Alveoloplasty

Alveoloplasty is an oral surgical procedure in which the alveolar ridge is reshaped by removing or recontouring bone to create a smooth, uniform ridge form suitable for prosthetic rehabilitation. Following the extraction of one or more teeth, the residual alveolar ridge often presents with irregular bony projections, sharp spicules, undercuts, or uneven contours that would prevent the comfortable and stable seating of a removable prosthesis. The surgeon uses rongeurs, bone files, or rotary instruments to trim and smooth the bone to the desired contour, and the soft tissue is then repositioned and sutured over the recontoured ridge. Alveoloplasty may be performed at the time of extraction or as a separate procedure after initial healing has occurred.

The clinical indication for alveoloplasty extends beyond denture preparation. The procedure is also performed to improve ridge anatomy prior to implant placement, to eliminate bony exostoses or tori that interfere with prosthetic fit, and to correct ridge irregularities that cause chronic soft tissue irritation. When performed in conjunction with multiple extractions, alveoloplasty allows the surgical site to heal in a configuration that optimizes the prosthetic outcome from the outset, reducing the need for subsequent relines or adjustments. The procedure is typically performed under local anesthesia and may be combined with other surgical procedures such as soft tissue recontouring or socket preservation depending on the overall treatment plan.

Billing for alveoloplasty requires careful attention to the distinction between alveoloplasty performed in conjunction with extractions and alveoloplasty performed as a separate procedure, as these scenarios are assigned different CDT codes. When alveoloplasty is performed at the same visit as extractions in the same quadrant, some payers consider the bone smoothing to be included in the extraction fee and may deny the alveoloplasty code as a bundled service. Billing teams should review each payer's policy on bundling, submit a clear narrative describing the extent of bone recontouring performed, and attach radiographic or photographic documentation when available to support the medical necessity of the alveoloplasty as a distinct surgical service.