Maxillary Tuberosity Reduction (Soft Tissue)
The primary objective of soft tissue maxillary tuberosity reduction is to provide adequate interarch space for proper denture construction in the posterior area and a firm mucosal base of consistent thickness over the alveolar ridge denture-bearing area. Maxillary tuberosity reduc-‘ tion may require the removal of soft tissue and bone to achieve the desired result. The amount of soft tissue available for reduction can often be determined by evaluating a presurgical panoramic radiograph. If a radiograph is not
. of the quality necessary to determine soft’ tissue thickness, this depth can be measured with a sharp probe after local anesthesia is obtained at the time of surgery. Local anesthetic infiltration in the posterior maxillary
area is sufficient for a tuberosity reduction. An initial elliptic incision is made over the tuberosity in the area requiring reduction, and this section of tissue is removed (Fig. 13-17). _ After tissue removal the medial and lateral margins of the excision must be thinned to remove exce’ss. soft tissue, which allows further soft tissue reduction and provide a tension-free soft tissue closure. This can be accomplished by digital pressure on the mucosal surface of the adjacent tiss.
suewhlle sharply excising tissue tangential to the mucosal surface (fig. 13-18). After the flaps are thinned, digital pressure can be used to approximate the tissue to evaluate the vertical reduction that has been accomplished. If adequate tissue has been removed, the area is sutured with interrupt. ed or continuous suturing techniques. If too much tissue
has been removed, no attempt should be made to close the wound primarily. A tension-free approximation of the tissue to bone should be accomplished. which all’5 the open wound area to heal by secondary intention. Sutures are removed in 5 to 7 days, and impressions can generally e taken 3 to 4 weeks post operatively.