What Is It?
A tuberosity is a rounded bony protrusion behind your last molar in the upper jaw. It is covered by your gum. A tuberosity reduction makes the tuberosity smaller.
What It’s Used For
If you have all of your teeth, a tuberosity usually is not a problem. However, if you lose your upper teeth and need a denture, the tuberosity may hang down beyond the rest of your upper jaw. This makes it difficult for a denture to fit properly. The upper denture stays in place because it makes a seal with your jaw and the roof of your mouth (palate). A large tuberosity can prevent this seal from forming.
Tuberosity reductions are less common today because dental implants are becoming more popular. In addition, fewer people lose all their teeth and require upper dentures.
However, some people with teeth and some who are receiving implants in their upper jaw may also need this procedure. If a tuberosity is large, it can interfere with the way the teeth and jaws come together (occlusion). A tuberosity reduction can fix the problem.
An oral and maxillofacial surgeon usually performs a tuberosity reduction. He or she will coordinate with your general dentist or a dentist who specializes in dentures (a prosthodontist).
In some people, the sinus cavity extends into the tuberosity. The surgeon needs to know where your sinus cavity is in relation to the tuberosity. For this reason, you may need X-rays before the procedure.
Your dentist or prosthodontist may make an acrylic guide for your jaw. The guide will show the oral surgeon how much bone and tissue need to be removed. To make the guide, your dentist will:
- Make an impression of your jaw
- Make a plaster cast
- Grind down the tuberosity areas of the cast to the proper level
- Make the guide from the cast
The guide fits over your gums like a denture would. During the procedure, the surgeon will test the mold in your mouth to make sure enough bone and tissue have been removed. In most people, only the bulbous gum tissue that covers the tuberosity needs to be trimmed and removed.
How It’s Done
You will receive local anesthesia to numb the area before the procedure. You also may receive medicine in a vein to make you drowsy. This is called intravenous sedation.
Your surgeon will cut and remove any extra gum tissue. In some cases, he or she also may trim down the bone underneath. If a guide has been made, it will be tested in your mouth.
Once the surgeon removes enough bone and tissue, the area will be closed with stitches. The procedure usually takes less than an hour.
You may get antibiotics and pain medicine after the procedure. Your oral surgeon will tell you how to rinse your mouth regularly and keep the area clean. The stitches will be removed in 7 to 10 days if they are not the type that dissolve on their own.
You will have some swelling in the area for the first few days. Don’t wear your old dentures, unless your dentist made them specifically for you to use after the procedure.
Some people need to wear a temporary denture continuously for one to two weeks. This is called an immediate denture. Your surgeon will tell you when you can remove the denture and for how long at a time. After two to three months, the immediate denture may need to be relined or replaced to improve the fit. That’s because the tissues are likely to shrink as they heal.
If you did not have an immediate denture made, your dentist or prosthodontist can start making a denture for you four to eight weeks after the surgery.
All types of surgery carry risks of excess bleeding and infection. However, these are very rare in tuberosity reduction.
The tuberosity and the sinus are close to one another. For this reason, the surgeon may enter your sinus accidentally during the procedure. This happens rarely and is usually corrected at the time of the surgery. If you notice blood in your nose after the surgery, there probably is a hole in your sinus. Contact your surgeon. If you breathe through your nose and feel air entering your mouth, your stitches have opened and the hole in your sinus is exposed.
When To Call a Professional
After a tuberosity reduction, contact your dentist or surgeon if you:
- Notice excessive bleeding or swelling after the first 24 to 48 hours
- Have symptoms of an infection (fever, chills)
- Believe you have a hole in your sinus
- Believe your stitches have opened or come loose