In this post I would like to discuss important information regarding immediate complete dentures treatment.
You should read this post if you anticipate loosing all your teeth in one or both jaws and would like to learn about immediate dentures.
What are Immediate Dentures?
Immediate denture are type of treatment where artificial denture prosthesis is made before removal of the teeth and delivered immediately after removal of the teeth. This approach allows immediate restoration of your smile and oral functions.
There are several different types of immediate dentures. Complete (also called full) immediate denture replaces all teeth in one jaw and partial immediate denture replaces several but not all teeth in one jaw. When immediate denture is made for the top jaw it it called an upper or maxillary immediate denture. When it is made for the bottom jaw, it is called a lower or mandibular immediate denture. Here a link which explains different types of dentures. In this post I will discuss immediate complete dentures.
Immediate complete denture can be a part of denture treatment where final prosthesis for the replacement of the teeth is a removable complete denture.
Immediate complete denture can also be a part of the implant treatment. In that case immediate denture treatment is carried out in the initial stages of treatment.
What are the Indications and Contraindications for Immediate Complete Dentures?
Immediate complete dentures are indicated in situations where patient is loosing all remaining teeth in one or both jaws and would like to have prosthetic replacement of his or her teeth immediately after removal of the teeth. Majority of patients with hopeless teeth can be candidates for immediate denture treatment.
Immediate dentures are contraindicated for patients who has certain poorly controlled medical conditions and who will not be able to tolerate oral surgery. In rare instances immediate dentures can be also contraindicated for patients with unfavorable jaw anatomy and for patients with exaggerated palatal / gag reflexes. Some patients with dexterity problems may also be poor candidates for denture treatment.
What are the Pros and Cons of Immediate Complete Dentures?
The advantage of immediate denture treatment include immediate restoration of smile and oral functions of chewing, swallowing and speech.
Denture is artificial prosthesis which is very different from the natural teeth. The space denture occupies is bigger than the space taken by the natural teeth. Denture also sits on the gum areas of the jaws which are normally not covered by any type of foreign body. Denture also does not function like the natural teeth. During chewing, biting and swallowing denture acts as one unit opposite to individual teeth with each one acting independently. As a result of these differences denture requires adaptation on the patient part and learning on how to use it. Denture treatment may alter speech /sounds, impair swallowing, cause discomfort of the soft tissues and decrease chewing efficiency.
Immediate denture typically does not have a try in stage. Try is stage is an important step where dentist places a prototype of the final prosthesis in the mouth and evaluates smile and accuracy of the denture. Presence of the compromised teeth does not allow try-in of the denture prototype. As a result there is a possibility that your denture may have less than ideal smile, fit, and bite. Some of the inaccuracies in the immediate denture can be easily corrected by simple adjustment of the denture, but sometimes there are situations where a new denture will have to made after appropriate healing time.
Removal of the teeth is always accompanied by the shrinkage of the supporting bone. As a result immediate denture requires a number of adjustment and reline appointments (see below) in order to improve patient’s comfort and denture fit. These additional maintenance requirement of immediate denture increase the cost of treatment.
Shrinkage of the jaw bone can also cause settling of the denture with negative effect on patient’s smile and oral functions. As a result in some situations a new denture has to be made after appropriate healing time.
What is Treatment Process with Immediate Dentures?
Treatment with immediate dentures includes the following stages: (1) initial evaluation, (2) immediate denture fabrication, (3) surgical stage and denture delivery, and (4) maintenance stage.
During initial evaluation, a dentists examines in detail condition of the mouth. X-rays, photographs and models of your jaws are taken. Based on this information treatment options are developed and presented to the patient. This stage may take one to two appointments.
Immediate denture Fabrication
Once decision is made to go ahead with an immediate denture, additional records are taken. These typically includes models and bite record. In some situations selective teeth have to be removed before fabrication of the denture. The records are than transferred to the laboratory and immediate denture is fabricated. Typically several appointments may be required and denture fabrications takes several weeks.
Surgical Stage and Denture Delivery
During surgical stage of the treatment, remaining teeth are extracted and if necessary additional surgeries are performed on the jaw bone to create more favorable anatomy for the denture. Immediately after surgery , immediate denture is adjusted if necessary, tissues conditioning material is placed inside the denture and denture is places into the patient’s mouth. Surgical stage and denture delivery is typically carried out on the same appointment.
During maintenance stage, denture is adjusted and relined as needed. Patient is typically recalled on the weekly basis for adjustments and relines for the first several weeks. As jaw bone healing stabilizes you may be recall on a monthly basis. After complete healing of the jaw bone, which may take almost one year, immediate denture is re-evaluated by the dentist. If denture is determined to be acceptable it is converted into a permanent denture with the help of reline procedure. Denture which does not satisfy certain acceptability criteria are than replaced with a new denture.
Immediate Dentures and Implant Treatment
Immediate denture prosthesis can also be part of the implant treatment. Depending on the condition of your mouth and design of the final implant prosthesis your immediate denture is used as temporary prosthesis. However in some cases it can also be converted to a permanent implant prosthesis.
What additional procedures are performed besides denture fabrication and tooth removal?
It is a surgical procedure where jaw bone is shaped so there is adequate space for the prosthesis, It can also be performed in order to create favorable shape of the jaw bone for the prosthesis function. Alveoloplasty surgery may not be required for all patients.
Exostosis and Torus Removal Surgery
Exostosis and Torus are normal jaw bone projections which may be present in some patients. If patient will require a complete denture they will interfere with denture function and if not removed can cause discomfort.
Immediate dentures treatment requires a number of denture adjustments since the prosthesis position changes during bone shrinkage. Denture adjustment included modification of the denture surface and denture bite.
Tissue Conditioning, also called Soft Reline
Tissue conditioning is performed during healing stage and includes placement of a temporary soft liner inside the denture in order to improve comfort and fit of the denture. During immediate denture treatment patient may require several or more soft reline appointments.
Hard reline is a procedure where the base of the denture is resurfaced with a new hard material. Hard reline can be done in the dental office or outsourced to the dental laboratory. Hard reline is typically performed at the completion of gum and jaw bone healing.
What Materials are Used in Immediate Complete Denture Fabrication?
Immediate dentures are made from specially designed dental polymers (plastics). The gum portion of the denture is called denture base and is colored so it looks like gum tissues. The artificial teeth come in several different colors. The reline materials are always used with immediate denture treatment and also mad from specially designed dental polymers. Majority of patients tolerate these materials very well, however on some very rare occasions patient may develop an allergy to dental plastics.
What are the Costs Involved in Immediate Denture Treatment?
Immediate dentures typically present with moderate to high cost of treatment. The overall cost of treatment typically includes immediate denture prosthesis, tooth extractions and additional surgery if needed, denture adjustments and relines. Some of the patients may also require a separate new denture at the completion of the treatment.
Who are the Qualified Specialists for Immediate Denture Treatment?
Immediate dentures are a challenging treatment and requires a qualified and experienced team. In addition to general dentists and denturists who may perform this type of treatment, the list of most qualified specialists includes prosthodontists and oral surgeons. Prosthdontists are dental specialists with the expertise in tooth restoration and replacement and oral surgeons specialize in dental surgery.
Thank you for reading,
Dr. Alex Shor