logging in or signing up immediate dentures praveen_badwaik Download Post to : URL : Related Presentations : Let's Connect Share Add to Flag Embed Email Send to Blogs and Networks Add to Channel Copy embed code: Embed: Flash iPad Dynamic Copy Does not support media & animations Automatically changes to Flash or non-Flash embed WordPress Embed Customize Embed URL: Copy Thumbnail: Copy The presentation is successfully added In Your Favorites. Views: 2126 Category: Education License: All Rights Reserved Like it (0) Dislike it (0) Added: September 30, 2010 This Presentation is Public Favorites: 3 Presentation Description ppt Comments Posting comment... Premium member Presentation Transcript Slide 1: An immediate denture is “a complete denture or removable partial denture fabricated for placement immediately after the removal of natural teeth” First references ---- Richardson in 1860 (Zarb,. Prosthodontic Treatment for Edentulous Patients, 12th Edition. Elsevier, 2003. 9). Immediate Dentures: Two popular types : Two popular types Conventional / Classic immediate Denture ---- relining/refitting is done Interim / Transitional / Nontraditional immediate Denture ----- New CD is made Immediate Complete Denture : Immediate Complete Denture Conventional immediate denture -the denture is intended to be relined to serve as the long-term prosthesis. Interim (or transitional) immediate denture (IID): -after healing is completed, a second, new complete denture is to be fabricated as the long-term prosthesis. (Zarb, George A. Zarb. Prosthodontic Treatment for Edentulous Patients, 12th Edition. Elsevier, 2003. 9.1). Immediate RPD : Immediate RPD Normally made of acrylic with “ball clasps” No posterior teeth –only acrylic “bite pads” Transitional Replaced after healing with cast RPD Advantages : Advantages Maintenance of a patient's appearance Circumoral support, muscle tone, vertical dimension of occlusion, jaw relationship, and face height can be maintained. The tongue will not spread out as a result of tooth loss Less postoperative pain as extraction sites are protected Easier to duplicate (if desired) the natural tooth shape and position Adaptation easier. Speech and mastication are rarely compromised, and nutrition can be maintained Availability of tissue-conditioning material Patient’s psychological & social well-being is preserved Disadvantages : Disadvantages Immediate dentures are a more challenging The anterior ridge undercut (by the presence of the remaining teeth) may interfere with the impression procedures The presence of different numbers of remaining teeth in various locations frequently leads to recording incorrectly the centric relation position No denture tooth try-in in precludes knowing what the denture will actually look like on the day of insertion more chair time, additional appointments, and therefore increased costs Explanation to the Patient Concerning Immediate Dentures : Explanation to the Patient Concerning Immediate Dentures Do not fit as well as normal complete dentures. The pain of the extractions, in addition to the sore spots caused by the immediate denture, will make the first week or two after insertion difficult. It will be difficult to eat and speak initially The esthetics may be unpredictable because an anterior try-in is not possible Explanation to the Patient Concerning Immediate Dentures : Explanation to the Patient Concerning Immediate Dentures Immediate dentures must be worn for the first 24 hours without being removed by the patient. If they are removed, they may not be able to be reinserted for 3 to 4 days. The dentist will remove them at the 24-hour visit Immediate dentures will “loosen” during healing, tissue conditioners will be required 6 to 9 months after insertion at least a reline will need to be done, possibly a remake . The patient is responsible for fees. Technique : Technique Examination/Diagnosis/Treatment Plan Informed consent Oral hygiene procedures Extract (usually all) posterior teeth Wait 4 weeks for healing Technique : Technique Preliminary impressions Final impressions Jaw relation records Tooth set up and try in Extraction and insertion Post insertion care Examination/Diagnosis/Treatment Plan : Examination/Diagnosis/Treatment Plan Assess tissue undercuts (especially in the anterior maxilla -reduce during extractions -use 2 piece tray for impression Is VDO correct? Imitate or change tooth arrangementfor esthetics or denture stability -midlines, occlusal plane, vertical overlap, length of maxillary incisors Conventional or transitional Technique : Technique Examination/Diagnosis/Treatment Plan Informed consent Oral hygiene procedures Extract (usually all) posterior teeth Wait 4 weeks for healing Preliminary impressions : Preliminary impressions Use dentate or partially edentulous stock trays Final Impressions : Final Impressions Normally need to use 2 piece custom tray If no large tissue undercuts may be able to us 1 piece custom tray Full arch custom tray : Full arch custom tray 1 piece tray : 1 piece tray Border molding & Final Impression : Border molding & Final Impression 2 piece tray : 2 piece tray Reassembling two sections : Reassembling two sections Jaw relation records : Jaw relation records Occlusion rims : Occlusion rims Mounted casts : Mounted casts Tooth set up and try in : Tooth set up and try in Extraction and insertion : Extraction and insertion Have lab complete set up and modify cast as directed. -use perio probing to guide cast modification Compare with pre-extraction casts : Compare with pre-extraction casts Extraction and insertion : Extraction and insertion Request a surgical stent (guide) Extraction and insertion : Extraction and insertion Extract teeth Use surgical guide to contour ridge Seat the denture -try not to use of PIP -check for over extensions THE DENTURE MUST BE FULLY SEATED Adjust occlusion Give post insertion instructions Timeline for insertion appointment : Timeline for insertion appointment 0-15 (min)-review med history and LA 15-60-extractions 60-75-move patient to pros cluster 75-120-insert and adjust-instructions Instructions to patient : Instructions to patient Do not remove until tomorrow's appointment If it comes loose/out put it back in place immediately Sot/liquid diet for 24 hours Avoid rinsing Take analgesic Expect red saliva 24 hour appointment : 24 hour appointment Remove and clean denture Relieve sore spots Do not use PIP 1 week : 1 week Relieve sore spots Use PIP Refine occlusion Follow up : Follow up Use tissue conditioner to refit as needed Remove any socket convexities to avoid healing defects Reline or remake in 6 to 9 months You do not have the permission to view this presentation. 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