Complete Dentures: Immdediate Dentures/additions Flashcards
What is the definition of an immediate denture?
Is one that is constructed prior to the extraction of the natural teeth & inserted immediately after their removal
How many types of immediate dentures are there? What are they?
-
Remove all remaining teeth and provide immediate c/c dentures(would be allot of XTN and a lot of guess work to simulate gums)
2.Extract posterior teeth first & let that area heal up before taking impressions of the mouth - Final stage remove anteriors and then place an denture immediately (would mean less guess work from technician and patient will retain anterior teeth for longer. - Provide a post immediate denture - so we extract teeth and then start taking impressions for construction of denture ( sockets will need to heal and the ones will be resorting/healing (so rare satisfactory option.
- Take out worst teeth (Most mobile/causing pain) and then make a transitional partial denture and progressively add to the denture until it becomes a C/C denture,(as more teeth become of poor prognosis
What are the factors with regards to removing all remaining teeth and providing a denture?
-> Only one surgical required
-> Initial fit of denture will be poor (guess work with shape of jaw, open sockets from ex , bleeding ands swelling from ex and LA)
-> Rapid bone loss and remodelling of jaws
-> Dentures often soon become loose and & ill-fitting
What’s re the factors with regards to the option of removing all posterior teeth first and then removing anterior and providing a denture?
This will help the final denture to be well fitting especially in the posterior due to the healed sockets
negative the tongue wont have any teeth or denture present therefore will take advantage of this and spread around the area so later on when denture is present tongue may feel tight
What’s are the factors with regards to option 3 of post-immediate denture and when would you consider this?
In this case the teeth are extracted and sockets are left to heal before denture is made
*when this will be done**
If a patient has no interest in keeping there dentition
They have a poor or neglected mouth - multiple problems where we think it isn’t worth having the teeth any longer
Patient doesn’t want to bother with or accept provisional or partial dentures
When would you consider option 4 and what is it?
Tends to be used most often
MAke partial dentures for the gaps that are already existing
Or to extract teeth of hopeless prognosis first and then make partial denture and then add more teeth as patiant loses more and more teeth
advantages
Patient keeps there natural teeth for longer, which helps with retention and stability of partial denture (will also maintain OVD therefore help with aesthetics
Task can be completed over years (gives patient the chance to improve with OHI)
It is planned so nothing too big for the dentist and technician to deal with at once. (Also helps determine if pt actually can wear dentures before its too late)
What will you do in the first visit when providing immediate dentures?
- History
- Exam
- Radiographs (of teeth we are thinking of extracting)
- Primary impressions as though were making partial dentures so (modify stock trays with silicone putty or impression compound in the edentulous areas, Extend stock tray where it is under extended. And take an alginate impression) then send these off for a special tray.
What would you do after hours have completed all the checks in visit 1?
You will look at all the checks and then decide which type of immediate denture you want, i.e option 1,2,3 or 4.
What would you do in visit 2?
If pt has posterior teeth, extract.
If no posterior teeth are present then take secondary impressions just like partial dentures. We will carry out border moulding, and green/pink stick to extend the trays to pick up functional impression of sulcus’s
Send these off for record rims
What would we do in visit 3 for immediate dentures?
Record occlusion with the record rims - e.g Ala travel plane… (add more)
What would you do in visit 4 of providing a immediate denture?
You will now do a try in
Can only do try in for the teeth already missing,
(although we are going to extract anterior we don’t get a chance to do them, just posterior to check to see balanced occlusion and balanced articulation on those teeth and check if they have got the correct OVD)
What will the technician have to do after the patients try in session in visit 4? And what will they use to do this?
The technician will have to convert the study cast they have of the patients mouth to what they think the pt mouth will look like after extraction. They will user chisels and sandpaper to remodel it. (They maintain a long line to see long axis of tooth and they also have a horizontal line showing the level of the bone , pocket depths are also sent to technician) once rounded off, they will make a complete denture off that and we done get a chance to do a complete denture try in anterior teeth with patient
What happens in visit 5?
Extraction and fit
The extractions are done carefully to reduce trauma and preserve bone. (Pt will be numb)
Denture will be checked and patient will be numb
What issues will the patient have and how long for? What can you do about this?
Review the patient after 24hrs - we should be the first ones to take dentures out. Check occlusion rubbing and can use tissue conditioner if loose or sore to make denture comfortable.
Pt will be uncomfortable for the 24hrs, swelling, post op pain and trauma from denture making eating difficult.
Pt may complain of pain and excess salivation, loss of taste and unable to eat.
If dentures removed will be difficult to insert back in due to swelling
Should have Emphasised dentures should stay in for the previous 24hrs
Why should you see the patient after 1 week?
Initial swelling will be reduced and dentures will become loose.
Occlusion can be more assessed more accurately and adjustments can be made
Contaminated tissue conditioner may need replacement
Pt should be free of most pain and discomfort
