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Rem pros pt. 3 (Immediate Dentures (Types (Conventional (Denture refitted…
Rem pros pt. 3
Immediate Dentures
Ex & Dx
Pts needs
- Attitides, expectations, occupation, motivation,
- Explanation of cost, problems
General Health
- systems review, medications, surgical hx
Orofacial Tissues
- General (smile, lip, profile ect), Occlusion (OVD, RVD rel, OB/OJ), Perio, Supporting tissues (ridge, frena, sulci)
Radiographs
Tx Plan
Extraction
= 1-Stage – single procedure (not recommended if difficult extraction)
or
= 2-Stage – promotes fit and stability (disadvantaged by taking ages)
--> Post-extraction immediate denture (delayed placement)
or
--> Transitional partial denture – Gradual addition until definitive made
Types
-
Interim/Transitional
First short-term prosthesis (IID) is fitted
= 2nd denture made after healing and IID relines as a spare
Advantages
• Denture acts as ‘bandage’ for healing
• Function returns sooner
• Psychological advantages = easier for patient to accept having extractions
• Minimum of interruption of patient’s life
• Assists soft tissue adaptation, prevents soft tissue change
• OVD maintained
Disadvantages
• Increased complexity of clinical procedures
• Limited try-in evaluation
• Increased patient discomfort (denture trauma AND surgical trauma)
• Increased denture maintenance (adjustments, relines, etc)
• Increased patient visits
• Increased treatment cost
Contraindications
Surgical Risk
Radiation/Bisphos Therapy, Bleeding Disorder, Medically Compromised, Underlying pathologies
-
Relining
Most frequently prescribed intervention
- 6 - 12 months following immediate denture placement
- Adding a new layer of processed material to the base
- Minimal – moderate changes present
Examples
Ufi Gel hard
(Permanent hard liner)
= chair-side technique, often for ill fitting dentures
Molloplast-B
(permanent soft liner)
= Extreme ridge resorption
Soft lining on the denture will help to relieve pain and increase patient adaptation, no attached gingiva
Viscogel
(Tissue conditioners)
- Used to relieve the pressure over inflamed/trauamtized tissue
- functional impressions for eventual relining
Clinical Remounting
- To correct for the fact that:
Adjusted denture bases seat more accurately than record bases
- Accommodate for errors made during the making of centric relation record
= Construct a “putty” cast that can be used for the mounting purposes during the mill-in stage.
Remaking Denture
indications= Lost midline, worn dentition, poor aesthetic show of teeth, occlusal plane is not balanced, CO does not equal CR