Exodontia.Info
Reduction of
Hyperplastic Tuberosities
If you have all of your teeth, an enlarged tuberosity usually
is not a problem.  However, if you lose your upper teeth
and need a denture, an enlarged
tuberosity may hang
down beyond the rest of your upper jaw, which 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).  An enlarged tuberosity
can make this seal difficult to achieve.

Tuberosity reductions are not as common today because
dental implants are becoming more popular and as fewer
people lose all their teeth and need upper dentures.

However, some people with teeth and some who are
receiving implants in their upper jaw may also need this
procedure.  If the
tuberosity is enlarged, it can interfere
with the way the teeth and jaws come together
(
occlusion).  A tuberosity reduction can fix the problem.


Preparation

An Oral Surgeon usually performs a tuberosity reduction,
in coordination with a general dentist or a dentures
specialist (
prosthodontist).

In some people, the sinus cavity (
antrum) extends into the
tuberosity.  The Oral Surgeon needs to know where your
sinus cavity is in relation to the
tuberosity, so you may
need X-rays before the procedure.

Your dentist / prosthodontist may make a plastic mold of
your jaw to show the Oral Surgeon how much bone +/-
soft tissues need to be removed.  To make the mold, your
dentist will take an impression of your jaw, make a plaster
cast and grind down the
tuberosity areas of the cast to the
proper level.
The mold fits over your gums like a denture.  During the
procedure, the Oral Surgeon will test the mold in your
mouth to make sure enough bone and tissue have been
removed.  In most people, only the bulbous soft tissue
needs to be trimmed and removed.
Photo of the Roof of the Mouth (palate) showing enlarged
(
hyperplastic) tuberosities
The tuberosity is numbed up with local anæsthesia; if you are nervous or anxious,
sedation in conjunction with the local anæsthesia, can be used.

The oral surgeon will remove the extra gum tissue from the tuberosity, and, in some
cases, trim down the bone underneath.  If a mold has been made, it will be tested
in your mouth.

Once the oral surgeon has removed enough gum tissue +/- bone, the oral surgeon
will stitch the operation site closed.  The procedure usually takes less than an hour.


Follow-Up

You will be advised as to what pain-killers to take; also, you may be prescribed
antibiotics, if though clinically appropriate.  Post-operative instructions will be given.  
The stitches fall out 2 - 3 weeks post-operatively.

You will have some swelling in the area for the first few days.  Don't wear dentures
that were made before your surgery, unless your dentist made specifically for you
to use after the procedure.  Some people need to wear an ‘immediate denture’
continuously for 1 - 2 weeks after the surgery.

Your surgeon will tell you when and for how long the denture may be removed.  
After two to three months, the ‘
immediate denture’ may need to be relined /
replaced to improve the fit because the tissues are likely to shrink as they heal.

After a couple of months, the said dentures need to be relined or changed to fit
better because the tissues get smaller as they heal.

If you did not have an immediate denture made, your dentist /
prosthodontist can
start making a denture for you 4 - 8 weeks post-surgery.


Risks

All surgical procedures carry risks of excess bleeding and infection.  However,
these are very rare in tuberosity reduction.


Useful Website:

Colgate World of Care
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 less
prominent / smaller.