What is pre-prosthetic surgery?
A prosthesis is an artificial replacement of a missing part of the body. Dental prostheses refer to replacement parts to replace teeth - like dentures, bridges, or dental implants. Pre-prosthetic surgery is most commonly done before the fabrication of removable dentures.
Depending on the diagnosis, the pre-prosthetic surgeries can include:
- Alveoloplasty
- Tuberosity reduction
- Torus and exostosis removal
- Removal of excess soft tissue
- Frenectomy
- Vestibuloplasty
Why should I seek treatment?
The goal of pre-prosthetic surgery is to achieve optimal soft and bony tissue at the denture bearing area, thus facilitating the construction of a removable denture and improving its stability and function.
A well-functioning removable denture requires an ideal denture-bearing area, with features including:
- Wide and smooth alveolar ridge
- No bony undercuts
- No sharp ridges
- No flabby ridges or fibrotic tuberosities
- No interfering muscle insertions
- Healthy mucosa
- Adequate interarch space
Pre-prosthetic surgeries are indicated to reshape the alveolar process, smooth out sharp bony edges and remove excess bone and/or soft tissue in order to improve denture fit and prevent pain during denture wear.
The above diagram is an example of an alveoloplasty procedure that involves reducing a bony protuberance that may interfere with a removable denture fit. An incision is made on the gum to expose the uneven bone. After bone smoothening, the gums are sutured back into position.
The above photo shows a benign bony lump at the roof of the mouth (palatal torus), which may affect denture stability and needs to be removed before denture fabrication.
What should I expect?
Before the procedure
Consultation is performed to discuss the indications and rationale for surgery, the nature of the procedure and its potential risks. Surgical risks include wound breakdown, permanent or temporary numbness, post-operative infection, prolonged pain or bleeding, oral nasal or oral antral perforation and the need for repeat surgery to achieve optimal results.
During the procedure
Pre-prosthetic surgery is mostly done under local anaesthesia in the dental clinic by oral and maxillofacial surgeons. There will be some stretching and vibrations during the procedure, but patients are kept comfortable and pain-free by the local anaesthesia. Sutures will be placed to close up the wounds and help to stop bleeding.
After the procedure
Patients will be seen for post-operative review 1-2 weeks after the procedure when sutures will sometimes have to be removed. Resorbable sutures that do not require removal are used most of the time. Your surgeon will inform you of the best time for denture fabrication, which is generally around 3 months after pre-prosthetic surgery.
What to expect after treatment?
Patients are usually only reviewed for a short period before they are referred back to the restorative dentist or prosthodontist to fabricate the prosthesis.