9 - Immediate dentures Flashcards

1
Q

Define an immediate denture.

A

Any removable prosthesis fabricated for placement immediately following the removal of a natural tooth/teeth

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2
Q

What are the advantages of immediate dentures? (9)

A
  • guide for permanent denture
  • guide for OVD
  • maintains speech and function
  • self esteem
  • avoids drifting or over-eruption of surrounding teeth
  • better adaptation to denture wearing
  • ridge form preservation
  • post-extraction healing
  • prevents collapse of facial musculature
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3
Q

What are the disadvantages of immediate dentures?

A
  • temporary due to bone level resorption (MANAGE expectations)
  • only last 6-12 months
  • poor adaptation to ridge occurs quickly
  • increased complexity of prosthetic stages
  • ongoing maintenance required (eg relines)
  • increased cost and patient visits
  • undercut areas can be problematic
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4
Q

What influences the complexity of the prosthetic stages of an immediate denture?

A
  • index teeth can present issues if malpositioned to record occlusion
  • design is limited to acrylic plate and wrought clasps in partials
  • try in is limited to those teeth that are already missing, extensions etc can be checked here
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5
Q

When are immediate dentures contraindicated?

A
  • ORN or MRONJ
  • pre-chemo/radiotherapy
  • when a denture is not required (eg function and aesthetics are sufficient)
  • pathological issues eg large cyst
  • major fractures
  • dementia
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6
Q

What are the stages of constructing an immediate denture?

A
  • same as for other dentures
  • exam and assessment for which teeth are to be removed (clinical and radiographic)
  • MH important (MRONJ/ORN risks or anticoagulants)
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7
Q

What is the initial aftercare of immediate dentures?

A
  • denture should be kept in for 24hrs post op to prevent pocket swelling
  • can be unpleasant so warn patient
  • ideally review next day
  • remove denture to assess inflammation and clot formation
  • after 24hrs, warm saline mouthwash and patient to remove denture after mealtimes, rinse mouth and clean denture
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8
Q

What is the longer term aftercare of immediate dentures?

A
  • review 1-2 weeks
  • may need fixative
  • review 1 month
  • consider reline as resorption begins
  • usually replace after 6 months
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