Preimplantation Surgery

There is a basically different approach to restorative dentistry on the part of the implantologist and that of the conventional dentist. It is this difference that affects how tissues should be surgically prepared for the restoration.

The conventional restoration is seated over existing residual tissues. Hopefully, the soft tissues are tightly adapted to a well defined, regular arch. Corrective surgical procedures may be necessary to reshape the alveolar bone, improve the adaptation of the soft tissues over it, level interfering structures, reduce the amount of soft tissues, or more clearly define the crest including deepening the frenum and to alter neighboring structures. Also surgery is sometimes necessary to more easily accommodate the flanges of the restoration or to prepare the palate to accept a palatal bar, a horseshoe bar, or the palatal portion of a full removable denture. In summary, the conventional approach accepts the existing residual tissues or adapts them to better serve as a base for restorative dentition.

The implantologist looks at the residual tissues in terms of how he can use them to create a new base for restoration. The new base ideally will be more stable, more structurally distinct, and be restricted only to the alveolar crest. This prosthetic approach seeks to establish a series of firm vertical posts that lie in a relatively normal dental plane. These posts, not the residual tissues, will support the prosthesis.

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