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An immediate denture is a complete denture or

removable partial denture fabricated for


placement immediately after the removal of
natural teeth


(Zarb,. Prosthodontic Treatment for Edentulous Patients, 12th Edition. Elsevier, 2003. 9).

Immediate Dentures:




Immediate Complete Denture
Conventional immediate denture

-the denture is intended to be relined to serve as the
long-term prosthesis.

Interim (or transitional) immediate denture (IID):

-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