Immediate dentures Flashcards
When should immediate dentures be prescribed?
When the remaining teeth are a health risk (infection/radiotherapy)
When fewer visits are essential (cost and time)
When teeth are so misaligned or overerupted that traditional dentures are impossible to provide
When the status and prognosis for remaining teeth are hopeless
What are the contra-indications for an immediate denture?
the elderly
Large bony undercuts
Difficult extractions
What are the different types of immediate denture?
Labial flange
No labial flange
conventional flange is the ideal to aim for
What is the problem with having a flange on an immediate denture?
Immediately after extraction there isn’t enough space for the flange - but dentures without flange dont provide good retention
May compromise temporarily and place flange once resorption takes place
What are the significant factors in the assessment of immediate dentures
Current partial denture - can it be used as a transitional, is it worth adding teeth on to the denture they have or is it not usable
History of nausea - test with partial denture first
Undercuts - if severe prolonged surgery will be needed
Prior to treatment what does the patient need to be told?
- warn patient that the immediate denture that will be provided will not be permanent
- That it will be replaced by a permanent denture when resorption has slowed down and further expense will be incurred
- Ensure that there is adequate emergency follow up - post insertion pain is frequent
when would you see the patient after fitting the immediate denture?
Ask them to come back the next day, tell them to not remove the denture for 24 hours - as they would have developed clots and will be messy
What are the steps for going from having a partial denture to making a complete immediate denture?
Posterior teeth extracted, can start procedure after healing 2-3 months after
After impressions a registration is carried out as for a parital denute then a wax try-in
The positions of anterior teeth are recorded by means of a silicone putty template which is adapted as far back as the molars - it is retained to allow reproduction of the site of the anterior teeth prior to processing
When try-in approved and template made, the plaster teeth cut from the model
In the region of the removed teeth, residual undercuts removed and sharp edges sandpapered
What are the steps for going from having a partial denture to making a complete immediate denture? after models are modified?
Models are duplicated and clear, acrylic surgeon’s guides are prepared and processed - used to help achieve haemostasis
Teeth extracted with minimal trauma
Surgeons guides are placed over the extraction sockets and where blanching of the underlying tissue the bone is removed
The dentures are inserted and any defects in occlusion corrected
Once denture fitted, cant be removed for 24 hours
When fitting the immediate denture, what do you do after 24 hours?
After 24 hours, gently remove, rinse with warm salted water can do some adjustments
Tissue conditioner - gel put in on the fitting surface of denture that adapts to the fitting surface and is comfortable - only work for week then peel it off
3-4 weeks to do a more permanent soft-tissue relin or hard re-line
What is the programme of review after fitting an immediate denture?
1 day - adjust fitting surface and occlusion
1 week - correct pain, advise use of denture fixative if security is a problem and a conditioner - gel lining that sits on the surface - makes retention more effective and more comfortable
1month - further corrections, autopolymerising additions, temporary soft lining
6 months - permanent reline
12 months - replace with permanent dentures
