Immediate Dentures

Immediate dentures
Nikita Aggarwal
1st yr pg
Department Of Prosthodontics
Contents
• Conventional immediate dentures
• Interim immediate dentures
• Avantages and disadvantages
• Indications & contraindications
• Clinical procedures
• Laboratory procedures
• Post operative care
Immediate dentures
• A complete or removable partial denture
fabricated for placement immediately
following the removal of natural teeth
-GPT
Immediate denture
Conventional Interim
Types of ICD based on buccal flange
• (i) immediate complete denture at the full labial buccal
flange, which has a vestibule portion identical to a
conventional denture; in this case, a surgical preparation of
the mouth vestibule filling is required;
• (ii) immediate complete denture with partial buccal flange
in which only the initial portion of the buccal side is made,
above the cervical edge of artificial teeth. This procedure
does not require bone surgery because it does not reach
the undercut area of the alveolar ridge;
• (iii) immediate complete denture without vestibule flange,
having teeth mounted directly on the!alveolar ridge (it
shows better aesthetic results but may fail to provide
adequate lip support when there is a bone resorption.
Advantages
• Prevents patient embarrassment .
• Promotes patient health
• Guide for esthetics
• Maintenances of ridge form
• Hastens adaptation to denture
Disadvantages
• Incorrect centric relation record
• No try in
• Complex clinical procedure
• Cost
Comparative advantages
• Conventional • Interim
• Better initial retention • One surgical visit
• Easier surgical session • Less time
• Overall cost less • Better complex
procedure
Contraindication
• Systemic conditions
• Mobile teeth
• Attitude and desire of patient
Diagnosis & Oral examination
• Medical evaluation
• Patient expectations
• Oral examination:
Tori , undercuts
Tuberosity
Mobility
Pre existing dentures
Tooth modification :
• Occlusal prematurities will interfere with guiding the
patient to centric relation.
Treatment planning
• Indications in conventional immediate dentures :
• When only few (anterior) teeth remain.
• Patient can function without posterior teeth 3-4
weeks.
• When 2 surgical visits are feasible.
• Indications of interim immediate dentures :
• When multiple anterior and posterior teeth remaining
• When remaining teeth + teeth supported removable
partial denture is present .
• When patient cannot go without partial denture or
remaining posterior teeth for functional and esthetic
reasons
Impression technique
• Single custom tray
• Split impression technique
Posterior segment
Anterior segment
Stock tray
Putty index
Preliminary Impression
• Tray selection
• Peripheral borders & palatal surface
• Posterior limit
• Loose teeth
Custom tray fabrication & final
impression :
• Single step custom tray impression
• Sectional custom tray impression
Single full arch impression
• Mainly for IID, also CID
• Block out teeth & undercuts
• Tray outline
• Resin is adapted
Sectional custom tray impression
• Only in CID
Anterior Posterior
Segment Segment
tray tray
• Draw the outline
• Block the undercuts
Posterior section- CD custom tray
Anterior section:
• Stock tray modified 1
• Custom tray
• Putty index
3
Jaw relation – CID
• Acrylic resin adapted
• Anatomical landmarks and teeth as guide
• Evaluate existing vertical dimension- if needed -Open
the bite
-Close the bite
• Centric relation
Verifying teeth & the jaw relations with
patient
• Confirm esthetic desires of patient

Midline
Lip line
Diastema
Rotated teeth
overlap
• Casts are marked with the information
• Discuss surgical and denture placement protocols

Laboratory phase:
In CID
Laboratory phase: in IID & CID
• Setting anterior teeth :
• Mark the teeth, remove
• Pencil line placed on labial surfaces of lower anterior
teeth indicates vertical overlap in natural dentition and
is guide for setting denture teeth.
• Shallow socket is scrapped in the cast indicating
gingival margin.
• Zero depth lingually, 2mm depth facially
• Overdenture abutments are trimmed to a dome shape
to approx- 3 mm above the free gingival margin or
slight.
• Trimmed areas smoothened
• Avoid removing incisive papilla
Boil out :
Surgical
template
Surgical template
Surgery
• Before surgical appointment - Reduction of over
denture abutments & sectioning of FPD are one if
required.
• Surgical template - Guides bone trimming.
• Denture is seated
• Pressure indicating paste is used
• If fit is not enough- tissue liner is used with Burlew foil
to cover extraction sites
Post operative instructions
First 24 HRS
• Avoid rinsing, drinking hot liquids alcohol.
• Ice packs – 20min on, 20 min off
• Do not remove the dentures, due to swelling,
premature removal will make re insertion difficult
• Diet- liquid, soft if tolerated
Recall after 24 hrs – clinical evaluation
• Ask patient for sore spots felt,

• Rinse the mouth, then remove dentures
• Check sore spots
• Pressure indicator paste
• Re evaluate denture –Occlusal discrepancy
Retention
First post operative week- instructions
• Wear immediate denture in night for 7 days after
extraction
CONCLUSION
• Immediate dentures are demanding for both the
patient and dentists, still they undoubtedly give the
patient a better treatment option so that his
esthetic and functional requirements are not
compromised even during the healing phase during
his transition to partial or total edentulism.

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• Confirm esthetic desires of patient

• Discuss surgical and denture placement protocols

• Ask patient for sore spots felt,

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