immediate dentures

Views:
 
Category: Education
     
 

Presentation Description

ppt

Comments

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

authorStream Live Help