What is alveoplasty?
Alveoplasty is a surgical procedure used to smooth out the jawbone. This is done in areas where teeth have been removed or where teeth have been lost. Alveoplasty can be done alone but it is usually performed at the same time with tooth extraction. Oral surgeons usually do alveoplasties although some dentists are also trained to do it.
What is alveoplasty used for?
When teeth are extracted from the jawbone, a hole is left behind. Even when the gums have completely healed, there will still be high and low points in the bone. This can make it difficult for dentures to be fitted. The denture base can rub against the high points and may cause sore spots. The fit of the denture may also be affected.
People who have had missing teeth for quite some time have lost some of their bone in their jaws already. The top of the jawbone, referred to as the ridge, can become very thin. Some people may have a lip of bone that protrudes from the jaw. Dentures may not fit well in these cases. Dentists use alveoplasty in order to smooth out these lumps in the jawbone, flatten the ridge of the jaw, or to taper the ridge of the jaw.
If only one tooth is being removed then alveoplasty is not usually done. The area usually heals normally in this case. If a sharp edge of bone remains after the tooth is removed then alveoplasty may be performed to smoothen it out.
Aside from smoothing the jawbone, alveoplsty will also hasten the healing process after multiple teeth extraction. When your dentist removes a tooth, an open socket will be filled with a blood clot. The gum will heal over the socket. In alveoplasty, the gums will be sutured over the hole. This will speed up the healing and control the bleeding since there is no more open socket left.
It is important to heal quickly for some people like cancer patients. They may have to get radiation therapy on their head or on their neck and require tooth extraction. Radiation will dry up the salivary glands and it will reduce blood flow to the jaw. This will increase the risks of tooth decay. When the teeth are removed, radiation therapy can not begin until the sockets have fully healed. Through alveoplasty, the area will be able to heal faster. Therapy will not be delayed. In some cases, even if only one tooth is removed, alveoplasty may have to be done.
How do you prepare for an alveoplasty?
Preparation for alveoplasty will depend on the individual. Some people will be required to rinse with antimicrobial mouthwash prior to surgery. They may also be required to take antibiotics and pain medication before they go through surgery.
Dentists may make a model for some patients of their jaw so that the surgeon will know where to remove the bone and how much bone has to be removed. The dentist will take an impression of the teeth and the jaw and a cast will be created. The cast is ground down in the areas where the bone is removed. A plastic model of the cast, referred to as a stent, is manufactured. The stent looks very similar to a denture although it is made with clear material. The oral surgeon will use the stent as a guide during the surgery. The right amount of bone must be removed and the stent will serve as a guide.
How is alveoplasty done?
Alveoplasty is performed in the dentist’s office under local anaesthesia or using an intravenous sedation combined with local anaesthesia. Some of the patients may need general anaesthesia so their procedures may have to be done at the hospital. If teeth have to be removed then they will be extracted first prior tot the alveoplasty.
The surgeon will make an incision in the gum tissue and peel it back to expose the bone. The surgeon will use a rotary drill to remove the necessary bone and then use a file to smoothen it. When the bone has been smoothed, the surgeon will irrigate the area so that all the bone particles and debris are removed. If a stent is needed then the surgeon will replace the gum tissue over the bone and set the stent above it. Since the stent imitates the shape of a denture, the surgeon will be able to determine if the right amount of bone was removed. If the stent does not fit well then more bone will be removed until the stent fits properly. The gum tissue will be replaced and then it will be stitched closed. Surgeons usually use locking sutures that minimize the bleeding and seals the tissues closed.
What are the follow-up procedures for alveoplasty?
After an alveoplsty procedure, the area will be sore for around a week. For the first few days, you may have to take painkillers. Over-the-counter medication can be used after that. Acetaminophen, Tylenon, Ibuprofen, Advil, and Motrin are some suggestions.
There will be swelling for the first twenty four hours. This will subside later on. You can use ice on your face in order to keep the swelling down. You might notice that there is some bruising under your jaw line, on your cheeks, on your chin, and inside your mouth.
Your surgeon may prescribe antibiotics in order to prevent infection of the area, especially if you are old and if you have had a lot of teeth removed. You may have to use an antibacterial rinse that your dentist will provide. You must also rinse with a saline solution in order to keep your mouth clean.
You have to eat soft foods and cold foods until the stitches have fully dissolved. You must also avoid using a straw because the suction may encourage bleeding. After a week or two, your surgeon will evaluate you once more so that the healing is monitored and so that they can make sure that there are no infections.
What are the risks of alveoplasty?
The risks of alveoplasty are
- Excessive bleeding which is a rare complication. This is when the area oozes with blood for the first twenty four hours. This bleeding should eventually taper off
- Infection in the mouth since there is a lot of bacteria there. The risk is relatively low but your surgeon may still prescribe some antibiotics in order to help prevent infections
- Opening of the wound happens when the stitches become loose. This will open the wound and end up exposing the bone. If this happens then you must contact your surgeon right away
- Trauma to the nerve that causes the sensation to the lips and the chin. This is a rare complication that can happen when alveoplasty is performed on the lower jaw. If the nerves are bruised then the lip and chin may feel numb even after the local anaesthetic has worn off. Your lip will not droop and no one will be able to determine whether your nerve was bruised. Nerves take a lot of time to heal and it may take as long as six months for them to heal completely. In very rare cases, the nerves may become permanently damaged and numbness may be permanent
After alveoplasty, you should contact your surgeon if you experience:
- excessive bleeding and increased swelling after the first day
- any signs of infection like chills, fevers, inflammations
- loosening of the stitches and the exposition of the bone