Preprosthetic Surgery

{Preparing the Mouth for Dentures}

During or following the removal of teeth in preparation for dentures, it frequently becomes necessary to remove bony irregularities which would interfere with the fabrication and comfortable wearing of a denture {prosthetic replacement}.These irregularities {undercuts or exostosis} may be associated with the ridge {alveolar bone} which held the teeth.Occasionally these bony knots are in the middle of the palate or under the tongue to either side of the midline.Failure to remove these areas would result in extreme discomfort wearing or chewing with the appliance, lack of ability to keep the denture in your mouth, and sore spots which would be very slow to heal.Muscle attachments can be located extremely high on the ridge which may need to be removed {frenectomy}prior to making a denture.

Alveolar bone loss{atrophy}is often a problem with patients who have been without their natural teeth for a long time.This results in problems with retention {keeping a denture in your mouth}, stability {resistance to side-to-side motion during chewing}, and pain on biting or chewing.These problems often can be improved by soft tissue procedures to make the existing ridge more useable.Bone grafting may be beneficial in some cases to add substance on which to rest a denture.Nerve repositioning procedures may help improve pain when the nerve to the lip, exposed on the upper surface of the ridge, is traumatized during chewing.Dental implants are often the best solution to all of these problems.A consultation with our doctor will allow us to evaluate and recommend a treatment which may improve these problems.

The bony ridge {alveolar bony ridge} exists for one purpose, to hold and support teeth.When the teeth are removed, there is an initial consolidation of the bone to fill in the tooth sockets.This process of remodeling the ridge usually takes 6 weeks to stabilize.For the rest of the patient’s life there is gradual loss of the remaining alveolar bone. As the ridge loses both width and height with this melting process, the denture which was made to fit the ridge years earlier now has flanges which are too long and they will cut into the soft tissues under the lip and tongue.Scar tissue can form over time which has to be removed before a new denture is made.There also is a void under the denture created with the loss of bone which causes the gum to enlarge to fill the void.This results in a flabby ridge which can prevent the making of a new denture.Surgery to remove scar tissues and flabby ridges is usually an office procedure under a local anesthetic.

The placement of dental implants requires adequate bone to support and allow them to be stable during chewing.Where there is inadequate bone, grafting can be accomplished to prove the necessary bone support. The procedure to add bone in the floor of the sinus above the upper teeth to allow implant support is called a sinus lift procedure or floor of sinus bone graft.The lower jaw has a sensory nerve in the center below the tooth bearing area which may become closer to the mouth as the ridge melts away after the loss of teeth.If there is inadequate bony ridge for implant placement above the nerve or the ridge is excessively narrow, bone grafting can be accomplished to provide the needed requirements.

Providing the best care during the psychologically and physically stressful transition to dentures is a cooperative effort between the patient, our doctor and the dentist who is making the replacement teeth.Our office will coordinate your care to help make the process as pleasant as possible.