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IMMEDIATE DENTURES

Definition Is a dental prosthesis constructed to replace the natural teeth and associated structures of the maxilla and / or the mandible and inserted immediately following tooth or teeth removal. It may replace one tooth or all the teeth in one arch or the two arches

Requirements A prosthesis is not a living tissue, but it must be an accepted part of a system composed of living tissue Must be compatible with the surrounding* oral environmental Restore function of mastication*

Harmony with, speech, respiration and* deglutition Esthetically accepted* Preservation of the remaining tissues* It is a challenge to the dentist to accomplish these requirements, therefore each patient must be analyzed and evaluated on an individual basis

Advantages Act as a splint to help control bleeding,* protect against trauma from tongue , food and opposing teeth. Prevent mouth fluids and food particles from entering the sockets. Protect blood clots (Promote Rapid Healing )

Supported lips cheeks and the tongue* seem to regain adequate functions of speech ,mastication and deglutition Less difficulty to make the polished surface* in compatible with surrounding musculature Natural teeth help to establish VDO and* teeth replacement ????)precautions e.g over eruption ,attrition ,false diminished (inter occlusal distance ,centric R &O

Disadvantages Additional work and cost* (No try-in )except delayed immediate* Less accuracy and permanence of fit* In most cases advantages out-weight ( disadvantages

Diagnostic procedure Dental history, visual and digital* examination )bone loss around teeth, (position of teeth, exostosis, under- cuts Systemic* If there is systemic complication may affect components of healing or tissue regeneration

Mouth preparation Scaling & curettage* Home care and mouth wash* (to reduce bleeding and accelerate healing )

One Step Immediate Complete ( Denture )interim C.I.D


In some cases it is necessary to fabricate immediate denture without prior extraction of posterior teeth e.g teeth are excessively loose ,causing severe pain or patient wants to reduce extraction visits This method not suitable for general practice and done in hospital

Procedures Alginate impression* Mounting casts by the aid of wax inter-* occlusal record Duplicate casts to aid in teeth setting* Remove teeth from casts, trim the ridges* and fabricate clear acrylic template

Process the denture* Patient is admitted to hospital, remove* teeth, trim the ridge , deliver the denture This technique gives successful results, its* main drawback being rapid resorption renders the denture ill fit after few weeks and two relining are needed with the first .three months

Two Step Complete Immediate (Denture )conventional C.I.D


All posterior teeth are extracted except one* in each side and the denture is fabricated after 2 3 months Procedure Primary impression* Final impression) single method or two* (stages method

Face- bow & mounting, arrange posterior* teeth, try in to verify posterior teeth arrangement Modify the master cast by removing the* teeth and contouring the ridge in cases with maxillary protrusion or under-cut and clear acrylic template is fabricated Process the denture*

Extract anterior teeth and surgical* (procedure is done )alveoplast Insert the denture, adjust, patient's* instructions

Delayed Immediate Dentures


These dentures are inserted few days after* teeth extraction The waxed up dentures are tried in the* mouth with zinc euginol paste or elastomeric wash and impressions are made )closed mouth(, denture is processed Indicated if extensive bridge or implants are* .removed, large cyst

Partial Immediate Dentures


(Socketed type )flangeless** Artificial teeth are set without flange,* indicated in upper jaw, deep undercut, high lip line with short lip Good appearance, does not interfere with* lip and easily to be arranged Neck may interfere with healing and after* few months needs relining and contraindicated with excessive bone loss

Flanged type** Indicated if there is no undercut, excessive bone loss or the need for splint Contraindicates in undercut or active lip Good retention, rapid healing ,easily relined Sometimes )poor esthetic and may cause (trauma to mucosa

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