Immediate Dentures

Question 1

Give some advantages of immediate dentures (11)

Answer 1

Guide for aesthetics
Speech
Function
Self esteem
Avoids drifting/tilting/overeruption of remaining teeth
Promotes health
Better adaptation to dentures
A guide for OVD
Post-extraction healing
Ridge form is preserved
Prevents collapse of facial musculature

Question 2

Give some disadvantages of an immediate denture

Answer 2

Temporary due to resorption - manage patient expectations
Increased complexity of prosthetic stages
Undercut areas problematic as no bone resorption at time of extraction

Question 3

Give some potential contraindications of an immediate denture

Answer 3

Some ORN/MRONJ areas
Sometimes pre-chemo/radiotherapy
Denture not required - no major aesthetic or functional deficit
Pathological issues eg - large cysts
Major fractures
Lack of consent
Dementia

Question 4

Describe the clinical stages of immediate dentures

Answer 4

Same sequence as for other dentures but occasionally skip and modify stages
Exam and assess - teeth to be removed
Medical history - MRONJ/ORN risk/anticoagulants
Sometimes need to coordinate with oral surgery/need for sedation

Question 5

What should be written on the lab card for immediate dentures?

Answer 5

Which teeth are to be extracted
Arrangement - overbite
Material
Data required for insertion

Question 6

Describe the initial aftercare of immediate dentures

Answer 6

Dentures to be kept in for 24 hours
Ideally review on day after insertion or soon after
Remove dentures and examine mouth for healthy clots, identify areas of inflammation
After 24 hours - advise warm saline mouthwash and patient to remove denture after mealtimes, to rinse mouth and clean denture - soft toothbrush, soap and water

Question 7

Describe the further aftercare of immediate dentures

Answer 7

Review after 1-2 weeks - further adjustment as required
May need denture fixative
Review after a month - assess adaptation
Consider temporary reline
May need repeat reviews, more temporary relines, soft or definitive relines
Usually replace at 6 months to a year depending on rate of resorption

Question 8

What are chairside relines?

Answer 8

Reline material directly placed in fitting surface of denture and moulded in the mouth
Can be used in localised areas

Question 9

Describe a one stage immediate denture

Answer 9

To replace one or two anterior teeth eg - trauma/abscess/root fracture
Upper and lower impressions recorded
High quality interocclusal record required to confirm occlusion
Choose shade
Prescription to laboratory including design and which teeth to be extracted
Extraction(s) and insertion of denture at next visit