Immediate dentures are prostheses fabricated and inserted immediately following tooth extraction. There are two main types: conventional (classic) immediate dentures which serve as long-term prostheses, and interim (transitional) immediate dentures which will be replaced later after healing. The clinical and laboratory procedure involves making impressions, modifying the stone cast for improved fit, optionally using a surgical template, and inserting the denture immediately after extractions with follow-up relines and adjustments as needed. Immediate dentures can help maintain appearance, function, and quality of life but require more appointments and technical skill compared to delayed dentures.

1. IMMEDIATE
DENTURES
Nikita Aggarwal
1st yr pg
Department Of
Prosthodontics
Preceptor: Dr. Gaurav Issar

2. CONTENTS
 Introduction
Types of Immediate Dentures
Advantages and Disadvantages
Indications an Contraindications
Clinical and Laboratory procedure
Post operative care

3. INTRODUCTION- IMMEDIATE
DENTURE
Any fixed or removable dental prosthesis
fabricated for placement immediately
following the removal of a natural
tooth/teeth
- GPT 9

4. INTERIM/PROVISIONAL
PROSTHESIS
a fixed or removable dental prosthesis, or maxillofacial
prosthesis, designed to enhance esthetics, stabilization,
and/or function for a limited period of time, after which it
is to be replaced by a definitive dental or maxillofacial
prosthesis; often such prostheses are used to assist in
determination of the therapeutic effectiveness of a specific
treatment plan or the form and function of the planned for
definitive prosthesis.
- GPT 9

6. For a patient facing the loss of
all his/her remaining natural
teeth, there are 4 treatment
options available-

7. OPTION 1
To remove all remaining teeth and wait for 6-8 months for
the extraction site to heal. The complete denture is made
following healng.

8. OPTION 2
To convert an existing RPD into an Interim Complete
Denture
OPTION 3
To make a conventional immediate complete denture

9. OPTION 4
To place implans and fabricate dentures or if some teeth
are healthy can be use as to make an overdenture

10. TYPES OF IMMEDIATE DENTURES
Conventional (classic)
i. Long term prosthesis
ii. Can be relined
iii. Good stability and
retention at placement
iv. Cost is less
Interim (transitional or non
traditional)
i. Transitional prosthesis
ii. New denture to be made
after healing
iii. Fair stability and
retention which must be
improved by relining
during healing
iv. Cost is higher ( two
dentures will be made)
Prosthetic treatment for edentulous patients, Zarb, Bolender 12th edition

11. Conventional (classic)
i. Esthetics cannot be
changed
ii. If all post. Teeth are
initially remove, the
V.D.O. is not preserved (
opposing premolars can
be preserved or this)
iii. No transitional denture
Indications
i. Only anterior teeth
remian or a few posterior
that do not support the
existing R.P.D.
ii. Two extraction visits are
feasible
Interim (transitional or non
traditional)
i. Esthetics can be improved in
the second denture
ii. As post. Teeth need not be
removed before fabrication
of IID, the V.D.O. may be
preserved.
iii. Can be made from
transitional denture
Indications
i. When multiple anterior and
posterior teeth are present or
existing R.P.D. that patient
wishes to retain until
insertion – esthetics ;
function

12. TRANSITIONAL IMMEDIATE
DENTURE
It is an interim immediate
denture.
However it is a R.P.D. serving
as an interim preosthesis to
which artificial teth will be
added as all the natural teeth
are lost.
It may become an interim
complete denture when all of
the natural teeth have been
removed from the dental

13. CLASSIFICATION BY ARTHUR M. LAVERA AND ARTHUR
J. KROL - 1973
According to buccal flange, ICDs can be classified into
three categories:
(i) Immediate complete denture at the full labial buccal
flange, which has a vestibule portion identical to a
conventional denture; in this case, a surgical preparation
of the mouth vestibule is required

14. (ii) Immediate complete denture with partial buccal
flange in which only the initial portion of the buccal side
is made, above the cervical edge of artificial teeth. This
procedure does not require bone surgery because it
does not reach the undercut area of the alveolar ridge;
(iii) Immediate complete denture without vestibule
flange, having teeth mounted directly on the alveolar
ridge (it shows better aesthetic results but may fail to
provide adequate lip support when there is bone

15. ADVANTAGES
1. Maintenance of patient’s appearance as they are not
without teeth even for a day
Psychological and social well being is
preserved as the patient does not
have to go without teeth, no
interruption of normal lifestyle.

16. 2. Bandage or ressing effect to the wounds of
exraction and alveolectomy.
-Controls haemorrhage
-Prevents outside contamination of wound
-Maintain rugs or other therapeutic agents at
the site of the wounds

17. 3. Less post-operative pain as extraction site is
protected.
4. Vertical dimension, jaw relation, muscle tone,
facial height and tongue position is maintained.
5. The horizonatal and vertical position of anterior
teeth can be more accurately replicated

18. 6. Patient is likely to adapt more easily to dentures
at the same time that recovery from surgery is
progressing.
7. Speech and mastication are rarely compromised
and nutrition is maintained.
8. Tissue conditioning material allows for
correction and refinement of denture fitting
surface

19. DISADVANTAGES
1. The presense of different number of remaining
teeth in various locations frequently leads to
incorrect recording of centric relation and V.D.O.
2. It is a more difficult and demanding procedure,
more chair time, additional appointments and
therefore increased costs are unavoidable.

20. 3. Interim relines with tissue conditioners will be
neeed periodically.
4. There is no opportunity to observe the anterior
teeth at the try-in appointment;esthetic result
cannot be evaluated.

21. INDICATIONS
i. Patient is socially active
ii. Good health
iii. Available time and can afford multiple visits

22. CONTRAINDICATIONS
1. Emotionally disturbe indivisuals with
psychological disorers
2. Poor surgical risks-
• Cardiac / Endocrine disturbances
• Systemic condition that effects blood clotting
• Post irradiation of the head and neck regions
3. Uncooperative patients
4. Patients with extensive bone loss

23. CLINICAL AND LAB PROCEDURE

25. PROTECTION OF LOOSE TEETH FROM
EXTRACTION DURING PRELIMINARYOR
FINAL IMPRESSION PROCEDURES

26. CUSTOM TRAY

27. SINGLE FULL ARCH CUSTOM
IMPRESSION TRAY

28. TWO TRAYS OR SECTIONAL
IMPRESSION TRAY

29. THE CAMPAGNA COMBINATION
IMPRESSION

31. CAST MODIFICATION
Most well known methos are-
1. Standard (1958)
2. Jerbi (1961)
3. Spatial Modelling (2008)
Phoenix, R. D., & Fleigel, J. D. (2008). Cast modification
for immediate complete dentures: Traditional and
contemporary considerations with an introduction of
spatial modeling. The Journal of Prosthetic Dentistry,
100(5), 399–405. doi:10.1016/s0022-3913(08)60244-9

32. STANDARD

33. JERBI

35. Both the above techniques yielded reasonable
success on clinical observation
Though there is overzealous reduction at the
facial, lingual and interproximal areas.
Dentures bases would bind in these aras during
placement preventing the complete seating,
necessitating the adjustment of denture base,
supporting hard and soft tissues or both.

37. SPATIAL
MODELLING

38. SURGICAL TEMPLATE
I. Accurate adaptation
of an immediate
denture to
underlying tissue is
desirable for the
comfort of the
patient and health
of tissues
II. Accurate adaptation
in the surgical site I

39. Hence a surgical template is recommended
It is a thin, transparent form duplicating the tissue
surface of an immediate denture and is used as a
guide for surgically shaping the alveolar process.

40. SURGICAL TEMPLATE
Four methods-
1. Vacuum form method
2. Sprinkle on technique (using clear acrylic resin)
3. Light cured clear material
4. Process the etemlatein clear acrylic resin, create
by waxing up flasking and heat processing.

41. Advantages
Areas of binding are
clearly identified by
blanching of
theunderlying soft
tissues. Clinicians use this
information to guide
osseous recontouring at
the time of extraction
Hence improved seating
of immediate denture and
minimized damage to soft
tissues
Disadvantages
Modifications are
performed at the expense
of valuable osseous
tissues.

42. COMPARISON

43. While transparent surgical guides are an
indispensable component of immediate denture
therapy, they should not mandate unnecessary
reduction of the supporting bone.
Instead, cast modification should be performed
with a thorough appreciation for the spatial
arrangement and physical characters of the
supporting hard and soft tissues.

44. POST OPERATIVE CARE AND
PATIENT INSTRUCTIONS
The first 24 hours
1. Patient is instructed not to remove the denture
from the mouth
2. Avoid rinsing, drinking hot liquids or alcohol.
3. soft or liquid diet

45. FIRST VISIT AFTER DENTURE
INSERTION
Ask the patient where they feel sore
Remove the denture and wash it
Check the tissue for sore spots, relate to the
denture. This will appear as strawberry re spots.
Adjust any gross occlusal discrepancy in centric
relation or excursions

46. Re-evaluate the denture for retention, place tissue
conditioner if retention is unsatisfactory.

47. FIRST POSTOPERATIVE WEEK

48. FURTHER FOLLOW UP CARE

49. DENTURE RELINE

50. CONCLUSION

51. REFERENCES
1. Glossary of prosthodontics terms, 9th edition
2. Immediate denture service; Arthur m lavere and Arthur j krol (JPD jan 1973 vol 29
no 1,10-15)
3. Phoenix, R. D., & Fleigel, J. D. (2008). Cast modification for immediate complete
dentures: Traditional and contemporary considerations with an introduction of
spatial modeling. The Journal of Prosthetic Dentistry, 100(5), 399–
405. doi:10.1016/s0022-3913(08)60244-9
4. Immediate dentures: a clinical review and case repot (J Odontol Res
2015;3(1)44-48. )
5. Annals of Dental Research (2013) Vol 2 Suppl 1: 114-118 © Mind Reader
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