Dr. Hemant R Gadge et al. / IJRID Volume 4 Issue 3 May.-June.

2014

Available online at www.ordoneardentistrylibrary.org

ISSN 2249-488X

Case- report

INTERNATIONAL JOURNAL OF RESEARCH IN DENTISTRY

IMMEDIATE DENTURES- A CLINICAL REPORT
Dr. Hemant R Gadge*, Dr Mahesh A Gandhewar, Dr Sumanth Kori, Dr Suresh nagral, Dr Vijayanti lotwani
Department of Prosthodontics, A.C.P.M. Dental College & Hospital Dhule, Maharashtra
Received: 20 Apr. 2014; Revised: 22 May 2014; Accepted: 26 June. 2014; Available online: 5 July 2014

ABSTRACT
When dentists treat patients for immediate dentures, they assume responsibility not only for the clinical and laboratory techniques unique to
immediate denture fabrication, but also the responsibility for informing their patients about their treatment options, instructing their patients
in the care of their oral tissues and dentures, and for continuing maintenance of the immediate dentures.
Key words; fabrication procedures, immediate denture, interim prosthesis.

INTRODUCTION
In an era of both preventive and conservative dentistry, it is rare for any dental patient to become
edentulous.2The placement of complete denture immediately following the removal of natural teeth is not new.
As early as 1860, Richardson described the use of immediate dentures. In line with present day immediate
dentures are a necessity to prevent distress, anxiety and embarrassment to many people.
According to GPT 8 Immediate Denture is defined as: -Any removable dental prosthesis fabricated for
placement immediately following the removal of natural tooth/ teeth.1
Immediate dentures can be traumatic if patients are not informed fully about the complexity of the clinical and
laboratory procedures, the need for immediate denture maintenance, and the costs associated with immediate
denture treatment.4The importance of continuing care for immediate denture patients must be explained to
patients and the dangers of neglecting continuing care must be emphasized.6
Clinical report:
A 52 years old female patient named Kadambini Rao came to the Department of Prosthodontics at
A.C.P.M.Dental college and hospital Dhule with chief complaint of lower anterior missing teeth (31, 32, 41)
and mobility with upper anterior teeth (11, 21, 22) (fig 1&2).
Detailed medical and dental history of patient was taken, there was no significant history. On clinical
examination there was grade II mobility with 11, 21, 22 and missing teeth 31, 32, 41 (fig4).On radiographic
examination, periapical radiolucency was seen with 11,21,22 (fig:3) and the prognosis of these teeth were poor.
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Patient was suggested for extraction with 11, 21, 22 but was not willing to undergo extraction as she was
conscious esthetic The patient was informed about immediate prosthesis and convinced for extraction and
immediate denture was planned.
Alginate impression of both the arches were made (fig 5),the proper shade & size of teeth were selected using
the patients existing teeth as a guide6 and patient was referred to Department of oral and maxillofacial surgery
for extraction of 11,21,22.
After alginate impression of both the arches model cast( fig.6) were prepared, mid line marking was done on
maxillary cast and mounted on three point articulator (fig 7&8).
The teeth to be extracted were broken and the denture base was prepared. The teeth were arranged according to
the mid line marking on maxillary cast (fig.9). After teeth arrangement denture was processed (fig10 &11).
Patient was recalled for extraction of 11,21 and 22(fig.12)and also for the insertion of immediate denture(fig.13)
& RPD (fig.14).
The patient was given postoperative home care instructions, which include: not removing the denture for 24hrs,
the use of analgesics and ice packs, if necessary, and appointed the next day for postoperative examination and
any needed adjustments. The patient was recommended bland, semisolid, pureed diet, nutritional supplements
and plenty of oral fluids. Post insertion instructions were given. The sutures were removed after 7 days and the
healing was uneventful.
Discussion:
Although there are limitations to an immediate denture, the final outcome is usually positive .The most
important esthetic advantage of immediate denture is that the patients are spared of the inconvenience and
distress of being seen in public without teeth.6 One disadvantage of immediate denture is the inability to review
tooth arrangement and esthetics before processing and inserting the dentures.6The dentist must make the patient
realize that this denture will be an interim prosthesis that will have to be remade in order to modify the
unsatisfactory features of the restoration. In most situations, the anterior teeth are arranged to duplicate the
patients natural tooth arrangement. The positions of natural anterior teeth are not always compatible with
esthetics, and it may not be desirable to duplicate these positions for every patient.7
An immediate denture requires more visits for adjustment. This type of appointments can therefore
become prolonged and stressful for both dentist and patient; therefore it is very important to explain this at the
beginning of the treatment and to select the appropriate case from the psychological point of view.7
Conclusion:
Patient was satisfied by the prosthesis (fig.15,16). Immediate dentures allow patients to continue their social and
business activities without being in edentulous state8.Immediate denture promotes better ridge form.7In
immediate denture services, there is no opportunity for an anterior try in. Therefore, the esthetic & phonetic
results are not known for certain until the prosthesis is inserted.8 The dentist must make the patient realize that
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this denture will be an interim prosthesis that will have to be remade in order to modify the unsatisfactory
features of the restoration.5It is important for both the patient and the dentist to understand the limitations of the
procedure.6
References:
1. Glossary of prosthodontics terms 8thedt.
2. Rahn AO, Hearthwell CH. Textbook of complete dentures. 5th ed.Philadelphia: Lea & Febiger 1993,
p.486-8.
3. Sonja
Kraljevic, Josip Panduric Tomislav Badel Robert celic. Immediate complete denture.
ActaStomatol Croat, Vol. 35, br. 2, 2001
.
4. Gerald L.Herman Compendium.Esthetic& emotional factors in immediate denture construction.The
Compendium of continuing Education in Dentistry Vol.X,No.9 September 1989.
5. Anca Jivanescu, Corina Marcauteanu, Dorin Bratu Immediate complete denture- a case report.STMJ
2003, Vol. 53, No. 3-4
6. Demer W. Minimizing problems in placing Immediate complete denture.J Prosthet Dent 1972;27:27584.

7. Dr.Jaini Ji.Immediate denture with unusual bone morphology IAJD Vol 2

Figures:-

Fig 1Preoperative front view

Fig 2 maxillary arch

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Fig 3:Radiographs of Maxillary teeth

Fig 4:Mandibular arch

Fig 5: Alginate impression of both the arches

Fig 6: Model cast prepared

Fig 7: Midline &occlusion plane marking on maxillary cast

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Fig 8: Casts mounted on three point articulator

Fig 9: Teeth arrangement

Fig 10,11: Processed denture

Fig 12: After extraction

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Dr. Hemant R Gadge et al. / IJRID Volume 4 Issue 3 May.-June. 2014

Fig.13 the insertion of immediate denture

Fig.14; RPD insertion

Fig 15: Preoperative photograph

Fig 16: Post operative photograph

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