the surgical modification of the alveolar process and its surrounding

structures to enable the fabrication of a well-fitting, comfortable and

aesthetic dental prosthesis
 CLASSIFTATIon

HARDTISSUE SOFT TISSUE

Aveda
1
ridge preservation .Frenectory
-

Entruction techniques 2. Vestibulo plasty

of rootstamps
preservation
-
-

3. Redundant tissue envision

c. Alvector
ridge augmentation 4.
Repositioning of inferior
a. Mandibulas alwedar nerve

b.
plamillary
Alveolar correction
ridge
3.

primary
-

aludoplasty +
->

secondary
n

Toriremoval
->

->
Tuberoplasty
Gewinl tubercle reduction
->

4. Patter
quatlic surgery
RIDGEAuurtenaIon)

achieved by building up the atrophied jaw bone using autogenous bone,

allogenic bone or alloplastic material

CRITERIA

Pg1036
• Gross atrophy of the jaws with the risk of mandibular fracture.
• Atrophy of the jaws with knife-edge ridge causing prosthetic
difficulties.
• Insufficient alveolar dime nsion for implant placement.

HoxILIA ranIBLE
1.
Only bone
grafting .
Inlay bone
Sandwich
graftI nloci
fied,
2. Sandwich
graft
2.
graft Visor

Sinus
3.
Superior border
augmentation
life
3.
↳.
Inferior border
augmentation
Disser
5.
graft
MoxI& nonint
-> Distruction oster
genesis
combined
Orthognathic surgery
->
with
ALVEULOPLASTY

Surgical recountering of the alveda proces

GOALS ->

fast
broud
->

midge
->

removing shap irregularities

->
uniform muw sa thickness

CLASSIFICATION

SIMPLE INTERSEPTAL POST

EXTRACTION
Devin'sall
plasty
Obwegeses'salmoloplasty
->
PROCEDURE

flap a
envelop type
Incision ->
mucopersiosteal along crest
of the
augion
->
adequateD-P emtension
dentical
->
incision
given if necessary
Rewuntowing Raungel ->

Bone
->

file
->
Bone but

b it
ut
Irrigation avoid over
Closne -> continual simple interupted

DEAN'S
anterior
->

only for mamillary

-> reduces
gross manillary aweel
-> should have adequateheight
ADVANTAGE DISADVANTAGE

labial prominess
ridge thickness
->
I ↳ I

->
Ibone resorption
-> puscle attachments left
undisturbed
PROCEDURE
canine
interceptal
bone from canine to

Bony cut
-

labial coater at distal end

-> Vertical cuts only in

Fracture -> labial corter with periosteal elevator

->
compassed palatal direction
into

-> rumore
any
sharp margin
Suture

OBWEGESER's MODIFICATION

>both labial & palatal cortices are expositioned

-> anterior over jet
Procure -

spalatal plateisalso fractured a expositioned

 NETIBULOPLASTY

surgical procedure wherein oral vestibule is deepened by changing

the soft tissue attachments.

Goals of the surgery

• To increase the size of denture bearing area
• To increase the height of the residual alveolar ridge

LABIOBUCLAL (InGurL

↳ Trauners
Hamilla Handibular Coldwell's
·submucosal
·Kayanjian
->
Pocket
inlay ->
Godwine
->

grafting -Liewillchie
i. Mucosal advancement vestibuloplasty

• mucous membrane of the vestibule is undermined and

advanced to line both sides of the extended vestibule
• adequate amount of bone and healthy mucosa
i. Closed submucous vestibuloplasty (Obwegeser)
ii. Open view submucous vestibuloplasty

Procedure
• vertical incision in midline
• Blunt dissection to create submucosal tunnel
• Supraperiosteal dissection
• Closure
ii. Maxillary pocket inlay vestibuloplasty

• used for extension of ridge in the atrophic maxilla.

• pockets are created on either side of the pyriform aperture and
denture flanges are extended into these pockets for stability
• Preoperatively patient’s denture is modified with extended
labial flanges.

iii. Grafting vestibuloplasty

• raw surface of the ridge with its periosteal attachment is

covered with a split thickness skin graft in order to maintain the
depth of the vestibule at the desired level.
• The flange of the new denture should be of sufficient length to
maintain the new depth of the sulcus.
• 50% relapse can take place
Clark’s technique

Clark’s technique is the reverse technique of the Kazanjian’s

technique. It is based on the following principles:

• Raw surface on connective tissue contracts, whereas when

covered with epithelium will have minimum contracture.
• Raw surface on bone does not undergo contracture.
• For repositioning and fixation, epithelial flap must be
undermined adequately.
• Soft tissues which are repositioned tend to return to their
normal position, therefore over correction is necessary.