Immediate denture- An important treatment modality

Abstract

An immediate complete denture is a restoration of the lost natural teeth and associated tissues which is inserted into the patients mouth immediately following the extraction of remaining teeth. The removal of all the remaining teeth and placement of the complete denture are important in patients’ life. The transition from dentulism to edentulism should be psychologically atraumatic as far as possible.
The cases presented here are conventional (classic) immediate denture and interim (transitional or non transitional) immediate denture which offer good esthetic and functions.

Key words – conventional immediate denture, interim immediate denture.

Full text

Theyfulllinatolerabledegreeall
therequirementsof articialteethunder
any circumstances, if we expect that the
mastication, this function being more or
less imperfectly performed with such
pieces.” But late on in the year 1951
Sears said that “ in cases where some
of the natural teeth remain in place it
is wise to consider the advisability of
constructing dentures before the teeth
are removed”2.
Dental professionals have recognized
the patients wish and need to avoid an
edentulous period which resulted in the
fabrication of the denture that can be
placed in the patients mouth immediately
following the removal of last natural
teeth. The success of the immediate
denture depend on the correct indication
and precise execution of clinical and
laboratory procedure.
►Case report 1
A 55 year old male patient was
referred to the department of
Prosthodontics for oral rehabilitation.
Onintra-oralexaminationteethpresent
were12,14,15,21,22,23,31,32,33,34,36,3
7,38,42,44,46,47(FigI)
Orthopantomography was advised
(Fig 2). Upper and lower alginate
impressions were made; study models
were fabricated and articulated. All the
facial measurements were recorded.
Immediatedenture-animportanttreatment
modality
* Kalpana Hasti, **Anurag Hasti, ***Rahul Sharma, ****Aprajita Mitra
Abstract
An immediate complete denture
is a restoration of the lost natural
teeth and associated tissues which
is inserted into the patients mouth
immediately following the extraction
of remaining teeth. The removal of all
the remaining teeth and placement of
the complete denture are important
in patients’ life. The transition from
dentulism to edentulism should be
psychologically atraumatic as far as
possible.
The cases presented here are
conventional (classic) immediate
denture and interim (transitional or
non transitional) immediate denture
which offer good esthetic and
functions.
Key words: conventional immediate
denture, interim immediate denture.
KDJ 2016 | Vol. 39 | No. 1 | Pg 27-29
*Reader,Dept.ofProsthodontics,JaipurDentalCollege;**Reader,***SeniorLecturer,****P.GStudent,Dept.of
Prosthodontics,SchoolofDentalSciences,ShardaUniversity;CorrespondingAuthor:Dr.KalpanaHasti
Email-kalpanagupta78@yahoo.com
After the diagnosis of the cast,
radiograph evaluation and clinical
examination, a conventional immediate
denture was planned. The patient was
referred to the department of Oral and
Maxillofacial surgery for extraction of
36,37,38and44,46,47andwasadvised
toreportbackafter6–8weeks.When
thepatientreportedafter6weeks,the
healing was found to be satisfactory.
(Fig 3 and 4)
►Procedure
Upper and lower alginate impressions
were made. A custom tray was fabricated
for Camphagne’s
3
impression technique.
Border molding was done using green
stickcompoundandnalimpression
was made using Zinc Oxide Eugenol and
dentulousareainAlginateasapick-up
impression material.
A master cast (Fig 5), record base
and occlusal rims were fabricated. Jaw
relation was recorded. 14 and 34 were
used as a vertical stop. The records
were transferred on to the articulator,
Posterior Teeth arrangement was done
and upper 12 and 22 were arranged to
conrmesthetics,labialfullness,lower
lip line, size and shape of teeth. Try
–inwasdone.Thecastmodication
was done by the technique given by
Jerbi
4
. Flasking and curing was done
followedbynishingandpolishing.On
the day of insertion all the remaining
►Introduction
Patient increasing demand for
natural appearance of the lost teeth
has become a challenge to the dentist1.
The placement of complete denture
immediately following the removal of
natural teeth is not new. Richardson (in
theyear1860)emphasizedonimmediate
denture service, saying that “the value of
temporary sets of teeth to the patient on
the other hand is questionable.
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KDJ – Kerala Dental Journal CASE REPORT

anterior teeth were extracted and denture insertion was
done.(Fig6,7,8)
Patient was advised to wear the denture overnight
and for 3 consecutive days and recall was done after
24 hours. Patient complained of ulceration in the upper
canine region and in the posterior mylohyoid region and
the required trimming was done. Patient was advised to
continue wearing denture and called for suture removal
afteraweek.Patientwasrecalledafter6monthstocheck
for the retention and stability of both the dentures and
assessed for relining.
►Case report 2
A 29 years old female patient was referred to department
of Prosthodontics for replacement of missing teeth. On
examination,theteethpresentwere13.14,15,16,23,25,26,34,
35,36,37,45,47,48.Alltheremainingteethwerefoundtobe
periodontically involved with Grade II and Grade III mobility.
(Fig 9 and 10)
Orthopantography (OPG) was advised. Upper and lower
Alginate impressions were made and study models were
evaluated. Patient was referred to department of Periodontics
for opinion. The OPG revealed severe bone loss. Patient
was diagnosed with aggressive periodontitis. After diagnosis,
examination and OPG evaluation an interim immediate denture
was planned. The custom tray is fabricated.
Border molding is done using low fusing impression
compoundandnalimpressionwasmadewithmedium
body rubber base impression material.(Fig 11) On the master
castrecordbasewasfabricatedandonlyanteriortry-inwas
done. The casts were articulated in the normal occlusion of
the patient. Posterior arrangement was done and the cast
modicationwasdonebythetechniquegivenbyJerbi4.
Fig. 9: Preoperative
Fig. 8: Postoperative
Fig. 7: Completelyextractedmaxillaryarch
Fig. 6: Completelyextractedmandibulararch
Fig. 5: Mastercast
Fig. 4: Mandibulararchpostextraction
Fig. 3: Maxillaryacrhpostextraction
Fig. 2: DiagnosticOPG
Fig. 1: Preoperative
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Kalpana Hasti

Flaskingandcuringwasdonefollowedbynishingand
polishing. On the day of insertion all teeth were extracted
and denture insertion was done. Patient was advised to
wear the denture overnight and for 3 consecutive days and
recall was done after 24 hours (Fig 12,13,14,15). Patient was
advised to continue wearing denture and called for suture
removalafteraweek.Patientwasrecalledafter6months
to check for the retention and stability of both the dentures
and assessed for relining.
►Discussion
When removal of teeth becomes necessary an immediate
denture is an important treatment modality. There are many
advantages of immediate dentures as it acts as a matrix which
controls hemorrhage, prevents contamination and provide
protective covering over the wounds.
It provides restoration of phonetics and masticatory
functions and facilitates transition of the edentulous state
5
It enables the patient to continue to engage in social and
business activities without an embarrassing period of staying
edentulous
6
. As in the case of conventional immediate dentures
there are many advantages of CID than IID. The use of
transitional partial denture to replace posterior teeth prior to
the removal of the anterior teeth is highly recommended. As
discussed in interim immediate complete denture case report,
successful treatment of aggressive periodontitis depends a lot
in early diagnosis of the disease. When diagnosed in late stage
the treatment option is extraction. A young female patient
suffering from aggressive periodontitis and loss of all her teeth
has a devastating effect on functionally, and psychologically
so a fabrication of IID is useful method.
►Conclusion
In the era of implant and immediate implant treatment,
immediate complete denture treatment should still be
considered as an important treatment modality. A detailed
extraoral and intraoral evaluation and correct treatment
planning will lead to a successful replacement of missing
structures with immediate dentures which is functionally
acceptable to the patient.
►Reference
1. Puthanakar N.Y, Pappachan B, Patil A.G. Full mouth rehabilitation
by immediate denture prosthesis- A case report. Annals and
Essences of Dentistry.2012;4(4):28-33.
2. Goswami R, Singh M. Immediate denture- a spatial modeling way.
Guident. Sept 2012;42-44.
3. Campagna SJ. An impression technique for immediate dentures.
J Prosthet Dent. 1968;20: 196-203. 3
4. Jerbi.F.C Trimming the cast in the construction of immediate
denture J Prosthet Dent 16:1047-1053, 1966.
5. Wiebelt F.J. Two steps better immediate dentures. Quitessence
Int. 1980;5:27-30.
6. Gilboa I, Cardash H.S. An alternative approach to immediate
overdentures. J Prosthodont.2009:18;71-75.
Fig. 15: PostoperativeFig. 14: Processeddenture
Fig. 13: Postextractionmandibulararch
Fig. 12: PostextractionmaxillaryarchFig. 11: FinalimpressionFig. 10: Preoperativeintraoral
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Immediate denture - an important treatment modality