 Hello everyone welcome back to another session in dentistry and more Today, we have one topic from Pre-prosthetic surgery that is alveolar plastic along with we have alveolarctomy. I just kept it in order to differentiate the two similar terminologies So last session we finished one topic from pre-prosthetic surgery that was Maxillary Tori and mandibular Tori so this Topics that is the pre-prosthetic surgery will be taken part by part. So I don't want to take it in a single lengthier session So pre-prosthetic surgery as we all know it is carried out to reform or redesign the soft or heart issues By eliminating the biological hindrances to receive a comfortable and stable processes so in order to receive a Processes that is a Stable and a comfortable one. We need to perform some procedure in the Heart or soft issues that is a redesigning and reforming. It's nothing but Pre-prosthetic surgery So what are the basic aims of pre-prosthetic surgery that is to provide adequate Bonnie support for the new denture Similarly the soft tissue support optimal vestibular depth elimination of any Bonnie deformities like Tori prominent myelohydridge or genial tubercle or Even to correct the maxillary and mandibular ridge relationship But What are the characteristics of ideal denger base? So we are doing all these to create an ideal denger base. So an ideal denger base should have adequate bone support then There should be good soft tissue Coverage there should not be any undercuts There should not be any sharp Ridges There should be adequate Suckers depth there should be Proper maxillary or maxillomantibular Relationship that is arch relationship There should not be any soft tissue folds or there should not be any muscle fibers Which mobilizes processes? So we need to create all these With the help of pre-prosthetic surgery So we are directly Jumping to alveolar plastic basically this pre-prosthetic surgeries are like Alveolar ridge correction ridge extension and ridge augmentation So that will be a lengthier session. So today I will be dealing about only alveolar plastic. This comes under alveolar ridge correction so alveolar ridge Correction so also we have Procedures like extension and augmentation So moving on alveolar plastic before that we need to learn what is alveolectomy alveolectomy Alveolectomy is nothing but ectomy is Intiquating removal. Okay. So removal of alveolar Bond so if it is Aestectomy It is a removal of bond. So this is alveolectomy. So it is a removal of alveolar bond So Basic procedure is like after extraction whenever there is presence of any sharp margins at interdental or Interceptile or labia buckle Alveolar crest they should be trimmed with bond rauncher or Round bar and smoothened with a bond file. So it will be cut basically but whereas the alveolar plastic is a different procedure it is Defined as surgical Recontouring. Okay. It is not removal. It is recontouring The alveolar process. So this procedure is done with the purpose to take care of bony projections or sharp crystal bond or undercuts So conservation is a key factor in The procedure unlike our alveolectomy where the removal is happening So alveolar plastic we have three types So alveolar plastic the first one is simple alveolar plastic Simple one. I just mentioned it as a then Interceptile Alveolar plastic, it can be further divided as deans alveolar plastic or Obvix's Modification and last one is post Extraction Alveolar plastic. So the simple alveolar plastic, simple alveolar plastic As a bone areas which requires recontouring should be exposed using a flap basically a envelope type of flap Then an incision is given Emucoperio still incision along the crest of the ridge with adequate anterior posterior extension Then with proper visualization Sometimes we give a vertical incision so with good visualization we do the alveolar plastic procedure using a rauncher bone file or Using a bone burr with a Handpiece so bone burr in the handpiece. So this procedure should be a Performed with copious saline irrigation in order to avoid overheating and bone necrosis. So there will be chances of Overheating And ultimately it results to necrosis. So in order to avoid that we need to provide saline Irrigation So continuous saline irrigation during the procedure is essential. So after this the edges of the flap Trimmed and then sutured with continuous or non-continuous sutures Whereas the second one that is Dean's Interceptile Alveolar plastic That is second one Which is done only on maxillary anterior region to reduce gross maxillary Orgid so mostly done immediately after the extraction of anterior teeth. Okay So this one interceptor is done on maxillary anterior teeth So this technique is best used in area where the ridge is of relative regular contour and adequate height But there is a undercut to the depth of the labial vegetable So in those cases we can perform the Interceptile alveolar plasticity. We are talking about so they are forgot to mention Dean's Interceptile alveolar plasticity So the advantages are the label prominence is reduced without reducing the height of the ridge The period steel attachment to the bone can be maintained here by reducing the bone resorption So the all the muscle attachments are left undisturbed, but the problem is there will be decrease in ridge thickness Ridge thickness will be reduced That is a disadvantage of Dean's interceptal alveolar plastic So the basic procedure is after this anterior teeth extraction interceptal bone is cut With the burr from canine to canine region With the same burr vertical cuts are made only in the labial cortex at distal end of the canine Extraction socket bilaterally without perforation of the labial mucosa Now labial cortex is fractured with period steel elevator and compressed into palatal direction in approximation with a palatal plate. So we are crushing this Labial plates that is a labial cortex and towards the lingual or the palatal plate after removing any sharp margins We do the suturing The second modification that is obvexious modification In this the both the labial and palatal cortex are reposition So this is done when the anterior object is too gross that cannot be reduced just by labial plate repositioning So in that case we need to perform both labial and lingual repositioning So procedure is almost same as Dean's alveolar plastic But the only addition is that the palatal plate in this technique the palatal plate is fractured to at its base and reposition with Labial plate in palatal direction. So that is the difference between these two So that was all about alveolar plastic. So alveolar plastic is almost like a creek contouring Alveolar lectomy is bone cutting or bone removal. So alveolar plastic we have three techniques One is a simple alveolar plastic Interceptile alveolar plastic Post extraction alveolar plastic that we haven't mentioned post extraction alveolar process the same procedure after the extraction. We do the contouring of the margins of the alveolar socket. So in interceptile we have deans and obvexious Types so in deans only the palatal cortex, sorry the buckle cortex is crushed In this technique we have both labial and lingual cortex So that was all about alveolar plastic. It's commonly asked short not So I'll come up with a new topic in our line maxillofacial surgery. Thank you