Immediate dentures Flashcards
methods of transition?
immediate dentures
clearance of remaining natural teeth prior to making dentures
transitional partial dentures
overdentures
implants
- removable implant supported denture
what are factors to consider when providing dentures?
1) condition of remaining teeth and supporting tissues
- high incidence of caries
- few if any teeth considered restorable
- advances in generalised severe chronic periodontal disease - remove teeth to keep as much bone as possible for denture
2) improvement in appearance
3) resolution of malocclusion issues
4) natural teeth opposing edentulous ridge
- presence of ‘flabby’ upper ridge or potential to develop condition by retention of lower anterior dentition
5) age an health of pt
- reduction in adaptive capability
what are immediate dntures?
denture that will replace the teeth that the pt had following an extraction
can be a complete or partial existing denture
- may need a new denture down the line as resorption occurs
is an IR a new denture?
can be a new appliance (partial or complete) or as an addition to a denture already being worn
why reline denture post-extraction?
1) PT ability to eat after extraction
2) May have more bone resorption
- need to keep realigning denture due to bone resorption from extraction
- acrylic in area affected by bone resorption
- need to do temporary religns as healing occurs
explanation to pt for immediate denture?
1) they do not fit as well as complete dentures. may ned temporary relines with tissue conditioners and may require denture adhesives
2) they will cause discomfort. the pain of the extraction, in addition to the sore spots caused by the immediate denture, will make the first week r 2 after insertion difficult
3) it will be difficult to eat and speak initially
4) unpredictable aesthetics. without anterior try-in, the appearance of the immediate denture may be different from what you or the dentist expect
5) many other denture factors unpredictable… gagging, increased salivation, different chewing sounds and facial contour
6) it may be difficult or impossible to insert the immediate denture on the first day
7) must be worn for first 24 hours without removal - dentist removes
- if removed, cannot be reinserted for 3-4 days
8) denture may need relined within 6 months as the tissues change post extraction- fee for this
advantages of immediate dentures? - patient
- maintenance of dental appearance and facial contour
- minimise disturbance of mastication and speech
facilitate adaption to dentures
maintenance of pt well-being
advantages of immediate dentures? - dentist
reproduce jaw relationship from natural teeth
us key info regarding form and arrangement of the natural teeth
able to modify anterior teeth where appropriate
disadvantages?
1) case selection - overbite difficult
deep overbite (class II div2) and large overjet (class II div 1)
2) pt mist understand the need for early replacement 4-8 months
3) issues associated with maintenance of dentures
4) staged extraction - remove posterior
contraindications of extracting all teeth at once?
pt at risk of bacteraemia
pt with history of post extraction haemorrhage
- DOACS
gross oral sepsis
- multiple carious apical radiolucency’s - mass infection
- higher chance of dry socket post extraction
- important to achieve oral cleanliness before extraction
if in doubt contact pt GP
different tupes of flange?
full depth
partial depth
when to go for partial extension?
reduced ridge and full in uncomfortable for pt
e.g. anterior flange missing
why avoid partial flange/
pt can get use to partial flange, when they have full flange replacement denture, harder to adapt to this
stages in PR?
1) pt assessment
- what are the pt expectations
- take primary imp using stock tray
- alginate
- cast
prescribe for occlusal rim
partial occlusal rim to regular dimensions on light cured acrylic base
2) bite registration
- prescription for second imps
- design denture
- especially important if cant be hand articulated
3) second imps
final decision on teeth
-prescription for try-in
- if many teeth need replaced already
- don’t need try-in if no teeth are extracted yet
- be clear on prescription what teeth need to be added to denture
4) try-in (if there are pre-existing edentulous area?
what to do if you have not extracted any teeth yet?
if only posteriors, is it worth doing a try-in?
