IMMEDIATE DENTURE

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Lec-13Tikrit University College of DentistryprosthodonticsDr: Reem Ahmed5th classIMMEDIATE DENTUREAn immediate denture is “a complete denture or removable partialdenture fabricated for placement immediately after the removal ofnatural teeth.there are two types of immediate denture: 1- interim IM. 2- conventional IM. interim (transitional)immediate denture :“a dental prosthesis to be used for a short interval of time for reasons ofaesthetics, mastication , occlusal support, or convenience or tocondition the patient to the acceptance of an artificial substitute formissing natural teeth until more definitive prosthetic therapy can beprovided. “These are immediate dentures used temporarily, during the healingperiod of the patient to preserve ridge contour, until the permanentdenture can be fabricated . They are mainly indicated in patients withperiodontal disease going in for total extraction. They help to preservethe contour of the ridge until a permanent denture can be fabricated. Conventional immediate denture :“it is an immediate denture, which can be later modified to serve asthe permanent prosthesis. It is usually done for patients undergoingtotal extraction .The treatment outline while preparing a conventionalimmediate denture consists of the extraction of the posterior teethfollowed by the extraction of the anterior teeth. The ridge in theposterior region are allowed to heal before the extraction of thecden.tu.edu.iq1

Lec-13Tikrit University College of DentistryprosthodonticsDr: Reem Ahmed5th classanterior teeth. The denture is inserted on the appointment ofextraction of the anterior teeth.The denture will relined after 6-9months for long service treatment ADVANTAGES of Immediate denture: Maintenance of a patient's appearance Circum oral support, muscle tone, vertical dimension of occlusion,jaw relationship, and face height can be maintained. The tongue willnot spread out as a result of tooth loss Less postoperative pain is likely to be encountered because theextraction sites are protected Easier to duplicate (if desired) the natural tooth shape and position Adaptation easier. Speech and mastication are rarely compromised,and nutrition can be maintainedDISADVANTAGES of Immediate denture: Immediate dentures are a more challenging The anterior ridge undercut that is caused by the presence of theremaining teeth may interfere with the impression procedures The presence of different numbers of remaining teeth in variouslocations frequently leads to recording incorrectly the centric relationposition No denture tooth try-in in precludes knowing what the denture willactually look like on the day of insertion more chair time, additional appointments, and therefore increased costs.cden.tu.edu.iq2

Lec-13Tikrit University College of DentistryprosthodonticsDr: Reem Ahmed5th classCONTRA INDICATIONS: 1- poor general health 2- uncooperative patientEXPLANATION TO PATIENT CONCERNING IMMEDIATE DENTURE Do not fit as well as normal complete dentures. The pain of the extractions, in addition to the sore spots caused by theimmediate denture, will make the first week or two after insertion difficult. It will be difficult to eat and speak initially The esthetics may be unpredictable because an anterior try-in is not possible.CLINICAL PROCEDUREThe procedure for fabrication of immediate denture are similar tothose for making partial and complete dentures, with some modifications.1. Impression are made in irreversible hydrocolloid (alginate)in stock trayand poured to reproduce study cast.These casts are not enough for fabricating the immediate denture on .2-Custom tray and final impression:There are two ways to fabricate the final impression tray, depending on thelocation of the remaining teeth and operator preference. Both are successfulas long as they are done properly.Type A: SINGLE FULL ARCH CUSTOM IMPRESSION TRAY.This method more closely resembles a routine custom tray for partial andcomplete denture. it can be used both when only anterior teeth remaining andwhen anterior and posterior teeth are remaining.a. The tooth area are blocked out with two sheet wax and edentulous areas areblocked out and treated like a complete denture impression tray.b. a stop effect is establishedc. the tray out lined to be 2-3mm short of the vestibular area.d. Auto-polymerizing acrylic resin or light cured resin is adapted over the cast.cden.tu.edu.iq3

Lec-13Tikrit University College of DentistryprosthodonticsDr: Reem Ahmed5th classe. the tray is polished . we can use with any preferred impression material eitherelastomeric or irreversible hydrocolloid .fig:- special tray is completedType B:two –tray or sectional custom impression tray:This method is used only when the posterior teeth have been removed. It involvesfabricating two trays on the same cast- one in the posterior, which is made like anedentulous tray, and one in the anterior.a. outline the borders of the tray again to be 2-3mm short of the vestibule butcovering the posterior limit and the retromolar padb. one layer of sheet wax is put on edentulous area.c. adapt auto-polymerizing acrylic or light cured acrylic to the posterioredentulous areas. This tray should cover the lingual surfaces of the teeth( only)and extend up beyond the incisal edge of the teeth to include a handled. for the anterior section , some operators prefer variations: one is to adapt acustom ;another is to use a stock tray. Then with the 1st part we makingimpression with (zinc oxide euogenol is preferred).Then the impression iscden.tu.edu.iq4

Lec-13Tikrit University College of DentistryprosthodonticsDr: Reem Ahmed5th classremoved and inspected , excess material is removed then it is replaced in themouth , the anterior section of the impression is made.(a)(b)fig- a-two tray before seated on the cast/b- after impression making3-jaw relation is recorded.4-try in the denture in the patient mouth.5- the teeth we want to be extracted is cut in the laboratory beforeflasking.6- request surgical stent(guide), used to guide for surgically shaping thealveolar process, made from clear cold cure acrylic.cden.tu.edu.iq5

Lec-13Tikrit University College of DentistryprosthodonticsDr: Reem Ahmed5th class The surgical guide is made on a duplicate model of trimmed modelprior to packing acrylic . The S. G. can be constructed by : 1- vacuum forming /pressure forming technique. 2-cold cure3-heat cure7- Extract teeth 8-Use surgical guide to contour ridge To aid in the correct positioning and seating of an immediatedenture , most dentist and oral surgeons will prescribe for a surgicalguide to be constructed by a dental technician . Most dentists andoral surgeons use a SURGICAL GUIDE after removing teeth prior to theinsertion of immediate dentures. 9-Seat the denture, the denture should fully seated-try not to use of Pressure indicating paste-check for over extensions.instruction given to patient after extraction and insertion ofimmediate denture Do not remove until tomorrow's appointment If it comes loose/out put it back in place immediately liquid diet , soft diet for 24 hours Take analgesic Expect red salivacden.tu.edu.iq6

Lec-13Tikrit University College of DentistryprosthodonticsDr: Reem Ahmed5th class Refrain from smoking , drinking alcohol ,using a straw vigorous rinsingor doing vigorous activity during the 1st hours. These activities couldinterfere with clot formation and slow healingAfter 24hour (appointment)Remove and clean denture ,relieve sore spots and do not usepressure indicating pasteAFTER 1WEEK Relieve sore spots Use pressure indicating paste Refine occlusionFOLLOW-UP Use tissue conditioner to refit as needed Remove any socket convexities to avoid healing defects Reline or remakein 6 to 9 monthscden.tu.edu.iq7

Lec-13cden.tu.edu.iqTikrit University College of DentistryprosthodonticsDr: Reem Ahmed85th class

those for making partial and complete dentures, with some modifications. 1. Impression are made in irreversible hydrocolloid (alginate)in stock tray and poured to reproduce study cast. These casts are not enough for fabricating the immediate denture on . 2-Custom tray and final impression:- There are two ways to fabricate the final impression tray, depending on the location of the remaining .

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fill the denture, but rather should follow the internal contours. Figure 11: To facilitate correct positioning of the denture, have an assistant help you to retract the lip so that both the anterior and the posterior vestibules can be seen simultaneously. Seat the denture until the impression material expresses over the denture

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Dental Laboratory. The Wax Try-in for Immediate Denture is designed to verify vertical dimension, esthetics, phonetics, and facial support. Improvements and modifications to the denture can be made at this time. After modifications are complete, the Dental Laboratory processes an immediate denture 2. Re-mount and Equilibration 3.

Impression Making for Complete Denture Impression generally is a negative likeness or copy in reverse of the surface of an object. Dental impression is an imprint or negative likeness of the teeth and/or edentulous area and adjacent tissue. Complete denture impression is a negative registration of the entire denture bearing, stabilizing and border seal areas of either the maxilla or

Impression for complete denture Lecture: قا لا دبع يلع د.م Impression It is the negative replica of the teeth and surrounding structure in the oral cavity, introduced as a gel form then becomes relatively hard or set while in contact with these tissues. Complete denture impression It is the negative registration of the entire denture bearing, stabilizing and border seal areas .