Alveoloplasty, Tori, & Exostosis Removal
Alveoloplasty, tori removal and exostosis removal all involve surgery to smooth different parts of the jawbone and alveolus, the part of the jawbone that houses the teeth.
Alveoloplasty is a surgical procedure that reshapes and smooths out the jawbone where a tooth has been extracted. The part of the jawbone that houses the teeth is called the alveolus, and "plasty" means molding, so alveoloplasty is the process of molding or reshaping the surrounding jawbone. When a tooth is extracted, the socket (the hole where the tooth was located) heals over the course of several weeks. The healed area where the tooth once was is called an edentulous ridge, and it may be uneven or bumpy. This bumpy area will not serve as a good foundation for a replacement tooth or dental prosthesis. Smoothing out the jawbone creates a solid surface for the replacement teeth to rest.
The procedure can be performed either at the time of tooth extraction or after the site has fully healed. When you prepare for your tooth extraction, your dentist will evaluate your jaw and decide if it needs recontouring. Dentists often conduct this procedure at the same time as the tooth extraction to facilitate healing and prevent a future unnecessary surgery. Alternatively, the procedure can be performed once the site has healed but before the artificial tooth is placed to make sure the shape of the jaw supports the new device.
Tori and Exostosis removal:
An exostosis (also referred to as an osteoma) is a benign growth of new bone on top of existing bone. In the mouth, these occur on the cheek side of either the upper or lower jaw. When the excess bone is on the inside of the jaw it is referred to as tori, specifically lingual tori on the lower jaw or palatine tori on the roof of the mouth. These are benign growths of normal bone, are actually quite common, and typically do not require any intervention. In some cases, this excess bone grows to the point that it can interfere with tongue position, cause airway and breathing issues, prevent proper fit of dentures, impair esthetics and function, lead to frequent trauma from food, or become infected due to the thin type of tissue covering the bone. In this case, your Dentist may recommend removing the excess bone in a procedure called tori or exostosis removal, depending on the location of the excess bone. This procedure requires the removal of the excess bone and reshaping the remaining bone to restore normal contours.
For alveoloplasty or tori/exostosis removal, the patient will be anesthetized with a local anesthetic to ensure the treatment is pain free. If you are anxious about the procedure, be sure to discuss sedation options with your dentist prior to your surgery appointment. Your dentist will make an incision at the gumline to expose the underlying jawbone. Once the bumpy or excessive bone is exposed, your Dentist will use surgical instruments to smooth and adjust the bone to the desired shape. Once the proper contour is achieved, the area will be thoroughly irrigated and then the tissue will be put back into place. Sutures will be placed to ensure proper positioning and allow for proper healing.
Your Dentist will likely prescribe an antibiotic mouthwash for use post-operatively, along with a recommendation of ibuprofen and Tylenol. Ice, popsicles and other cold foods can help minimize discomfort during the first few days following surgery. Most patients report moderate discomfort for 5-7 days following an alveoloplasty, tori or exostosis removal. You will need to keep the area clean and may need to limit the type of foods you eat for the first few days as food trapped in the surgical area can raise your risk of infection.