Immediate dentures - clinical & laboratory procedures Flashcards
What is an immediate denture, and what treatment options are considered when replacing failing teeth?
A denture made and fitted immediately after the extraction of one or more teeth—extraction and insertion occur on the same day.
Treatment options include:
- No treatment—allow exfoliation.
- Extract teeth and wait 6–12 months before denture.
- Extract and start denture immediately—won’t fit well due to healing sockets.
- Preferred: Construct denture ahead, indicate teeth for extraction, extract + fit on same day.
What are the main advantages of immediate dentures?
Maintain aesthetics, speech, function, self-esteem immediately post-extraction
Prevent tooth drifting, tipping, overeruption
Preserve ridge form and facial structure
Improve adaptation to dentures
Promote better healing
Act as a guide for occlusal vertical dimension (OVD) and aesthetics
What are the main disadvantages of immediate dentures related to fit, technical issues, and patient factors?
Fit:
Impression made while teeth still present
Poor fit as sockets heal unpredictably
Frequent relines needed
Must manage expectations early
Technical:
Difficult impressions (mobile/misaligned teeth)
Occlusion issues (drifted/tilted teeth)
No try-in for aesthetics if anterior teeth involved
Acrylic only; no immediate chrome
Insertion over fresh sockets can be difficult
Patient Factors:
Cost: Pay twice (immediate + final denture)
Time: Many appointments (initial, eases, reline, final)
Adaptation can be hard, esp. for new wearers
Risk of premature extractions (pain/infection)
Can’t trial aesthetics beforehand—irreversible if dissatisfied
What design features and clinical assessments are important for immediate dentures?
Design Considerations:
Flange design (full, gum-fitted, half flange) influenced by undercuts and lack of resorption
Adjust design to account for expected healing changes
Clinical Assessment:
Full history (medical & dental)
Check for MRONJ risk, anticoagulants
Radiographs as needed
Assess mobility, caries, periodontal status
Decide if referral for extractions is needed
Clinical stages are similar to conventional dentures but may need modifications
What is the recommended immediate and long-term aftercare for immediate denture patients?
Immediate Aftercare:
Leave denture in for 24 hours
Review ideally the next day: remove denture, check healing, ease if needed
After 24h: remove after eating, rinse with warm saline, clean denture with soft toothbrush, soap and water
Follow-Up:
1–2 weeks: Ease denture, consider fixatives
1 month: Check tissue adaptation
Chairside reline (e.g. coe-soft) if needed
Multiple reviews may be required
Replace denture at 6–12 months, depending on bone resorption
What are chairside relines and when is a one-stage immediate denture used?
Chairside Relines:
Temporary/soft/definitive
Placed directly into fitting surface
Fill space between tissue and denture during healing
Can be repeated multiple times
One-Stage Immediate Denture:
Used to replace 1–2 anterior teeth in emergencies (e.g. trauma, fracture)
Visit 1: Consent, impressions, jaw reg, shade selection, lab prescription
Visit 2: Extractions + fit
Visit 3: Review
What information must be communicated to the lab, and what steps occur during the fitting of an immediate denture?
Lab Communication:
State it’s an immediate denture
List teeth to extract
Specify tooth arrangement, overbite, shade, mould, material, date required
Technician marks long axes → helps reset teeth after “sawing off” during lab work
In the Clinic (Fitting Day):
Verify denture teeth match planned XLA
Give LA, extract teeth
Consider socket management (sutures)
Fit denture (adjustments likely)
Post-op instructions and schedule review
