In this article, we will discuss what an immediate denture is and how it is fabricated.
Introduction to the Immediate RPD Concept
Definition of immediate dentures – an immediate denture is “a complete denture or removable partial denture fabricated for placement immediately after the removal of natural teeth.” The indications for immediate dentures are determined as indications for a transition denture with the main goal of transition to a complete denture. In this case, teeth need to be extracted but not immediately. Usually, they are medically compromised.
When there is an indication for a patient’s teeth extraction and he/she is not psychologically prepared. Interim removable partial dentures are also used for a short period. Interim removable partial dentures are used for a short time (up to 3 months), before a definitive denture. An interim removable partial denture has two main elements:
- The acrylic major connector
- The wrought wire clasps
The reason for immediate denture-making is the need for a temporary period or financial constraints. Another indication is a sudden loss of teeth before sufficient healing has occurred (accidents, after extractions).
Design of Immediate Dentures
The design requires bracing as a lingual/ palatal major connector, provides bracing, and contacts teeth at the heights of contour. The design includes clasps (wrought wires) which can be of different types such as circumferential, ball clasps, Adams clasps, or rest cingulum. These are also retentive elements. Rests are usually wrought wire or cast retainers, used for the long term.
Acrylic may be used over cingulum rest seats. The Major connector is defined to be a major connector characterized by full palatal coverage which increases strength and stability. Retentive clasps can be embedded into major connectors when or if the denture has to be extended to the first molars. Classification of immediate complete dentures involves conventional dental care.
In conclusion, the immediate denture is characterized by the fact that the denture is intended to be relined to serve as the long-term prosthesis; and interim (or transitional) immediate denture.
After the extraction after wound healing is completed, a second, new complete denture is to be fabricated as the long-term prostheses. Immediate RPDs are made normally from acrylic with “ball clasps”. A transitional denture is replaced after healing with a cast denture.
Advantages of Immediate Dentures
Maintenance of a patient’s appearance is one of the most important advantages of immediate dentures. Circumoral support, muscle tone, the vertical dimension of occlusion, jaw relation, and face height can be maintained also. The tongue will not spread out as a result of tooth loss.
Less pre-operative pain is likely to be encountered as the extraction sites are protected. It is easier to duplicate (if desired) the natural tooth shape and position is possible. Adaptation is also easier. Speech and mastication are rarely compromised and nutrition can be maintained.
Disadvantages of Immediate Dentures
There are several disadvantages of immediate RPD such as immediate dentures being more challenging, and the anterior ridge undercut that is caused by the presence of the remaining teeth may interfere with the impression procedures. The presence of different numbers of remaining teeth in various locations frequently leads to the incorrect record of the centric relation position.
No denture tooth try-in precludes knowing how the denture will look on the day of insertion. Immediate RPD is characterized by more chair time, additional appointments, and therefore increased cost.
Explaining to the Patient
Explanation to the patient concerning immediate dentures includes some directions:
- Do not fit immediate RPD as well as normal complete dentures.
- The pain after the extractions, in addition to the sore spots caused by the immediate denture, will make the first week or two after insertion difficult. It will be also difficult to eat and speak initially. The aesthetics may be unpredictable because an anterior try-in is not possible.
- Immediate dentures must be worn for the first 24 hours without being removed by the patient. If they are removed, it may not be possible to reinsert them for up to 3 – 4 days. The dentist will remove them at the 24-hour visitation. Immediate dentures will “loosen” during healing, and tissue conditioners will be required. From 6 up to 9 months after insertion at least one reline should be done, probably a remake.
To conclude, immediate dentures are a very useful way to overcome denture problems with the correct case selection.