April 29, 2017
Extractions and lost teeth often leave high and low points in the jawbone. This minor surgical procedure re-contours and smooths the alveolar ridge (jawbone). It is often used as part of the extraction procedure involving multiple teeth, or before the placement of implants, transplants or dentures.
Why a dentist would perform an alveoloplasty?
Any time a tooth is lost or removed the dentist must plan for how the site may be restored. Alveoloplasty makes the bone smooth and round, optimizing the shape of the jawbone. This facilitates the healing process and helps the patient avoid most complications. It also preserves more of the alveolar bone to improve the comfort and security of dentures or other appliances.
An alveoloplasty is often a substantial part of the process when multiple, consecutive teeth are removed. Access to the larger expanses makes it is easier for dentists to identify ridge irregularities. And as part of the extraction process, an alveoloplasty also prevents the necessity of a second, separate surgery at a later date. Another advantage is that the procedure does not alter or significantly impact the healing timeline.
That said, despite your dentist’s best efforts, there still may be a need for stand-alone alveoloplasty. For example, there might be an existing problem where the patient has additional lumps of bone or some type of skeletal irregularity. Or the healing and natural reshaping after an extraction might progress differently than anticipated. In these cases a separate alveoloplasty might be best. The procedure is also common when isolated teeth have been removed over a number of years, making it difficult for the dentist to envision or control the outcome.
When an alveoloplasty is paired with your tooth extraction, the dentist will administer anesthesia, remove the tooth and cut the gum creating a “surgical flap,” to expose the bone. As a stand-alone procedure the dentist will also use an anesthetic and slice open the gum to get access to the jawbone. Then the dentist proceeds to reshape the bone by using a series of bone files, dental drills, and rongeurs. The dentist also uses plenty of fluids, water or saline solution, to irrigate the extraction site. This washes away debris and keeps the bone tissue moist and cool. Lastly the dentist positions the surgical flap back in place and sutures it to close the site.
The complexity of the procedure depends on the location, degree of correction, and the expanse of the extraction site. Smaller lumps only need work on the surface of the bone. Larger ones require the removal of sections of bone. In some cases, instead of removing the dense outer layer of bone (cortical plate), the dentist compresses the bone. This corrects the unwanted ridge by allowing the jawbone to collapse on itself once the tooth has been removed while also preserving the cortical plate.
Follow-up for alveoloplasty
Recovery from this minor procedure is much like that of an ordinary dental extraction. The site might remain sore for about a week. The dentist will prescribe pain medication, tell you the type of diet to consume (avoiding hard and hot foods), and give you instructions for gentle oral hygiene. If the dentist has concerns about infection, he or she might prescribe an antibiotic as well. Call the dentist immediately if you experience excessive bleeding, symptoms of infection, or weakening of the stitches that exposes the bone. Otherwise, after about two weeks the dentist will recall you for a follow-up visit to check on the stiches and your recuperation.