Excision of osseous tuberosities, dentoalveolar structures
CPT4 code
Name of the Procedure:
Excision of osseous tuberosities, dentoalveolar structures
Common name(s): Bone removal of jaw prominences, Tuberosity reduction
Summary
The procedure involves surgically removing bony prominences (osseous tuberosities) within the jaw's dental arch to create a smoother contour. This is typically done to alleviate discomfort, enhance the fit of dentures, or as part of a larger corrective dental surgery.
Purpose
This surgery addresses issues related to irregular bony growths in the jaw which can cause discomfort, interfere with oral functions, or impede the fit and stability of dental appliances such as dentures. The goal is to provide a smoother bone contour to improve oral function and comfort.
Indications
- Discomfort or pain due to bony protrusions in the jaw.
- Difficulty in fitting dentures or other oral appliances securely.
- Preparatory step for other dental or orthodontic surgeries.
- Presence of benign bony growths affecting oral health.
Preparation
- Pre-procedure consultation including dental examination and medical history review.
- Imaging studies like X-rays or CT scans to assess the bone structure.
- Instructions for fasting if general anesthesia will be used.
- Temporary cessation of certain medications, as advised by the healthcare provider.
Procedure Description
- Anesthesia: Local anesthesia to numb the area or general anesthesia for full sedation.
- Incision: A small incision is made in the gum to access the bony prominence.
- Bone Removal: Specialized instruments are used to shave, file down, or remove the excess bone.
- Smoothing: The bone is contoured for a smooth and even surface.
- Suturing: The gum tissue is stitched back into place.
Tools, equipment, or technology used:
- Dental drills and bone cutters
- Surgical scalpel
- Sutures
Anesthesia or sedation:
- Local anesthesia or general anesthesia based on the complexity and patient preference.
Duration
The procedure typically takes between 30 minutes to 1 hour, depending on the extent of the surgery required.
Setting
This procedure is usually performed in a surgical center, outpatient clinic, or hospital with specialized dental surgery facilities.
Personnel
- Oral and maxillofacial surgeon or a specialized dental surgeon
- Surgical assistants
- Anesthesiologist (if general anesthesia is used)
- Nurses
Risks and Complications
- Common risks: Infection, bleeding, swelling, pain.
- Rare risks: Nerve damage, adverse reaction to anesthesia, delayed healing.
Benefits
- Improved comfort and reduced pain.
- Better fit and function of dentures or oral appliances.
- Enhanced oral function and aesthetics.
- Benefits typically realized within a few weeks post-surgery.
Recovery
- Pain management with prescribed medications.
- Soft-food diet recommended for several days post-surgery.
- Regular oral hygiene and gentle rinsing with saltwater solution.
- Follow-up appointment to check healing and remove sutures, if non-dissolvable sutures were used.
- Most patients can resume normal activities within a week, though full recovery may take a few weeks.
Alternatives
- Non-surgical options, such as modifications to dentures or other oral appliances.
- Orthodontic adjustments to alter the alignment without surgical intervention.
- These alternatives may not provide as definitive or immediate results.
Patient Experience
During the procedure, depending on the type of anesthesia used, the patient might feel pressure but no pain with local anesthesia or be completely unconscious with general anesthesia. Post-procedure, the patient may experience discomfort, swelling, and mild pain, which can be managed with medications and dietary adjustments. Regular follow-ups ensure proper healing and address any concerns promptly.