IMMEDIATE DENTURE

Dr Muhammad Rizwan Memon

F.C.P.S (Pak) S.C.H.S (KSA)
Assistant Professor
 Definition
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)
 What's the difference between conventional
dentures and immediate dentures

Complete dentures are called "conventional" or

"immediate" according to when they are made and when
they are inserted into the mouth.

Immediate dentures are inserted immediately after the

removal of the remaining teeth. To make this possible,
the dentist takes measurements and makes the models of
the patient's jaws during a preliminary visit.
 Types
Based on the Number of Prosthesis:

a) Conventional/ classic ID: the denture is intended to be

relined to serve as the long-term prosthesis.

b) Interim/ transitional ID: after healing is completed, a

second, new complete denture is to be fabricated as
the long-term prosthesis.
 Indications
• Patients with few remaining anterior or
posterior teeth are indicated for extraction.
• Physically & mentally stable patients
• Social personality
• Economically affordable
 Contraindications
• Patients with poor general health
• Terminally ill patients
• Post-irradiated jaws
• Blood disorders
• Psychological disorders
• Uncooperative patients
 Advantages
 Maintenance of a patient's appearance. Psychological advantage
(patient is spared from inconvenience & stress of edentulousness)
 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.
Natural teeth aid in vertical relation positioning & selecting artificial
teeth.
 Adaptation easier. Speech and mastication are rarely compromised, and
nutrition can be maintained
 Serve as a splint i:e reduces pain, control bleeding, protect the healing
socket from trauma.
 Less TMJ disturbances.
 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

 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
• 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 .
 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.
 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
Instructions to patient
Do not remove until tomorrow's appointment
If it comes loose/out put it back in place
immediately
Soft/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
THANK U