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D1 Spring - Complete Removable Pros > 6 - 3/6: Immediate Complete Dentures > Flashcards

6 - 3/6: Immediate Complete Dentures Flashcards

1
Q

What is inflammatory papillary hyperplasia “IPH”?

A

A reactive tissue growth usually developing under a denture

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2
Q

Where does IPH occur?

A

On a hard palate beneath denture base

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3
Q

What is an IPH?

A

Asymptomatic red or pink nodules on mucosa of hard palate and occasionally the residual ridge

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4
Q

What is IPH directly related to?

A

Constant wearing of ill-fitting denture and poor oral hygeine

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5
Q

What is present in IPH combination syndrome?

A

Candida

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6
Q

What are two popular protocols for immediate dentures?

A

Conventional
Interim/transitional

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7
Q

What are conventional immediate dentures?

A

Reline the immediate denture after healing and ridge stable (6 months)
ONE DENTURE

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8
Q

What are interim/transitional immediate dentures?

A

Aim is to use for short period, then it is replaced by the definitive prosthesis when healing is complete
TWO DENTURES

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9
Q

What is hopeless?

A

Periodontal prognosis

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10
Q

When are immediate dentures fabricated?

A

Prior to extracting natural teeth

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11
Q

What did richardson JA view immediate complete dentures as?

A

Practical treatise on mechanical dentistry
- was considered “luxury treatment” for many years following

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12
Q

What is done in conventional/classic immediate dentures?

A

Refining/refitting

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13
Q

What is done in interim/transitional/nontraditional immediate dentures?

A

New CD is made

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14
Q

What are advantages to immediate complete dentures?

A

Prevent patient embarassment
Provide guide for optimal esthetics
Provide guide for OVD

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15
Q

What are advantages to immediate dentures as stated by the book?

A
  • maintenance of patient’s appearance
  • circumoral support, muscle tone, VDO, jaw relationship, face height maintained
  • tongue will not spread out as a result of tooth loss
  • less postoperative pain as extraction sites are protected
  • easier to duplicate the natural tooth shape and position
  • adaptation easier. Speech and mastication are rarely compramised, nutrition can be maintained
  • availability of tissue-conditioning material
  • patient’s psychological and social well being is preserved
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16
Q

What are disadvantages to immediate dentures?

A
  • Increased complexity - impressions, CJR
  • lack of clinical evaluation of trial denture-anterior esthetics
  • increased maintenance
  • greater number visits = more cost
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17
Q

What are disadvantages to immediate dentures as stated by the book?

A
  • more challenging
  • undercut anterior ridge
  • incorrect recording of CRP
  • no denture tooth try in
  • more chair time = additional appts
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18
Q

What are explanations to the patient concerning immediate dentures?

A
  • Do not fit as well
  • pain of extraction and sore spots
  • initial difficulty eating and speaking
  • unpredictable esthetics
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19
Q

What are the steps taken when making an immediate denture?

A
  • exam/diagnosis/ tx plan
  • preliminary impressions
  • secondary impressions
  • maxillo mand. relationship records
  • posterior trial placement
  • extractions - insertion
  • post insertion care
20
Q

What should you examine and diagnose in a patient?

A

Tori
Tuberosities
Frenal attachments

21
Q

What are the steps taken in two-phase surgical regiment?

A

Phase 1: remove posterior teeth, alveoloplasty, tuberosity reduction
Fabricate Denture
Phase 2: extract anterior teeth at denture insertion appointment

22
Q

What occurs during phase 1 surgery?

A

Removal of posterior teeth
Surgical correction of tuberosities
Wait 6-8weeks, begin fabricating the immediate denture

23
Q

What occurs during phase 2 surgery?

A

Extract anterior teeth
Labial frenectomy, if needed

24
Q

What are benefits of 2 phase surgery?

A

Simplifies clinical procedures
Reduces post-placement care
Improves denture comfort and retention

25
Q

What should you do during the diagnosis step?

A
  • determine patient’s expectations
  • educate patient about limitations of complete dentures and his/her role in successful outcome
26
Q

What are secondary impression techniques?

A

Stock tray
Custom impression tray
Combination
Campagna technique

27
Q

What makes border molding more difficult?

A

Presence of teeth

28
Q

What may make OVD determination easier?

A

Presence of anterior teeth

29
Q

What may make CJR registrations more difficult?

A

Malposed, drifted, mobile teeth

30
Q

What do you do during posterior trial placement?

A

Confirm correct mounting of casts
Confirm OVD is correct
Midline and incisal plane location - mark cast for reference

31
Q

How should you set anterior teeth?

A

Midline and incisal plane marked
Alternate tooth arrangement - set every other tooth
Minimal alveolar ridge modification

32
Q

When is the surgical template required?

A

If any alveoloplasty or bone smoothing is anticipated
Fabricated at wax elimination stage of processing

33
Q

When should you not schedule a surgery/insertion?

A

On a friday or day before a holiday or vacation

34
Q

What are the steps of extracting remaining teeth?

A

Alveoloplasty, frenectomy in anterior, if needed

35
Q

When should you reduce abutments and place amalgam?

A

Prior to extractions

36
Q

What are interim immediate denture steps?

A
  1. Make preliminary impressions for diagnostic casts
  2. Make a custom impression tray
  3. Border mold, make a final impression, mark the posterior seal, and carve it into the maxillary cast
  4. Make a record base/wax rim, make an interocclusal record, mount cast
  5. Set anterior denture teeth - alternating placement; complete posterior tooth placement
  6. Final wax, process, complete
  7. request a clear surgical guide, at the time the denture is processed
37
Q

How long should immediate dentures be worn for?

A

24 hours
If removed, may not be able to be reinserted for 3-4 days

38
Q

What will happen to immediate dentures during healing?

A

Loosen

39
Q

What are instructions for a patient who got extractions?

A

Soft diet
Some bleeding to be expected
may have swelling 3-4 days
Return to clinic next day; 24 hours post op

40
Q

What are instructions for a patient after surgery?

A

Do not remove until tomorrows appt
If it comes loose/out put it back in place immediately
Soft/liquid diet for 24 hours
avoid rinsing
take analgesic
expect red saliva

41
Q

What do you do during the 24 hour appointment?

A

remove and rinse denture
relieve any obvious pressure areas
evaluate retention and occlusion

42
Q

What do you do during the 72 hour appointment?

A

Evaluate extraction sites
Evaluate tissue, denture retention, oral hygeine

43
Q

What happens as tissue shrinks from denture contact?

A

Retention will usually decrease and require tissue conditioner

44
Q

What is decided after 4-6 months?

A

Reline/rebase/remake

45
Q

What should you do during the follow up?

A
  • use tissue conditioner to refit as needed
  • remove any socket convexities to avoid healing defects
  • reline or remake in 6-9 months

D1 Spring - Complete Removable Pros (18 decks)

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