Immediate Dentures

Question 1

How can you convert from a dentate to edentulous state with dentures?

Answer 1

Inadequate dentition to immediate complete denture to permanent CD
OR
Lack of disease - Inadequate dentition to transitional partial denture to transitional complete denture to permanent CD
OR
Inadequate dentition - partial denture - complete overdenture - permanent compete denture

Question 2

Indications for immediate dentures?

Answer 2

When remaining teeth are a health risk (infec, RT)
When fewer visits are essential (cost, time)
When teeth are so misaligned or overerupted that transitional dentures are impossible to provide
When the status and prognosis for the remaining teeth is hopeless

Question 3

Contraindications to immediate dentures?

Answer 3

Elderly
Large bony undercuts
Difficult extractions

Question 4

Types of immediate complete dentures?

Answer 4

Labial flange - ideal to aim for

No labial flange

Question 5

Significant factors to record in assessment?

Answer 5

Current partial denture - use as transitional
History of nausea - Test with partial denture first
Undercuts - if severe prolonged surgery needed

Question 6

What to warn the pt of prior to tx?

Answer 6

Warn pt that immediate denture provided will not be permanent - it will be replaced by a permanent denture when resorption has slowed down and further expense will be incurred
Ensure there’s an adequate emergency follow up - post insertion pain is frequent so do not do them on a friday

Question 7

Steps to make an immediate denture?

Answer 7

Impressions
Registration
Wax try in
Silicone putty template records position of anterior teeth and is then retained = reproduction of anterior teeth site prior to processing
When try in is approved and template made = plaster teeth are cut from the model - level with the gingival margins
In the region of the removed teeth - residual undercuts removed and sharp edges sandpapered smooth
Modified models duplicated and clear acrylic surgeon’s guides are prepared and processed
Teeth extracted
Surgeons guides are placed over extraction sockets
Where blanching of the underlying tissues occurs, bone is removed
Insert dentures, correct occlusion defects

Question 8

How and when to review immediate dentures? (review programme)

Answer 8

1st day - adjust fitting surface and occlusion
1st week - correct pain, advise use of denture fixative if security is a problem
1st month - further corrections, temporary soft lining
6th month - permanent reline
12th month - replace with permanent dentures