Immediate Complete Denture

IMMEDIATE
DENTURE
Guided by- Presented by-
Dr. Mallika Shetty Dr. Snigdha Saha
Contents
• Introduction • Indications
• Contraindications
• Definitions • Advantages
• Disadvantages
• History
• Diagnosis and
• Classifications
treatment planning
• Requirements
• Treatment • Post insertion care
• Review of literature
Preliminary impression
• Summary
Final impression • Conclusion
Maxillomandibular relation
Laboratory procedures
Denture insertion
INTRODUCTION
• Advances in therapy have helped patients with periodontal
disease retain part of their natural dentition for an extended
period of time. These patients can be well served by properly
designed removable partial dentures.
• At some point the periodontal condition of the remaining teeth

may deteriorate to the extent that a complete denture should be
considered
Winkler S, editor. Essentials of complete denture prosthodontics. Year Book Medical Pub; 1988. 3 rd edition- 2015, p- 476
For the patient facing the loss of all his or her
remaining natural teeth, there are 3 treatment options
Conventional
complete denture
Interim complete
denture
Conventional
immediate
complete denture
Winkler S, editor. Essentials of complete denture prosthodontics. Year Book Medical Pub; 1988. 3 rd edition- 2015, p- 476- 491
GPT-9
any fixed or removable dental prosthesis fabricated for placement
immediately following the removal of a natural tooth/teeth
Boucher
• Dentures constructed before all the remaining teeth have been removed
and inserted immediately after removal of all the remaining teeth.
Heartwell
• A dental prosthesis constructed to replace the lost structure and the
associated structures of maxilla and/ or mandible and inserted immediately
following the removal of remaining teeth.

History
• As early as 1860 , Richardson described the use of immediate
dentures.
• Campagna 1968 used full arch tray with holes cut out for remaining
anterior teeth for final impression.
• Raczka and Esposito( 1995): “jiffy dentures”/ IID.
Raczka TC, Esposito SJ. The" jiffy" denture: a simple solution to a sometimes difficult problem. Compendium of continuing education in
dentistry (Jamesburg, NJ: 1995). 1995 Sep 1;16(9):914-6.
CLASSIFICATION
1. CONVENTIONAL (classic)
IMMEDIATE DENTURE (CID)
This is a type of immediate denture
which, after it is made and healing is
completed, the same denture is refined or
relined to serve as long term prosthesis.
Zarb GA, Bolender CL, Eckert SE, Jacob R, Fenton A, Mericske-Stern R. Prosthodontic treatment for edentulous patients. Complete
dentures and implant-supported prostheses. 12th. ed. St. Louis: Mosby. 2004.
2. INTERIM OR TRANSITIONAL OR NON-
TRADITIONAL IMMEDIATE DENTURE (IID) :
This is a type of immediate denture in which after the healing is
completed, a second new complete denture is fabricated as long term
prosthesis.
Zarb GA, Bolender CL, Eckert SE, Jacob R, Fenton A, Mericske-Stern R. Prosthodontic treatment for edentulous patients. Complete dentures and
implant-supported prostheses. 12th. ed. St. Louis: Mosby. 2004.
Conventional type-
• Posterior teeth are extracted first leaving the first premolars. After 3-6
weeks, anterior teeth are extracted.
Transitional type-
• No teeth are extracted prior to the construction. The denture is
constructed prior to and is placed immediately following the extraction
of all remaining natural teeth. It is indicate for apprehensive patients who
will not readily accept two or more surgical procedures.
Zarb GA, Bolender CL, Eckert SE, Jacob R, Fenton A, Mericske-Stern R. Prosthodontic treatment for edentulous patients. Complete dentures and
implant-supported prostheses. 12th. ed. St. Louis: Mosby. 2004.
Diagnostic dentures
• Used primarily to diagnose a patient’s problem. The

anterior segment contains the artificial teeth, while the
posterior segment consists of flat occlusal blocks made of
plastic resins
Zarb GA, Bolender CL, Eckert SE, Jacob R, Fenton A, Mericske-Stern R. Prosthodontic treatment for edentulous patients. Complete dentures and implant-
supported prostheses. 12th. ed. St. Louis: Mosby. 2004.
There are 3 schools of thought in regard to
the construction of a labial flange for ICD
Labial flange
Partial flange type
Flangeless immediate dentures
Immediate denture service ; Arthur M Lavere and Arthur J . Krol ;( JPD Jan 1973 vol 29 no 1) 19/135
Labial flange
Indications Contraindications
No large Pronounced undercuts

anterior bony are present in the
undercuts are anterior labial region.
present
The lip line and
lip activity are
normal Immediate denture service ; Arthur M Lavere and
Arthur J . Krol ;( JPD Jan 1973 vol 29 no 1) 19/135
Partial flange type
When undercuts are present The patient has an unusual lip

on the labial and buccal activity
sections of the residual ridge
Immediate denture service ; Arthur M Lavere and

Flangeless Immediate Denture
When deep undercuts are When periodontal disease exist with

present substantial amount of bone loss
A high lip line and an active When an anterior fixed partial
lip denture has been worn resulting in
an uneven contour of anterior
residual ridge
Immediate denture service ; Arthur M Lavere and
Requirements
According to Heartwell,
Compatibility with surrounding oral environment
Restoration of masticatory efficiency within limits
Function in harmony with the activity necessary in

speech, respiration and deglutition
Esthetic acceptability
Preservation of tissues that remain

Indications
• Dentulous or partially edentulous patients whose remaining teeth are
periodontally compromised and needs to be extracted.
• Patient who are socially active
• Wish to retain their natural appearance immediately after extractions.
Zarb GA, Bolender CL, Eckert SE, Jacob RF, Fenton AH. Prosthodontic treatment for edentulous patients: complete dentures and
implant supported prosthesis. 13th ed. Elsevier:2013;pg.281-90.
Contraindications
Patient with a disease of debilitating nature
Patients for whom multiple extractions might be unwise because of
systemic conditions
Indifferent unappreciative patients
Patients with acute periapical or periodontal pathosis

Patients who have to undergo surgery in the anterior region for the
remkval of deeply embedded teeth.
Zarb GA, Bolender CL, Eckert SE, Jacob RF, Fenton AH. Prosthodontic treatment for edentulous patients: complete dentures and implant supported
prosthesis. 13th ed. Elsevier:2013;pg.281-90.
Advantages
Patient’s There will be no time where he or she will be
perspective
without teeth. Patients are less apprehensive and
therefore able to continue their social and
business activities without embarrassment.
Digestive It remains uninterrupted as the patient is not
function
without teeth at any time. However, the diet is
limited for a short period following insertion of
prosthesis.
Winkler S, editor. Essentials of complete denture prosthodontics. Year Book Medical Pub; 1988. 3 rd edition- 2015, p-
476
General Less affected as there is only a minimal change
appearance
in muscle tone and the occlusal vertical
dimension can be maintained
Unfavourable speech and chewing habits are not
likely to occur
Tongue is not given the chance to enlarge
Winkler S, editor. Essentials of complete denture prosthodontics. Year Book Medical Pub; 1988. 3 rd
edition- 2015, p- 476
Ridges
Less resorption will take place
Resultant ridges are better preserved
Patient
the patient becomes adjusted to the change
recovery
(extraction and wearing a denture) more
quickly.
Controls hemorrhage, prevents contamination and
Matrix
provides a protective covering over the wound.
or
It can be used to maintain medications in place.
bandage
Patient experiences less pain.
Artificial Can be set in identical position once occupied by the
teeth natural teeth
Size, shade, shape can be duplicated
Unwanted diastemas and rotations can be eliminated

with the natural teeth as a guide.
Disadvantages
Following insertion,
the alveolar bone and The immediate denture should be
soft tissue will relined or remade in six minths to
remodel in and a year following insertion. The
around the extraction dentist should inform this to the
sites. patient prior to the start of the
treatment.
as the healing
proceeds and
resorption occurs, the
denture will not fit as
well.
Winkler S, editor. Essentials of complete denture
prosthodontics. Year Book Medical Pub; 1988. 3rd
edition- 2015, p- 476
Treatment with an immediate
complete denture is more
costly.
There can be no anterior try-

in. the aesthetics of the
immediate denture cannot be
evaluated until the insertion
appointment.
Winkler S, editor. Essentials of complete denture prosthodontics. Year Book Medical Pub; 1988. 3 rd edition-
2015, p- 476
Diagnosis and Treatment Planning
• Is defined as the determination of the
Diagnosis nature, location and cause of the
disease.
Treatment • Is a consideration of all diagnostic findings

that have a bearing on the pre-operative
planning treatment to the post insertion treatment.
Heartwell CM, O’Rahn A. Textbook of complete dentures. Hamilton, Ont.: BC Decker Incorporated; 2002. p- 437-479
Patient Consultation
examination interview
Heartwell CM, O’Rahn A. Textbook of complete dentures. Hamilton, Ont.: BC Decker Incorporated;
2002. p- 437-479
• Patient examination should include
1. Visual and digital examination
2. Local and systemic conditions
3. Roentgenographic study
4. Accurately articulated study casts
5. An appraisal of any existing prosthesis and all anatomic entities
that influence the procedures.
In the Consultation Interview, the dentist appraises the
patient’s mental attitude and their expectations, wants, and
past dental history and determines existing systemic
conditions of which the patient is aware.
2002. p- 437-479
• Local factors evaluated by roentgenographic study, accurately
articulated study casts, and visual and digital examination include:
Condition of the tooth to be

extracted
Position of the teeth
Presence of bony or tissue undercuts that must be reduced or
eliminated. Exostosis that might interfere with the denture fabrication
Endodontically
Multi-roots Ankylosed roots
treated roots
Hooked or embedded or
Hypercementosis
curved roots Impacted
These may require extensive surgery which might effect the prognosis
Heartwell CM, O’Rahn A. Textbook of complete dentures. Hamilton, Ont.: BC Decker Incorporated; 2002. p- 437-
479
Systemic Status
• Necrosis, osteoporosis and xerostomia in patients with poorly controlled diabetes.
• Poor clotting mechanism in patients with cardiovascular and cerebrovascular

diseases.
• Mucosal disorders, psychogenic symptoms of burning tongue or palate
• Keratotic lesions
• Osteoporosis
• Adult rickets
Past Dental History
• Dental experience related to missing natural teeth are essential
information.
• Hemorrhagic tendencies, excessive swelling, excessive post-operative

pain and or allergic reaction to local anaesthetics when the teeth were
extracted must be evaluated.
Diagnostic mounting of pre-extraction
casts
• They serve as pre-extraction record
• Patient’s existing midline and modification of it’s

position
• Many immediate denture will require modification

of opposing teeth to correct the occlusal plane or
to eliminate prematurity in centric relation.
2002. p- 437-479
To evaluate whether patient’s existing
maximum occlusal position coincides
with the planned centric relation postion
for immediate denture
To estimate the angle’s

classification of occlusion for the
patient
Consultation Interview
Based on the patient’s mental attitude,
they can be
Philosophical
Exacting
Indifferent
Hysterical
Heartwell CM, O’Rahn A. Textbook of complete
dentures. Hamilton, Ont.: BC Decker Incorporated;
2002. p- 437-479
What to expect from the denture?
They may not fit very well; they need temporary linings with tissue
conditioners.
The esthetics maybe unpredictable.

Immediate dentures must be worn for the first 24 hours without
removal by the patient . If they are removed they may not be able to
reinsert it for 3-4 days.
Because supporting tissue changes are unpredictable, immediate
dentures will become lose over time.
Heartwell CM, O’Rahn A. Textbook of complete
dentures. Hamilton, Ont.: BC Decker Incorporated;
2002. p- 437-479
Treatment
Preliminary impression
Final impression
Record of the maxillo-mandibular relation
try-in
Surgery and insertion
Post-operative instructions
Preliminary impressions
• Fabrication of cast
• Fabrication of custom
tray
Fabrication of cast
• Used for diagnosis and treatment planning
• Identify irregularities in the opposing arch that could create occlusal instability
when the immediate denture is made.
• Evaluate the bone and soft tissue undercuts and evaluate the frenum attachments.
• Definitive treatment planning cannot be considered until all diagnostic aids are
evaluated.
Zarb GA, Bolender CL, Eckert SE, Jacob RF, Fenton AH. Prosthodontic treatment for edentulous patients: complete dentures and implant
supported prosthesis. 13th ed. Elsevier:2013;pg.281-90.
Fabrication of custom impression tray
• Regardless of the technique, the clinician will identify a peripheral

extension to which the custom tray should extend.
• Then a custom tray is fabricated with appropriate amount of spacer

between the natural teeth and the impression tray.
• Relief of about 1-3mm is given.
Management of loose teeth
• Loose teeth can be blocked-out by

adding periphery waxat the
cervical areas
• By generously applying a lubricating

medium to the teeth.
Soni A. Use of loose fitting copper bands over extremely mobile teeth while making impressions for immediate dentures. Journal of Prosthetic
Dentistry. 1999 May 1;81(5):638-9.
Lee, H., & Park, C. (2009). A method to make a preliminary impression of mobile teeth. The Journal of Prosthetic Dentistry, 102(1), 52–53.
•The impression technique described
combines elastomeric impression materials
and irreversible hydrocolloid to make an
accurate preliminary impression of
extremely mobile and misaligned teeth.
Lampraki, E., Chochlidakis, K. M., Rossopoulos, E., & Ercoli, C. (2016). An alternative impression technique for mobile teeth. The Journal of Prosthetic
Dentistry, 116(4), 492–495.
Dentistry, 116(4), 492–495.
Lampraki, E., Chochlidakis, K. M., Rossopoulos, E., & Ercoli, C. (2016). An alternative impression technique for mobile teeth. The Journal of Prosthetic Dentistry,
116(4), 492–495.
Dentistry, 116(4), 492–495.
Dentistry, 116(4), 492–495.
Final Impression
Two Using a single impression tray

fundamental
techniques
Using a double impression tray
Single impression tray technique
• This technique may be used when anterior and or posterior teeth

remain.
• It is most useful when the teeth maintain their positional stability and
would not be displaced by the impression.
• If the soft tissue is compressible, the remaining natural anterior teeth

will act as a tray stop while making the impression.
• This technique may require border molding in the
edentulous areas to establish the full peripheral extension.
• Once border molding is established, the final impression is

made using an elastomeric impression material.
Double Impression tray technique
An impression tray is used in the posterior portion to record

the soft tissues only
This tray would then be indexed in such a way that it would

connect to an anterior tray that would record the anterior teeth at
rest
• This approach is particularly effective when the anterior teeth are quite
mobile.
• The difficulty with this technique is the indexing of the two segments.
• The more stable the indexing  better the technique will perform.
• To accomplish this,
1. The anterior segment maybe extended in such a way as to capture a large
segement of the posterior tray.
2. Specific irregularities on the occlusal surface of the posterior segment may be

made.
Campagna Impression Technique
Campagna SJ. An impression technique for immediate dentures. J Prosthet Dent. 1968; 20(3):196-203.
Posterior palatal seal
• Regardless of the impression technique, the posterior limit of the
maxillary complete denture must be established.
• The technique for doing so is identical to that used in complete

dentures.
Zarb GA, Bolender CL, Eckert SE, Jacob RF, Fenton AH. Prosthodontic treatment for edentulous patients: complete dentures
and implant supported prosthesis. 13th ed. Elsevier:2013;pg.281-90.
Maxillomandibular relation records
Wax rims are

fabricated to
Fabrication of
proper height and
denture base
Undercut areas
width
around teeth are
blocked out with
wax
Zarb GA, Bolender CL, Eckert SE, Jacob RF, Fenton AH. Prosthodontic treatment for edentulous
patients: complete dentures and implant supported prosthesis. 13th ed. Elsevier:2013;pg.281-90.
The record base and occlusal rims are
tried in for patient
comfort
An evaluation of patient’s
existing vertical dimension is
accomplished
The occlusion rims are trimmed

to desired vertical dimensions of
occlusion
Zarb GA, Bolender CL, Eckert SE, Jacob RF, Fenton AH. Prosthodontic treatment for
edentulous patients: complete dentures and implant supported prosthesis. 13th
ed. Elsevier:2013;pg.281-90.
Facebow Transfer, Protrusive records And Articulation
Zarb GA, Bolender CL, Eckert SE, Jacob RF, Fenton AH. Prosthodontic treatment for edentulous patients: complete dentures and implant supported prosthesis.
13th ed. Elsevier:2013;pg.281-90.
The centric relation record is made at a slightly increased vertical
dimension using a free –flowing medium on the occlusion rim such as
impression paste.
The centric relation record is removed from the mouth, trimmed, and
verified.
The mandibular cast is mounted using the centric relation record. A

protrusive interocclusal record is made to set the condylar guidance
on the articulator.
• Midline or newly selected midline is recorded on the land area of the
master cast, middle of the face should be considered for reference.
• The anterior plane of occlusion (using the inter- pupillary line as a

guide) is determined and marked on the base of the cast. In case
posterior teeth are present and are extruded, intraoral landmarks
corresponding to ala-tragus line is marked.
Laboratory procedures
The immediate denture differs from the traditional denture in that

the cast must be modified to represent the anticipated changes that
will occur with surgical removal of teeth
Richardson DW. Dental laboratory procedures: Complete dentures, vol 1| Robert M. Morrow, DDS, Kenneth D.
Rudd, DDS, and John E. Rhoads, DDS, St. Louis, 1986, The CV Mosby Co., p-413-424
Tooth Selection, Arrangement Of Posterior
Teeth And Posterior Try In
Existing dentition is used to select the shade and mould.
Arrangement of posterior teeth in centric occlusion.
The trial denture bases are tried in the mouth and used to verify
vertical dimension of occlusion and centric relation record as with
complete dentures.
Richardson DW. Dental laboratory procedures: Complete dentures, vol 1| Robert M. Morrow, DDS, Kenneth D. Rudd, DDS,
and John E. Rhoads, DDS, St. Louis, 1986, The CV Mosby Co., p-413-424
Diastemas can be eliminated, slanted teeth can be
straightened, and the smile line can be modified for
improved esthetics.
These changes should be discussed with the patient,

since there is no opportunity to have an anterior try-in.
Richardson DW. Dental laboratory procedures: Complete dentures, vol 1| Robert M. Morrow, DDS, Kenneth D. Rudd, DDS, and
John E. Rhoads, DDS, St. Louis, 1986, The CV Mosby Co., p-413-424
Replacement of Anterior teeth
Alternate Removal and arrangement of

teeth
Arrangement of one side and then other

side
Richardson DW. Dental laboratory procedures: Complete dentures, vol 1| Robert M. Morrow, DDS, Kenneth D. Rudd, DDS, and John E.
Rhoads, DDS, St. Louis, 1986, The CV Mosby Co., p-413-424
Richardson DW. Dental laboratory procedures: Complete dentures, vol 1| Robert M. Morrow, DDS, Kenneth D. Rudd, DDS, and
John E. Rhoads, DDS, St. Louis, 1986, The CV Mosby Co., p-413-424
Richardson DW. Dental laboratory procedures: Complete dentures, vol 1| Robert M. Morrow, DDS, Kenneth D. Rudd, DDS, and John E. Rhoads, DDS, St. Louis, 1986,
The CV Mosby Co., p-413-424
Richardson DW. Dental
laboratory procedures:
Complete dentures, vol 1|
Robert M. Morrow, DDS,
Kenneth D. Rudd, DDS,
and John E. Rhoads, DDS,
St. Louis, 1986, The CV
Mosby Co., p-413-424
Richardson DW. Dental laboratory procedures: Complete dentures, vol 1| Robert M. Morrow, DDS, Kenneth D. Rudd, DDS, and John E. Rhoads,
DDS, St. Louis, 1986, The CV Mosby Co., p-413-424
Complete wax-up
is done and
prepared for
denture processing
Richardson DW. Dental laboratory procedures: Complete dentures, vol 1| Robert M. Morrow, DDS, Kenneth D. Rudd, DDS, and John E. Rhoads, DDS,
St. Louis, 1986, The CV Mosby Co., p-413-424
Cast trimming is done as
Denture is flasked in stone, wax prescribed by the dentist or
boiled out and flask is cooled. better yet completed by the
dentist.
Cast modification for immediate complete
dentures
By Standard
By Jerbi
Spatial remodelling
Phoenix RD, Fleigel JD. Cast modification for immediate complete dentures: traditional and contemporary considerations with an introduction of
spatial modeling. Journal of Prosthetic Dentistry. 2008 Nov 1;100(5):399-405.
Phoenix RD, Fleigel JD. Cast modification for immediate complete dentures: traditional and contemporary considerations with an introduction of spatial
modeling. Journal of Prosthetic Dentistry. 2008 Nov 1;100(5):399-405.
Phoenix RD, Fleigel JD. Cast modification for immediate complete dentures: traditional and contemporary considerations with an introduction of spatial
modeling. Journal of Prosthetic Dentistry. 2008 Nov 1;100(5):399-405.
A stock tray
Impression is
Cast is wet with loaded with
separated by
clear slurry water alginate is placed
directing a stream
to prevent the in position and an
of air between the
alginate from impression of the
cast and the
sticking flasked cast is
impression
made
Stone is poured in the impression to
make a cast
This cast will be used for the

fabrication of the surgical template
Richardson DW. Dental laboratory procedures: Complete dentures, vol 1| Robert M. Morrow, DDS, Kenneth D. Rudd, DDS, and John E. Rhoads, DDS,
St. Louis, 1986, The CV Mosby Co., p-413-424
Surgical template
• It is a thin ,transparent form duplicating the tissue surface of an
immediate denture and is used as a guide for surgically shaping the
alveolar process (Farmer,1983).
• To ensure that adaptation of the immediate denture to the edentulous

ridge is nearly identical to the adaptation of the denture to the trimmed
cast, a surgical template is recommended
Farmer JB. Surgical template fabrication for immediate dentures. The Journal of prosthetic dentistry. 1983 Apr 1;49(4):579-80.
It should be :
•Transparent.
Methods of fabrication:
•2mm thick to provide rigidity and

•Vaccum form method
uniform transparency.
•Sprinkle on technique
•Able to be seated securely in the
•Light cured clear material
mouth .
•Conventional (wax up, flasking and
heat processing)
Farmer JB. Surgical template fabrication for immediate dentures. The Journal of prosthetic dentistry. 1983 Apr 1;49(4):579-
80.
Cast and stone are painted with tin-foil
substitute, care being taken not to apply on
the ridge lap area of the denture teeth
Denture base resin is mixed according to

the manufacturer’s instructions and trial
packed to assure minimum flash
Denture processing
• After finishing and polishing, the dentures are stored
in water or 1:10 dilution of 5% to 6% hypochlorite
solution and water.
• Dentures with teeth that have a metal occlusal surface

should not be stored in sodium hypochlorite solution
PROBLEM CAUSE SOLUTION
Aesthetics of immediate 1. Denture teeth not placed 1. Place the denture teeth in
denture not acceptable in the position of the the same place as the
natural teeth. natural teeth as
2. Overcorrection has been acceptable
done 2. Avoid drastic corrections
which may result in poor
aesthetics
Immediate denture and Cast over trimmed prior to Judicious trimming is
surgical template do not packing the immediate mandatory
demonstrate good denture
adaptation on insertion
Denture insertion
Immediate dentures should be disinfected prior to the placement.
Pressure areas inside the denture (indicated by rocking) can be located

with pressure indicating paste and trimmed.
When occlusal prematurities are verified, a quick occlusal correction

is done to allow simultaneous bilateral contacts.
Heartwell CM, O’Rahn A. Textbook of complete dentures. Hamilton, Ont.: BC Decker Incorporated; 2002. p- 437-
479
• If immediate denture will be found inadequate retentive, a tissue
conditioning liner can be placed at this stage but the material should
not be allowed to get into the extraction sites.
Burlew foil' can be used to cover the extraction

sites for this procedure
Post-insertion care
The patient is seen 24 hours following insertion.
• The occlusion is checked with articulating paper or soft wax before the
removal of the denture.
• The denture is then carefully removed and the tissues are evaluated.
• Any ulceration from denture pressure or overextension from the base

should be relieved.
• The tissue surface of the denture is cleaned.
• The patient is asked to gently rinse with a mouthwash.
• Removal and re-insertion should be done as few times as possible

during this appointment.
After 48 hours the patient is seen again
• Everything done at the first appointment is repeated again.
• The patient is asked to clean the denture several times a day and to
utilize warm saline rinses.
• The patient should wear the denture at night for 3 days following
insertion.
• Diet at this point will include baby foods, cooked vegetables, chopped
meat, fish.
The patient is seen at one week following insertion
• Sutures, if utilized, are carefully removed.
• The occlusion is again checked for prematurities.
• The tissue surface of the denture can be evaluated with PIP.
• Specific complaints, if any, should be evaluated.
• If a tissue conditioner is placed at insertion, it should be replaced at this

time and every succeeding week until replaced with a resilient liner.
• After 3 to 4 weeks of healing, the patient is seen again.
• Subjective complaints are addressed.
• A clinical remount can be performed at this time.
• The occlusion is refined on the articulator.
• After the patient has worn the immediate denture for about 4 to 5
weeks and the extraction sockets have filled, treatment linings are
began with a resilient self-curing chairside liner.
• Besides providing greater comfort to the patient, this lining will keep
the denture in its normal relationship by preventing it from settling.
• The number of post insertion appointments, the patient will need
depends on many factors, including age, general health, tissue
sensitivity and the patient’s emotional and psychological state.
• The patient is instructed to call if he has any problems between

appointments.
• After 6 months the denture should be relined or remade.
• If the patient is satisfied with the aesthetics and function of the

denture, then a reline is adequate.
• If the patient has complaints about the aesthetics of the immediate

denture or it lacks adequate extension or retention, it must be remade.
Review of literature
The immediate overdenture.
• The use of remaining roots of teeth enhances denture stability and
retention. Teeth previously considered hopeless can now be used
successfully as an aid in denture retention.
• Here, an immediate denture is constructed using prefabricated male

and female attachments.
Feldstein S, Teitel M. The immediate overdenture. Journal of the American Dental Association (1939). 1976
Oct 1;93(4):775-8.
Comparing ridge resorption with various
surgical techniques in immediate dentures
• The three surgical techniques
1. simple tooth extraction
2. labial plate
3. intraseptal alveoloplasty.
• The conclusion of this study clearly indicated that simple

tooth extraction is the best surgical approach to be followed
to preserve as much of the residual alveolar ridge as possible.
Michael CG, Barsoum WM. Comparing ridge resorption with various surgical techniques in immediate dentures.
The Journal of prosthetic dentistry. 1976 Feb 1;35(2):142-55.
One-appointment construction of an immediate transitional
complete denture using visible light-cured resin
• A technique is described for construction of an immediate transitional

complete denture in one appointment using self-curing tooth colour and visible
light-cured resins.
• Conventional immediate denture therapy may be too prolonged for medically

or physically compromised patients.
• This alternative treatment reduces laboratory, dentist, and patient time, thereby
providing a fast and economical service.
Khan Z, Haeberle CB. One-appointment construction of an immediate transitional complete denture using visible light-
cured resin. The Journal of prosthetic dentistry. 1992 Sep 1;68(3):500-2.
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Immediate Complete Denture

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IMMEDIATE

• At some point the periodontal condition of the remaining teeth

following the removal of remaining teeth.

• Raczka and Esposito( 1995): “jiffy dentures”/ IID.

• Used primarily to diagnose a patient’s problem. The

Partial flange type

Flangeless immediate dentures

No large Pronounced undercuts

When undercuts are present The patient has an unusual lip

Immediate denture service ; Arthur M Lavere and

When deep undercuts are When periodontal disease exist with

Restoration of masticatory efficiency within limits

Function in harmony with the activity necessary in

Preservation of tissues that remain

• Patient who are socially active

• Wish to retain their natural appearance immediately after extractions.

Patients with acute periapical or periodontal pathosis

Tongue is not given the chance to enlarge

Resultant ridges are better preserved

teeth natural teeth

Size, shade, shape can be duplicated

Unwanted diastemas and rotations can be eliminated

There can be no anterior try-

Treatment • Is a consideration of all diagnostic findings

Condition of the tooth to be

• Poor clotting mechanism in patients with cardiovascular and cerebrovascular

• Mucosal disorders, psychogenic symptoms of burning tongue or palate

• Hemorrhagic tendencies, excessive swelling, excessive post-operative

• Patient’s existing midline and modification of it’s

• Many immediate denture will require modification

To estimate the angle’s

The esthetics maybe unpredictable.

Record of the maxillo-mandibular relation

Surgery and insertion

• Used for diagnosis and treatment planning

• Regardless of the technique, the clinician will identify a peripheral

• Then a custom tray is fabricated with appropriate amount of spacer

• Relief of about 1-3mm is given.

• Loose teeth can be blocked-out by

• By generously applying a lubricating

Two Using a single impression tray

• This technique may be used when anterior and or posterior teeth

• If the soft tissue is compressible, the remaining natural anterior teeth

• Once border molding is established, the final impression is

An impression tray is used in the posterior portion to record

This tray would then be indexed in such a way that it would

2. Specific irregularities on the occlusal surface of the posterior segment may be

• The technique for doing so is identical to that used in complete

Wax rims are

The occlusion rims are trimmed

The mandibular cast is mounted using the centric relation record. A

• The anterior plane of occlusion (using the inter- pupillary line as a

The immediate denture differs from the traditional denture in that

Arrangement of posterior teeth in centric occlusion.

These changes should be discussed with the patient,

Alternate Removal and arrangement of

Arrangement of one side and then other

This cast will be used for the

• To ensure that adaptation of the immediate denture to the edentulous

•2mm thick to provide rigidity and

Denture base resin is mixed according to

• Dentures with teeth that have a metal occlusal surface

Immediate dentures should be disinfected prior to the placement.