Prosthodontics

Immediate removable
partial denture an
esthetic option

Abstract
|| Brief Background
In the present scenario patients are usually very cautious about
their dental aesthetics, especially those who are in direct contact
with the general public, such as teachers, doctors, executives,
social workers etc. The immediate denture is an aesthetic option
which enables them to interact without the fear of presenting
themselves as an edentulous patient. The article presents cases
of edentulous patients and their rehabilitation.
|| Materials and Methods
The treatment planned consisted of extraction of hopeless teeth
and their replacement with suitable removable partial dentures.
|| Discussion
Both the patients fall within the category of the individuals seeking immediate rehabilitation of edentulous state, one patient
was teacher and the other a social worker. Both the patients
wanted immediate replacement of the maxillary anterior teeth.
So an immediate temporary partial denture was constructed for
them.
|| Summary and Conclusions

Dr. Lakshya Kumar

Lecturer

From the patients point of view, the preservation of the natural

appearance of a person is of major importance. The aim of this
clinical case series is to present cases in which aesthetics is maintained for social and psychological wellbeing of the patient.

Correspondence Address
Dr. Lakshya Kumar
Department of Prosthodontics
Faculty of Dental Sciences
C.S.M Medical University
Lucknow, Uttar Pradesh

|| Key Words
Immediate denture, dental prosthesis, temporary partial denture

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|| Introduction
An immediate denture is a dental prosthesis constructed
to replace the lost dentition and associated structures
of the maxillae and mandible and inserted immediately
following removal of the remaining teeth.1 This can
be partial or complete interim, immediate denture
prosthesis. The main advantage of immediate denture
is that it helps in maintaining psychological status
of the patient. There are some contraindications to
immediate dentures, such as cardiac, endocrine, and
blood disturbances, slow healing potential, acute
periapical or periodontal diseases, extensive bone loss,
or mental incapacity, indifferent and uncooperative
patients.

Depending on the clinical conditions the patients were

advised to go for extraction of the respective teeth
and later on replacement by immediate partial denture
prosthesis. Case 1was a teacher by occupation and
she was quite adamant and did not want to remain
edentulous for any length of time as it was quite
embarrassing for her. Patient 2 was a social worker
and she also wanted a quick replacement of the
teeth. Both the patients were very cooperative and
philosophical.

|| Case Presentation
Case 1
A 17 year female patient reported to the Department of
Prosthodontics with the chief complaint of correction
of broken front teeth. On clinical examination it was
diagnosed that the patient was partially edentulous
having faulty partial denture for teeth 12, 21 and 22.
The condition of 11 was compromised with periapical
bone loss and periodontal abscess.(Fig.1 a) Medical
history was non-significant.

fig 1 (a)

Fig. 1 a,b:

Pre -operative intraoral view (case 1,2)

fig 2 (a)

Case 2
A 28 year female patient reported to the department
of Prosthodontics with the chief complaint of missing
maxillary anterior teeth. On clinical examination the
patient had missing 11 and mobile 21. The patient
wears RPD for the missing 11 but it was fractured
somehow. The condition of 21 was peridontically
compromised .(Fig.1b). Medical history was noncontributory.

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fig 1 (b)

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The patients were referred to the department of

periodontics for oral prophylaxis. After complete
scaling the primary impression of the maxillary and
mandibular arch was made in irreversible hydrocolloid
(Zelgan 2002, Dentsply, India) impression material for
both the patients. The casts were articulated with
the help of intercuspation of the remaining teeth to
a mean value articulator. The proper shade and size

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of teeth were selected and teeth arrangement was

completed; while arranging the anterior teeth the
natural tooth was trimmed from the cast and artificial
teeth were placed respectively. Artificial anterior teeth
were arranged in such a fashion that it reflected the
position of the patients natural teeth. While arranging
anterior teeth we estimated the amount of ridge to be
removed from the stone model3.

The maxillary and mandibular wax up was completed,

invested and dentures were cured. The teeth planned
for extraction were extracted on the very next
appointment and the patient was referred back to
the Department of Prosthodontics for partial denture
insertion (Fig 2a,b). The maxillary partial dentures were
inserted and checked for areas of excessive pressure
and adjusted (Fig 3a,b). The patient was given
postoperative homecare instructions, which include:
not removing the denture for 24 hrs, the use of
analgesics and ice packs, if necessary, and appointed
the next day for postoperative examination and any
needed adjustments.( Fig. 4). The patients were
satisfied with the aesthetics of the partial denture (Fig.
5 a,b).

fig 2 (b)
Fig 2 (a,b): After tooth extraction

fig 4 (a)

fig 3 (a)

fig 4 (b)

fig 3 (b)
Fig. 3 a,b:

Fig. 4 a,b:

Immediate denture inserted

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Patient one week post operative

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45

1) Compatibility
environment;

with

the

surrounding

oral

2) Restoration of masticator efficiency;

3) Harmony with the functions of speech, respiration
and deglutition;
4) Aesthetic acceptability; and
5) Preservation of the remaining tissues.4
For the dentist it is a challenge to accomplish the
requirements in immediate denture service. To
accomplish these requirements, it is mandatory that
each patient be analyzed and evaluated on an individual
basis. The best patient for immediate dentures is the
philosophical type. Their motivation for denture is
the maintenance of health and appearance, and they
accept replacement of natural teeth that cannot be
saved as a normal procedure. These patients overcome
conflicts and organize their time and habits in an orderly
manner. They eliminate frustrations and learn to adjust
rapidly. The philosophic patient will listen to and carry
out instructions in an intelligent manner. Their mental
attitude contributes to a favourable prognosis for the
immediate denture.5 The advantages are:

fig 5 (a)

1. Patient does not have to suffer through edentulous

period
2. Reduced pain and swelling
3. Current aesthetics retained in dentures
4. Patient adapts rapidly
5. Good speech and appearance are retained
6. Patient does not develop undesirable habits and is
more cooperative emotionally
7. Acts as a bandage to control haemorrhage,
promotes rapid healing
8. Provides for minimum social interruptions and
maximum psychological advantages.
Disadvantages:
1. The procedures are time consuming and require
more appointments, particularly during the
adjustment phase.

fig 5 (b)
Fig. 5 a,b: Extra oral view of patient

2. The resorption is faster than the healed tissue. So

frequent relining is required to keep the denture in
a functional state.

|| Discussion
The patients vary greatly in what they want, expect and
demand. To attain the maximum degree of success,
the following requirements should be satisfied:

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Another limitation of the immediate denture is that

the laboratory technician may not have sufficient
space to position the teeth correctly and aesthetically.

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The soft tissue and overall ridge are very full at the time
of extraction, but after several weeks the resorption is
accentuated.6

Co-authors

|| Conclusion
The fabrication of removable partial denture is quite
a simple procedure. It should be performed in a daily
practice because it is an easy method to achieve
aesthetics for such demanding conditions.

Dr. Kamleshwar Singh

Assistant Professor

Dr. Rajesh Kumar Nigam

Intern

Dr. Jitendra Rao

Associate Professor

|| References
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5th ed. Philadelphia: Lea & Febiger 1993, p.486-8.

2.

Ashok Soni. Use of loose fitting copper bands over

extremely mobile teeth while making impressions for
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3.

Rodney D. Phoenix JeffreyD. Fleigel, Cast modification

for immediate complete dentures: Traditional and
contemporary considerations with an introduction of
spatial modeling. J Prosthet Dent 2008; 100:399-405.

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4.

Jonkman RE, Van Maas MA, Kalk W. Satisfaction

with complete dentures and complete immediate
overdentures. A 1-year survey. J Oral Rehab 1995;
22:791-6.

5.

Gotlieb A, Askinas S. An atypical immediate denture: A

clinical report. J Prosthet Dent 2001; 3:241-3.

6.

Gardner LK, Parr GR, Rahn AO. Modification of

immediate denture sectional impression technique using
vinyl polysiloxane. J Prosthet Dent 1990; 64:182-4.

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4/29/2013 11:53:02 AM

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