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IMMEDIATE DENTURESIMMEDIATE DENTURES
DefinitionDefinitionIs a dental prosthesis constructed to replace Is a dental prosthesis constructed to replace the natural teeth and associated structures the natural teeth and associated structures of the maxilla and / or the mandible and of the maxilla and / or the mandible and inserted immediately following tooth or inserted immediately following tooth or teeth removal. It may replace one tooth or teeth removal. It may replace one tooth or all the teeth in one arch or the two archesall the teeth in one arch or the two arches
RequirementsRequirementsA prosthesis is not a living tissue, but it must A prosthesis is not a living tissue, but it must be an accepted part of a system be an accepted part of a system composed of living tissuecomposed of living tissue
**Must be compatible with the surrounding Must be compatible with the surrounding oral environmentaloral environmental
**Restore function of masticationRestore function of mastication
* *Harmony with, speech, respiration and Harmony with, speech, respiration and deglutitiondeglutition
**Esthetically acceptedEsthetically accepted**Preservation of the remaining tissuesPreservation of the remaining tissues
It is a challenge to the dentist to accomplish It is a challenge to the dentist to accomplish these requirements, therefore each patient these requirements, therefore each patient must be analyzed and evaluated on an must be analyzed and evaluated on an individual basisindividual basis
AdvantagesAdvantages * *Act as a splint to help control bleeding, Act as a splint to help control bleeding,
protect against trauma from tongue , food protect against trauma from tongue , food and opposing teeth. Prevent mouth fluids and opposing teeth. Prevent mouth fluids and food particles from entering the and food particles from entering the sockets. Protect blood clotssockets. Protect blood clots
( ( Promote Rapid HealingPromote Rapid Healing))
**Supported lips cheeks and the tongue seem Supported lips cheeks and the tongue seem to regain adequate functions of to regain adequate functions of speech ,mastication and deglutitionspeech ,mastication and deglutition
**Less difficulty to make the polished surface Less difficulty to make the polished surface in compatible with surrounding musculaturein compatible with surrounding musculature
* *Natural teeth help to establish VDO and Natural teeth help to establish VDO and teeth replacement ????)precautions e.g teeth replacement ????)precautions e.g over eruption ,attrition ,false diminished over eruption ,attrition ,false diminished inter occlusal distance ,centric R &O(inter occlusal distance ,centric R &O(
DisadvantagesDisadvantages**Additional work and costAdditional work and cost
**No try-in )except delayed immediate(No try-in )except delayed immediate(**Less accuracy and permanence of fitLess accuracy and permanence of fit( ( In most cases advantages out-weight In most cases advantages out-weight
disadvantagesdisadvantages ) )
Diagnostic procedureDiagnostic procedure**Dental history, visual and digital Dental history, visual and digital
examination )bone loss around teeth, examination )bone loss around teeth, position of teeth, exostosis, under- cuts (position of teeth, exostosis, under- cuts (
**SystemicSystemicIf there is systemic complication may affect If there is systemic complication may affect components of healing or tissue components of healing or tissue regenerationregeneration
Mouth preparationMouth preparation**Scaling & curettageScaling & curettage
**Home care and mouth washHome care and mouth wash( ( to reduce bleeding and accelerate healingto reduce bleeding and accelerate healing))
One Step Immediate Complete One Step Immediate Complete Denture )interim C.I.D(Denture )interim C.I.D(
In some cases it is necessary to fabricate In some cases it is necessary to fabricate immediate denture without prior extraction immediate denture without prior extraction of posterior teeth e.g teeth are of posterior teeth e.g teeth are excessively loose ,causing severe pain or excessively loose ,causing severe pain or patient wants to reduce extraction visitspatient wants to reduce extraction visitsThis method not suitable for general practice This method not suitable for general practice and done in hospitaland done in hospital
ProceduresProcedures**Alginate impressionAlginate impression
**Mounting casts by the aid of wax inter-Mounting casts by the aid of wax inter-occlusal recordocclusal record
**Duplicate casts to aid in teeth settingDuplicate casts to aid in teeth setting**Remove teeth from casts, trim the ridges Remove teeth from casts, trim the ridges
and fabricate clear acrylic templateand fabricate clear acrylic template
**Process the dentureProcess the denture**Patient is admitted to hospital, remove Patient is admitted to hospital, remove
teeth, trim the ridge , deliver the dentureteeth, trim the ridge , deliver the denture**This technique gives successful results, its This technique gives successful results, its
main drawback being rapid resorption main drawback being rapid resorption renders the denture ill fit after few weeks renders the denture ill fit after few weeks and two relining are needed with the first and two relining are needed with the first three monthsthree months..
Two Step Complete Immediate Two Step Complete Immediate Denture )conventional C.I.D(Denture )conventional C.I.D(
**All posterior teeth are extracted except one All posterior teeth are extracted except one in each side and the denture is fabricated in each side and the denture is fabricated after 2 – 3 monthsafter 2 – 3 monthsProcedureProcedure
**Primary impressionPrimary impression**Final impression) single method or two Final impression) single method or two
stages method(stages method(
**Face- bow & mounting, arrange posterior Face- bow & mounting, arrange posterior teeth, try –in to verify posterior teeth teeth, try –in to verify posterior teeth arrangementarrangement
**Modify the master cast by removing the Modify the master cast by removing the teeth and contouring the ridge in cases teeth and contouring the ridge in cases with maxillary protrusion or under-cut and with maxillary protrusion or under-cut and clear acrylic template is fabricatedclear acrylic template is fabricated
* *Process the dentureProcess the denture
**Extract anterior teeth and surgical Extract anterior teeth and surgical procedure is done )alveoplast(procedure is done )alveoplast(
**Insert the denture, adjust, patient's Insert the denture, adjust, patient's instructionsinstructions
Delayed Immediate DenturesDelayed Immediate Dentures
**These dentures are inserted few days after These dentures are inserted few days after teeth extractionteeth extraction
**The waxed up dentures are tried in the The waxed up dentures are tried in the mouth with zinc euginol paste or mouth with zinc euginol paste or elastomeric wash and impressions are elastomeric wash and impressions are made )closed – mouth(, denture is made )closed – mouth(, denture is processedprocessed
**Indicated if extensive bridge or implants are Indicated if extensive bridge or implants are removed, large cystremoved, large cyst..
Partial Immediate DenturesPartial Immediate Dentures
****Socketed type )flangeless(Socketed type )flangeless(**Artificial teeth are set without flange, Artificial teeth are set without flange,
indicated in upper jaw, deep undercut, indicated in upper jaw, deep undercut, high lip line with short liphigh lip line with short lip
**Good appearance, does not interfere with Good appearance, does not interfere with lip and easily to be arrangedlip and easily to be arranged
**Neck may interfere with healing and after Neck may interfere with healing and after few months needs relining and few months needs relining and contraindicated with excessive bone losscontraindicated with excessive bone loss
** **Flanged typeFlanged typeIndicated if there is no undercut, excessive Indicated if there is no undercut, excessive bone loss or the need for splintbone loss or the need for splintContraindicates in undercut or active lipContraindicates in undercut or active lipGood retention, rapid healing ,easily relinedGood retention, rapid healing ,easily relinedSometimes )poor esthetic and may cause Sometimes )poor esthetic and may cause trauma to mucosa(trauma to mucosa(
THANK UTHANK U
