IMMEDIATE DENTURES DR. KATE MAUNDU

1. Immediate Dentures
Maundu C.N
MDS II (PROS)
University of Nairobi

2. Definition
• An immediate denture is “any removable
dental prosthesis fabricated for placement
immediately following the removal of a
natural tooth/teeth.”
GPT 8 (2005)

3. Types
1. Conventional immediate dentures
2. Interim immediate dentures
(Gooya et al. 2013).

4. 1. Conventional (or classic) immediate
denture (CID)
• Fabricated to be immediately placed after
extraction of natural teeth.
• Can be used as the definitive or long-term
prosthesis.
• After healing, denture is refitted or relined to
serve as long-term prosthesis.
(Zarb &Bolender, 2004).

5. 2. Interim (or transitional or non-
traditional) immediate denture (IID)
• Used for a short time after tooth extraction.
• After healing, this immediate denture is
replaced with a new final long-term
prosthesis.
(Zarb &Bolender, 2004).

6. Indications for CID’s
• Selected when only anterior teeth remain
• Also if patient is willing to have posterior teeth
extracted before denture fabrication
processes begin.
(Zarb &Bolender, 2004).

7. Indications for IID’s
• Used when anterior and posterior teeth
remain until the day of extraction and
placement of the immediate denture.
(Zarb &Bolender, 2004).

8. Merits of Immediate Dentures
1. Maintenance of the patient’s appearance
because there is no edentulous period.
2. Circum-oral support, muscle tone, vertical
dimension of occlusion, jaw relationship, and
face height can be maintained*.
(Zarb &Bolender, 2004).

9. Merits of Immediate Dentures
3. Less post-operative pain likely to be
encountered because the extraction sites are
protected.
(Zarb &Bolender, 2004).

10. Merits of Immediate Dentures
• Interim immediate denture preserve facial
appearance and height, maintain muscular
tone, enhances phonetics and reduces post-
extraction pain (Seals et al. 1996).

11. Merits of Immediate Dentures
4. Patient likely to adapt more easily to
dentures as from surgery is progressing.
(Zarb &Bolender, 2004).

12. Merits of Immediate Dentures
5. Tissue-conditioners for correction and
refinement of the denture’s fitting surface, at
the insertion and subsequent appointments.
(Zarb &Bolender, 2004).

13. Merits of Immediate Dentures
6. The patient’s psychological and social well-
being is preserved.
(Zarb &Bolender, 2004).

14. Merits of Immediate Dentures
• Jonkman et al. (1995) found that 1 year after
denture placement, 76% to 79% of patients
with immediate dentures eat properly and
had adapted to denture wearing.

15. Demerits of Immediate Dentures
1. More challenging than complete dentures
because teeth make impressions and jaw
registration harder to record.
(Zarb &Bolender, 2004).

16. Demerits of Immediate Dentures
2. Anterior ridge undercut caused by remaining
teeth may interfere with impression
procedures and hamper accurate record of
any posteriorly located undercut, that may
be important for retention.
(Zarb &Bolender, 2004).

17. Demerits of Immediate Dentures
3. Remaining teeth in various locations may
lead to wrong centric relation record and
VDO.
• Occlusal adjustment, selective pre-treatment
extractions, may be needed to make accurate
records at the proper VDO.
(Zarb &Bolender, 2004).

18. Demerits of Immediate Dentures
4. No try-in.
• Careful planning, operator experience,
attention to details of the technique, and
explanation to the patient best address this
problem.
(Zarb &Bolender, 2004).

19. Demerits of Immediate Dentures
5. More difficult and demanding procedure,
more chair time, additional appointments;
greater cost implications.
(Zarb &Bolender, 2004).

20. Comparative Advantages
and Disadvantages of Immediate Dentures
1. The CID will usually have better initial
retention and stability because fewer teeth
are usually extracted on the day of
placement.
2. The CID has an easier surgical session on the
second surgical (denture placement) date.
(Zarb &Bolender, 2004).

21. Comparative Advantages of Immediate
Dentures
3. The overall cost of the CID is less.
4. The IID technique results in two dentures,
which is advantageous for some patients.
5. The IID has only one surgical visit.
(Zarb &Bolender, 2004).

22. Comparative Advantages of Immediate
Dentures
6. The IID procedure takes less overall time,
from the dentist’s meeting the patient to
placing the denture.
7. Patient with IIDs can use all their teeth or
wear their existing removable partial
denture(s) up until the day of extraction.
(Zarb &Bolender, 2004).

23. Comparative Advantages of Immediate
Dentures
8. The IID lends itself better to complex
treatment plans, especially in a patient who
needs an upper immediate denture opposing
a lower transitional removable partial
denture.
9. The IID is better for less experienced
practitioners because a second denture can
correct any imperfections.
(Zarb &Bolender, 2004).

24. Comparative Disadvantages of
Immediate Dentures
1. The CID technique requires two surgical
visits.
2. The CID technique includes a period of
posterior partial edentulism, which impairs
mastication and compromises esthetics.
3. The CID takes longer to fabricate, especially
in complex treatment plans.
(Zarb &Bolender, 2004).

25. Comparative Disadvantages of
Immediate Dentures
4. The single surgical visit for the IID is more
involved and lengthy than for a CID.
5. The retention and stability of the IID is less at
insertion.
• However, modern tissue conditioning
techniques negate this disadvantage.
(Zarb &Bolender, 2004).

26. CONTRAINDICATIONS OF IMMEDIATE
DENTURES
1. Poor general health and surgical risks.
2. Uncooperative.
• Do not appreciate scope, demands, and
limitations of immediate dentures.
(Zarb &Bolender, 2004).

27. Contraindications of Immediate
Dentures
3. Patients who do not object to going through
edentulous healing period.
• Do extractions then conventional complete
dentures.
• Simpler and less expensive.
(Zarb &Bolender, 2004).

28. DIAGNOSIS, TREATMENT PLANNING,
AND PROGNOSIS
Factors to Consider
• Advanced periodontal disease.
• Aberrant occlusal relationships.
• Might require “staged” surgical approach.
(Zarb &Bolender, 2004).

29. TREATMENT PLANNING
Factors to Consider
• Patient smile, occupation, and preference.
• The agreement by both patient and dentist is
that if the esthetic and occlusal outcome is
not satisfactory, a new definitive prosthesis
will be made.
(Zarb &Bolender, 2004).

30. TREATMENT PLANNING
Factors to Consider
• A careful explanation to the patient of the
limitations of immediate denture service
should always be given.
• It is helpful to have a list including all possible
difficulties.
(Zarb &Bolender, 2004).

31. Oral Examination
• A full mouth series of radiographs should be
taken.
(Zarb &Bolender, 2004).

32. Full mouth series of radiographs
(Zarb &Bolender, 2004).

33. (Zarb &Bolender, 2004).
Orthopantomogram View

34. Oral Examination
• The dental and medical history of the patient.
• A head and neck examination.
• Periodontal probings/full charting of all the
teeth, frenum position, tori presence.
(Zarb &Bolender, 2004).

35. Oral Examination
• Teeth to be retained as over-denture
abutments should be selected.
• Evaluation and palpation of the potential
denture-supporting tissues and the posterior
palatal seal area should be carried out.
(Zarb &Bolender, 2004).

36. Oral Examination
• The patient should be classified according to
the partially edentulous classification system
of the American College of Prosthodontists
(McGarry, Nimmo, and Skiba, 2002) or
another system.
• This aids in the determination of prognosis.
(Zarb &Bolender, 2004).

37. Classification System for the
Partially Edentulous Patient
Class I
Class II
Class III
Class IV
Diagnostic Criteria
1. Location and extent of the
edentulous area(s)
2. Condition of the abutment teeth
3. Occlusal scheme
4. Residual ridge
Ideal or minimally
compromised
Moderately
compromised
Substantially
compromised
Severely
compromised

38. Oral Examination
• The shade and mould of the existing teeth.
• Gingival shade.
• Diastemata, rotations, and overlapping of
teeth.
(Zarb &Bolender, 2004).

39. Oral Examination
Other Considerations
• Existing midline.
• VDO and freeway space.
• Shade, mould, tooth position, lip support,
smile line and shade of the denture base, of
any existing prosthesis.
(Zarb &Bolender, 2004).

40. Tooth Modification
• Analysis of the occlusion and the plane of
occlusion is best made by performing a
diagnostic mounting of the preliminary casts.
• These preliminary casts serve as a pre-
extraction record.
(Zarb &Bolender, 2004).

41. Tooth Modification
• Study casts used to plan and mark occlusal
tooth modifications to be done at the final
impression visit later.
• The rationale of performing tooth
modifications on teeth that will later be
extracted has however been questioned.

42. Prognosis
• Expectations to be noted:
1. Anticipated difficulties (e.g., inability to
achieve a reliable centric relation
position).
2. Esthetic demands on the part of the
patient.
(Zarb &Bolender, 2004).

43. Prognosis/Anticipated Difficulties
3. A compromised residual ridge for denture
support.
4. Systemic diseases and medications that
may affect denture success.
5. Sensitive tissues or sharp, bony
prominences that may necessitate more
sore spot adjustment.
(Zarb &Bolender, 2004).

44. Prognosis
• The American College of Prosthodontics
Classification for Partially Edentulous Patients
(McGarry, Nimmo, Skiba et al., 2002) should
be noted.
(Zarb &Bolender, 2004).

45. Classification System for the
Partially Edentulous Patient
Class I
Class II
Class III
Class IV
Diagnostic Criteria
1. Location and extent of the
edentulous area(s)
2. Condition of the abutment teeth
3. Occlusal scheme
4. Residual ridge
Ideal or minimally
compromised
Moderately
compromised
Substantially
compromised
Severely
compromised

46. Referrals/Adjunctive Care
• Surgical consultation should occur early.
• Requests for surgery/not to do surgery (e.g.,
when bone trimming is not needed or when
saving teeth for overdenture abutments), and
future surgical considerations (e.g., dental
implants) are also identified.
(Zarb &Bolender, 2004).

47. Referrals/Adjunctive Care
• An endodontic consultation concerning any
treatment needed for planned over-denture
abutments should be done, if necessary.
• The endodontic treatment can start at any
time.
(Zarb &Bolender, 2004).

48. Referrals/Adjunctive Care
• Periodontal consultations should also be
scheduled for any remaining teeth in the
opposing arch or over-denture abutments as
needed.
• It is usually preferable to do any needed
periodontal therapy after the placement of
the immediate denture.
(Zarb &Bolender, 2004).

49. Referrals/Adjunctive Care
• Removal of periodontally compromised
adjacent teeth frequently improves and even
reduces the periodontal treatment that may
be required for the remaining teeth.
• General scaling of the teeth to minimize
calculus deposits should however be done
first.
• This will reduce the postoperative edema and
chance of infection.
(Zarb &Bolender, 2004).

50. Other Treatment Needs
• For the patient with a single CID, restorations
and crowns can be completed during the 3 to
4 weeks of healing after the first surgical visit
and also coincident with the immediate
denture procedures.
(Zarb &Bolender, 2004).

51. Other Treatment Needs
• For the patient with a single IID, restorations,
crowns, and the definitive removable partial
dentures procedures for the opposing arch are
done after placement of the IID.
• The only exception to this is if a transitional
removable partial denture is planned for the
opposing arch; this is fabricated coincident
with the immediate denture procedures.
(Zarb &Bolender, 2004).

52. CLINICAL AND LABORATORY
PROCEDURES

53. First Extraction/Surgical Visit
• If a clinical decision is made to undertake
preliminary extractions (CID technique), the
patient should have the identified (usually
posterior) teeth removed as soon as possible.
(Zarb &Bolender, 2004).

54. First Extraction/Surgical Visit
• Opposing premolars that preserve the VDO
are retained.
• Canines or other anterior teeth may also
provide the centric or vertical stops.
• Hard and soft tissue surgery done at this first
surgical visit e.g. tori&/tuberosity reduction,
and frenectomy.
(Zarb &Bolender, 2004).

55. First Extraction/Surgical Visit
• 3 to 4 weeks of healing before preliminary
impressions.
• If any posterior teeth to be over-denture
abutments, RCT done earlier and teeth
reduced before the impression appointment.
(Zarb &Bolender, 2004).

56. Preliminary Impressions and
Diagnostic Casts
• Alginate impressions in stock trays.
• Tray should reach all peripheries and posterior
extensions.
(Zarb &Bolender, 2004).

57. Preliminary Impressions and
Diagnostic Casts
(Zarb &Bolender, 2004).

58. Preliminary Impressions and
Diagnostic Casts
• Impressions are poured in stone and are used
to make custom trays for the final
impressions.
• If an IID is planned, the preliminary
impressions and casts will contain all of the
remaining teeth.
• If a CID is planned, these will contain only
anterior teeth.
(Zarb &Bolender, 2004).

60. Loose Teeth
• Protected from extraction during impressions by:
1. Blocking cervical areas using periphery wax.
2. Applying a lubrication onto them.
3. Placing copper bands over them (Soni, 1999).
4. Placing over them vacuum-formed plastic teeth
(Vellis, Wright, Evans et al., 2001).
5. Placing holes in the tray and using an amalgam
condenser to release the tray over loose teeth
(Goldstein, 1992).

61. Custom Trays
1. Single Full Arch Custom Impression Tray.
2. Two-Tray or Sectional Custom Impression
Tray.

62. Single Full Arch Custom Impression
Tray
• Resembles a routine special tray for
removable partial dentures.
• Can be used in the CID technique.
• Only tray that can be used for IID technique.
• Used with anterior teeth are remaining or
when both anterior and posterior teeth are
remaining.

63. Single Full Arch Custom Impression
Tray Fabrication
• Blocked out undercuts with two sheet wax
thicknesses.

64. Single Full Arch Custom Impression
Tray Fabrication
• Occlusal stops; holes through the wax anteriorly or
posteriorly and in the tuberosity or posterior palatal
seal areas.

65. Single Full Arch Custom Impression
Tray Fabrication
Maxillary (A) and mandibular (B) full arch
custom impression trays.

66. Two-Tray or Sectional Custom
Impression Tray
• Used only when the posterior teeth have been
removed (CID).
• Two trays on the same cast—one in the
posterior, made like a complete denture tray,
and one in the anterior (backless tray).

67. Two-Tray or Sectional Custom
Impression Tray(s) Fabrication

68. Two-Tray or Sectional Custom
Impression Tray(s) Fabrication
Sectional tray techniques use a posterior custom impression tray,
which can be covered by an anterior custom impression tray (A)
or a stock tray (B). (Courtesy Dr. Arnold Rosen.)

69. Two-Tray or Sectional Custom
Impression Tray(s) Impressions
The posterior component of the sectional impression technique. Maxillary posterior
section is border molded (A), and the final impression is made (B).
C, Mandibular border molding. D, Impression.

70. A, Maxillary posterior impression re-seated in the mouth. B, Try-in of the anterior section of
maxillary tray. C, Sectional maxillary final impression removed (by unhinging) together and
reassembled. D, Mandibular completed final sectional impression.

71. Plaster and pumice (50:50) mix for boxing is the method least likely to
cause distortion of sectional impressions. Boxing wax is applied to this
to complete the boxing before pouring the impression.

72. Maxillary (A) and mandibular (B) final casts produced from the single full arch
custom impression tray method for interim immediate dentures (IIDs). The final
casts for a maxillary (C) and mandibular (D) conventional immediate denture (CID)

73. (A) Mandibular record base with occlusion rim for an IID that uses the remaining
teeth and halfway up the height of the retromolar pad as a guide to location of
the posterior plane of occlusion. Maxillary (B) and mandibular (C) final casts and
record bases for conventional immediate dentures (CIDs).

74. Jaw Registration
• Existing VDO may be retained.
• VDO to be increased if there is uneven tooth
loss, mobility, and tooth wear creating over-
closure.
• VDO to be reduced by grinding the natural or
stone teeth on the master cast, in case of
drifting and supra-eruption.
• A face-bow transfer and a recording of centric
relation are made.

75. Articulation and Denture Teeth Set-Up
A, Mounted casts for immediate upper and lower dentures
(IID). Right lateral view (B) and left lateral view

76. Articulation and Denture Teeth Set-Up
For upper and lower CIDs, D, Frontal view.
E, Right lateral view.

77. Setting the Denture Teeth
• The articulated casts used for setting any
anterior/ posterior teeth that are missing.
• Try-in (if possible).
• Not always possible (e.g., when all teeth in the
arch are present as in some patients with
IIDs).

78. Setting the Denture Teeth
A and B, Posterior tooth setup for a try-in for conventional immediate
dentures (CIDs).

79. (A) “X” : Tooth for removal, “O”:
Overdenture Abutment , (B) Extraction
site trimmed , (C) The extraction site
should be convex (not concave).
Mdline and interpupillary line,
transferred to the base of the cast.

80. (A) “X” : Tooth for removal, “O”:
Overdenture Abutment , (B) Extraction
site trimmed , (C) The extraction site
should be convex (not concave).
Mdline and interpupillary line,
transferred to the base of the cast.

81. Setting the Denture Teeth
• Conservative trimming (Jerbi, 1966), using the
pocket depths as guides.
• Facial portion can be further trimmed to the
pocket depth line.
• Lingual or palatal tissues should not be
trimmed because they will not collapse to the
pocket depth after extraction.

82. Setting the Denture Teeth
• Overdenture abutments trimmed to a dome
shape 3 mm above the free gingival margin or
slightly higher than the final form (1 to 2 mm
above the gingival margin) planned.
• Maximum amount of trimming usually
halfway between the buccal and the palatal
gingival margins.

83. Setting the Denture Teeth
A, Every other tooth is set on the maxillary and the
mandibular casts.
B, The remaining teeth are removed.

86. Processing and Finishing the Dentures
• Remount cast to preserve the face-bow should
be done for later patient remounting .
• Casts flasked like for complete dentures.

87. Processing and Finishing the Dentures
• At boil-out, casts are smoothed with a knife to
a harmonious rounded contour.
• Custom characterization of the denture bases
also possible at this time.

88. Processing and Finishing the Dentures
• Dentures processed and finished as in
complete dentures.
• Laboratory remount before removing the
dentures from their casts and finishing.
• Undercut areas of the denture kept slightly
thick to allow for insertion over undercuts.
• Dentures manoeuvred over undercuts during
insertion.

89. Insertion
• Reduction of overdenture abutments &/or
sectioning of pre-existing bridges done first.
• Remaining teeth then extracted.
• Care taken to preserve the labial plate of
bone.

90. Insertion
• To manage posterior undercuts, select
alternate path of insertion and withdrawal of
the denture combined with judicious
trimming.
• Bumps inside immediate denture resulting
from over-trimming of the cast should be
reduced to allow for a convex ridge healing.
• These procedures are duplicated on the
surgical template.

91. A surgical template is made at boil-out from the master cast (A) by
making an alginate impression. B, This is poured in stone. C, A wax-up
is done. D, This can be processed in clear acrylic resin.

92. Insertion
• Surgical template used as guide to ensure
prescribed bone trimming is done adequately.
• Template should contact all tissue surfaces.
• Inadequate bone reduction areas blanch
under pressure and are seen through the clear
template.
• Template seating uniformly and completely
after bone trimming indicates that denture
will also fit.

93. Insertion
Denture should seat well with good firm bilateral occlusion
and no gross deflective contacts.
Pressure areas (indicated by rocking) located with pressure-
indicating paste and trimmed.

94. Insertion
• Only brief occlusal correction is done to
eliminate interferences e.g. at denture heel
areas, and to allow simultaneous bilateral
contact.
• Further refinement of the occlusion usually
done at a later date.
• Frena should be checked for proper relief.

95. Postoperative Care and Patient
Instructions
• Avoid rinsing, hot liquids or alcohol.
• No denture removal during the first 24 hours.
• Inflammation, and discoloration likely to
occur.
• Manage with ice packs (20 minutes on, 20
minutes off) on the first day.

96. Postoperative Care and Patient
Instructions
• Premature removal of dentures; reinsertion
impossible for 3 to 4 days or until reduction of
swelling.
• Reinserted dentures can further cause more
sore spots.
• Pain from extraction sockets not be eliminated
by denture removal.
• Managed by analgesics. (Holt, 1986).
• Denture aids in haemostasis; not entirely
though.

97. Review Appointment
• Done after 24 hours.
• Patient warned before denture removal.
• Sore spots appear strawberry-red.
• Pressure indicating paste of help diagnosing.
• Relieve areas; replace denture ASAP.
• Check for centric and lateral excursions.
• Tissue conditioner if retention unsatisfactory.

98. First Postoperative Week
• Wear dentures at night for either 7 days or until
swelling reduction.
• Recurrence of nocturnal swelling may preclude
morning denture reinsertion.
• After day 1, denture and mouth cleaned 3 to 4
times daily; extraction sites kept clean.
• Denture quickly reinserted; worn continuously.
• Suture removal after 1 week then dentures
removed at night.

99. Further Follow-up Care
• Further sore spot adjustments.
• After 2 weeks, remount casts are poured, the
maxillary denture is related to its semi-
adjustable articulator using the remount
matrix made before flasking.
• A centric relation record is used to remount
the mandibular denture, and refinement of
the occlusion is performed.

100. All dentures should be remounted after delivery. Remounting
the immediate denture should occur after swelling has
subsided, between week 1 and week 2 postoperatively.

101. Subsequent Service for the Patient
with an Immediate Denture
• Ridge resorption is fastest during the first 3
months (Tallgren, Lang, and Walker, 1980).
• Patient put on a recall schedule for changing
denture liner.
• New light-cured soft liners long-lasting
depending on the rate and amount of bone
resorption and denture hygiene frequency and
methods, diet, and smoking habits.

102. Subsequent Service for the Patient
with an Immediate Denture
• Complete socket calcification is at 8 to 12
months after tooth extraction.
• Bone volume of the ridge is reduced 20% to
30% during the first 12 months.
• Lower ridge resorption is about twice that for
the upper ridge (Tallgren, Lang, and Walker,
1980).

103. Subsequent Service for the Patient
with an Immediate Denture
• Patients with CIDs typically get definitive
reline (laboratory acrylic or chair side acrylic
or light-cured resin) within the first 3 to 6
months.
• Regular visits and adjustments are needed
throughout the first year (Tallgren, Lang, and
Walker, 1980).

104. Subsequent Service for the Patient
with an Immediate Denture
• 2nd dentures may be started for IID patients
within 3 to 6 months.
• 2nd dentures may need relining (laboratory
acrylic or chair side acrylic or light-cured resin)
after tissues fully heal.
• The IID can be worn as a spare if a laboratory
reline is selected for the second denture.

105. Subsequent Service for the Patient
with an Immediate Denture
• CID’s may still fail and necessitate a new
denture (thus making them IID’s in these
cases, and patients should be warned).

106. Overdenture Tooth Attachments,
Implants, or Implant Attachments
• Overdenture attachments should be
accomplished after healing and before the
definitive prosthesis so that attachment
components can be processed into the second
denture or reline.

107. Overdenture Tooth Attachments,
Implants, or Implant Attachments
• If patient was to get implants, healing after
implant placement takes place under the
immediate denture.
• Avoid wearing the prosthesis after implant
surgery (usually 1 to 2 weeks).

108. Overdenture Tooth Attachments,
Implants, or Implant Attachments
• The immediate denture is reinserted after
relieving and tissue-conditioning procedures.
• After implant uncovering, immediate denture
is relieved to accommodate the healing
abutments and serve as the prosthesis until
replacement by the definitive prosthesis.

109. G, A clear resin duplicate of interim denture serves as a surgical template. Its
placement on the preliminary cast helps to plan the best implant/bar assembly
location. H, After implant placement and healing, try-in of final implant bar
assembly. I, Final implant attachment overdenture. J, Patient’s smile with
(second) implant overdenture. If planned well, the patient’s interim denture can
also be relined to “fit” the bar assembly.

110. References
1. Glossary of Prosthodontic Terms, Version 8 (2005).
2. Gooya A, Ejlali M, Adli AR. Fabricating an interim immediate
partial denture in one appointment (modified jiffy denture). A
clinical report. J Prosthodont. 2013;22:330–3.
3. Zarb GA, Bolender CL. Prosthodontic treatment for edentulous
patients. 12th Ed. Vol. 8. St. Louis: The C.V. Mosby Co; 2004. pp.
123–159.
4. Immediate complete dentures. Seals RR Jr, Kuebker WA, Stewart
KL, Dent Clin North Am. 1996 Jan; 40(1):151-67.
5. Jonkman RE, Van Waas M, Kalk W: Satisfaction with complete
immediate dentures and complete immediate overdentures: a 1-
year survey, J Oral Rehabil 22:791-796, 1995.

111. References
6. McGarry TJ, Nimmo A, Skiba, JF et al: Classification system
for partial edentulism, J Prosthodont 11:181-193, 2002.
7. Holt RA Jr: Instructions for patients who receive immediate
dentures, J Am Dent Assoc 112:645-646, 1986.
8. Tallgren A, Lang BR, Walker GF et al: Roentgen cephalometric
analysis of ridge resorption and changes in jaw and occlusal
relationships in immediate complete denture wearers, J Oral
Rehabil 7:92, 1980.