Alveolectomy, including curettage of osteitis or sequestrectomy

Name of the Procedure:

Alveolectomy
Common Name(s): Alveolar bone surgery, Bone shaving surgery
Technical/Medical Terms: Alveolar ridge resection, Curettage of osteitis, Sequestrectomy

Summary

Alveolectomy is a surgical procedure that involves the removal of part of the alveolar bone, which supports the teeth. It often includes curettage, the scraping out of infected bone tissue (osteitis), or sequestrectomy, the removal of dead bone segments (sequestra). This procedure helps to ensure a healthier oral environment and prepares the jaw for subsequent treatments like dentures or implants.

Purpose

Alveolectomy addresses infection or diseased bone tissue in the alveolar ridge, typically due to chronic infections or trauma. The goals are to remove infected or dead bone, promote healing, and reduce pain or discomfort.

Indications

• Chronic infection or inflammation of the alveolar bone (osteitis)
• Presence of dead bone (sequestra) due to inadequate blood supply or infection
• Preparation for dental prostheses like dentures or implants
• Extensive periodontal disease not responsive to other treatments

Preparation

• Pre-procedure instructions may include fasting for a specified period before surgery.
• Patients might need to adjust current medications, such as blood thinners.
• Diagnostic tests, including dental X-rays or CT scans, assess the extent of bone damage.

Procedure Description

1. Anesthesia: Local or general anesthesia is administered to ensure the patient is pain-free.
2. Incision: A small incision is made in the gum tissue to access the alveolar bone.
3. Bone Removal: Diseased or dead bone is carefully removed using specialized dental instruments.
4. Curettage: The affected area is scraped free of infected tissue.
5. Sequestrectomy: Any dead bone segments are excised.
6. Suturing: The incision is closed with sutures.

Tools: Dental scalpels, curettes, bone rongeurs.
Technology: Dental X-rays, possibly cone-beam CT imaging.

Duration

The procedure typically takes 1-2 hours, depending on the extent of bone removal required.

Setting

Alveolectomy is usually performed in a hospital operating room, outpatient surgical center, or a specialized dental clinic.

Personnel

• Oral surgeon or maxillofacial surgeon
• Surgical nurse or dental assistant
• Anesthesiologist or nurse anesthetist (if general anesthesia is used)

Risks and Complications

• Bleeding
• Infection at the surgical site
• Swelling and bruising
• Nerve damage leading to temporary or permanent numbness
• Delayed healing or non-healing of the bone
• Rarely, an adverse reaction to anesthesia

Benefits

• Effective removal of infected or dead bone, promoting healing
• Preparation of the jaw for dental prostheses
• Reduction of chronic pain and improvement in oral health
• Immediate benefits within a few days to weeks post-surgery

Recovery

• Pain management with prescribed medications
• Soft diet to minimize stress on the surgical site
• Instructions on oral hygiene to prevent infection
• Follow-up appointments to monitor healing
• Recovery time varies from a few days to several weeks

Alternatives

• Antibiotic therapy for minor infections (without surgery)
• Non-surgical debridement or scaling for early-stage periodontal disease
• The main benefit of alveolectomy over alternatives is the thorough removal of problematic bone, leading to more comprehensive relief from symptoms.

Patient Experience

• The patient may experience mild to moderate discomfort during recovery, managed with pain medication.
• Swelling and bruising are common but typically subside within a week.
• Adherence to post-operative care instructions is crucial for optimal healing and comfort.
• Some patients report a tingling or numb sensation that usually resolves over time.

This description aims to provide a clear and comprehensive overview of the alveolectomy procedure in a layman's terms format.