Immediate Dentures

Transitional Complete
Conventional Complete
Partial

UWO School of
Dentistry

Objectives
Immediate Dentures
Know:
Describe and prescribe appropriate types of
ID
Clinical protocols associated with each type
Laboratory protocols
Post-insertion care

UWO School of
Dentistry

Immediate Transitional
Dentures
Complete clearance
Indications
Multiple extractions
Patient needs/demands

UWO School of
Dentistry

Immediate
Transitional Denture
A denture made without prior extraction
of teeth
Synonyms:
Interim
Temporary
Provisional

UWO School of
Dentistry

Immediate
Transitional Dentures
Indications

Multiple extractions
Esthetics
Function
Conventional ICD
contraindicated

UWO School of
Dentistry

Immediate
Transitional Dentures
Technique:
Alginate impressions
Lab or office pour
Gypsum model
Hybrid model

Mounted models
Arbitrary estimation of contour

UWO School of
Dentistry

Immediate
Transitional Dentures

UWO School of
Dentistry

Immediate
Transitional Dentures

Before

After

UWO School of
Dentistry

Immediate
Transitional Denture

UWO School of
Dentistry

Immediate Transitional
Dentures
Problems
Intensive post insertion care
Short-term solution
More expensive

UWO School of
Dentistry

Conventional Immediate
Dentures
Maxillary six anteriors
Posterior teeth extracted 812 weeks previously
Predictable, stable ridge
contour
UWO School of
Dentistry

Conventional Immediate
Complete Dentures
Concept
Remove all posterior teeth
about 3 months before
making immediate denture

UWO School of
Dentistry

Conventional Immediate
Complete Dentures
Rationale
Allows for posterior segment
to heal and stabilize
Maintains anterior teeth for
appearance, some function

UWO School of
Dentistry

Conventional Immediate
Complete Dentures
Indications
Maxilla
anterior teeth present
Cooperative patient

Not Recommended
Both jaws
simultaneously
Mandibular arch

UWO School of
Dentistry

Immediate Dentures
Impression Techniques
Single custom tray
Split impression technique
Posterior segment
Anterior segment
Stock tray
Putty index
UWO School of
Dentistry

Split Impression Tray Alginate

Retention
lugs
Handl
e

UWO School of
Dentistry

UWO School of
Dentistry

Stock Tray Technique

Short-comings
Small oral opening
Proclined maxillary
anterior teeth
Anatomic accuracy of
vestibule

UWO School of
Dentistry

Split Impression TrayPutty-Index Technique

Tray extends to and contacts incisal edge of anterior

teeth
UWO School of
Dentistry

Putty-Index Technique

UWO School of
Dentistry

UWO School of
Dentistry

UWO School of
Dentistry

Putty-Index Technique

UWO School of
Dentistry

Putty-Index Technique

UWO School of
Dentistry

Conventional Immediate
Dentures
Cast trimming guidelines
Normal periodontal condition
Rule of Thirds

Advanced periodontal
deterioration
X-ray & probing measurements

UWO School of
Dentistry

Conventional Immediate
Dentures
Rule of thirds
Normal gingival/bone
relationship

UWO School of
Dentistry

Rule of Thirds Cast Trim

Step 1

Remove tooth at
gingival level

Step 2

Recess Socket 1
mm

Rule of Thirds Cast Trim

Step 3

Labial edge
recess to incisal
third mark

Step 4

Mid-point recess
to mid-width labial
cut

Rule of Thirds Cast Trim

Step 4

Step 5

Round over lingual aspect of

socket

Rule of Thirds Cast Trim

Step 5

Step 6

Round off labial to

middle third, sand

ICD Master Cast Trim

Trimmed areas
sanded smooth
Avoid removing
incisive papilla

UWO School of
Dentistry

ICD Surgical Template

Fabricated after cast
trim
Used to locate pressure
areas on mucosa at
time of surgery
Denture trimmed
according to blanched
mucosa observed
under template
UWO School of
Dentistry

Immediate Partial Dentures

Framework
incorporates wrought
wire retentive loops
for tooth attachment
Loops bent into place
at processing stage,
after cast trim

UWO School of
Dentistry

Special Lab Rx for ICD

For tooth set-up:
Anterior teeth:
Cut anterior teeth off cast at gingival level.
Set anterior teeth on cast for patient viewing.

Posterior teeth:
Arrange posterior teeth on record base in
(balanced/monoplane/lingualized) occlusion and
wax-up for try-in evaluation.
UWO School of
Dentistry

Special Lab Rx for ICD

For processing and cast trim:
Refine occlusion
Complete wax-up
Flask and return lower half of flask
for cast trim
Make surgical template in clear acrylic resin

UWO School of
Dentistry

Post Extraction Instructions

Do not remove denture

Keep head elevated
Small amounts of blood in saliva is normal
Diet: soft and warm, not hot
Avoid:
Spitting, rinsing
Strenuous activity
Alcohol, smoking
UWO School of
Dentistry

Post Insertion Management

Recall next day
Remove denture
Apply topical anesthetic to
traumatized mucosa
Locate over extensions and pressure
areas and adjust
Reappoint 1 week
UWO School of
Dentistry

Post Insertion Management

Healing, shrinkage, resorption
Patient remount
Relines
Interim within first 12 months
Definitive 12 months +

UWO School of
Dentistry

Post Insertion Management

Remount when:
Healing edema resolved
Traumatized mucosal lesions healed
Usually within 14-21 days

UWO School of
Dentistry

Post Insertion Management

Reline
Short term tissue conditioners
Mid-term intermediate direct liners
E.g. Kool liner

Long-term standard reline protocol

UWO School of
Dentistry

Immediate Denture Appendix

Review clinic & lab protocols
Try in
cast trimming

UWO School of
Dentistry

Special Lab Rx for ICD

For tooth set-up:
Anterior teeth:
Cut anterior teeth off cast at gingival level.
Set anterior teeth on cast for patient viewing.

Posterior teeth:
Arrange posterior teeth on record base in
(balanced/monoplane/lingualized) occlusion and
wax-up for try-in evaluation.
UWO School of
Dentistry

ICD Try-In
Sectional wax-up
Anterior segment for
patient viewing
Posterior segment for
check record

UWO School of
Dentistry

ICD Try-In
Posterior removable
section used for:
Confirmation of
horizontal and vertical
relationships
Tooth shade

UWO School of
Dentistry

Special Lab Rx for ICD

For processing and cast trim:
Refine occlusion
Complete wax-up
Flask and return lower half of flask
for cast trim
Make surgical template in clear acrylic resin

UWO School of
Dentistry

IDC Master Cast Trim

Invested maxillary
model in lower flask
half:

Teeth removed
Sockets recessed
Ready for Step 3
Ready for arbitrary
posterior palatal seal

UWO School of
Dentistry

ICD Master Cast Trim

Trimmed areas
sanded smooth
Avoid removing
incisive papilla

UWO School of
Dentistry

ICD Surgical Template

Fabricated after cast
trim
Used to locate pressure
areas on mucosa at
time of surgery
Denture trimmed
according to blanched
mucosa observed
under template
UWO School of
Dentistry