- Corrects bone and gum problems that make a denture rub or lift
- Most procedures are done in one visit under local anaesthetic
- Final denture impressions are taken once the gum has healed
Pre-prosthetic surgery is the umbrella term for the minor surgical procedures used to prepare the mouth for a denture. A denture rests on the bone and gum beneath it; if that foundation is rough, sharp or the wrong shape, even a carefully made denture will rub, rock or cause sores. These procedures correct the foundation: they smooth sharp bone edges, remove bony lumps that are in the way, release gum attachments that lift the denture out of place, and take away excess tissue.
Let us say it up front: most people who have dentures made need none of these procedures. This page is for those who hear “we need to correct this area first” at their examination.
Why does a denture rub or not fit?
After teeth are extracted, the bone reshapes itself, and in the process sharp points or uneven steps can be left in places. The gum over these bumps is thin, and as the denture presses on it during chewing, it becomes painful and develops sores. In jaws where a lot of bone has been lost, the problem is different: the muscles that move the lips, cheeks and tongue, and the gum attachments, end up close to the top of the ridge and lift the edge of the denture as you talk and eat. Wearing an ill-fitting denture for a long time creates a problem of its own: where the denture edge constantly rubs, folds of excess tissue grow.
Some of these problems are solved by adjusting the denture, others only by correcting the foundation. We make that distinction at the examination.
What does pre-prosthetic surgery involve?
| Procedure | What it solves |
|---|---|
| Alveoloplasty | Smooths sharp bone edges and irregularities left after extractions |
| Torus removal | Removes a bony lump on the palate or the inner side of the lower jaw that stops the denture seating |
| Frenectomy | Releases a lip or tongue attachment that reaches the edge of the denture |
| Vestibuloplasty | Deepens the groove between lip and ridge in a resorbed jaw to make room for the denture edge |
| Soft tissue correction | Reduces excess tissue caused by denture rubbing, or an overgrown bulge at the back of the upper jaw |
Alveoloplasty
This is usually done at the same appointment as the extractions: the bone edge is rounded off and the gum is stitched over it. So if several teeth are to be removed for a full denture, planning this step together with the tooth extraction makes more sense than going through a second surgery later. We do not remove more bone than necessary; that same bone is what will carry the denture and, if an implant is ever needed, hold the implant too.
Tori and bony lumps
A torus is a benign, slow-growing bony lump, either in the middle of the palate or on the inner side of the lower jaw level with the premolars. Tori are common, and most people go their whole lives without noticing theirs. We leave them alone unless a denture is needed or the thin gum over them keeps getting sore. If the edge or the palate section of the denture would sit right on top of one, it is removed.
Frenectomy and vestibuloplasty
The thin band of tissue that connects the lip or tongue to the gum moves closer to the top of the ridge as the bone resorbs, and lifts the denture edge with every movement. A frenectomy shortens or repositions this attachment; it is a short procedure. Vestibuloplasty is more extensive and is done less often today, because in a severely resorbed jaw an implant is usually the more predictable way to hold a denture in place.
Removing excess tissue
When the edge of an ill-fitting denture rubs the same spot for years, folded, firm tissue grows there. First we adjust that edge of the denture or ask you to stop wearing it for a while; once the inflammation settles, some of the tissue shrinks on its own. What remains is removed surgically and sent for pathology examination. If the bulge at the very back of the upper jaw has grown so large that it leaves no room for a denture between it and the lower jaw, it is reduced as well.
Will I be without a denture while I heal?
The final impression is taken once the gum has healed; for most procedures that means a few weeks. An impression taken earlier copies swollen tissue, and once the swelling goes down the denture will be loose. So that you are not left without teeth in the meantime, the inside of your current denture can be relined with a soft lining, or a temporary denture can be used; which suits you depends on the procedure. Because the bone keeps changing shape in the first months, the new denture may need relining after a while.
For the overall process of getting a full denture, see full dentures; for a comparison of denture types, see dentures and prosthetic dentistry.
Could implants make more sense than surgery?
Sometimes, yes. In a lower jaw with severe bone loss, a full denture tends to move with the tongue and cheeks, however much we correct the foundation. In that case, a denture that clicks onto two or more implants often offers a more lasting solution than vestibuloplasty. We explain the options on our implant-supported prosthetics page.
Recovery after pre-prosthetic surgery
These procedures are carried out under local anaesthetic, and you generally feel no pain during them; there may be tenderness and swelling for a few days afterwards. In the first few days, soft, lukewarm food, brushing that does not strain the wound and the prescribed mouthwash are enough. Do not put your denture in over the wound unless your dentist tells you to. If swelling gets worse, or you develop a fever or difficulty swallowing, do not wait: contact us or go to the nearest emergency department, wherever you are.
At our clinic in Bayraklı, İzmir, we treat these procedures as part of your denture plan. The cost depends on the type of procedure and how many areas are treated; you receive a written, itemised quote after the examination.
Common questions
Does everyone need surgery before getting dentures?
No. In most people having dentures made, the foundation is already suitable, or minor problems are solved by adjusting the edge of the denture. Surgery only comes into question when the foundation itself would stop the denture fitting, however carefully the denture is made.
Is the bony lump on my palate dangerous?
A hard, smooth bony lump in the middle of the palate (a torus) is benign and does not need treatment in its own right. However, a swelling that grows quickly, is soft, bleeds or has a sore that will not heal is not a torus; if you notice anything like that, have it examined without delay.
Can I wear my old denture after these procedures?
It depends on the procedure. In some cases the inside of your existing denture is relined with a soft material and worn during healing; in others, the wound needs to go without a denture for a few days. We tell you which applies before the procedure, so you are not caught unprepared.
Does smoothing the bone weaken the jaw?
Not when it is done correctly; only the sharp edges and irregularities that make the denture rub are removed. We take care not to remove more bone than necessary, because that bone both carries the denture and leaves room for an implant if one is needed later.
How long do I have to wait for denture impressions?
For most procedures, a few weeks for the gum to heal. After more extensive bone correction, this can take longer. Because the bone keeps changing shape over the following months, the denture may need relining within the first year.
Can several procedures be done at the same appointment?
Often, yes. Alveoloplasty, torus removal and a frenectomy in the same jaw can be combined into one appointment, which also means you go through healing only once. If extensive work is needed in both jaws, we can split it into two appointments.
Not sure if this is right for you?
Send us a photo. We will tell you honestly what you need — and what you do not.