RP - immediate dentures Flashcards
Explain the clinical stages for an immediate denture
exam and assess - teeth to be removed are assessed clinically and radiographically if required
impressions - accurate, fully extended (alginate in stock trays)
occlusion - index teeth may be present
design - usually simple acrylic plate
second imps - special trays
try in - limited to those teeth already missing
check extensions, occlusion, shade
xLA and finish
*must check denture before xLA
What are the advantages of immediate replacement dentures?
maintain pre-extraction information
continuity of denture wearing - ensuring maintenance of skills and familiarity of denture wearing to be maintained
maintenance of vertical and horizontal jaw relationship
denture covering extraction socket may protect initial bloodclot
what type of extractions may an immediate denture replace?
simple not surgicals
what must you always advise pt of when giving them an IR?
denture will become loose and will require replacement (financial implication)
what must be considered when providing a pt with an IR?
take molars out first and allow healing
number of teeth to be replaced - risk of haemorrhage, post xLA swelling, how much LA you have to administer
healed areas
3 types of IR designs?
flanged
part flanged - if bone too bulky
open face (teeth sit directly above ridge of denture) - bone very bulky, undercut in buccal sulcus
what design of IR should be used after xLA and bone removal (septal or radical alveolectomy)?
flanged
what are the advantages of a flanged IR?
retention
undercuts
aesthetics
when would you consider an open face IR?
bulky anterior alveolar ridge
cannot utilise undercuts for retention as too deep
flange would give too much support to upper lip (fat lip)
what instructions are given to the lab when requesting an IR?
which teeth are to be extracted
arrangement
shade
flange type
material
date for insertion/ extractions
what are the aftercare instructions for IRs?
dentures to be kept in for 24hours
review appt ideally on day after insertion if feasible
remove dentures - examine mouth for healthy clots, identify areas of inflammation and ease denture
after 24hours - warm saline mouthwash and remove denture after mealtimes to rinse mouth and clean denture
if 24 hours review not possible - ensure pt has post op instructions
how should dentures be cleaned?
soft toothbrush soap and water
when do you review IRs?
1 week - further adjustment if required
1 month - assess adaptation
6 month recalls
when would you do a one stage immediate denture?
to replace one or two anterior teeth in an otherwise intact arch
explain the process of a one stage immediate denture
upper and lower imps recorded
wax squash bite if required to confirm occlusion
choose shade
lab prescription including design
xLA and insertion at next visit
