IMMEDIATE

DENTURES
 Definition

An immediate complete denture is a dental prosthesis

constructed to replace the lost dentition and
associated structures of the maxillae and/or
mandible and inserted immediately following
removal of the remaining natural teeth
Requirements of Immediate Complete Dentures

Compatibility with the surrounding oral

environment.
Restoration of masticatory efficiency within limits.
Function in harmony with the activity necessary in
speech, mastication, and deglutition.
Esthetically acceptability.
Preservation of the tissues that remain.
 Indications
Any patient whose remaining teeth are indicated for
extraction is a potential candidate for an immediate
denture. However such a candidate must be physically
and mentally be prepared to undergo the increased
number of visits to the dentist as well as greater cost.
 Contra indications
Any patient unable to undergo multiple extractions. Example:
blood dyscrasias and cardiac disease
In acute periodontal infection
Patients incapable of showing responsibility towards the
treatment e.g. senile, mentally retarded and indifferent patients.
Extensive bone loss adjacent to remaining teeth
 Advantages
Maintenance of
Appearance
Circumoral support
Muscle tone
Occlusal vertical dimension
Jaw relationships
Facial height

Easier Adaptation

Speech, mastication rarely compromised

Less postoperative pain & bleeding
extraction sites protected
Pressure from denture base

Easier to duplicate natural tooth shape & position (if

desired)

Tongue will not spread out as result of tooth loss

Nutrition can be maintained

 Disadvantages
More challenging to set teeth.
Less space for teeth as ridge resorption hasnt occurred.

Alveolar ridge undercuts around remaining teeth may

make impressions more difficult.

Unstable or inadequate occlusion can make recording

centric position difficult.
 Types Of Immediate Dentures
CONVENTIONAL IMMEDIATE DENTURES-
intended to be relined to serve long-term

INTERIM IMMEDIATE DENTURES-after healing a second

new complete denture is fabricated as a long-term prosthesis
 CONVENTIONAL INTERIM IMMEDIATE
IMMEDIATE DENTURES DENTURES
Definitive or long-term prosthesis Transitional or short-term
prosthesis
After healing is complete, it is After healing, a second denture is
relined made
Patient usually has only anterior Patient usually has both anterior
teeth (plus possibly premolars) and posterior teeth

Usually has good retention and
stability at placement, which is
possible to maintain during
healing
Usually has only fair retention and
stability at insertion, which must
be improved by provisional
relines (tissue conditioning) during
healing

The overall cost of CID treatment The overall cost of treatment is

is less than IID treatment greater than ClD treatment
because it is the cost of the CID because it includes the cost of the
plus a reline interim
denture and a second denture
 CONVENTIONAL INTERIM IMMEDIATE
IMMEDIATE DENTURES DENTURES

Longer time for treatment Lesser time than CID

completion

Generally indicated when anterior Generally indicated when both

teeth remain. anterior and posterior teeth remain

indicated when patient can indicated when the patient cannot

function without posterior teeth for or will not go without posterior
3 months teeth

At placement of the ClD, usually At placement usually both anterior

only anterior teeth are extracted and posterior teeth are extracted

Indicated when two extraction Indicated when only one surgical

visits are feasible visit is preferable
 CONVENTIONAL
IMMEDIATE DENTURES
Esthetics of the CID cannot be
changed
At the end of the treatment, the
patient has one denture
OVD is usually not preserved as
posterior teeth are extracted
(preserved if premolars are
retained)
Contraindicated for a patient who
has a complex treatment plan
Not useful for converting existing
prostheses such as
removable partial dentures
INTERIM IMMEDIATE
DENTURES
The second denture procedure
after the allows an alteration of
esthetics
At the end of the treatment, the
patient has a spare denture
OVD is preserved as posterior
teeth will not be removed before
fabrication of IID
Indicated when the patient will
become edentulous one arch and
partially edentulous in the
opposing arch for the first time or
complex procedures are needed
Can be useful in converting
existing prostheses to an IlD
 Procedure For Making Immediate Dentures
Plan two stage extractions removing posterior teeth first
leaving only six anterior teeth- Allow 4-6 weeks healing
time.
Primary impression
Immediate dentures impression techniques

Single custom tray

Split impression technique
Posterior segment
Anterior segment
Single full arch custom impression tray
It more closely resembles a routine custom
tray used for removable partial denture.
This type of tray is effective when only anterior
teeth are remaining or when anterior and
posterior teeth are remaining.
 Two trays or sectional impression tray-pick up
impression

This method used only when the posterior teeth are not
present .
It involve fabricating two trays on the same cast ,one in the
posterior which is made like in complete denture (close
fitted )
The second tray placed in the anterior (backless
tray) or we can use stock tray in combination with
posterior tray .
 Stock Tray Technique

Special tray Stock tray Special tray

Final impression & working cast
 JAW RELATION
Doing that by using record bases and occlusal
rims , and the vertical dimension recorded ,
centric relation is recorded also and
transferring to articulator in the normal
procedure used with complete or partial
denture .
Setting the posterior teeth, verifying jaw
relation ,and try-in of posterior teeth
appointment
 Try-in appointment
The denture base and posterior teeth are tried-in the mouth :
-verifying vertical dimension of occlusion
-centric relation as with complete denture
Record land marks on the cast to confirm the patients
esthetics.
A : midline or newly selected midline is recorded on the
base area of the master cast
B :the anterior plane of occlusion
C :ala-tragus plane should be located and noted .
D :high lip line should be determined on the cast.
Anterior teeth selection is confirmed with patient .
Contouring the cast
 Setting of anterior teeth
First way: produce a labial index of the natural
teeth before they are cut off the cast.
The index can be produced quite simply by
molding silicone putty against the labial surface of
the teeth and ridge on the cast.
Then the artificial teeth are then set into the index
while its held against the cast.
 Setting of anterior teeth
Second way: remove teeth singly from the cast
and immediately wax an artificial teeth into
position so that the adjacent teeth serve as a guide
to the position of the artificial replacement .
 Setting Of Anterior Teeth
Third way: scribe guidelines on the cast
recording the position , angulations and
incisal level of the natural teeth .
The denture is constructed on a working cast which
is trimmed to the anticipated contour of the ridge
after surgery.

A clear acrylic template is processed on a

duplication of this cast and is used as a guide to
control the amount of bone removal at operation .
Completed Prosthesis
Extraction of remaining teeth
Denture Insertion
 Post-operative care and patient
instruction
First 24 hour :
Patient should avoid removing the immediate
denture.
Patient should avoid hard food and drinking hot
fluids or alcohol .
Patient can partially control inflammation and
swelling by using ice pack .
Patient should be reminded that the pain from
extraction will not reduced by removal the
denture.
Analgesic , antibiotic , are prescribed to patient.
 Patient should be seen after 24 hours
for:
Denture should be rinsed and washing patient mouth
with dilute mouth wash.
Quickly checking the tissue sore spots related to
denture.
Adjustment of over extension and any gross occlusal
discrepancy .
The denture should be kept out of patient mouth only
for short time.
 First post-operative week
Patient should wear the denture at night for first 7 days
after extraction or until swelling reduction .
Suture removal if present and changing tissue conditioner
if use.
 Further follow up care
Patient should be seen one month later, 4-6
months intervals .
The major reason for frequency of changing
temporary liner depend on the rate and
amount of bone resorption and ability of
patient to keep the liner clean.
Relining may be necessary to achieve esthetic
and occlusion requirement.