Immediate Dentures

Question 1

what is inflammatory papillary hyperplasia and where does it occur

Answer 1

a reactive tissue growth usually developing under a denture
- occurs on hard palate underneath denture base

Question 2

describe the appearance of IPH

Answer 2

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

Question 3

IPH is directly related to:

Answer 3

constant wearing of ill fitting denture and poor oral hygiene

Question 4

with IPH ____ is frequently present

Answer 4

candida

Question 5

IPH can be related to?

Answer 5

combination syndrome

Question 6

what are the two protocols for immediate dentures

Answer 6

• conventional: reline the immediate denture after healing and ridge stable (6 months) ONE denture
• interim/transitional: aim is to use for short period, then it is replaced by the definitive prosthesis when healing is complete TWO dentures

Question 7

when are immediate dentures fabricated

Answer 7

prior to extracting natural teeth

Question 8

with a conventional/classic immediate denture _____ is done

Answer 8

relining/refitting

Question 9

with an interim/transitional immediate denture ___ is made

Answer 9

new CD

Question 10

what are the advantages of the immediate CD

Answer 10

• prevent patient embarassement
• provide guide for optimal esthetics
• provide guide for OVD

Question 11

what are the disadvantages of immediate dentures

Answer 11

• increased complexity- impressions, CIR
• lack of clinical evaluation of trial denture anterior esthetics
• increased maintenance
• greater number of visits - more costs

Question 12

what needs to be explained to patients about immediate dentures

Answer 12

• do not fit as well as normal CD
• the pain of the extractions in addition to the sore spots caused by the immediate denture will make the first week or two after insertion difficult
• will be difficult to eat and speak clearly
• the esthetics may be unpredictable because an anterior try in not possible

Question 13

what are the steps of an immediate denture

Answer 13

• exam/dx/tx plan
• prelim impressions
• secondary impressions
• maxillo-mand relationship records
• posterior trial placement
• extractions - insertion
• post insertion care

Question 14

what do you look for in the exam and dx

Answer 14

• tori
• tuberosities
• frenal attachments

Question 15

what is the two phase surgical regimen to maintain RPD abutment teeth

Answer 15

• phase 1: remove posterior teeth, alveoplasty, tuberosity reduction
• fabricate denture
• phase 2: extract anterior teeth at denture insertion appointment

Question 16

what is phase 1 in immediate CD

Answer 16

• removal of posterior teeth
• surgical correction of tuberosities
• wait 6-8 weeks, begin fabricating the immediate denture

Question 17

what is phase 2 in immediate CD

Answer 17

• extract anterior teeth
• labial frenectomy if needed

Question 18

what are the benefits of 2 phase surgery

Answer 18

• simplifies clinical procedures
• reduces post placement care
• improves comfort and retention

Question 19

what needs to be done at dx

Answer 19

• determine patients expectations
• educate pt about limitations of complete dentures and his/her role in successful outcome

Question 20

what are the secondary impression techniques

Answer 20

• stock tray
• custom impression tray
• combination
• campagna technique

Question 21

presence of teeth makes border molding ______

Answer 21

more difficult

Question 22

in max mand registrations presence of anterior teeth would may OVD determination:

Answer 22

easier

Question 23

in max mand registrations _______ would make CJR registrations more difficult

Answer 23

malposed, drifted, mobile teeth

Question 24

with RPD what comes after max mand relations

Answer 24

posterior try in NO anterior try in

Question 25

what happens in posterior trial placement

Answer 25

- confirm correct mounting of casts - confirm OVD is correct - midline and incisal plane location- mark the cast for reference

Question 26

after posterior try in what do you do

Answer 26

set anterior teeth

Question 27

what happens in setting anterior teeth

Answer 27

- midline and incisal plane marked - alternate tooth arrangement - set every other tooth - minimal alveolar ridge modification

Question 28

what is Jerbi's rule of third

Answer 28

minimal cast trimming

Question 29

when is surgical template used

Answer 29

if any alveoplasty or bone smoothing is anticipated - made at wax elimination stage of processing

Question 30

dont schedule surgery/ insertion on:

Answer 30

a friday of day before a holiday or vacation

Question 31

what do you do after the extraction of remaining teeth

Answer 31

- denture insertion - PIP - relieve any pressure areas - bilateral occlusal contacts

Question 32

when you place an immediate overdenture what do you need to do before

Answer 32

reduce abutments and place amalgam prior to extractions

Question 33

what are the interim immediate denture steps

Answer 33

- make preliminary impressions for diagnostic casts - make a custom impression tray - border mold, make a final impression, mark the posterior seal, and carve it into the maxillary cast - make a record base/wax rim; make an interocclusal record, mount caasts - set anterior denture teeth- alternating placement; complete posterior tooth placement - final wax, process, complete - request a clear surgical guide at the time the denture is being processed

Question 34

immediate dentures must be word for:

Answer 34

the first 24 hours without being removed by the patient

Question 35

if the immediate denture is removed before 24 hours

Answer 35

they may not be able to reinsert for 3-4 days due to swelling

Question 36

______ will remove dentures at 24 hour visit

Answer 36

the dentist

Question 37

immediate dentures will ___ during healing, tissue conditioners will be required

Answer 37

loosen

Question 38

______ after insertion at least a reline will need to be done, possible a remake

Answer 38

6-9 months

Question 39

what are the instructions to the patient after immediate CD

Answer 39

- soft diet, - bleeding expected - swelling 3-4 days - return to clinic the next day, 24 hour post op - dont remove until appt tomorrow - if it comes loose put back in immediately - avoid rinsing - take analgesic

Question 40

what happens at the 24 hour appointment

Answer 40

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

Question 41

what is done at the 72 hour appointment

Answer 41

- evaluate extraction sites - evaluate tissue, denture retention, oral hygiene

Question 42

what happens as tissue shrinks from denture contact

Answer 42

retention will usually decrease and require tissue conditioner

Question 43

when is occlusal correction done

Answer 43

remount- when patient is comfortable 2-3 weeks

Question 44

tissue conditioner changed when

Answer 44

as needed

Question 45

decision to reline/rebase/remake is made after:

Answer 45

4-6 months

Question 46

what is done at follow up

Answer 46

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