[Surgical and prosthetic approach to the difficulties of fitting in the completely edentulous]

Prosthetic Surgery must not be considered as an exceptional process. It is likely to transform the comfort and stability of a complete prosthesis if the indications are well laid down. Two elements combine towards its success. 1. The surgical action, which may be -- a limited vestibuloplasty, destined to abolish the small ligaments, the hyperplasias or the polypoid formations; --an extensive vestibuloplasty, intended to deepen the non-retentive vestibules. The process of choice is a super-periosteal plasty of the CLARKE or VRASSE and BATAILLE type. It may be used above all on the mandible. For the maxilla, CELESNIK's intervention may be associated with it; --free skin grafts. They do not always give the results anticipated because of the cicatrical retraction which is almost constantly observed. 2. The retention is as important as the surgery. It is carried out by an anchorage with wires, in a hammock or transcutaneous, and by a plate of resin lined with a layer of elastomeres of silicon. The material appears very much superior to the sponges of polyvinylic alcohol advocated by VRASSE and NETTER.