Immediate dentures are dentures constructed and inserted immediately following tooth extraction. The document discusses the definition, history, advantages, and types of immediate dentures. It provides details on the clinical and laboratory procedures for fabricating immediate dentures, including making impressions, arranging teeth, processing the denture, and inserting it following extractions. Post-insertion patient instructions and maintenance are also outlined.

1. Immediate dentures
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2. Introduction
 Not new
 History-The use of immediate denture
Richardson (1860)
 Significant milestones
 As physiologically and psychologically atraumatic as possible
 The best interest of the patient is their appearance (Public demand)
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3.  Definition
 Advantages and disadvantages
 Types
 Clinical and laboratory procedures
 Patient instructions and maintenance
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4. Definition
 A denture constructed before the extraction of the teeth which it
replaces and fitted immediately after the teeth are extracted.
( MacGregor, 1989)
 A dental prosthesis constructed to replace the lost dentition and
associated structures of the maxillae and /or mandible, and
inserted immediately following removal of the remaining natural
teeth .
(Heartwell,1965)
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5.  A denture placed immediately after the extraction of
the remaining 6 anterior teeth, the posterior teeth
having been removed 6 weeks prior to making the
dentures.
Payne(1964)
LaVere(1973)
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6. Advantages of immediate denture
1. Prevent patient embarrassment
 Reluctant to have their condemned teeth removed if
their teeth are not replaced immediately
 Fear edentulous state
2. Promote patient health
 Immediate denture prevent the prolong retention of
diseased teeth
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7. 3. Provide guide for optimal esthetics
 Form, size, color and arrangement of the natural teeth
reproduced more easily
 The most natural appearing dentures are immediate
denture
 Have opportunity to copy
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8. 4. Provide guide for occlusal vertical dimension
 Presence of some maxillary and mandibular natural
teeth provide guide
 By two means: -Centric holding teeth (contact of
opposing teeth)
-From observation of closet speaking
space
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9. 5. Promote better healing
 As a surgical stent pressure to soft tissues to
facilitate healing
 Formation and protection of blood clots
reduced bleeding and post extraction pain
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10. 6. Promote better ridge form
 Results in an edentulous ridge with better form and
more resilient soft tissue covering
Kelly and Sievers (1959), John (1966)
7. Prevent collapse of facial musculature
 Orbicularis oris muscle needs the support of anterior
teeth for proper function and for normal lip contour
 Change in tongue shape is prevented
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11. 8. Hasten patient adaptation to denture
 Completely edentulous state for a long time
learn new habits in speaking and chewing
 Makes the adjustment to speaking and eating with
dentures much less difficult
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12. Disadvantages
 Accurate reproduction is not possible if natural teeth
are maloccluded
 Need additional expense and time
 General health sometimes may not permit multiple
extractions
 Not possible for all types of patients
 Gross oral sepsis and other pathology
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13. Types
1. With anterior teeth socketed (Open face design)
2. Labial flange without alveolectomy
3. (a) Labial flanged with alveolectomy (Excision)
(b) Labial flanged with alveolotomy (Incision)
4. Post-immediate or delayed immediate dentures
5. Immediate partial denture
6. Immediate complete overdenture
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14. 1.With anterior teeth socketed (Open face design)
Advantages
 Very natural appearance
 Easy to insert
 Exact reproduction of tooth position
 Easier to set in laboratory
 No interference with lip musculature
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15. Disadvantages
 Poor retention and inadequate support
 No longer natural appearance
 Short denture life
 Slightly difficult to rebase
 Irregularities of anterior ridge may develop
 Sockets and gingivae must not be traumatized during
surgery
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16. 2. Labial flange without alveolectomy
Advantages
 Good retention and support
 Rapid healing with smooth ridges
 Ease of rebasing
 Stronger denture
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17. 2. Labial flange without alveolectomy
Disadvantages
 Poor appearance owing to labial fullness
 Difficult in case of undercuts
 Lack of space around necks of the teeth
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18. 3.(a) Labial flanged with alveolectomy (Excision)
 Prominent premaxilla to prevent insertion of flange
denture and give a poor appearance if socketed teeth
were used
 Limited anterior interalveolar space and deep vertical
overlap
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19. (b) Labial flanged with alveolotomy (Incision)
 The operation of transeptal alveolectomy or interseptal
alveolotomy
 Collapsing of anterior buccal plate by surgical means to
eliminate the undercut
Disadvantages
 Undercut cannot always be completely eliminated
 From the point of alveolar ridge preservation, it should
always be avoided if possible
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20. 4. Post-immediate or delayed immediate dentures
 Used after removal of extensive bridges or implants
 Where there is pathology e.g. large cyst
 To replace posterior and anterior teeth at the same
time
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21. 5. Immediate partial denture
 For esthetic reasons or space maintenance
 Used socketed dentures with proper follow-up
treatment prior to construction of bridges
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22. 6. Immediate complete overdenture
 Advantages are similar to the overdenture treatment
 Maintenance of more residual ridge integrity
 Denture stability and retention
 Patient’s subjective perception
 Psychological support
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23. Clinical and Laboratory Procedures
 Explained advantages and limitations
 Agreed the extra expense involved
 rebase in a few months
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24. Clinical and Laboratory Procedures
 The posterior teeth are extracted
 Decide which teeth to be retained (1st premolar, incisors and
canines)------correct jaw relationship
 under LA or GA
 minimum 2 visits
 smoothing interdental and inter radicular alveolus
 adequate suturing
 Allowed to heal for 3 weeks, 6 weeks or 8 weeks depending on
various factors
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25. Clinical and Laboratory Procedures
 Allowed to heal (recall visits) for
 3 weeks,
 6 weeks or 8 weeks depending on various factors
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26.  Alginate impression is made with stock tray as a
preliminary impression
 Two layers of wax used to block out the undercuts in
the dentulous areas of the cast
 Individual tray fabricated over the diagnostic cast
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27.  Master impression made in alginate or elastomer
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29.  Record blocks prepared on the stone cast
 Jaw relations registered in returded contact position
 Set Posterior teeth
 For anterior teeth
 local alginate impression with sectional tray
 pour wax into it
 invested and process individually
 Draw fillings, stains or any peculiar characteristics
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30.  tried in the partial wax dentures for occlusion(with
posterior teeth)
 anterior teeth (Shade, shape, form)
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31.  The anterior teeth in the master cast broken away up
to the cervical margin
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32.  The sockets about 1-2mm
deepened
 Further 1-2mm at the
labial part of socket
made
 Only the labial aspect of
the artificial teeth
occupied the socket
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33.  The arrangement of
anterior teeth should in
harmony with the
existing teeth as well as
posterior teeth
 Never socket a lower
denture which is always
better with a labial
flange
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34.  The denture flasked, de-waxed , packed, processed
and finished
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35.  During the insertion appointment, the remaining
anterior teeth extracted as atraumatically as possible
 finished denture is seated in the patient mouth
 adjustments to the dentures ------contraindicated
 dismiss the patient with certain instructions
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36. Patient instructions
 Advised to wear the denture continuously for the next
24 hours (MacGregor, 1989), (Seal et al, 1996), 48
hours (Jaypee, 2003)
 Oral cavity kept meticulously clean after the first 24
hours and until healing is completed
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37.  At recall visit
 Rinsed with suitable mouth wash
 instruct to clean after every meal
 Next visit is after 3-5 days
 Checked occlusion and perfected by selected
grinding
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38.  Relining should be necessary after 2-3 months
 A new denture may be necessary after 1-2 years
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44. Procedures for immediate complete overdenture
 Reduced the crown to be used as an abutments to the
desired form in the master cast.
 Trimmed the teeth to be extracted up to gingival
margin in the master cast.
 Fabricated the overdenture over this master cast.
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45.  Done endodontic treatment of the abutment teeth a
few days prior to the insertion
 Done the crown reduction of abutment teeth as the
crown on the master cast.
 Removed the teeth to be extracted atraumatically
 Inserted the immediate complete overdenture
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46. Conclusion
 Immediate dentures allow patients to continue their
social activities without being in an edentulous state
 Dentists are responsible not only the fabrication of
immediate denture but also informing the patients
about their treatment options, instructions to take
care of their oral tissues and dentures, and continuing
maintenance
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