Residual Ridge Resorption – Revisited

Residual ridge resorption (RRR) is a term that is used to describe the changes which affect the alveolar ridge following tooth extractions, and which continue even after healing of the extraction socket. The most significant feature of this healing process is that the residual bony architecture of the maxilla and mandible undergoes a life-long catabolic remodelling. The rate of reduction in size of the residual ridge is maximum in the first three months and then gradually tapers off. However, bone resorption activity continues throughout life at a slower rate, resulting in loss of varying amount of jaw structure, ultimately leaving the patient a ‘dental cripple’. Rehabilitation of a totally edentulous patient using a conventional complete removable denture is a routine clinical procedure, yet at times it can be a difficult and challenging process. All these patients have been through a period of edentulousness that varies from weeks to months or even years and the promise of having ‘teeth’ again often makes their expectations unrealistically high. The challenges facing the clinician are therefore manifold and this is the reason why there remains a wide variation in the predictability of clinical success. Even experienced clinicians know fully well that it is not possible to completely satisfy all the needs of edentulous patients, even with a well-fabricated prosthesis. There is a wide range of variation seen within the community as regards the needs, expectations, and responses to treatment. Before initiating treatment it is therefore, essential that the dental surgeon provide all patients with sufficient information regarding treatment options and the expected outcome of each. This allows them to make adequately informed decisions regarding their needs. The treatment options are to be presented in such a manner that each modality of treatment has a perspective that is relevant to the patient’s needs and expectations. It is also imperative that all treatment advice should be in consonance with the clinical findings and physical parameters of the existing oral condition.