Week 1- Immediate Dentures

Question 1

Why may a patient need an immediate denture?

Answer 1

• Perio with many mobile teeth
• Generalised neglect- rampant caries
• Collapsed dentition- no posteriors

Question 2

What are the advantages of immediate dentures?

Answer 2

• No period of edentulism
• Less pain with denture
• Protection of extraction sites
• Pt can masticate food
• Immediate appearance change

Question 3

For fabrication of conventional dentures, how long should you wait after extracting teeth?

Answer 3

3 months

Question 4

What are the clinical steps of immediate dentures?

Answer 4

1. Examine pt, send for OPG and take primary impressions.
2. Take secondary impressions with special tray
3. Make wax rims (if occlusion unstable or collapsed bite)
4. Take jaw relations and shade of teeth
5. Send to lab asking technician to remove teeth to be extracted (can have extra appt to try in teeth that are already missing)
6. Extract teeth and insert denture
7. Review in few days

Question 5

When do you take centric relation vs centric occlusion during bite registration?

Answer 5

CR: if you want to open VDO

CO: if you’re relying on pt biting down and teeth are contacting

Question 6

What are disadvantages of immediate dentures?

Answer 6

• No opportunity to look at aesthetics, speech, lip support etc
• The maxillary denture may not have retention as no posterior seal has been made.

Question 7

What additional step is required after fabrication of immediate denture?

Answer 7

Reline as denture will become very loose.

Question 8

When should a denture be remade rather than relined?

Answer 8

• Incorrect VDO
• Incorrect CR
• Lack of retention
• Speech, masticatory issures
• Poor aesthetics

Some problems cannot be solved with a denture reline

Question 9

What is the ADA item number for immediate tooth replacement?

Answer 9

736

Question 10

What are the 2 immediate denture impression techniques?

Answer 10

1. Single custom tray
2. Split impression technique (Posterior segment, Anterior segment)

Question 11

What is COE-SOFT?

Answer 11

Soft denture lining material

Question 12

When can two trays or sectional impression trays used for impressions?

Answer 12

When posterior teeth are not present

Question 13

What is two tray technique?

Answer 13

Special tray is used to capture edentulous ridge using greenstick & ZOE. Then, overall alginate impression can capture the teeth.

Question 14

What is the lab step following bite registration?

Answer 14

Remove teeth to be extracted from articulated models and set teeth into position.

Question 15

What is the purpose of a surgical clear stent?

Answer 15

To allow for adjustment of bony undercuts. If tissue blanches through stent, remove bone in that area.

Question 16

What are post op instructions for immediate dentures?

Answer 16

• Leave in dentures for at least 24hrs.
• Avoid smoking & exercise
• Ice packs for 20minutes per hour. After 24 hours, heat compress can be used.

Question 17

How is soft lining denture material used?

Answer 17

1. Mix powder & liquid together
2. Place denture for few mins
3. Remove denture
4. Trim excess
5. Tell pt to leave denture in for at least 24hours.

Question 18

What is the purpose of gum fitted teeth (no labial flange)? + Why is it problematic?

Answer 18

• Avoid fullness of upper lip
• Initially aesthetically pleasing
• Can be problematic for retention as denture isn’t sealed anteriorly.

Question 19

Why should dentures be left in mouth for 24 hours?

Answer 19

• If they are removed, swelling may occur and dentures may be unable to be reinserted.
• Denture also helps limit bleeding and enables clots to form in exo sockets.