An immediate denture is a removable partial or complete denture fabricated immediately after tooth extraction. There are two types: a conventional immediate denture intended for long-term use after relining, or an interim immediate denture that will later be replaced. Immediate dentures provide benefits like maintaining appearance and function during healing but require more skill to fabricate and fit due to tissue changes. Patients should expect pain, difficulty eating and speaking initially, and need relines or a remake in 6-9 months after healing is complete.
An immediate denture is a removable partial or complete denture fabricated immediately after tooth extraction. There are two types: a conventional immediate denture intended for long-term use after relining, or an interim immediate denture that will later be replaced. Immediate dentures provide benefits like maintaining appearance and function during healing but require more skill to fabricate and fit due to tissue changes. Patients should expect pain, difficulty eating and speaking initially, and need relines or a remake in 6-9 months after healing is complete.
An immediate denture is a removable partial or complete denture fabricated immediately after tooth extraction. There are two types: a conventional immediate denture intended for long-term use after relining, or an interim immediate denture that will later be replaced. Immediate dentures provide benefits like maintaining appearance and function during healing but require more skill to fabricate and fit due to tissue changes. Patients should expect pain, difficulty eating and speaking initially, and need relines or a remake in 6-9 months after healing is complete.
-after healing is completed, a second, new complete denture is to be fabricated as the long-term prosthesis.
(Zarb, George A. Zarb. Prosthodontic Treatment for Edentulous Patients, 12th Edition. Elsevier, 2003. 9.1).
Immediate RPD Normally made of acrylic with ball clasps
No posterior teeth only acrylic bite pads
Transitional
Replaced after healing with cast RPD Advantages Maintenance of a patient's appearance
Circumoral support, muscle tone, vertical dimension of occlusion, jaw relationship, and face height can be maintained. The tongue will not spread out as a result of tooth loss
Less postoperative pain is likely to be encountered because the extraction sites are protected
Easier to duplicate (if desired) the natural tooth shape and position
Adaptation easier. Speech and mastication are rarely compromised, and nutrition can be maintained
(Zarb, George A. Zarb. Prosthodontic Treatment for Edentulous Patients, 12th Edition. Elsevier, 2003. 9.2.1).
Disadvantages Immediate dentures are a more challenging
The anterior ridge undercut that is caused by the presence of the remaining teeth may interfere with the impression procedures
The presence of different numbers of remaining teeth in various locations frequently leads to recording incorrectly the centric relation position
No denture tooth try-in in precludes knowing what the denture will actually look like on the day of insertion
more chair time, additional appointments, and therefore increased costs
(Zarb, George A. Zarb. Prosthodontic Treatment for Edentulous Patients, 12th Edition. Elsevier, 2003. 9.2.2). Explanation to the Patient Concerning Immediate Dentures
Do not fit as well as normal complete dentures.
The pain of the extractions, in addition to the sore spots caused by the immediate denture, will make the first week or two after insertion difficult.
It will be difficult to eat and speak initially
The esthetics may be unpredictable because an anterior try-in is not possible
(Zarb, George A. Zarb. Prosthodontic Treatment for Edentulous Patients, 12th Edition. Elsevier, 2003. 9.4.3.1).
Explanation to the Patient Concerning Immediate Dentures
Immediate dentures must be worn for the first 24 hours without being removed by the patient. If they are removed, they may not be able to be reinserted for 3 to 4 days. The dentist will remove them at the 24-hour visit
Immediate dentures will loosen during healing, tissue conditioners will be required
6 to 9 months after insertion at least a reline will need to be done, possibly a remake . The patient is responsible for fees.
Technique Examination/Diagnosis/Treatment Plan Informed consent Oral hygiene procedures Extract (usually all) posterior teeth Wait 4 weeks for healing
Technique Preliminary impressions Final impressions Jaw relation records Tooth set up and try in Extraction and insertion Post insertion care Examination/Diagnosis/Treatment Plan
Assess tissue undercuts (especially in the anterior maxilla -reduce during extractions -use 2 piece tray for impression Is VDO correct? Imitate or change tooth arrangement for esthetics or denture stability -midlines, occlusal plane, vertical overlap, length of maxillary incisors Conventional or transitional Technique Examination/Diagnosis/Treatment Plan Informed consent Oral hygiene procedures Extract (usually all) posterior teeth Wait 4 weeks for healing
Preliminary impressions
Use dentate or partially edentulous stock trays Final Impressions Normally need to use 2 piece custom tray If no large tissue undercuts may be able to us 1 piece custom tray 2 piece tray
1 piece tray
Jaw relation records
Tooth set up and try in
Extraction and insertion Have lab complete set up and modify cast as directed. -use perio probing to guide cast modification
Extraction and insertion Request a surgical stent (guide) Extraction and insertion Extract teeth Use surgical guide to contour ridge Seat the denture -try not to use of PIP -check for over extensions
THE DENTURE MUST BE FULLY SEATED
Adjust occlusion Give post insertion instructions
Timeline for insertion appointment 0-15 (min) -review med history and LA 15-60 -extractions 60-75 -move patient to pros cluster 75-120 -insert and adjust -instructions Instructions to patient Do not remove until tomorrow's appointment If it comes loose/out put it back in place immediately Sot/liquid diet for 24 hours Avoid rinsing Take analgesic Expect red saliva 24 hour appointment Remove and clean denture Relieve sore spots Do not use PIP
1 week Relieve sore spots Use PIP Refine occlusion
Follow up Use tissue conditioner to refit as needed Remove any socket convexities to avoid healing defects Reline or remake in 6 to 9 months