Definition & Overview
An alveolectomy is a surgical dental procedure that aims to remove some or all of the alveolar bone that surrounds a tooth and change the shape and surface of the jawbone to prepare it for subsequent procedures. It is considered as the most effective dental surgery in removing infected teeth right from the roots and is often done as a preparatory step prior to the placement of dental prosthetics. It has a high success rating and a low risk of severe complications.
Who Should Undergo and Expected Results
An alveolectomy is ideal for patients with severely infected teeth that can no longer be saved and thus have to be extracted and replaced with prosthetic teeth such as dentures and dental implants.
This multi-purpose procedure aims to:
- Remove infected teeth from the roots
- Prepare the jaw bone for the placement of dentures
- Remove a wisdom tooth
- Reduce the height of alveolar sockets prior to a crown lengthening procedure
- Remove protuberant alveolar bones
While damaged teeth are usually removed through an extraction, an alveolectomy becomes necessary in complex cases, such as when the roots of the infected teeth are cracked, curved, or too close to the nerves, making it difficult to remove them through a traditional extraction procedure. The need for an alveolectomy is usually determined when the patient undergoes a dental x-ray scan prior to a dental extraction.
Once the infected tooth is removed with its roots, the dentist goes on to smoothen the remaining jaw bone to give it the right shape to accommodate and stabilise a denture or implant. This step aims to remove any sharp edges and bone undercuts and increase the space between the mandibular and maxillary ridges. This also helps protect the mucosa from possible trauma that may occur due to the use of a prosthetic dental appliance. Dentures can be placed one to two days after the procedure.
In the case of wisdom teeth, an alveolectomy is used to completely remove an impacted tooth, which cannot grow completely due to an unfavorable position or a lack of sufficient space.
How is the Procedure Performed?
An alveolectomy is an outpatient procedure performed under either local or general anesthesia. It is performed by an oral surgeon with the use of key dental instruments, such as a power scaler, a sharp hand scaler or curette, and scaling and polishing tools.
Prior to an alveolectomy, the infected tooth is extracted from its roots by making an incision in the gums surrounding it, giving the surgeon access to the alveolar bone. Various dental instruments are then used to adjust the shape, contour, height, and surface of the bone. The incisions are then closed up using sutures before a dressing is placed over the wound for protection.
Patients can go home a few hours after the procedure or once the effects of anaesthesia have worn off. Recovery after an alveolectomy is generally fast and is typically uncomplicated. To promote healing and protect patients from pain and infection, antibiotics, pain relief medications, and anti-inflammatory medications are typically prescribed.
Possible Risks and Complications
As with all other oral surgeries that require incisions, an alveolectomy is associated with some risks and complications, such as:
- Bleeding – The risk of bleeding is a significant issue following an alveolectomy. Although not life-threatening, this can delay healing and cause some problems for the patient.
- Pain and swelling
The risk of complications tends to increase depending on the complexity of the case. Mild cases and impacted tooth removal are considered as low-risk cases, as well as alveolectomy performed on one quadrant of the mouth. The risk, however, is higher for alveolectomies performed on 2 or more quadrants.
Some steps can be taken to help prevent these complications and speed up the healing process. These include taking preemptive antibiotic medications and refraining from strenuous activities during the recovery period. Blood-thinning medications should also be avoided.
Dym H., Ogle O. “Oral Surgery for the General Dentist, An Issue of Dental Clinics.”
Dhina M., Koka S., Rieck KL. “A Tooth-Stabilized Surgical Template for Alveolectomy.” J Prosthet Dent. 2013 Dec;110(6):529-31. http://www.ncbi.nlm.nih.gov/pubmed/24176180