Alveoloplasty is an oral surgical procedure involving the modification of the jawbone’s structure. This type of surgery falls under the category of pre-prosthetic procedures, meaning it prepares the mouth’s underlying tissues for an artificial device. Modifying the bone contour is often necessary before receiving certain dental restorations, such as dentures. The primary goal is to create a stable and comfortable foundation for the long-term success and fit of prosthetic appliances.
Defining Alveoloplasty
Alveoloplasty is a specialized dental operation focused on surgically reshaping or smoothing the alveolar ridge, which is the thick bone section of the jaw that naturally holds the teeth. The term combines “alveolus” (tooth socket area) and “plasty” (to mold or surgically form). This procedure is typically performed by an oral and maxillofacial surgeon, and it is distinct from a simple tooth extraction because it actively modifies the underlying bone structure. The primary goal is to achieve a smooth, uniform bony contour where the teeth were once located. This recontouring ensures that the overlying gum tissue heals without complications and achieves a shape that is supportive of a dental prosthetic.
Clinical Reasons for Alveoloplasty
The most frequent indication for alveoloplasty is preparation for prosthetic rehabilitation, particularly the fitting of full or partial removable dentures. After teeth are lost or extracted, the remaining alveolar ridge can be irregular, featuring sharp bony projections, often called spicules, or deep undercuts. These irregularities cause pain and chronic irritation when a rigid denture base presses against the gums. A smooth, contoured ridge allows a denture to rest securely and comfortably, distributing chewing forces evenly across the tissue. Without alveoloplasty, an ill-fitting prosthetic can lead to chronic sore spots, tissue ulceration, and instability, making it difficult to eat or speak.
The procedure is also necessary to correct severe bony undercuts, which are areas where the bone flares out, preventing the easy insertion or removal of a denture. By reducing these bony obstructions, the path of insertion for the prosthetic is simplified. Furthermore, the surgery may address exostoses, which are benign bony growths that can interfere with prosthetic wear. The recontouring process is designed to preserve as much bone height and width as possible while still eliminating the sharp or obstructive areas.
How the Procedure is Performed
The alveoloplasty procedure typically begins with the administration of local anesthesia to completely numb the surgical area. For patients who experience anxiety or for more extensive cases, options for conscious sedation or general anesthesia may also be used. The oral surgeon makes a precise incision in the gum tissue, often along the crest of the alveolar ridge. This incision allows the surgeon to gently lift a flap of gum tissue, known as a mucoperiosteal flap, to expose the underlying jawbone.
With the bone clearly visible, the surgeon uses specialized instruments to perform the contouring. The most common tools are surgical handpieces with rotary burs or bone files, which are used to meticulously shave and smooth the bone surface. The surgeon carefully removes any sharp points, bony prominences, or excessive bulk that would interfere with the fit of a future prosthetic. Throughout the bone reduction process, the area is frequently irrigated with sterile saline to keep the surgical field clean and cool.
Intraseptal Alveoloplasty
In some situations, an intraseptal alveoloplasty, also known as Dean’s technique, is used. This involves removing the bone between the sockets and compressing the outer plates. This technique achieves a more favorable contour without requiring excessive removal of the outer bone plates.
Once the surgeon confirms that a smooth, even ridge contour has been achieved, the gum tissue flap is repositioned over the newly shaped bone. The surgical site is then closed using sutures, which hold the gum tissue firmly in place against the bone to encourage proper healing. The duration of the entire operation is relatively short, often taking less than an hour, depending on the extent of the reshaping required.
Recovery and Post-Operative Expectations
Immediately following the procedure, patients should expect some degree of swelling (edema) and mild to moderate pain in the surgical area. Applying ice packs to the outside of the face in 15-minute intervals for the first 24 to 48 hours can significantly help to manage the swelling. The surgeon will typically prescribe analgesic medication to control discomfort and may also prescribe antibiotics to prevent potential infection.
Patients must adhere to specific oral hygiene and dietary instructions to promote uneventful healing. It is advised to maintain a soft diet for several days, avoiding hard, crunchy, or hot foods that could irritate the surgical site. Activities that create negative pressure in the mouth, such as using a straw or smoking, must be avoided for at least the first 48 hours to prevent dislodging the blood clot. The patient is usually instructed to begin gentle salt water rinses 24 hours after the surgery to keep the area clean and aid the healing process.
If non-dissolvable sutures were used, they are typically removed by the surgeon during a follow-up appointment, usually scheduled about one to two weeks post-surgery. The gum tissues require several weeks to fully heal and mature before the final prosthetic impressions can be accurately taken. Patients should contact their dental professional immediately if they experience excessive bleeding, a fever, or severe, unmanageable pain.