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Definitions
Advantages and disadvantages of immediate dentures Contraindications of immediate dentures Basic over view of an immediate denture fabrication Surgery and Immediate Denture Insertion
Patient instructions
Review of literature Conclusion References
Definition
The glossary of prosthodontic terms defines an immediate denture as a complete or removable partial denture constructed for insertion immediately following the removal of natural teeth.
An immediate denture after healing can be relined and refitted to be used as a definitive denture but an Interim immediate denture is worn only during the healing period to be replaced with a new prosthesis as soon as healing is complete.
One of the first references to immediate dentures in the literature was that of Richardson in 1860 (Seals, 1999).
Advantages
Maintenance of a patient's appearance
No edentulous period. No interruption of a normal lifestyle of smiling, talking, eating, and socializing.
Adaptation to dentures
Speech, mastication and nutrition can be maintained.
Disadvantages
Poor general health or who are at poor surgical risks (e.g., post irradiation of the head and neck regions, systemic conditions that affect healing or blood clotting and psychological disorders).
uncooperative, cannot understand and appreciate the scope, demands, and limitations to the course of immediate denture treatment
History taking
Preliminary examination
Oral examination Jaw relation and occlusion Radiographic examination
Putty-index technique
Jaw Relation
Setting the posterior Denture Teeth/Verifying Jaw Relations and the Patient Try-in Appointment
The articulated casts are used for setting any anterior/posterior teeth that are missing so that a tryin can be accomplished with the patient.
The midline or newly selected midline is recorded on the base area of the master casts.
A discussion of placement of diastema, rotated teeth, notches, and other natural arrangements should occur so that the patient is actively involved in the esthetic decisions.
Ridge lapping
Recess Socket 1 mm
Step 3
Step 4
Step 4
Step 5
Step 5
Step 6
Keep the undercut areas of the denture slightly thick at this point to allow for insertion over undercuts. These areas can be thinned later before sending the patient home.
The surgical template is used as a guide to ensure that the prescribed bone trimming is done adequately.
Patient instructions
Dentures must be left into the mouth during first 24 hours
Ice compress on face for 20 minutes on repeatedly for the first 24 hours. No chewing, liquid diet
After the first 24hours, patient should carefully remove the denture twice a day Recall after 24 hours Occlusal corrections from 48hrs to 1-2weeks Recall every 3 months, adjustments with tissue conditioning material
Following the bone resorption period (approximately 6 to 12 months) a more permanent reline will be placed.
Review
of literature:
Distolingual undercut Buccal and lingual undercuts in the bicuspid region Sublingual undercuts Incisive fossae and canine eminences Distolingual and anterior combinations Labial and lingual undercuts
Septal alveolectomy
Radical alveolectomy
Trial anterior artificial tooth arrangement for an immediate denture patient :A clinical report
A technique is described that allows the esthetic try-in of the maxillary anterior artificial tooth before the extraction and completion of an immediate denture
Posterior artificial tooth try in done with modified anterior wax up in anterior labial flange area.
To relate the maxillary denture to remaining teeth and supporting tissues, an impression of the adjusted denture was made and a new maxillary cast fabricated.
The maxillary artificial anterior teeth were arranged to reflect the position of the patients natural teeth.
Labial index of the completed anterior artificial tooth arrangement was made with impression plaster.
After the separation of the index the teeth were fixed using autopolymerizing acrylic resin. Denture was finished and inserted immediately after the extraction.
Majid B et al (2004)
Described fabrication of a clear surgical template that minimizes pressure caused by immediate complete dentures on a surgical area.
Conclusion
Patient education. Meticulous treatment planning. Staging extractions. Good impression technique. Tissue conditioners and remounts. ____________________________ = improve the predictability of the outcome.
References :
1.
BOUCHER,S prosthodontic treatment for edentulous patients edition & 11th edition .
9th
2.
CHARLES HEARTWELL & ARTHUR O RAHN Sylabuss of complete dentures 4th edition.
3.
4. 5.
JOHN J SHARRY- Complete denture prosthodontics 2nd edition. JOHN N ADERSON, ROY STORER Immediate dentures & replacement dentures 3rd edition
6.
7. 8.
12th edition.
9.. MM Devan The Trasition From Natural To Artificial Teeth" JPD 1960 vol-1
10. William B Lineberg SURGICAL PREPARATION OF MOUTH FOR IMMEDIATE DENTURES 1963 vol 13 no 1
11. John P DahlbergReconstructing the Natural Appearance By Immediate denturesJPD 1965;205-210 12..M Heartwell IMMEDIATE COMPLETE EVALUATION 1965 vol 15 no 4 DENTURE; AN
13. Asok Soni Trial anterior artificial tooth arrangement for an immediate denture patient : A Clinical report ,JPD 2000 ;84 :260-263
14. Anton S Gotleib An atypical chairside immediate denture :A clinical report JPD 2001 :86 :241-243 15. Masjid Bissasu A simple procedure for minimising adjustmentsof immediate complete denture :Aclinical Report :JPD 2004 ;92: 125-127 16. Jonkman RE, van Waas MA, van 't Hof MA, Kalk W J Dent. 1997 Mar;25(2):107-11.
17. Geoffrey St George et al, Immediate Dentures: 1 diagnosis & treatment planning. Dent Update 2010 18. Geoffrey St George et al, Immediate Dentures: 2 Clinical stages of construction Dent Update 2010; 37: 154-160
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