Immediate Complete Dentures Protocol

General Guidelines:

1. All posterior teeth should be extracted prior to fabricating immediate denture.
2. Opposing bicuspids may be retained to preserve the vertical dimension of
occlusion
3. These posterior areas are allowed to heal for a short time, usually only 2 to 3
weeks prior to making impressions.

Protocol:

1. An impression is made to capture all peripheral borders and anatomy
according to the standard technique. The master impression is reviewed by the
faculty and approved by the GPD with their signature on the prescription.

2. Master impression is brought to laboratory for pouring. The master cast is
returned in 24 hours.

3. Master cast is reviewed for accuracy. If approved, it is submitted with a
prescription signed by the faculty and GPD. The master model is sent to the
laboratory for fabrication of posterior record bases and occlusion rims.

4. Record bases and occlusion rims are returned to the student

5. Students contour the bite rims in the mouth according to standard technique,
establish vertical dimension and determine centric relation. The case is
articulated by the student. The student selects teeth and orders a full set of
anterior and posterior teeth from Central Dental Laboratory.

6. The student completes a prescription requesting a posterior tooth arrangement
completion. The GPD approves and signs the prescription. The case is sent to
laboratory with the selected posterior teeth.

7. Laboratory will return posterior tooth arrangement and wax up. Check tooth
arrangement to accept or send back for alterations. Minor alterations must be
done chairside by the student.

8. The student with faculty supervision completes a final try-in of the posterior
tooth arrangement. They confirm the centric and vertical dimension. If the centric
relation does not coincide with the articulator mounting, the lower cast is
remounted with a new centric relation record until the articulator mounting and
the patient's centric relation coincide. Teeth are reset to any new mounting and
tried in again.

9. The student completes a prescription requesting anterior teeth arrangement by
the laboratory. Midline and incisal edge location must be marked as a guide to
the technician. The prescription should also request:
removal of teeth with MINIMAL CONTOURING of the cast
Full contour wax up extending to the depth of the suclus and
peripheral border for insertion
Posterior palatal seal scoring
FABRICATION of a clear acrylic surgical stent- this will help surgeons
to modify the ridges if necessary so they resemble the altered cast.
The GPD approves and signs the prescription.

10. Laboratory will return complete immediate dentures processed and finished
along with the surgical stent.

11. Insertion appointment must be set up in the mornings of MON-THU with Oral
surgery, so appropriate follow up protocols can be implemented. INSTRUCT
THE PATIENT NOT TO REMOVE THE DENTURES UNTIL YOU DO SO IN 24
HOURS. If dentures are removed, swelling may occur and prevent reinsertion of
prosthesis.

SEE patient instructions

12. Follow up in 24 hrs, 48 hrs or 78 hrs and then 1 week.
In the 24 hour follow up instruct on insertion and removal of prosthesis and
care and oral hygiene.


(NOTE: Medicaid does not cover for immediate dentures).