When it is needed

Preprosthetic surgery

Preprosthetic surgery usually involves preparing the oral cavity for the placement of removable dentures (removable full or partial dentures). Often, the patient’s treatment plan includes the placement of a removable denture as a temporary or final restoration.

Depending on the circumstances, the supporting structures of the patient’s mouth, bone and gum tissues, may require prior surgical procedures to ensure acceptable fit, function and comfort of the prosthesis.

The bone that supports the tooth is called alveolar bone, and the gum tissue is called gingiva.

Alveoplasty or alveolectomy involves reshaping or removing the alveolar bone. This is done to eliminate unwanted contours, ridges, or sharp edges in order to provide a smooth and more comfortable base for a denture. Alveolar bone procedures are often performed at the same time as multiple tooth extractions, but sometimes they are delayed to allow natural bone remodeling.
Gingivoplasty procedures are similar. They are performed to remove or reshape gum tissue to provide a more suitable surface for a removable denture. Sometimes excess soft tissue requires removal.

Removal or reduction of the maxillary tuberosity: The tuberosity is a rounded bony prominence behind the last molar in the upper jaw. It is covered by the gums. Reducing the tuberosity makes it less prominent/smaller. If you have all your teeth, an enlarged tuberosity is usually not a problem. However, if you lose your upper teeth and need a denture, the enlarged tuberosity may hang downward beyond the rest of the upper jaw, making it difficult for the denture to fit properly. The upper denture stays in place because it creates a vacuum with the jaw and the roof of the mouth (the palate). An enlarged tuberosity can make it harder to achieve this vacuum.

Tuberosity reductions are not as common today because dental implants are becoming increasingly popular and because fewer people lose all their teeth and need upper dentures. However, some people with teeth and some who receive implants in the upper jaw may also need this procedure. If the tuberosity is enlarged, it can interfere with the way the teeth and jaws meet (occlusion). Reducing the tuberosity can resolve the problem.

Postoperative care guidelines for preprosthetic surgery

Recovery

Rest with your head elevated when you arrive home after the procedure. Please limit your physical activity and movement to a minimum for the first 24 hours.

Ice Application

For the first 4-5 hours after surgery, we recommend placing an ice pack on your face at 20-minute intervals. This will help reduce facial swelling. If necessary, you can use an ice pack for 24 hours.

Medication instructions

Please take anti-inflammatory medication (NSAIDs) to prevent inflammation, swelling, and pain. If you need NSAIDs, we recommend taking 400mg–800mg of ibuprofen every six hours to reduce swelling and pain and to promote healing. Do NOT exceed 2400mg in a 24-hour period. If you experience excessive pain or discomfort, take the prescribed narcotic. Please take it as directed, together with the NSAID. If you were prescribed an antibiotic, please take it as directed. Be sure to finish the full course. If any of the medications cause severe nausea, itching, or a rash, discontinue use and contact our office immediately.

Gradual Bleeding

In the next few days after surgery, slight oozing may occur, which is not a cause for concern. Gently rinse your mouth with cold water or cold chamomile or sage tea (these teas contain tannic acid, which can help stop bleeding). Please avoid smoking and alcohol, as these activities negatively affect blood clotting and the healing of the surgical site. If bleeding continues, apply pressure to the surgical area by biting down on moistened gauze for 20 minutes. If the bleeding is moderate to heavy and lasts for several hours without stopping, please contact our office immediately.

Eating guide

When you return home after surgery, you may have something very soft to eat or something cold to drink. On the evening of the surgery, we recommend that you eat a soft, bland meal, as this is usually the best way to feel better. During the first week, please do not eat anything hard or crunchy.

Wound care

When possible, we will place a dressing over the surgical area to help keep you comfortable. Please DO NOT brush the areas covered with the dressing. If the dressing becomes loose or falls off and you still feel comfortable, continue avoiding brushing the surgical areas. If the surgical area feels uncomfortable without the dressing, please contact our office so we can place a new one. Please continue your regular oral hygiene routine on all other areas of your mouth. Use an antiseptic mouthwash at least once in the morning and once at night before bed until your next appointment at our office. You may also clean the dressed area by gently wiping it with cotton soaked in antiseptic mouthwash every morning, every night before bed, and after eating and drinking.