Intraseptal Alveoloplasty Medical Assignment Help

Intraseptal Alveoloplasty

An alternative to the removal of alveolar ridge irregularities by toe simple alveoloplasty technique is the use of an intraseptal alveoloplasty, or Dean’s technique, tnvolvlng the removal of intraseptal bone and the repositioning of the labial cortical bone, rather than removal of excessive or Irregular areas of the labial cortex.’ Ihis technique is best used in an area where the ridge is of relatively regular contour and adequate height but presents an undercut to the depth of the labial vestibule because of the configuration
‘of the alveolar ridge, It can be accomplished at the time of tooth removal or in the early initial postoper- _ ative healing period. After exposure of the crest of th e alveolar ridge by reflection of the mucoperiosteum, a small rongeur can be used to remove the intrasepta  portion of the alveolar bone (Fig. 13-9). After adequate bone removal has been accomplished, digital pressure should be sufficient to fracture the labiocortical plate of the alveolar’ ridge inward to approximate the palatal plate area more dose Occasionally, small vertical cuts at either end of the the labial cortical bone, rather than removal of excessive or Irregular areas of the labial cortex.’ Ihis technique is best used in an area where the ridge is of relatively regular contour and adequate height but presents an undercut to the depth of the labial vestibule because of the configuration ‘of the alveolar ridge, It can be accomplished at the time of tooth removal or in the early initial postoper-  ative healing period. After exposure of the crest of the alveolar ridge by reflection of the mucoperiosteum, a small rongeur can be
used to remove the intraseptal portion of the alveolar  bone (Fig. 13-9). After adequate bone removal has been accomplished, digital pressure should be sufficient to fracture the labiocortical plate of  he alveolar’ ridge
inward to approximate the palatal plate area more dose- , ly. Occasionally, small vertical cuts at either end of the labial prominence of the alveolar ridge can be reduced.

FIG. 13-7 A, Clinical appearance 'of maxillary ridge' after removal of teeth and, before bony recontourinq. 8, Properly contoured alveolar ridge free of irregularities and bony ~ndercuts,

FIG. 13-7 A, Clinical appearance ‘of maxillary ridge’ after removal of teeth and, before bony
recontourinq. 8, Properly contoured alveolar ridge free of irregularities and bony endercuts,

FIG. 13-8 Recontouring of a knife-edge ridge. A, Lateral view of mandible, with resorption resulting in knife-edge alveolar ridge. 8, Crestal incision extends 1 cm beyond each end of area to berecontoured (vertical-releasing incisions are occasionally necessary at posterior ends of initial incision). C, Rongeur used to eliminatel:iulk of ,harp,bony projection. 0, Bone file used to eliminate any minor irr~ularities (bone bur and handpiece 'can also be used for this purpose). E, Continuous suture technique for mucosal closure.

FIG. 13-8 Recontouring of a knife-edge ridge. A, Lateral view of mandible, with resorption resulting
in knife-edge alveolar ridge. 8, Crestal incision extends 1 cm beyond each end of area to berecontoured
(vertical-releasing incisions are occasionally necessary at posterior ends of initial incision).
C, Rongeur used to eliminatel:iulk of ,harp,bony projection. 0, Bone file used to eliminate any minor
irr~ularities (bone bur and handpiece ‘can also be used for this purpose). E, Continuous suture technique
for mucosal closure.

FIG. !3-9 Intraseptal alveoloplasty. A, Oblique view of alveolar ridge, demonstrating slight facial undercut. B; Minimal elevation of mucoperiosteal flap, followed by removal ot.intraseptal bone using fissure bur and handpiece. C, Rongeur used to remove intraseptal bone. 0, Digital pressure used to fracture labiocortex in palatal direction. E, Cross-sectional view of alveolar process. F, Cross-sectional view of alveolar process after tooth removal and intraseptal alveoloplasty. By fracturing labiocortex of alveolar process in palatal direction, labial undercut can be eliminated without reducing vertical height of alveolar ridge.

FIG. !3-9 Intraseptal alveoloplasty. A, Oblique view of alveolar ridge, demonstrating slight facial
undercut. B; Minimal elevation of mucoperiosteal flap, followed by removal ot.intraseptal bone using
fissure bur and handpiece. C, Rongeur used to remove intraseptal bone. 0, Digital pressure used to
fracture labiocortex in palatal direction. E, Cross-sectional view of alveolar process. F, Cross-sectional
view of alveolar process after tooth removal and intraseptal alveoloplasty. By fracturing labiocortex of
alveolar process in palatal direction, labial undercut can be eliminated without reducing vertical height
of alveolar ridge.

without significantly reducing the height of the ridge in this area. The periosteal attachment to the underlying bone can also-be maintained, thereby reducing postoperative bone resorption and remodeling. Finally, the muscle attachments to the area of the alveolar ridge can be left undisturbed in this type of ·procedure. Michael and Bar saunf repo~ted the results of a study comparing the effects of postoperative bone  esorption after three alveoloplasty techniques. In their study, nonsurgical extraction, labial alveoloplasty, and an intraseptal alveoloplasty
technique were compared to evaluate postoperative bony resorption. The initial postoperative results were similar, but the best long-term maintenance of alveolar ridge height was achieved with nonsurgicat extractions, and the intraseptal alveoloplasty technique r esulted in
less resorption than did removal of labiocortical bone for reduction of ridge irregularities. the main disvantge of the real aplactic injury copherison.

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

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