PRE-PROSTHETHIC FULL MOUTH PREPARATION

PUSHPENDU SARKARFINAL PROF. BDS

NBDC&H2016-17

  Preprosthetic surgery refers to the surgical procedures that can modify the oral anatomy to facilitate the retention of conventional dentures. According to the Glossary of Prosthodontic Terms (7), preprosthetic surgery is defined as surgical procedures designed to facilitate fabrication or to improve the prognosis of prosthodontic care. According to Bruce Donoff, preprosthetic surgery is that part of the oral and maxillofacial surgery designed to establish the best hard and soft tissue bases for prosthetic appliances

INTRODUCTION

OBJECTIVES• Elimination of disease• Conservation of oral structures•Provide residual tissue to withstand masticatory forces•Maintain function• Esthetics

ALVEOLAR ATROPHY

CAUSES

 ∆ Periodontal diseases∆ Trauma∆ Pt factors (age, gender, skeletal morphology)∆ Endocrine & metabolic disorders (hyperparathyrodism,Ca defeciency)∆ Dietary considerations∆ Mechanical factors (extractions,removable denture wearers,

Preprosthetic procedures Ridge correction

Alveoloplasty Mylohyoid

reduction Tuberosity

reduction Genial tubercles

reduction Removal of tori Removal of

exostoses

Removal of undercuts

Ridge extension vestibuloplasty

Ridge augmentation

Maxillary Mandibular

TYPES OF ALVEOLOPLASTY

MYLOHYOID RIDGE REDUCTION

TRAUNER’ S TECHNIQUE

MAXILLARY TUBEROSITY REDUCTION

GENIAL TUBERCLE REDUCTION

MANDIBULAR TORI REMOVAL

PALATAL TORI REMOVAL

TECHNIQUE

MOUTH PREPARATION FOR REMOVABLE & FIXED PARTIAL

DENTURE

OBJECTIVES

POINTS TO PONDERNaturally, mouth preparation must be accomplished before the

impression procedures that will produce the master cast on which the removable partial denture will be fabricated.

 Oral surgical and periodontal procedures should precede abutment tooth preparation and should be completed far enough in advance to allow the necessary healing period. If at all possible, at least 6 weeks, but preferably 3 to 6 months, should be provided between surgical and restorative dentistry procedures.

Relief of Pain and Infection: As early in the treatment process as possible all teeth that are causing pain or discomfort because of caries or defective restorations should be treated to eliminate the possibility of an acute episode of pain occurring during the treatment procedure. 

ORAL SURGICAL PREPARATION

As a rule, all pre-prosthetic surgical treatment for the removable partial denture patient should be completed as early as possible.

When possible, necessary endodontic surgery, periodontal surgery, and oral surgery should be planned so that they can be completed during the same time frame.

The longer the interval between the surgery and the impression procedure, the more complete the healing and consequently the more stable the denture bearing areas

EXTRACTION OF :Retained roots Malposed teethMobile teeth with loss of attachment

Bony cyst Major exostoses

Muscle and frenal attahments should be examined

Ridges should be palpated for bony spicules and knife edged ridges.

Soft tissue should be examined for pathological lesions.

 Dentofacial deformities:eg. Cleft lip

Accurate diagnosis of the problem areas during denture construction and determination of the necessity of surgery is accomplished by careful evaluation of the information systematically obtained from the patient. As conservation is the philosophy of surgical patient management. therefore every attempt should be made to preserve as much as oral structures as possible. Proper knowledge of the available surgical procedures helps in achieving the best results.

CONCLUSION

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