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Immediate dentures / lingual orthodontics courses

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Immediate dentures / lingual orthodontics courses

  1. 1. IMMEDIATE DENTURE INDIAN DENTAL ACADEMY Leader in continuing dental education www.indiandentalacademy.com www.indiandentalacademy.com
  2. 2. DEFINATION ‘THE GLOSSARY OF PROSTHODONTIC TERMS ‘DEFINES AN IMMEDIATE DENTURE AS A COMPLETE OR REMOVABLE PARTIAL DENTURE CONSTRUCTED FOR INSERTION IMMEDIATELYFOLLOWING THE REMOVAL OF NATURAL TEETH. www.indiandentalacademy.com
  3. 3. ADVANTAGES 1. NO EDENTULUS PERIOD. 2. PATIENT IS LESS APPREHENSIVE. 3. PATIENT CAN CONTINUE WITH HIS NORMAL ACTIVITIE. 4. DIGESTIVE FUNCTION IS NOT INTERRUPTED. 5. GENERAL APPEARANCE IS LESS AFFECTED . 6. LESS RESORBTION OF THE RIDGES . www.indiandentalacademy.com
  4. 4. 7.UNFAVORABLE SPEECH AND CHEWING HABITS ARE NOT LIKELY TO OCCOUR . 8.CENTRIC RELATION IS EASIER TO RECORD. 9.PATIENT TAKES LESS TIME TO ADJUST TO THE CHANGE,HEALING IS FASTER AND LESS PAINFUL. 10.THE IMMEDIATE DENTURE ACTS AS A MATRIX FOR CONTROLING HEMORRHAGE ,PROTECTS THE WOUND, PREVENTS CONTAMINATION. 11. THE NATURAL TEETH ACTS A GUIDE FOR THE SETTING OF THE ARTIFICIAL TEETH. www.indiandentalacademy.com
  5. 5. DISADVANTAGES 1. THE IMMEDIATE DENTURE NEED TO BE RELINED OR REMADE . 2. MORE EXPENSIVE . 3. NO ANTERIOR TRY IN www.indiandentalacademy.com
  6. 6. DIAGNOSIS AND TREATMENT PLANNING 1.MEDICAL HISTORY. 2.DENTAL HISTORY. clinical examination of hard and soft tissues periodontal status of the remaining dentition 3.Radiographs3.Radiographs ToTo evaluating the extent of bone loss. determine the presence of impacted teeth, retained roots, foreign bodies, exostoses, osteoporosis, cysts, and other pathology www.indiandentalacademy.com
  7. 7. Mounted diagnostic casts 1.To evaluate the tooth position, jaw relationships, and occlusal plane discrepancies. 2.Diagnostic casts also help to reveal and analyze undercuts . 3.The cast can be marked to show the oral surgeon where to recontour the bone . www.indiandentalacademy.com
  8. 8. TREATMENT PROCEDURES Initial Impressions. Initial impressions are made with irreversible hydrocolloid (alginate) in a stock tray. The impression should be well extended and have adequate hard and soft tissue detail. The impression is poured with dental stone. A custom tray is fabricated with autopolymerizing acrylic resin on the preliminary cast. www.indiandentalacademy.com
  9. 9. A custom tray is fabricated with autopolymerizing acrylic resin on the preliminary cast. The remaining teeth are covered with a double thickness of baseplate wax. This provides space for the impression material around the teeth. Any undercut areas are blocked out with wax. The tray borders should be sufficiently thick www.indiandentalacademy.com
  10. 10. Special tray fabricated on the cast www.indiandentalacademy.com
  11. 11. Secondary Impressions Prior to making the impression, the mobility of the remaining teeth must be evaluated. If the teeth are very mobile undercuts and interproximal are blocked with soft wax to avoid extracting the teeth with the impression. Tightly coating the teeth with petrolatum. In severe cases a vacuum-formed resin stent can be utilized as a protective sheath while making the impression www.indiandentalacademy.com
  12. 12. The custom tray is placed in the patient's mouth and evaluated. Overextended sections are relieved and borders reduced to provide room for the border molding material. The posterior palatal seal can be determined at this time and transferred to the tray. Border moulding is performed with green stick compound. www.indiandentalacademy.com
  13. 13. Special tray with boader moulding www.indiandentalacademy.com
  14. 14. Perforations are placed in the tray to enhance the flow of the impression material and increase its retention within the custom tray. The tissue surface of the tray and the borders are covered with the appropriate adhesive. Light –bodied polysulphide rubber is the material of choice for the final impression. www.indiandentalacademy.com
  15. 15. Final impression and master cast www.indiandentalacademy.com
  16. 16. Jaw Relation Records A recording base is fabricated from auto-polymerizing acrylic resin, and an occlusal rim is made from baseplate wax . A face-bow record is made to orient the maxillary cast on the articulator. Vertical dimension is determined . Phonetics is the most reliable way of evaluating the vertical dimension www.indiandentalacademy.com
  17. 17. The centric relation record is made with impression plaster or zinc oxide-eugenol impression paste. The centric relation record is removed from the mouth, trimmed, and verified . The mandibular cast is mounted using the centric relation record. A protrusive interocclusal record is made to set the condylar guidance on the articulator. www.indiandentalacademy.com
  18. 18. Jaw relation recording www.indiandentalacademy.com
  19. 19. Tooth selection and arrangement of posterior teeth The existing dentition is used as a guide. If the immediate denture opposes natural teeth then anatomic tooth form is desired. If opposes a complete denture then either anatomic or non anotomic teeth can be given. Porcelain teeth should never be used when the immediate denture oppose natural teeth. Posterior teeth are set to provide multiple bilateral posterior contact in centric and eccentric positions. www.indiandentalacademy.com
  20. 20. Shade selection www.indiandentalacademy.com
  21. 21. Posterior try- in Centric relation and vertical dimension are verified. Mandibular cast is remounted if required. Position of the posterior palatal seal is verified and scribed on the master cast. www.indiandentalacademy.com
  22. 22. Posterior try-in www.indiandentalacademy.com
  23. 23. Arrangement of anterior teeth Done after the posterior try –in The anterior teeth are removed one at a time from the master cast. Each teeth is reduced to the gingival margin with a rotary instrument and smoothened with a hand instrument . Denture tooth is placed in its place this procedure is repeated with each tooth. www.indiandentalacademy.com
  24. 24. Arrangement of anterior teeth www.indiandentalacademy.com
  25. 25. Denture is waxed up. Dewaxing is done . Denture is processed in the conventional manner. Stored in a germicidal solution and thoroughly rinsed prior to insertion . www.indiandentalacademy.com
  26. 26. Insertion procedure Patient is prepared for surgery. The remaining teeth is removed with minimum of trauma . A clear surgical is used to evaluate the prepared surgical site . The immediate denture is seated after surgery and gross occlusal prematurities are eliminated while the patient is still under LA. The denture must be manipulated as minimum as possible to minimize the damage to the surgical site. www.indiandentalacademy.com
  27. 27. Extraction of the anterior teeth and insertion of the immediate denture www.indiandentalacademy.com
  28. 28. If the dentures are poorly adapted or lacking in retention and stability Tissue conditioners can be placed. The following instructions are given to the patient. Application of cold packs . The patient is advised to wear the denture for the next 24 hours .and to avoid smoking ,expectoration and use of mouthwash. Soft diet. Appropriate pain control medication.www.indiandentalacademy.com
  29. 29. Post insertion care After 24 hours Check the occlusion . Denture is removed and the tissue is evaluated for ulceration and over extension. Tissue surface of the denture is cleaned . Patient is asked to rinse the mouth with a good tasting mouthwash. Then denture should be removed and reinserted as minimum number of times as possible . www.indiandentalacademy.com
  30. 30. After 48 hours All the things done during the previous appointment is repeated. Patient is instructed to clean the denture several times in a day. The patient should wear the denture in the night for three days. Soft diet www.indiandentalacademy.com
  31. 31. After one week Remove the suture . Recheck the occlusion. Tissue surface evaluated with pressure indicating paste . Any soreness or irritation relieved. Replacement of the tissue conditioner if placed at insertion, It should be replaced every week until resilient liner is placed. www.indiandentalacademy.com
  32. 32. 3 to 4 weeks later Subjective complaints are addressed. Clinical remount performed. Occlusion refined. Treatment lining with resilient chair side liners . resilient liners are repeated at intervals of 4-6weeks for six months www.indiandentalacademy.com
  33. 33. After 6 months The immediate denture is relined or remade. If the patient is satisfied with esthetics and function the denture is relined. If the patient is not satisfied with esthetics , retention or if the denture is not adequately extended the denture is remade . Before it is relined or remade the tissues should treated with tissue conditioners . www.indiandentalacademy.com
  34. 34. Summary Immediate denture is one option for the patient facing the edentulous state .An immediate denture provides restoration of esthetics ,phonetics and masticatory function. The patient does not have endure a long healing process with out teeth, it also facilitates the transition to the edentulous state. Proper follow up care is essential for the success of an immediate denture. www.indiandentalacademy.com
  35. 35. Thank you For more details please visit www.indiandentalacademy.com www.indiandentalacademy.com

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