preprosth 2552 sheet for 554 401

7/14/2019 Preprosth 2552 Sheet for 554 401

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(PreprostheticSurgery)

554 401 Minor Oral Surgery

4 2552

4

1.

2.

Preprosthetic surgery 554 401 (2552) 1


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3.

4.

1.

2. PowerPoint 3.



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(Preprosthetic surgery)

(preprostheticsurgery) (denture-bearing area)

(Characteristics of the best denture support)

1.

Preprosthetic surgery 554 401 (2552)

3


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2. - (antero-posterior)

(transverse) (vertical) 3. (alveolar process)

U ( 1)

4.(undercuts)

5. (attached keratinized mucosa) (primary denture-bearing area)



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6. (vestibular depth)

1

: Ochs MW, Tucker MR. Preprosthetic surgery. In: Peterson LJ, EllisE, Hupp JR, Tucker MR. editors.

Contemporary oral and maxillofacial surgery. 4 th ed. Missouri:Mosby; 2003. p. 250.

(retention) (stability)



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(Patientevaluation and treatment planning)

1. 2.

2.1

2.2 1. 2. 3.

3.

1.



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2.

2.1

2.1.1



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(Patients chief complaint andexpectations)

(ideal treatmentplan)

(appropriate or best treatment plan)

2.1.2

(Psychologic status)



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2.1.3

(Information of previous prosthetic

appliances)

(subjective symptoms)

(objective symptoms)



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2.1.4

(Past medical history)

hyperparathyroidism (osteoporosis)



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2.2 (Patient examination)

(existing tooth

relationship)

(amount and contour

of remaining bone)

(quality of soft tissue overlyingthe primary denture bearing area)

(vestibular

depth) (location of

muscle attachment)-

(jaw relationships)



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(bony and soft tissue pathologic

conditions)

2.2.1

(visual inspection andpalpation)

(ridgeform and contour) (exostosis andirregularities) (knife edge) (undercuts) (mylohyoid



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ridge)

(posttuberosity notching) (tuberosity enlargement)

(rest position) (torus palatinus)

(torusmandibularis)

(interarch relationship) (anteroposterior) (transverse)

(vertical)



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(overclosure)

skeletal class III

(inadequate interarch space)

(skeletal asymmetry)

skeletal class III lateral cephalogram posteroanteriorcephalogram

2.2.2



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(amount of attached,keratinized tissue)

(hypermobile fibrous tissue)

(buccinator muscle)

(mylohyoid muscle) (genioglossusmuscle)



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epulisfissuratum

(shallow vestibule)

(lingual vestibule) (manual manipulation)

(frenum) (labial frenum) (lingual

frenum) (buccal frenum) (high frenumattachment)



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(mental foramen)

2.3 (Radiographic

examination)

2.3.1 (Panoramicview)



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(maxillary sinus) (pneumatization)

2.3.2 (Periapicalview)

(abutment)

cephalogram (Watersview)

2.4 (Study model)



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(articulator)

(surgical stent) (torecomy of torus palatinus)



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3.

1.



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2.

Kent Jarcho 1

(bone graft) (osteotomy) (implant)



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(vestibuloplasty)



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ALVEOLARBONE

ADEQUATECONTOUR/HEIGHT

INADEQUATECONTOUR/HEIGHT

B. BONE GRAFT1.AUTOGENOUS

RIB,

ILIACCREST

2. ALLOGENIC

FROZENFREEZE

DRIEDDEMINERALIZED3. COMPOSITE

AUTOGENOUSCANCELLOUS

ALLOGENICDECALCIFIED

A. VESTIBLOPLASTY1. EPIDERMIS2. DERMIS3. PALATE

MUCOSA4.

REEPITHELIALIZATION5.

TRANSPOSITIONAL

C. OSTEOTOMY1. VISOR2.

INTERPOSITIONAL3.

DISTRACTION

OSTEOGENESIS

D.IMPLANT

FIXED SOFT TISSUE BASEAND

SULCUS DEPTH

INADEQUATE

ADEQUATE

1 (Alveolar ridge reconstruction): : Kent JA, Jarcho M.Ridge augmentation procedures withhydroxyapatite. In: Fonseca RJ Davis WH. editors.

Reconstructive preprosthetic oral and maxillofacial surgery. 2nd ed.Philadelphia: W.B. Saunders Company; 1995. p. 854.



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(Types ofpreprosthetic surgery)

(basic preprostheticsurgery)

2

1 . (hardtissue surgery)

1.1 (hard tissuereduction procedure)

1.1.1(alveoloplasty)

1.1.2 (maxillary tuberosity

reduction)



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1.1.3 (torectomy)

1.2 (alveolar ridge preservation

and augmentation)2. (soft tissuesurgery)

2.1 (maxillarytuberosity reduction)

2.2 (removal of unsupported

hypermobile tissue)2.3

(removal of inflammatory fibroushyperplasia)

2.4

(removal of palatal papillary hyperplasia)2.5 (correction of

abnormal frenum attachment)2.6

(vestibuloplasty)



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1.(Hard tissue surgery)

1.1 (Hard tissue reductionprocedure)

1.1.1 (Alveoloplasty)

1.

(2)

a bPreprosthetic surgery 554 401 (2552) 28


29/124

c

2

(a)

(b) (c)

: Hopkins R. Color atlas of preprosthetic surgery. Pennsylvania :Wolfe Medical Publications Ltd; 1987. p.34.



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2.

(mucoperiosteal flap)

3. (mucoperiosteal flap)

(primary closure)

(digital compression of the extraction socket) (buccal plate) intraseptal alveoloplasty (Deans technique)

(septum)



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( 3)

3 Intraseptal alveoloplasty (Deans technique): Ochs MW, Tucker MR. Preprosthetic surgery. In: Peterson LJ, EllisE, Hupp JR, Tucker MR. editors. Contemporary

oral and maxillofacial surgery. 4th ed. Missouri: Mosby; 2003. p.258.



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(edentulous ridge) (alveoloplasty by buccalreduction technique)

(saline irrigation)

black silk suture3-0 vicryl 3-0 interrupted suture continuous suture

( 4)

a b

cPreprosthetic surgery 554 401 (2552) 32


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d e

4 alveoloplasty by buccal reductiontechnique (a)

(exostosis)

(b)

(c) (d)

(e)

black silk3-0 continuous suture:

1.1.2

(Maxillary tuberosity reduction)



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(pneumatization)

( 5)

Error: Referencesource not found a

Error: Referencesource not found

b

5 (a) (b)



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: Hopkins R. Color atlas of preprosthetic surgery. Pennsylvania :

Wolfe Medical Publications Ltd; 1987. p.53

.

(buccal reduction)

( 6)



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Error: Reference

source not found

a

Error: Reference

source not found

b

6(a)

(b,c,d) (e) Coe pak (f)


c

dError: Referencesource not found


e

Error: Referencesource not found f

: Hopkins R. Color atlas of preprosthetic surgery. Pennsylvania :Wolfe Medical Publications Ltd; 1987. p.45-54.

1.1.3 (Torectomy)



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(toruspalatinus) (torus

mandibularis) 2:1

1.

2. (posterior dam)

3.

4.

5.

6.



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(greater palatinenerve) (incisive nerve)

(flap) Y

(mallet and curved chisel)

round bur

fissure bur



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fissure

bur

(dead space) (hematoma) black silk suture 3-0 interrupted suture ( 7)



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Error: Referencesource not founda

Error: Reference

source not found

b

7

(a) Y



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Y

2

(palatalmucosa) d(b,c) roundbur fissurebur

(d)

(e)

Error: Reference

source not found

c

Error: Reference

source not found f


dError: Reference

source not found

eError:

Reference sourcenot found

g



42/124

: (a,c,d) Ochs MW, Tucker MR. Preprosthetic surgery. In: Peterson LJ,Ellis E, Hupp JR, Tucker MR. editors.

Contemporary oral and maxillofacial surgery. 4 th ed.

Missouri: Mosby; 2003. p. 265-266. (b,e,f,g) Hopkins R. Color atlas of preprosthetic surgery.Pennsylvania : Wolfe Medical Publications Ltd; 1987. p.58-63.

(inferior alveolar nerve) (lingual nerve)

(sulcular incision)



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(bonefile) ( 8)


a

Error:Reference source

not found

b


c


d


e


f

8 (a)



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(b,c) round bur

fissure bur(d) (e) (f) : Ochs MW, Tucker MR. Preprosthetic surgery. In: Peterson LJ,Ellis E, Hupp JR, Tucker MR. editors.

Contemporary oral and maxillofacial surgery. 4 th ed. Missouri:Mosby; 2003. p. 267-269.

3-7 9

Error: Reference sourcenot found

a

9 (a) torectomy alveoloplasty ()(b)



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(c)

(self-curedacrylic) 1

4 () Coe pak

Error: Reference sourcenot foundb

Error: Reference sourcenot foundc



46/124

:



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1. 1.1

(greater palatineartery)

1.2

1.3



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1.4 (dehiscence)

(invertedmargin)

1.5 (flap necrosis)

1.6

dead



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space

2.

2.1

(inflammatory period)

NSAIDs

2.2



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2.3

2.4 (fascial space)

3-5



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(Post-operative care for hard tissue reductionprocedure)



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1.

non-steroidal anti-inflammatory drugs

2. (surgical stent)



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24-72

7



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(frenectomy)

(woundcontraction)

( 6)

2-3 4-6



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(boneremodeling phase)

3 . (Impression taking)

4-6



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1.2 (Alveolar ridge preservation and reconstruction)

1.2.1

.. 1962 Atwood 4

1. (Anatomic factor) (brachycephaly) (dolichocephaly)



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2. (Metabolic factor)

(metabolic bone disease) senile osteoporosis postmenstrualosteoporosis renalosteodystrophy

3. (Functional

factor)



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4. (Prostheticfactor)

(mechanical factors)

1.2.2 (Classification of alveolar ridges)



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Kent .. 1983 4 1



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(Class) (Characteristics)I Error:

Referencesource not

found

II Error:Referencesource not

found

(knife-edge)

III

Error:Referencesource not

found

()

external oblique

IV

Error:



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Referencesource not

found

1 Kent (KentsClassification of Alveolar Ridge) : : Kent JN, et al. Correction of alveolar ridgedeficiencies with nonresorbable hydroxylapatite.

J Am Dent Assoc. 1982;105:993.

1.2.3

(Current trends in alveolar preservation and

augmentation)

(vestibuloplasty)



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Kent (Kents classification)

Kents classification I



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Kents classification II

Kents classification III classification IV

(osteotomy) (distractionosteogenesis)

15



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(mentalis) (drooping chin) ( 10)

10 10

: Beck BE, Powers MP. Soft tissue considerations. In:

Fonseca RJ. editor. Oral and maxillofacialsurgery.Vol. 7. Reconstructive and implant surgery.

Philadelphia: WB Saunders Company; 2000.p. 315.



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1.2.4

(Types of bone graft and application in

Preprosthetic surgery)

3 1. Autogenous bone graft(Autograft)

(graft

rejection)

(1) (anterior borderof ramus) (external obliqueridge)



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(2) (iliac crest) (rib) (fibula) (tibia) (calvaria)

autogenous bone graft 3

cortical block graft ,corticocancellous block graft

particulate cancellousgraft particulate cancellous graft cortical graft particulate cancellous graft cortical block graft corticocancellous graft



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60%-70% 1

particulate

block graft particulate

cancellous graft titanium mesh particulate bone graft

membranous bone endochondralbone long

bone 2. Allogenic bone graft (Allograft)

(antigenic substance) allograft

demineralized freeze-



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dried bone allograft (DFDBA) demineralizedbone allograft (DBA) (block), (matrix), (particulate),

(putty) (gel ininjectable syringe) ( 11)

aError: Reference source not foundb Error: Reference

source not foundc Error: Reference source not found 11 (a) allograft (b) allograft

(c) particulate

: www.emedicine.com

allograft



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particulate

cancellous autograft allograft

allograft osteoinduction allograft

3. Xenograft

(bovine bone) (12)

12



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xenograft

: www.geistlich.com

xenograft autogenous bone graft autogenous bone graft allograft osteoconduction xenograft

4. Alloplast

hydroxyapatite, bioactive glass, tricalcium phosphate (13)



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(incorporation)

Error:Reference source notfound

13

: www.emdicine.com



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1.2.5 (Alveolar ridge reconstruction)

1. (ridge

augmentation)2. (sinus lift

procedure)3.

(onlay bone grafting)

4. Pedicled graft interpositional graft5. (alveolar

distraction osteogenesis) (ridge

augmentation) ( sinuslift procedure) Kentsclassification III IV (onlay bone



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graft), pedicled graft interpositional graft (distraction

osteogenesis) (osteogenesis) (soft tissue)

1. (Ridgeaugmentation)

autogenous graft cortical block corticocancellous block

( 14)



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a

b

c

14 (a) cortical block cancellous chips (iliaccrest)(b c)

monocortical block cancellous bone

:

allograft alloplast ( 15)



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ab c 15(a)

(mucoperiosteal tunneling) (b) allograft alloplast (c)

: Ochs MW, Tucker MR. Preprosthetic surgery. In: Peterson LJ,Ellis E, Hupp JR, Tucker MR. editors.

Contemporary oral and maxillofacial surgery. 4 th ed. Missouri:Mosby; 2003. p. 262.

7 4-6 3-4



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alloplast 4-6 autogenous bone graft allograft

2. (Sinus liftprocedure)

(buccal approach)

autogenouscancellous bone chips allograft xenograft autogenous bonegraft allograft xenograft ( 16)



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ab

16(a,b,c)

(rounddiamond bur)

c

Error: Reference

source not found

d



79/124

(bone lid) (d,e)

(f,g)

cancellous chips

e

Error: Reference

source not found

f

g

: (a,e) Spagnoli DB, Gollenhon SG, Misiek DJ. Preprosthetic andreconstructive surgery. In: Miloro M,

Larsen P, Ghali GE, Waite P.

editors. Petersons principles oforal andmaxillofacial surgery. 2nd ed.Ontario: BC Decker; 2004. p. 181.

(d,c,f,g)



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3. (onlay bone grafting)

corticocancellousblock ( 17)

60% 1

6



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17 superior border grafting

corticocancellous block : Peterson LJ, Ellis III E, Hupp JR, Tucker MR. Contemporaryoral and maxillofacial surgery. 2nd ed.

Missouri: Mosby; 1993. p. 338.

4. Pedicled graft interpositional graft

(free graft) Kents

classification IV visor osteotomy ( 18 a)

interpositional graft



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autogenous block graft

( 18 b)



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18 (a) visor osteotomy (b)

interpositional graft Le Fort I osteotomy

: Spagnoli DB, Gollenhon SG, Misiek DJ. Preprosthetic and

reconstructive surgery. In: Miloro M,Larsen P, Ghali GE, Waite P.editors. Petersons

principles of oral andmaxillofacial surgery. 2nd ed.Ontario: BC Decker; 2004. p. 181-183.

5. (Alveolar

distraction osteogenesis)

(distractionosteogenesis)


a b

83


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Ilizarov 1989 tension-stress theory (latency phase)

4-7 1 4 0.25

(activation phase) osteoprogenitor cell osteoblast

(consolidationphase) osteoid 3



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( 19)


a b

cd

85


86/124

19 alveolar distraction (a)

(b) distraction (c) distraction (d)

2 : Jensen OT, Pikos MA, Simion M, Vercellotti T. Bonegrafting strategies for vertical alveolar

augmentation. In: Miloro M, Larsen P, Ghali GE, Waite P.

editors. Petersons principles of oral andmaxillofacial surgery. 2nd ed. Ontario: BC Decker; 2004.

p. 231.



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2. (Soft tissuesurgery)

1. 2.

3.



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2.1 (maxillary

tuberosity reduction)2.2

(removal of unsupported

hypermobile tissue)2.3

(removal of inflammatory fibroushyperplasia)



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2.4 (removal of palatal papillary hyperplasia)

2.5 (correction ofabnormal frenum attachment)

2.6 (vestibuloplasty)

2.1 (Maxillary tuberosity reduction)

wedge

reduction (submucosal layer) ( 20)



90/124

a

b

c

d

20 (a,b)

(c) (d)



91/124

: Ochs MW, Tucker MR. Preprosthetic surgery. In: PetersonLJ, Ellis E, Hupp JR, Tucker MR.

editors. Contemporary oral and maxillofacial

surgery. 4th ed. Missouri: Mosby; 2003. p. 270.

2.2

(Removal of unsupported hypermobile tissue)

wedge reduction



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supraperiosteal excision

1-2

( 21)



93/124

ab

cd

21 (a,b) wedge reduction (c,d)

supraperiosteal excision

: Ochs MW, Tucker MR. Preprosthetic surgery. In:

Peterson LJ, Ellis E, Hupp JR, Tucker MR.



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editors. Contemporary oral andmaxillofacial surgery. 4th ed. Missouri: Mosby; 2003. p. 273.

2.3 (Removal of inflammatory fibrous hyperplasia)

epulis fissuratum epulis fissuratum

(soft liner) 2-4



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4 ( 22)

ab

cd

22 epulis fissuratum (a,b) (c,d)



96/124

: Ochs MW, Tucker MR. Preprosthetic surgery. In:Peterson LJ, Ellis E, Hupp JR, Tucker MR.


2.4 (Removal of palatal papillary hyperplasia)

(palatalpapillary hyperplasia) epulis fissuratum 24 epulisfissuratum 2-4 (electrosurgery)



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4 ( 23)

a b

23 (a) (b) : (a) Ochs MW, Tucker MR. Preprosthetic surgery. In:Peterson LJ, Ellis E, Hupp JR, Tucker MR.


(b) Hopkins R. Color atlas of preprosthetic surgery.Pennsylvania : Wolfe Medical Publications

Ltd; 1987. p.70.

2.5 (Correction ofabnormal frenum attachment)



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(labial frenum) (buccal frenum)

(lingual frenum)

3 diamond excision, Z-plasty V-Y advancement

diamond excision (curvedhemostat) 2

( 24)



99/124

a b

c d 24 diamond excision : Spagnoli DB, Gollenhon SG, Misiek DJ. Preprosthetic andreconstructive surgery. In: Miloro M,

Larsen P, Ghali GE, Waite P.editors. Petersonsprinciples of oral andmaxillofacial surgery. 2nd ed.

Ontario: BC Decker; 2004. p. 173.

V-Yadvancement (localizedvestibuloplasty)

V



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Y 2-3 (

25)

a

b

25 V-Y advancement : Ochs MW, Tucker MR. Preprosthetic surgery. In: PetersonLJ, Ellis E, Hupp JR, Tucker MR.

editors. Contemporary oral and maxillofacialsurgery. 4th ed. Missouri: Mosby; 2003. p. 279.



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Z-plasty diamond excision Z 60

2 ( 26)

26 Z-plasty : Spagnoli DB, Gollenhon SG, Misiek DJ. Preprosthetic and

reconstructive surgery. In: Miloro M,


a b cFlaps for

closing Flaps forclosing

Flaps forclosing

101


102/124



(Whartons duct) ( 27)



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27 : Spagnoli DB, Gollenhon SG, Misiek DJ. Preprosthetic andreconstructive surgery. In: Miloro M,



2.6 (Vestibuloplasty)

1.


a c

b

103


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15 Kentsclassification I II

2.

buccaladvancement flap

3.

Obwegeser

(submucousvestibuloplasty) .. 1959



105/124

( 28) 2

28 : Beck BW, Powers MP. Soft tissue considerations. In:Fonseca RJ. ed. Oral and maxillofacial

surgery.Vol. 7. Reconstructive and implant surgery.Philadelphia: W.B. Saunders Company; 2000.

p.327.


Buccal mucosadissected from

Supraperiostealdetachment

Acrylic splint.

105


106/124

Kzanjian flapvestibuloplasty ( 29) transpositional flapvestibuloplasty lip-switchvestibuloplasty ( 30) (lingual vestibule)



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a b

29 Kzanjian flap vestibuloplasty (a)

(submucosal layer) (b)

: Spagnoli DB, Gollenhon SG, Misiek DJ. Preprosthetic andreconstructive surgery. In: Miloro M,





108/124

a

b

30 lip-switch vestibuloplasty (a)

(b)

Kzanjian flapvestibuloplasty

: Spagnoli DB, Gollenhon SG, Misiek DJ. Preprosthetic andreconstructive surgery. In: Miloro M,

Larsen P, Ghali GE, Waite P.editors. Petersons

principles of oral andmaxillofacial surgery. 2nd

ed.



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(localized vestibuloplasty with secondaryepithelialization) (vestibuloplastywith skin graft)

2.6.1(Localized vestibuloplasty with secondaryepithelialization)



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2-3

blunt dissection



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(remodeling phase)

2-3 ( 31)

31

: Hopkins R. Color atlas of preprosthetic surgery.Pennsylvania : Wolfe Medical Publications Ltd; 1987.

p.19.

2.6.2(Vestibuloplasty with skin graft)



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(mucosal graft) (buccalmucosa)

(inner thigh) 0.012-0.018 medium split-thickness skin graft

(dermal layer) ( 32)



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32 : Beck BW, Powers MP. Soft tissue considerations. In:Fonseca RJ. ed. Oral and maxillofacial


p.329.

(floor-of-mouth



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lowering procedure)

2 5

(dermatome)

(soft liner) Coe pak



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(circummandibular wiring) 2-3 10

( 33 34)

a b

33 vestibuloplasty with skin

graft (a) (b)

(c)


c d

115


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(d) : Beck BW, Powers MP. Soft tissue considerations. In:Fonseca RJ. ed. Oral and maxillofacial


p.331



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a b c

d e f 34 vestibuloplasty with skin graft

(a) (b)

(c) (d) Coe pak(e) 3 ( ) (f)

3 :



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(displacement force)

(Post-operative care for soft tissue surgery )1.



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1-2

7

2.

2-3



120/124

( 35)

a b 35 (a) ()

(b) :

3.

2-3

4-6



121/124



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1. Beck BE, Powers MP. Soft tissueconsiderations. In: Fonseca RJ. editor.Oral and maxillofacial surgery. Vol. 7.Reconstructive and implant surgery.Philadelphia: WB Saunders Company; 2000.p.

309-58.2. Hopkins R. Color atlas of preprosthetic surgery.

Pennsylvania : Wolfe Medical Publications Ltd;1987.

3. Jensen OT, Pikos MA, Simion M, Vercellotti T.

Bone grafting strategies for vertical alveolaraugmentation. In: Miloro M, Larsen P, GhaliGE, Waite P.editors. Petersons principles oforal and Maxillofacial surgery. 2nd ed. Ontario:BC Decker; 2004. p. 223-34.

4. Kent JA, Jarcho M. Ridge augmentationprocedures with hydroxylapatite.In: Fonseca RJ, Davis WH. editors.Reconstructive preprosthetic oral and



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maxillofacial surgery. 2nd ed. Philadelphia: WBSaunders Company; 1995.

p. 853-936.5. Levin LM, Barber HD, Betts NJ, MacAfee KA,

Feinberg SE, Fonseca RJ. Bone induction andthe biology of grafting. In: Fonseca RJ, DavisWH. editors. Reconstructive preprosthetic oral

and maxillofacial surgery. 2nd ed. Philadelphia:WB Saunders Company; 1995. p. 41-72.

6. Marx RE. Biology of bone grafts. Oral andmaxillofacial surgery knowledge update. Vol. 1.1994. p. RCN3-RCN17.

7. Ochs MW, Tucker MR. Preprosthetic surgery.In: Peterson LJ, Ellis E, Hupp JR, Tucker MR.editors. Contemporary oral and maxillofacialsurgery. 4th ed. Missouri: Mosby; 2003. p. 248-304.

8. Spagnoli DB, Gollenhon SG, Misiek DJ.Preprosthetic and reconstructive surgery. In:Miloro M, Larsen P, Ghali GE, Waite P.editors.Petersons principles of oral andmaxillofacial



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surgery. 2nd ed. Ontario: BC Decker; 2004. p.157-187.

preprosth 2552 sheet for 554 401

Documents

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maxillofacial surgery

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minor oral surgery

best denture support1

overclosure skeletal

best treatment plan

area characteristics