Major pre‐prosthetic surgery. A review

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Abstract
Most patients who are rendered edentulous have satisfactory dentures constructed after a short period of healing and these dentures usually give several years of functional service. However, in patients who have been edentulous for many years and in whom considerable atrophy of the alveolar ridge has occurred, or who have been using an ill‐fitting prosthesis, there are problems of poor retention, and it is this group of patients who benefit most from pre‐prosthetic surgery. The aim of surgical procedures is to improve the denture bearing area, thus facilitating the construction of a denture and improving its function.Much of the work is of a minor nature, but if the denture bearing area is so reduced that support, retention and stability cannot be achieved, then major surgery may need to be considered. In this regard, relative and absolute augmentation procedures and recent developments in implantology have added new dimensions to the treatment of the atrophic mandible.This paper reviews these major procedures, briefly outlining the surgical protocols, and discusses the indications and results of the techniques as they are now practised.

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