Oral prosthetic rehabilitation plays a vital role in restoring function, aesthetics, and quality of life in partially or completely edentulous patients.1 The long-term success of prosthetic treatment depends on multiple factors, including prosthesis design, occlusion, supporting structures, and peri-prosthetic soft tissue health. Among these, the condition and management of soft tissues have gained increasing attention due to their direct impact on prosthetic stability and patient comfort.2

Inadequate soft tissue contours, excessive frenum attachments, shallow vestibules, hyperplastic tissues, and irregular ridge anatomy can compromise prosthesis retention and stability.3 These conditions may lead to poor adaptation of prosthetic margins, increased plaque accumulation, tissue inflammation, and eventual prosthesis failure.4 Surgical tissue management procedures such as gingivectomy, alveoloplasty, vestibuloplasty, and frenectomy are often indicated to correct these anatomical and pathological conditions prior to prosthetic rehabilitation.5

Despite widespread clinical use, the evidence regarding the direct effect of surgical tissue management on prosthetic stability remains limited and inconsistent. Some studies suggest improved retention and hygiene maintenance following surgical intervention, while others report minimal differences when compared to conventional prosthetic treatment alone.1 This lack of consensus necessitates further clinical evaluation.3

Therefore, the present study aimed to assess the effect of surgical tissue management on the stability of oral prosthetic rehabilitation by comparing clinical outcomes and patient satisfaction between surgically managed and non-surgically managed cases.

This prospective clinical study was conducted in the Department of Prosthodontics over a period of 12 months. Ethical approval was obtained prior to the commencement of the study, and informed consent was secured from all participants. A total of 80 patients aged between 30 and 65 years requiring oral prosthetic rehabilitation were included. Patients with uncontrolled systemic diseases, active periodontal infections, or a history of radiation therapy to the head and neck region were excluded.

  Group Allocation

• Group A (n = 40): Patients who underwent surgical tissue management prior to prosthetic rehabilitation
• Group B (n = 40): Patients who received prosthetic rehabilitation without surgical tissue management

Surgical tissue management included procedures such as gingivectomy, frenectomy, vestibuloplasty, and alveoloplasty, performed based on individual clinical requirements. A healing period of 4–6 weeks was allowed before prosthesis fabrication. Both groups received fixed partial dentures or removable prostheses fabricated using standardized clinical and laboratory protocols. The following parameters were evaluated at baseline, 3 months, and 6 months: Prosthetic stability (clinically assessed as stable or unstable), Peri-prosthetic soft tissue health (gingival index) and patient satisfaction (assessed using a 5-point Likert scale). Data were analyzed using statistical software. Descriptive statistics were calculated, and intergroup comparisons were made using the chi-square test and independent t-test. A p-value < 0.05 was considered statistically significant.

At 6 months, prosthetic stability was observed in 37 patients (92.5%) in Group A compared to 30 patients (75.0%) in Group B.

Table 1: Comparison of Prosthetic Stability at 6 Months

Group A demonstrated significantly better gingival health scores at all follow-up intervals compared to Group B (p < 0.05). High satisfaction scores (score ≥4) were reported by 85.0% of patients in Group A and 65.0% in Group B.

Table 2: Patient Satisfaction Scores at 6 Months

The present clinical study demonstrated that surgical tissue management prior to oral prosthetic rehabilitation significantly improves prosthesis stability, peri-prosthetic soft tissue health, and patient satisfaction. These findings reinforce the concept that successful prosthodontic outcomes are not solely dependent on prosthetic design and materials but are strongly influenced by the quality and architecture of supporting soft tissues.

In the current study, prosthetic stability at 6 months was observed in 92.5% of patients in the surgically managed group, compared to 75.0% in the non-surgical group. This improvement can be attributed to the correction of unfavourable tissue conditions such as hyperplastic gingiva, shallow vestibules, and high frenum attachments, which otherwise interfere with optimal prosthesis seating and retention. Similar outcomes were reported by Chander et al (2024)7 previous investigators, who noted improved denture retention and reduced displacement following pre-prosthetic soft tissue surgery, particularly in patients with compromised ridge anatomy. Studies evaluating vestibuloplasty procedures have reported an increase in denture stability ranging from 15% to 25% when compared with conventional prosthetic treatment alone.8 These findings align closely with the present study, where a 17.5% improvement in prosthetic stability was observed in the surgically treated group. Additionally, alveoloplasty has been shown to enhance the uniform distribution of occlusal forces, thereby reducing localized pressure points that may otherwise contribute to prosthesis instability and tissue soreness.9

Peri-prosthetic soft tissue health was significantly better in Group A throughout the follow-up period. Lower gingival index scores observed in the surgically managed group indicate reduced inflammation and improved plaque control. Previous studies by Duong et al (2022)10 and Gavounelis et al (2025)11 have reported similar trends, demonstrating that smooth gingival contours and adequate vestibular depth facilitate oral hygiene maintenance and reduce plaque accumulation around prosthetic margins. One comparative study reported a 30–40% reduction in gingival inflammation scores following gingivectomy procedures performed prior to fixed prosthetic rehabilitation.12

Patient satisfaction is a critical indicator of prosthetic success and treatment acceptance. In the present study, 85.0% of patients in the surgical group reported high satisfaction scores, compared to 65.0% in the non-surgical group. These findings are consistent with earlier reports indicating that patients who undergo pre-prosthetic surgical interventions experience better comfort, improved phonetics, and enhanced aesthetics.13,14 Improved tissue adaptation and reduced prosthesis movement during function are likely responsible for higher satisfaction levels observed in surgically treated patients. Several authors have emphasized that neglecting soft tissue discrepancies during treatment planning may compromise long-term prosthetic success, even when technically sound prostheses are delivered.9,10,13 Inadequate tissue management has been associated with increased incidence of sore spots, mucosal ulceration, and early prosthesis failure. The present study supports these observations, as a higher proportion of unstable prostheses and patient dissatisfaction was noted in the non-surgical group.

Despite the additional surgical phase, healing period, and cost, surgical tissue management appears to provide long-term benefits that outweigh these limitations. However, patient selection remains crucial, and surgical intervention should be based on thorough clinical evaluation rather than routine application.

LIMITATIONS

The current study includes the relatively short follow-up duration and reliance on clinical assessment rather than objective digital stability measurements. Future studies with longer follow-up periods, larger sample sizes, and incorporation of quantitative stability analysis are recommended to further substantiate these findings.

Surgical tissue management significantly enhances the stability, soft tissue health, and patient satisfaction associated with oral prosthetic rehabilitation. Proper evaluation and correction of soft tissue conditions prior to prosthesis fabrication should be considered an integral component of successful prosthodontic treatment.

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