Immediate Dentures Flashcards
(35 cards)
4 advantages of immediate dentures?
- Maintain appearance.
- Continuity of denture wearing - maintain skills and familiarity of denture wearing.
- Maintenance of vertical and horizontal jaw relationships.
- Denture covering extraction socket may protect initial bloodclot.
How do immediate dentures maintain pre- extraction information (3)?
- Tooth mould, shade, arrangement.
- OVD.
- Appearance.
5 case selection criteria for immediate replacement dentures?
- Leave only straight forward extractions for IR - surgicals not ideal.
- May need to coordinate around sedation or even GA appointments.
- Always advise patient before starting treatment that denture will become loose and will require replacement - FINANCIAL IMPLICATION.
- Require regular review.
- Can patient cope (financially, physically and emotionally).
2 instances where you would consider taking molars out and providing an immediate denture?
- Molar was the one tooth maintaining the OVD and you want to copy it.
- Molar had a clasp that was critical in retaining the existing denture.
3 things to consider when providing immediate dentures?
- Take molars out first and allow healing.
- Number of teeth to be replaced (risk of haemorrhage, post extraction swelling, how much LA you may have to administer).
- Healed areas.
3 types of immediate replacement dentures? (flange type).
- Flanged (border seal + engage undercut thus IMPROVE RETENTION).
- Part flange
- Open face (undercut in buccal sulcus, bone very bulky).
Advantage of full flange?
- Maintain border seal.
- Engage any undercut.
thus IMPROVE RETENTION.
What surgical extractions could you provide an immediate denture after? What flange design?
- After extractions and bone removal (septal or radical alveolectomy).
- FLANGED.
2 advantages of a flanged denture?
- Retention (engages undercuts)
- Aesthetics.
What is a case we would consider an OPEN FACE immediate replacement denture?
- BULKY UPPER ANTERIOR ALVEOLAR RIDGE.
- Cannot utilize undercuts for retention as too deep.
- Flange would give too much support to upper lip “fat lip”.
2 downsides of open face dentures?
- Resorption of ridge will lead to gap between denture and ridge.
- Transition from flangeless area to flanged aesthetically difficult.
What may be a better option than an open face denture? Why?
- Partial/ part flange as it would cover the gap between tooth and ridge that would develop after resorption.
What other cases other than complete edentulous may a IR denture be provided?
- PARTIAL denture - usually 1-2 ANTERIOR teeth.
- Can either be a new partial immediate denture or an IR addition to an existing denture.
What determines whether you will make a new partial immediate denture or make an IR addition to an existing denture?
How well the existing denture FITS.
Patient lost 2 anterior teeth. Already has a partial denture that fits decently well. What is done?
- Temporary additions of lost teeth.
- New well-fitting dentures after 6 months (healing).
Patient lost 2 anterior teeth. Already has a partial denture that fits badly. What is done?
- Make a new immediate replacement denture.
- Warn patient that the denture will start to become loose and gaps may develop in the denture where the teeth were removed.
- Will likely require replacement after 6 months - COST IMPLICATION.
Why do we need to fix deep overbites in denture wearers?
Would cause denture instability.
6 instructions to give to the lab for immediate dentures?
- Which teeth are to be extracted.
- Arrangment.
- Shade
- Flange type (part. full, flangeless).
- Material.
- Date for denture insertion/ extractions.
When setting teeth in wax for immediate dentures, why do we do one side and then the other?
Help judge:
- Incisal level
- Labial fullness
What must be done prior to extracting teeth for immediate dentures?
BEFORE giving LA check that dentures are ready and have correct teeth added on.
2 things to be mindful with when trying in immediate dentures right after extraction?
- Removing and re placing dentures often as that can cause bleeding from sockets.
- Placing the denture in with too much force as it can b hard to remove + may cause trauma.
Why do we ideally want patients to wear IR for 24 hours after insertion?
- To prevent the tissues from swelling overnight and patient unable to reinsert them in the morning.
Aftercare for IRs (4)?
- Dentures to be kept in for 24hrs - post op instructions.
- Review appointment ideally on day after insertion.
- After 24 hr: warm saline mouthwash for full week post extraction.
- Patient should remove denture after meals, rinse mouth and clean denture (soft toothbrush, soap and water).
What do we check in the review appointment after extractions for IR?
If the day after:
- Check for healthy clots in the sockets.
- Identify any areas of inflammation and ease denture.
- Check for trauma around sockets and in the sulci.
