RIDGE CORRECTION Alveoloplasty Tuberosity reduction Removal of tori Maxillary Mandibular Removal of maxillary tuberosity and exostoses

Alveoloplasty “Surgical recontouring of alveolar process” Purpose to take care of bony projections, sharp crestal bone or undercuts

principles Optimal ridge contour Permit early construction of dentures Preservation of alveolar bone Broad alveolar ridge Reduction irregularities Rounding off sharp ridges Preserve cortical bone as much as possible Defer surgery 4-6 weeks in case of periodontitis

Types Simple alveoloplasty Intraseptal alveoloplasty dean’s alveoloplasty Obwesenger’s modification 3. Post-extraction alveoloplasty

1) Simple alveoloplasty procedure after single sitting multiple extraction Compress buccal and lingual cortical plates with digital pressure Trim sharp spicules if exist with bone ronger Smoothened with bone file

2) Intraseptal alveoloplasty Dean’s interseptal alveoloplasty Only done in maxillary anterior region to reduce gross maxillary overjet Mostly done immediately after extraction of anterior teeth Obwesenger’s modification Both labial and palatal cortices are repositioned Done when anterior overjet is too gross that cannot be reduced by labial plate repositioning

3) Post-extraction Alveoloplasty Done in region where extractions are done at different times So in this case multiple areas will show sharp edges which are painful to touch Here crestal incision is taken and mucoperiosteal flap is elevated for trimming the sharp edges and subsequent suturing is done

Removal of palatal torus Palatal tori usually present on midline of hard palate Composed of cortical bone and may have cancellous component Palatal tori may interfere with denture retention

Indications: Extremely large torus filling the palatal vault Torus that extend beyond posterior dam area Traumatized mucosa over torus Deep bony undercuts that interfere with denture insertion and stability Interference with function Psychological considerations (e.g:malignancy phobia)

Removal of mandibular tori Torus mandibular is an exostosis found on lingual surface of mandible opposite the canine and premolar region Usually bilateral, maybe single, multiple or lobulated

Indications: Tori causing lingual undercuts and interfere with lingual flange extension of planned prosthesis When mucosal covering is ulcerated Large tori interfering with speech and deglutition

Maxillary tuberosity and exostosis removal Main reason for tubercle overgrowth - extraction of opposing mandibular 3rd molars and subsequent of supraeruption of maxillary 3rd molar, where remains as bony overgrowth after maxillary 3rd molar extraction Maxillary tubercle interfere with denture construction because it reduce inter-arch space

Torus reductions 1 4 2 3