The document defines an immediate denture as a complete or partial denture fabricated and placed immediately after tooth extraction. Immediate dentures are indicated for patients requiring extractions who want to maintain aesthetics and function. Contraindications include medical conditions preventing multiple extractions. Advantages are maintaining appearance, nutrition, and mental wellbeing. Types include conventional (posterior teeth extracted first) and interim (all teeth extracted at once). Steps involve preparing the patient, extracting teeth from posterior to anterior, alveolectomy, suturing, inserting a tissue conditioner denture. Postoperative instructions focus on keeping the denture in place for 24 hours and limiting activity to promote healing. Follow ups occur at 24 hours, 48 hours
2. Definition
• An immediate denture is “a complete denture or
removable partial denture fabricated for placement
immediately after the removal of natural teeth/tooth”
(Zarb,. Prosthodontics) Treatment for Edentulous Patients, 12th Edition. Elsevier, 2003. 9)
.Immediate dentures are denture constructed before all of the
remaining teeth have been removed and denture inserted
immediately following removal of the remaining teeth.
4. Contraindications
Patients having blood disorders therefore multiple
extractions cannot be done.
Eg: Haemophilia,severe aneamia,Hep B,C.
.Cardiac patients having anti-plattelates drugs.
Eg: Aspirin
. Acute periapical or periodontal infections with swelling
of tissues and abscess.
5. Advantages
Maintenance of dental appearance and facial contour.
Minimising disturbances of mastication, maintains
Nutrition and speech.
Reduction in ridge resorption.
Maintenance of the patient’s physical and mental
wellbeing.
Circumoral support, muscle tone, vertical dimension of
occlusion, jaw relationship and face height can be
maintained.
Less postoperative pain is likely to be encounter because
the extraction sites are protected.
Easy to refit by relining.
7. Disadvantages
. The anterior ridge undercut that is caused by the presence of the
remaining teeth may interfere with the impression procedure.
The presence of different numbers of remaining teeth in various
locations frequently leads to recording incorrectly the centric
relation position.
No denture tooth try-in in precludes knowing what the denture
will actually look like on the day of insertion
Inability to complete a comprehensive trial stage.
Increased maintenance:
.Relining with soft Or hard materials.
.Occlusal adjustments.
.Addition of a labial flange to an open-face denture.
Short service life
9. According to timing of teeth
extraction and Denture purpose
1. Conventional Immediate Denture
The posterior teeth would be extracted and allowed to heal before
extracting the anteriors.
The Denture is intended to be relined to serve as long term prosthesis.
2. Interim Immediate Denture
All remaining teeth are extracted on that day and immediate denture
inserted on same day.
After healing is completed ,second new denture is fabricated and
inserted as long term prosthesis.
10. Steps from Surgery to insertion of the
Immediate Denture
First step: preparing the patient for the surgery in case patient suffering
from systemic diseases such as diabetes ,hypertension and blood disorders
precautions should be taken before starting the surgical procesdure so the
appropriate dental managements for each systemic disorders should be
performed.
Second step: extraction of the teeth that were decided in first
appointment and in case of multiple extraction of the posterior teeth start
with the posterior teeth towards the anteriors to prevent damaging the
wound and allow healing of the posterior area and improve adaptation of
the denture over the alveolus and tuberosity.
Third step: After extraction alveolectomy is done in the
area.Alveoloplasty preserving as much as possible the vertical hieght and
cortical bone.Elimination of the gross irregularity is completed the tissue
is approximated with digit preesure.
11. Steps Conti:….
Fourth step: Incision are closed with continuous
or interrupted sutures.use of sutures depends on
number of teeth extracted.
Fifth step: Use of tissue conditioner in the
denture for better retention and faster healing.
Final stage: Insertion
12. Post operative Instructions
>Leave dentures in your mouth for first 24 hours.
>Removing the denture will not decrease pain due to
extractions and if you removed the dentures,you may not
be able to reinsert the denture.
>Denture also acts as bandage and limiting the bleeding and
help preventing breakdown of blood clot that forms in the
socket.
>Avoid
.spitting,rinsing
.alcohol,smoking
.strenous activity that cause intraoral muscular activity.
13. Post Op: Conti:….
Hold Ice packs against the extraction area no more
than 20minutes per hour for first 24 hours may reduce
swelling.
After 24 hours use heat compress.
Diet for the first 24 hours should be restricted to
liquids and soft foods.
After first 24 hours dentures should be removed after
every meal for cleaning.
Take prescribed medicines as directed.
14. Appoinments after Insertion
It is important to review a patient with dentures after first
24 hours.
1-After 24 hours: General checkup is made to ensure no
major ulceration has occurred and the socket is healing
well.
2-After 48 hours: Patient is seen for sore spots.
3- After 1 week: More detailed checkup and occlusal
adjustment.
4- After 1 month: socket has healed and temporary
relining may be required.
5- 3 to 6 months: Management of loss of fitting due to
bone resorption and may require reline/rebase.
6- After 1 year: New denture is made in case of Interim
Immediate Denture.