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immediate dentures n.
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IMMEDIATE DENTURES

IMMEDIATE DENTURES

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IMMEDIATE DENTURES

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  1. IMMEDIATE DENTURES

  2. Definition The glossary of prosthodontic terms defines an immediate denture as a complete or removable partial denture constructed for insertion immediately following the removal of natural teeth.

  3. ADVANTAGES OF IMMEDIATE DENTURES • Maintenance of • Appearance • Circumoral support • Muscle tone • Occlusal vertical dimension • Jaw relationships • Facial height • Tongue will not spread out as result of tooth loss

  4. Less postoperative pain & bleeding • Extraction sites protected • Pressure from denture base • Easier to duplicate natural tooth shape & position • Easier Adaptation • Speech, mastication rarely compromised • Nutrition can be maintained

  5. DISADVANTAGESOF IMMEDIATE DENTURES • More challenging modality than complete dentures • The presence of teeth makes impressions and maxillomandibular positions more difficult to record. • Expensive, time consuming, adjustments • Trial for anterior teeth not possible

  6. DISADVANTAGES • More challenging to set teeth • Less space for teeth as ridge resorption hasn’t occurred • Alveolar ridge undercuts around remaining teeth may make impressions more difficult • Unstable or inadequate occlusion can make recording centric position difficult

  7. Basic over view of an  immediate denture fabrication

  8. History taking • Dental history patients needs & expectations • Medical history

  9. Preliminary examination • Oral examination Jaw relation and occlusion • Radiographic examination

  10. Determine if OVD requires change at diagnosis appointment Use physiologic rest, interocclusal space measurements

  11. Preliminary Impressions and Diagnostic Casts • Impressions are made using irreversible hydrocolloid (alginate) in stock metal or plastic trays.

  12. Dual impression

  13. Fabrication of custom tray and final impression • Block out minor undercuts • Ensure tray flange not too far from vestibule • After border molding, should not lock into place

  14. Jaw relation records -Record base & occlusion rim used if unstable cast/contacts (wobbles, rocks)

  15. Jaw Relation Records • Determine OVD • Use physiologic rest, interocclusal space measurements • If anterior teeth are missing, use rims only to determine OVD, not incisal display • Once mounted, determine overbite, incisal display required

  16. Tooth Set-up and Try-in

  17. Extraction and Insertion

  18. THE DENTURE MUST BE FULLY SEATED • Otherwise occlusion will be unacceptable • Once fully seated, adjust occlusion as needed • Provide post insertion instructions • Verbal • Written – patient brochure

  19. Instructions to Patient • Do not remove until 24 hour appointment • If it comes loose/out replace immediately • Soft/liquid diet for 24 hours • Avoid vigorous rinsing • Take analgesic as prescribed • Expect red saliva

  20. 24 Hour Appointment • Remove and clean denture

  21. Relieve sore spotsDo not use PIP – use indelible stick Gross occlusal adjustment

  22. 1 Week Recall Appointment • Relieve sore spots • Use PIP • Refine occlusion – possible remount

  23. Continuing Care • Tissue conditioner to improve retention as needed • Remove any socket convexities to avoid healing defects • Reline or remake in 4 to 6 months • Postpone as long as patient can tolerate to ensure most of initial resorption complete