Genial Tubercle Reduction
Asthe mandible begins to undergo resorption, the ‘area of the attachment of the genioglossus muscle in the anterior portion of the mandible may become increasingly prominent. In some cases the tubercle may actually function as a shelf against which the denture can be constructed, but it usually requires reduction to construct the prosthesis properly. Before a decision to remove this prominence is made, consideration should be given to possible augmentation of the anterior portion of the mandible rather than reduction of the genial tubercle. If augmentation is the preferred treatment, the tubercle should be left to add support to the graft in this area. Local anesthetic infiltration and bilateral lingual nerve “blocks should provide adequate anesthesia. Acrestal incision is made from each
–premolar area to the midline of the mandible. A full-thickness mucoperiosteal flap is dissected lingually to expose the genial tubercle. The ‘genioglossus muscle attachment can be removed by a sharp incision.
Smoothing with a pur or a rongeur followed by a bone file removes the genial tubercle. . .The genioglossus muscle is left to reattach in a random
. fashion. As with the mylohyoid muscle and mylohyoid ridge reduction, a procedure to lower the floor of the mouth may also benefit the anterior mandible.