COMPLETE DENTURES - IMMEDIATE DENTURES Flashcards
immediate dentures
prothesis that is fitted immediately after extraction or modification of teeth
replaces the missing/modified teeth and where required adjacent hard and soft tissue
factors in assessing progression to immediate dentures
is a current partial denture available (could be used as a transitional denture)
history of nausea
can extractios be phases
undercuts
indications for immediate dentures
whehn remaining teeth are a health risk
when fewer visits are essential
when teeth are so misaligned or over erupted that transitional dentures are impossible to provide
when the status and prognosis for the remaining teeth is hopeless
ad of immediate dentures
maintain appearance
ability to duplicate existing teeth shape shade etc
able to maintain ICP and occlusal face height
prevent tongue spread in lower arch
initial protection of tooth sockets
what can be used to duplicate anterior tooth position
silicone index
techniciton can reproduce appearane of teeth
aids lip support natural apperance and speech
prevention of tongue spread and encroachment on neutral zone
if immediate dentures not fitted when posterior teeth are extracted muscles of the tongue can lose tone
- future denture wearing may be impacted as rehabilitation may be requried to adjust to denture teeth
how do immediate dentures protect tooth sockets
will aid haemostasis
reduce blood clot disturbance
reduce food impaction
disadvantages of immediate dentues
- Pain and discomfort
- Difficulty in predicting amount of bone loss post extraction
- Initial lack of patient proprioception due to anaesthesia
- Increased long term costs as relines and remakes necessary within a short timeframe
- Inability to check aesthetics at try in stage if mobile, drifted or over-erupted teeth
pain and predicting post surgery bone loss
fitting surface of immediate dentures can cause sig trauma to bony ridges
difficult to predict bone/soft tissue loss on extraciton
considerations when tx planning for immediate dentures
1) consent and alternatives
2) medical considerations
3) status of remaining dentition and complicating anatomical factors
4) jaw relationships, OFH and existing occlusion
5) radiographic investigations
6) surgical procedures
status of remaining dentition and complicating anatomical factors
1) presence and extent of caries
- determines teeth to extract
2) presence and extent of periodontal disease
3) periapical infections
4) number of remaining teeth
5) Tori and significant bony undercuts
- may affect denture base extension and design
if pt does not have a stable and reproducible ICP position and acceptable OFH how do you make the dentures in
centric relation
simple extractions effect on socket post extraction
more predictable post extraction ridge shape esp with teeth with conical roots
PP depth influences soft tissue collapse into the socket so probing depths useful
surgical extraction effect on socket post extraction
sig amount of bony socket may be lost
creates an unsightly gap if sockets are underprepared
over-preparation easier to correct as excess acrylic can be removed
alveolectmy and alvelotomy
- used to be used when a significant bony undercut was present in the anterior region preventing the use of a labial flange
- involved the removal of interproximal bone and forced collapse of labial bony plate]
