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Immediate Dentures 2013

Lecture to undergraduate students to cover the basics on immediate dentures.

Damien Walmsley

on 6 November 2013

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Transcript of Immediate Dentures 2013

Immediate Denture
may be defined as a denture that is made prior to the extraction of the natural teeth and which is inserted into the mouth immediately after the extraction of those teeth
Understand the need for immediate dentures
Minimise the potential disadvantages
Importance of communication
Informed consent from patient
The Clinical Decision
Leave the teeth
Prepare the patient
for IR dentures
Extract the teeth and
immediately replace them
with a denture usually anterior teeth
Try and keep teeth
When immediate dentures are proposed, patients should be advised of the necessity for early relining and/or remaking with associated additional visits and extra costs
Immediate Dentures can be

additions to partial dentures
transitional immediate dentures

new dentures, complete or partial,
to replace teeth that are missing
and/or to be extracted
What are Immediate Dentures?
Immediate Dentures
Professor Damien Walmsley

Providing Immediate Dentures
Further reading
Dental Update - Immediate dentures
Paper 1 - Treatment Planning
Paper 2 - Clinical Stage of Construction
Linked Lectures
Additions and Repairs

Relines, rebases and soft linings
On ecourse
Resources & References
May be considered
for overdenture abutments
Usually where large no. of teeth present
Extract the posterior teeth
Provides a stable site for IR denture
Teeth have a poor prognosis temporarily kept for transition to denture wearing
on balance it will help the patient
History and examination
Provisional Diagnosis and Treatment Plan

Preliminary impressions
Preliminary alginate imps for study casts
Provision of New Immediate Dentures
Master impressions

teeth cleansed of debris, plaque & calculus
impressions in alginate
Jaw registration

If sufficient tooth contact for jaw relationship,
interocclusal record is taken with shade and mould of teeth
If insufficient tooth contact,
occlusal rims will be required

Instructions to Laboratory

Teeth for extraction indicated on working casts
If immediate restoration is partial denture,
specify undercuts which must be blocked out
Instructions to set up artificial teeth in edentulous spaces for trial insertion in mouth
Try in ***

Check the occlusion & aesthetics
Teeth to be extracted are still present (REMEMBER COMMUNICATION)
Arrangements for tooth extraction

Preparations of cast before processing

dentist is responsible for removing teeth from cast and preparing it to receive artificial teeth.
depends upon bone levels and previous measurements
Extraction of teeth

Insertion of Dentures (KISS)
Minimal alterations remember patient has gone through a traumatic experience and will want to leave and go home ASAP

Dentures should not be removed for 24 hours
Post extraction instructions are given as normal
24 hrs

Dentures removed from mouth and cleaned with brush, soap and water
Mouth is examined for areas of soreness
Border overextension checked
Excessive pressure from denture base
Any obvious occlusal discrepancies

Oral and denture hygiene is given together with patient handout
1 week
All factors at 24 hour review checked again with evaluation and adjustment of occlusion

1 month
Possible soft lining (viscogel)

3 months
Will need a possible soft lining

6 months
An acrylic reline, chair side or laboratory based
12 months remake
Possible use of copy dentures
The Clinical Decision
The Clinical Decision
The Clinical Decision
Bone levels around teeth
is determined by using
periodontal probe & radiographs
Flanged Denture
Increased stability & retention
Improved strength
Tooth arrangement can be altered
No interference with sutures
Stable appearance
Easier relining
May produce unnatural fullness of lip
patient may not like appearance

Bony labial undercuts may prevent use of a full flange
Socketted (open-faced) denture
Is it any good?
Teeth sit into sockets of extracted teeth
Aesthetics good initially
Retention poor
Uneven ridge - Contra-indicated in Mandible
Loss of aesthetics as resorption continues
Difficult to reline/rebase or addition of flange
May produce unnatural fullness of lip and patient may not like appearance
Bony labial undercuts may prevent use of a full flange
Bone levels
around teeth
is determined by using periodontal probe
& radiographs
Bone levels
around teeth
is determined by using radiographs & periodontal probe
During the treatment always remember to

Remind the patient that temporary relining will be necessary at a review in near future


that permanent relining or the construction of new dentures will be necessary at a later stage
Why are IR dentures a good thing for patients ?

Maintenance of the soft tissue contour of the face
Maintenance of mental and physical well being
Aid the process of adaptation to dentures
Why are IR dentures a good thing for clinicians?

Use of existing occlusion for jaw registration procedures
Aesthetic Considerations
Disadvantages of IR dentures

Co-operation of the Patient
Increased Cost
No trial denture stage possible
Gross Irregularities of Teeth
Surgical and Anaesthetic Difficulties
Full transcript