The removal of a tooth, known as a dental extraction, is a common oral surgery procedure. Alveoloplasty is a surgical technique for reshaping or smoothing the jawbone. These two procedures are often performed together to ensure a better outcome for future dental work. This combined approach, immediate alveoloplasty, sets a proper foundation for healing and subsequent prosthetic treatment.
Defining Alveoloplasty
The term alveoloplasty is derived from “alveolus,” referring to the tooth socket, and “plasty,” meaning molding or surgical repair. Alveoloplasty involves surgically recontouring the alveolar ridge, the thickened bone that holds the tooth sockets. The goal is to eliminate irregularities on the bone surface.
The alveolar ridge can sometimes be uneven or sharp after a tooth is removed. By performing alveoloplasty, the surgeon creates a smooth, uniform surface on the jawbone. This smoothing prepares the mouth for prosthetic devices and prevents discomfort caused by irregular bone structure.
Clinical Indications for Combined Surgery
The most frequent reason for combining alveoloplasty with an extraction is to prepare the mouth for a comfortable and stable dental prosthetic, such as a full or partial denture. After extraction, the remaining bone may have high and low points or bony undercuts that interfere with the proper fit of a denture. Smoothing the ridge ensures the prosthetic rests securely and evenly against the gum tissue.
The procedure also eliminates sharp or irregular bone edges that may remain after a difficult extraction. These bony projections, sometimes called bone spurs, can irritate soft tissues, cause pain, or impede healing. Removing these irregularities promotes faster soft tissue healing over the extraction site.
Other scenarios requiring combined surgery include addressing large bony growths, known as exostoses or tori, which prevent the placement of a dental appliance. For patients requiring head or neck radiation therapy, alveoloplasty speeds up the healing of extraction sites, allowing cancer treatment to begin sooner.
The Surgical Process
The combined procedure begins with the dental extraction. Once the tooth is removed, the surgeon accesses the underlying bone by gently lifting a mucoperiosteal flap (gum tissue). This exposure allows a clear view of the alveolar ridge and the remaining bone structure.
Alveoloplasty involves the precise modification of the bone using specialized instruments. The surgeon uses tools like rongeurs for gross bone removal, rotary burs to contour the bone, and bone files to achieve a final, smooth surface. The surgical site is continuously irrigated with sterile solution to keep the bone cool and clear away debris.
The surgeon checks the jawbone’s contour to confirm all sharp edges and irregularities have been eliminated. After achieving the desired smooth shape, the gum tissue flap is repositioned over the newly contoured bone. The incision is then closed with sutures, minimizing post-operative bleeding and encouraging primary healing of the soft tissue.
Post-Procedure Care and Healing
Following the combined surgery, patients should expect some swelling, discomfort, and possibly bruising in the facial area. Swelling typically peaks around 24 to 48 hours after the procedure and can be managed by applying ice packs to the outside of the face in 20-minute intervals. Prescription or over-the-counter pain medications, as directed by the surgeon, help control post-operative pain.
Maintaining meticulous oral hygiene is important, but vigorous rinsing must be avoided for at least the first 24 hours to prevent disrupting the surgical site. Gentle rinsing with warm salt water can begin the day after surgery to keep the area clean and reduce inflammation. Patients must adhere to a soft, non-chew diet for several days, avoiding crunchy, spicy, or hot foods.
Sutures are often dissolvable and will disappear on their own, but non-dissolvable stitches are removed by the surgeon typically within 7 to 10 days. The initial healing of the soft tissue usually takes about one to two weeks. Complete healing and remodeling of the underlying bone, needed before placing permanent restorations, can take several months.