Pre-Prosthetic Surgery

What Is Pre-Prosthetic Surgery?

Pre-prosthetic surgery is the branch of oral and maxillofacial surgery that addresses conditions related to atrophy — whether mild or severe — of the upper jaw (maxilla) and/or the lower jaw (mandible).

In patients affected by this condition, the placement of any dental prosthesis — fixed or removable — is often impossible due to insufficient bone volume. Reconstructive pre-implant surgery is therefore necessary to create the foundation required for successful prosthetic rehabilitation.

These techniques can rebuild the jaw bones in both the vertical and horizontal dimensions — restoring both height and width where needed.

What Procedures Are Used in Pre-Implant Surgery?

What Other Pre-Prosthetic Procedures Are Available?

• Bone grafting — the material that currently offers the greatest reliability for this type of reconstruction is autologous bone (taken from the patient). It may be harvested in small quantities from within the oral cavity (the chin region or the angle of the mandible), or, where larger volumes are required, from the iliac crest or the calvarium. The choice of donor site depends on the extent and location of the defect to be repaired. Alternatives to autologous bone include animal bone, human donor bone (bone bank), or synthetic bone substitutes.
• Maxillary sinus floor elevation (sinus lift) — a widely used technique for increasing bone volume in the upper jaw.
• Osteotomies — in cases of severe maxillary atrophy, more complex surgical procedures may be required in addition to bone grafting.

What Other Pre-Prosthetic Procedures Are Available?

Pre-prosthetic surgery encompasses a range of procedures aimed at optimising the bone and soft tissues prior to prosthetic placement. Depending on the clinical situation, these may include: smoothing and recontouring of bony ridges, removal of irregularities that interfere with prosthetic support, management of frenula and mucosal attachments where these compromise prosthetic stability, correction of mobile or redundant soft tissue, and — where indicated — procedures to improve the prosthetic bed in order to enhance retention and comfort.
The choice of procedures depends on the individual clinical situation and the type of prosthesis planned. Objectives, timelines and priorities will be discussed and agreed during your specialist consultation.