillary alveolar ridge resorption has occurred, but the residual bony maxilla is adequate for proper denture support

Pre-Prosthetic Surgery Short Essays

Question 1. Ridge augmentation procedure.
Answer:

Ridge augmentation procedure

  • Superior border grafting:
    • Obtain 2 autogenous ribs
    • Contour it to the shape of the mandible
    • Fix one of it with the mandible with the help of wiring
    • Other rib is cut into small pieces & moulded around 1st rib
    • Closure of flap

Preprosthetic Surgery Superior Border Rib Grafting Fixed

  • Inferior border grafting:
    • Supraclavicular incision given
    • Subplatysmal dissection given
    • Hollow out the mandible
    • It is filled with graft particles
    • Fixation done with sutures & wiring

Preprosthetic Surgery Inferioe Border Grafting

Read And Learn More: Oral and Maxillofacial Surgery Question and Answers

  • Interpositional bone grafting:
    • Horizontal osteotomy done
    • Splitting of maxilla or mandible
    • Bone is grafted into the gap

Preprosthetic Surgery Interpositional Graft

Question 2. Indications & technique and Vestibuloplasty of sulcus extension procedure
Answer:

Indications:

  • Inadequate depth of sulcus
  • Inadequate retention for the denture
  • Inadequate stability of the denture
  • Difficulty in denture construction

Technique: Vestibuloplasty:

1. Labial Vestibuloplasty:

  • Kazanjian’s technique:
    • Submucosal dissection from inner aspect of lower lip
    • Supraperiosteal dissection given upto desired depth
    • Mucosal flap sutured at the desired depth

Preprosthetic Surgery Kazanjian Labial Vestibuloplasty Procedure

  • Clarke’s technique:
    • Incision given labial to the crest of alveolar ridge
    • Undermining of mucosal flap
    • Supraperiosteal dissection done
    • Mobilize the flap to the desired depth & suture

Preprosthetic Surgery Clarks Vestibuloplasty Procedure
2. Lingual Vestibuloplasty:

  • Trainer’s technique:
    • Incision given over lingual side of alveolar ridge
    • Supraperiosteal dissection given
    • Separation of mylohyoid muscle
    • Fixation of incisal edge of mylohyoid muscle to the desired depth

Mental nerve transposition:

Preprosthetic Surgery Mental Nerve Transposition.

Question 3. Alveoloplasty.
Answer:

Alveoloplasty

It is surgical recontouring of the alveolar process

Purpose:

  • Sharp bony margins
  • Sharp crestal bone
  • Undercuts

Types of Alveoloplasty:

1. Simple conservative technique:

  • Done when multiple extractions are done in single sitting
  • Immediately after extraction, buccal & palatal cortical plates are compressed together
  • If any bony spicules are present they are trimmed with rogue’s forcep
  • If excess redundant tissue is present it is trimmed with surgical scissors

Preprosthetic Surgery Simple Alveoloplasty After Multiple Extractions

2. Intra septal alveoloplasty:

  • Indications:
    • In maxilla
    • To reduce gross maxillary overjet
    • To reduce volume of cancellous bone Presence of undercut
    • In case of multiple extraction

Technique:

Preprosthetic Surgery Intraseptal Alveoplasty Technique

3. Obwegeser’s modification:

  • Cut the interseptal bone
  • Widen the socket at the base
  • Horizontal cuts made at the base of the socket
  • Make vertical cuts distal to the canine extraction sockets
  • Compress labial & palatal cortices
  • Sutures

Preprosthetic Surgery Obwegesers Modification For Intraseptal Alveoloplasty

Question 4. Alveolectomy.
Answer:

Alveolectomy

  • It is an alveolar ridge correction procedure
  • It is a procedure of surgical removal or trimming of the alveolar process

Need of Alveolectomy:

  • After extraction, presence of sharp bony margins
  • This interferes in the fabrication of denture

Technique of Alveolectomy:

Preprosthetic Surgery Alveolectomy Technique

Preprosthetic Surgery Alveolectomy

Preprosthetic Surgery Single Tooth Alveolectomy And Alveoloplasty

Question 5. Torus palatines.
Answer:

Torus palatines

It is exostosis/ overgrowth of cortical corticocancellous bone

Technique For Excision Of Palatal Torus:

Preprosthetic Surgery Excision Of Palatal Torus

Preprosthetic Surgery Palatal Tours And Its Surgical Excision

Question 6. Pre-prosthetic surgeries
Or

Enumerate pre prosthetic surgeries.
Answer:

Pre-prosthetic surgeries

  1. Bony surgeries:
    • Labial alveolectomy Primary alveoplasty Secondary alveoplasty
    • Excision of torus
    • Reduction of genial tubercle
    • Reduction of mylohyoid ridge
    • Maxillary tuberosity reduction
  2.  Soft tissues surgeries
    • Removal of redundant crestal soft tissues
    • Frenectomy
    • Excision of epulis

Aims:

  • Provide adequate bony tissue support
  • Provide adequate soft tissue support Elimination of bony interferances
  • Elimination of soft tissues interferences
  • Correction of maxillary and mandibular ridge relation
  • Relocation of frenal/ muscle attachments
  • Relocation of mental nerve
  • Excision of epulis

Pre-Prosthetic Surgery Short Question And Answers

Question 1. Dean’s alveoloplasty.
Answer:

Indication of Dean’s alveoloplasty:

  • Presence of adequate ridge contour & height
  • Skeletal malalignment
  • To correct the proclamation of anteriors

Principles of Dean’s alveoloplasty:

  • To facilitate the reception of dentures
  • Muscle attachments are left to heal
  • Periosteal attachment remains intact
  • Preservation of cortical plate
  • Minimizing post-operative resorption

The procedure of Dean’s alveoloplasty:

Preprosthetic Surgery Procedure Of Aveoloplasty

Preprosthetic Surgery Deans Interseptal Alveoloplasty Crestal Incision

Preprosthetic Surgery Suturing

Question 2. Frenectomy.
Answer:

Indications:

  • Frenum attachment upto alveolar crest
  • Ulceration at frenal attachments

Labial Frenectomy:

Preprosthetic Surgery Lebial Frenectomy
Z –  Plasty:

Indications:

  • Broad frenum
  • Short vestibule
  • Deepening of vestibule

V-Y Plasty:

Preprosthetic Surgery V And Y Plasty

Preprosthetic Surgery LAbial Frenectomy And Suturing Procedure

Lingual Frenectomy: Aims or Ankyloglossia:

  • To correct speech
  • Prior to denture construction
  • To improve tongue mobility

Technique:

Preprosthetic Surgery Ankyloglossia

Question 3. Torus mandibular is.
Answer:

Torus mandibular is

It is exostosis/overgrowth of cortical/corticocancellous bone

Technique For Excision Of Mandibular Torus:

Preprosthetic Surgery Technique For Excision Mandibular Torus
Question 4. Enumerate ridge augmentation procedures.
Answer:

  1. Mandibular augmentation:
    • Superior border augmentation Inferior border augmentation
    • Interpositional augmentation
    • Visor osteotomy
    • Onlay grafting
  2.  Maxillary augmentation:
    • Onlay bone grafting
    • Interpositional grafting
    • Sinus lift procedure
  3. Combination procedures:

Pre-Prosthetic Surgery Viva Voce

  1. Z plasty or Y-V plasty procedure is done for labial frenectomy
  2. Disadvantages of the use of autogenous bone include the need for donor-site surgery and extensive resorption after grafting
  3. The two muscles which are present in the floor of the mouth are the genioglossus and mylohyoid
  4. For removal of the bony tuberosity area, the incision is extended along the crest of the alveolar ridge distally to superior extent of the tuberosity area
  5. Interseptal alveoplasty involves the removal of inter-septal bone and repositioning of the labial cortical bone
  6. Alveolectomy for prosthetic reasons should be performed during the time of extraction of teeth
  7. Pre-prosthetic surgery on the mandible requires the preservation of the genial tubercles
  8. A skin graft vestibuloplasty prevents relapse by physically maintaining the depth of the vestibule

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