The document discusses immediate dentures, which are complete or partial dentures fabricated immediately after tooth extraction. It describes the differences between conventional (classic) immediate dentures and interim (transitional) immediate dentures. Conventional immediate dentures are intended as the long-term prosthesis and are made when only anterior teeth remain. Interim immediate dentures are short-term and are made when posterior teeth remain, requiring only one surgical visit. The document outlines the procedures, indications, contraindications, advantages and disadvantages of both types of immediate dentures.

2. RADHA.M
CRRI

3. AN IMMEDIATE DENTURE IS “A COMPLETE DENTURE OR
REMOVABLE PARTIAL DENTURE FABRICATED FOR
PLACEMENT IMMEDIATELY AFTER THE REMOVAL OF
NATURAL TOOTH”

4.  Conventional ( or ) classic immediate denture
 Interim( or ) transitional ( or ) non traditional
immediate denture

5.  Maintenance of a patient’s appearance because there is no
edentulous period .
 Less postoperative pain.
 Circum oral support , muscle tone , vertical dimension of
occlusion , jaw relationship and face height can be maintained.
 Easy to duplicate the natural tooth.
 Easy for the patients to adapt to the denture.
 Patients psychological and social well being is preserved.

6. The anterior ridge undercut that is caused by the
presence of the remaining teeth.
No anterior try in. Functional activities (eg : speech
&mastication)are likely to be impaired
More chair time, additional appointments , increased
cost.

7. Maxilla
Anterior teeth present
Cooperative patient
Multiple extractions
Esthetics
Function
Patient needs/demands

8.  Patients with poor general health.
 Un-cooperative patients.

10.  After this immediate denture is placed
and after healing is completed , the
denture is refitted or relined to serve as
the long – term process

11.  Indicated when anterior teeth are present or few
posterior teeth remain that do not support an existing
removable partial denture.
 Indicated when patients can function without posterior
teeth for approximately 3 months.
 Indicated when two extraction visits are fessible

12.  Contraindicated for a patient who has a complex
treatment plan ( e.g periodontal therapy , crowns
, fixed partial dentures and removable partial
dentures in the opposing arch )
 Contraindicated for changes in the vertical
dimension of occlusion

13.  CID will usually have better initial retention and
stability.
 CID has an easier surgical session and a second surgical
date.
 Cost of CID is less.

14.  It requires two surgical visits.
 The CID technique includes a period of posterior partial
edentulism , which impairs mastication and
compromises esthetics.
 The CID takes long time to fabricate.

15. 1.Impression procedures
a)Initial
b)Secondary
c)Alternative
2.Jaw relation record

16. 3.Teeth selection& arrangement of posterior teeth
4.Posterior try in.
5.Arrangement of anterior teeth.
6.Insertion procedure.
7.Post insertion care.

17.  Initial impressions are made with
irreversible hydrocolloid in a stock
tray
 The impression is poured with dental
stone
 A custom tray is fabricated with auto
polymerizing acrylic resin on the
primary cast
 The remaining teeth are covered with a
double thickness of base plate wax
.This provides space for the impression
material around the teeth

18.  The custom tray is placed in the patient’s mouth and evaluated
 The tray is trimmed if needed
 Heated stick compound is added sequentially to the borders of the tray
and border moulded in the mouth
 Perforations are placed in the tray to enhance the flow of the
impression material
 Light-bodied elastomer is the material of choice for the final
impression.
 The impression is poured with vaccum-mixed dental stone

19.  In this procedure , the impression is
a combination of two recording
mediums
 The edentulous areas and periphery
are recorded in zinc oxide eugenol
and the teeth are recorded with
alginate
 A custom tray is fabricated that
covers only the posterior section of
the cast.

20.  An impression is made of the
edentulous area only using zinc
oxide eugenol.
 The impression is removed from the
mouth and alginate adhesive is
applied to the outer surface of the
tray.
 The impression is reseated in the
mouth and stock tray is loaded with
irreversible hydrocolloid and placed
in the mouth.
 The impression is poured with
vaccum mixed dental stone.

21.  A recording base is fabricated from auto polymerizing resin
and an occlusal rim is made from base plate wax.
 A face bow record is made to orient the maxillary cast and
articulator.
 If the patient has no posterior occlusion, the tentative occlusal
vertical dimension should be determined as it would be if the
patient were totally edentulous.
 The Centric relation record is made at a slightly increased
vertical dimension using a free flowing medium on the occlusal
rim such as impression plaster or zinc oxide eugenol paste.
 The centric relation record is removed from the mouth ,trimmed
and verified.

22.  If the immediate denture will oppose the natural
teeth , anatomic tooth form is preferable.
 If the immediate denture will oppose the complete
denture, either anatomic or non anatomic tooth
form is preferable.
 The posterior teeth are arranged on the recording
base.
 The teeth are set so as to provide multiple bilateral
posterior contacts in centric relation.

23.  Centric relation and occlusal vertical dimension
are verified.
 The position of the posterior palatal seal is
verified.

24.  The anterior denture teeth are arranged after the posterior try-in
appointment
 The anterior teeth are removed one at a time from the master cast
alternatively
 Each tooth is reduced to the level of the gingival margin
Denture teeth is positioned in the place.
 Diastema can be eliminated
 Slanted teeth can be straightened
 Smile line can be modified for improved esthetics
 Wax-up of the denture is completed
 The denture is processed

25.  The patient is prepared for surgery
 Local anesthesia is adequate
 The remaining teeth should be removed
with a minimum of trauma
 After the surgical procedures are completed,
denture can be positioned and seated
 Once the denture is seated ,gross occlusal
prematurities can be eliminated
 Tissue conditioner & adhesive powder also
used
 The patient should be recalled

26.  The patient must not remove the
denture during the first 48
hours
 Tissue inflammation & edema
from the surgery may prevent
the reinsertion of the denture for
several days
 Soft diet is advised to minimize
trauma

27.  The patient is seen at one week following
insertion
 The number of post insertion appointments
the patient will need depends on many
factors including age , general health ,
tissue sensitivity ,and the patient’s
emotional and psychological state
 After the four to five weeks and the
extraction sockets have filled , treatment
linings are begun with a resilient self-
curing liner
 These resilient linings are repeated several
times at four-to-six weeks intervals
 Before the immediate dentures can be
relined , the tissues should be treated with
a tissue conditioner

29.  After this immediate denture is made and after
healing is completed , a second, new complete
denture is fabricated as the long term prosthesis
 GLOSSARY OF PROSTHODONTIC TERMS
defines interim prosthesis as a prosthesis designed
to enhance esthetics , stabilization , and / or
function for a limited period of time , after which
it is replaced by a definitive prosthesis

30. Patient needs/demands
Multiple extractions

31. Both jaws simultaneously
Mandibular arch

32.  The IID has only 1 surgical visit.
 The IID procedures takes less over all time.
 Patients with IID can use all their teeth or wear
their existing removable partial denture up until
the day of extraction.
 IID leads itself better for complex treatment
plans.

33.  The retention and stability of IID is less

34.  An alginate impression is made of the jaws with the
remaining teeth
 The wax is heated & and poured into the impressions of the
teeth up to their gingival margins . dental stone is poured
 Another cast is poured fully of dental stone
 Second cast is used for making base plate & also acts as
referrence cast
 We have two casts , one with wax teeth and one with stone
teeth.

35.  A centric jaw relation record is made
 Inter occlusal wax record are now mounted on a
plane line articulator and any missing teeth are
supplied and set up in good centric relation
 The waxing is completed
 Flasking is done over the wax and prosthetic
teeth

36.  During the dewaxing , precautions must be
taken so that the wax only softens but does not
melt
 During this stage , prosthetic teeth are removed
 All the teeth replaced with tooth- coloured
acrylic resin
 A liquid tin-foil is applied to the stone mould.

37.  The pink denture base resin is spared when it is
fairly soft
 It is cured for a hours at 160*F and allowed to
cool to room temperature
 Dentures are trimmed and polished

38.  Local anesthesia is given
 The tooth indicated for extraction
are removed atraumatically
 Interim denture is inserted as
earlier as possible

39.  Interim dentures are worn a minimum of 12 weeks
, but they can be used as long as four (or) five
months

40.  The second set of dentures should have minimum
modifications and yet improve the appearance of
the teeth and the patient
 The very desirable fullness of the ridge is
preserved by the interim dentures

41. CONVENTIONALIMMEDIATEDENTURE INTERIMIMMEDIATEDENTURE
•Definitive or long-term
prosthesis
•Transitional or short-term
prosthesis
•At the patient’s initial
presentation , usually only
anterior teeth are remaining
•At initial presentation both
anterior and posterior teeth are
remaining
•The over all cost of CID
treatment is less
•The overall cost of IID
treatment is greater than CID
treatment
•Treatment process takes longer
then the IID
•Treatment process takes lesser
time
•Usually has good retention &
stability at placement
•Usually has fair retention &
stability at insertion , which
must be improved by
provisional relines

43. SHELDON
WINKLER
BOUCHER