Immediate dentures 1

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Immediate dentures 1
2013-11-15 08:47:10
Immediate dentures

Immediate dentures 1
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  1. What are the challenging factors of immediate denture treatment?
    • limited evaluation of trial
    • increased complexity, cost, discomfort, maintenence, visits,
  2. What are the benefits of immediate denture treatment?
    • better healing, ridge form
    • prevents facial musclulature collapse, pathologic invasion, bone loss, embarassment
    • facilitates pt adaptation, health
    • guide for individual esthetics and perspective occlusion
  3. Basic understanding of immediate denture treatment sequence
    • 1 clinic: Exam & preliminary impressions
    • 1 lab: custom trays
    • 2 clinic: master
    • 2 lab: record base & occlusion rim
    • 3 clinic: max-mand relation, tooth selection
    • 3 lab: wax trial (if indicated)
    • 4 clinic: wax trial tryin, confirm mounting/esthetics
    • 4 lab: complete setup festooning, turn in for processing
    • * schedule extractions
    • 5 clinic: extractions/insertion, adjust tissue surface, flanges, occlusion, give care instructions
    • 6 clinic: 24 hr
    • 7 clinic: 72 HR
    • 8 clinic: one week, clinical remount
  4. Recognize the situations that require pre-prosthetic surgery so the properly-planned surgical procedure will be performed during extraction appt
    Preprosthetic surgery (alveoloplasty, tuberosity reduction, tori removal etc.) should be planned together with extraction for a case like this
  5. Oral exam checklist for potential immediate denture patients
    • 1. soft tissues
    • 2. ridge and alveolar contours (gross undercut or not)
    • 3. teeth:
    • - look for potential RPD
    • - abutments or overdenture
    • - support roots
    • 4. jaw relation, occlusal plane, and VDO (acceptable or overclosed)
    • 5. interarch space ( sufficient for prosthesis or not)
  6. Possible Diagnosis leading toward to immediate denture treatment option
    • Severe periodontitis
    • Partial edentulism
    • Rampant caries
  7. Describe two-stage surgical approach for immediate dentures. What is the indication and what are the advantages for this approach?
    • One-stage surgical approach: extract all teeth at the same time
    • Two-stage surgical approach: extract posterior teeth/and or problematic teeth first
    • 1. Ensure an optimal final impression that conform accurately to the contour of buccal, labial, and lingual vestibules.
    • 2. Shorter and simpler surgery at the time of ID delivery.
    • 3. After initial extraction some edentulous spaces become available for esthetic try-in and confirmation of jaw record
    • 4. Extraction of teeth that require immediate attention (e.g., infected and/or painful teeth)
  8. What are the four key questions that should be addressed to better manage our denture patient’s expectation?
    • 1. What are the benefits of having a denture vs. other options?
    • 2. How long will the denture last?
    • 3. What are the limitations of the denture?
    • 4. How much will the denture cost? (ID fee + permanent reline fee/or remake CD fee)
  9. What can immediate denture offer in terms of esthetics, function, and comfort? Should the dental implant option be included for the ID patient and why?
    • esthetics: excellent
    • function: restore some masticatory not all, pt adaptation
    • comfort: hard 1st week, improves after
    • Always inform the patients about implant option for the ultimate solution for function and comfort IF their expectation can not be met by the immediate denture phase.
    • Immediate denture is a transitional phase in order to remove
    • the hopeless teeth and regain the healthy oral environment.
    • Definitive replacement options (lab reline of ID, or new CD, or implant option)
    • will be revisited based on patient’s adaptation and response to their ID phase
  10. How to prepare our patient prior to the master impression appt
    • Place soft liner in the old partial denture, if indicated. Consult with instructor.
    • Instruct your patient to remove existing removable partial dentures for 24 hours prior to the final impression appointment.
    • Prophylaxis:remove all calculus from the remaining teeth so that the tissues will be in optimum condition during treatment planning, impressions, extraction and denture placement.