Immediate Dentures: Procedure, Benefits, and Aftercare

Denture Breakage and Repair

To repair a broken denture, ensure the fracture line fits perfectly without any missing material. Create dovetail retentions for the new material, avoiding the edges and focusing on the breaking line. Secure the fragments with a metal splint using wax and glue. Cast the denture's tissue surface with plaster, applying a separating agent. Incorporate auto-curable or thermocurable resin, and consider using metal mesh reinforcements for added strength. Cure the denture in boiling water, then remove the cast and plaster key. Polish the prosthesis with burs and rubbers to eliminate excess material. Note that there might be a slight color difference between the new and old material, but this is not a concern.

Immediate Removable Complete Dentures

An immediate denture is a prosthesis fabricated before tooth extraction and inserted immediately after the procedure, replacing the extracted teeth with artificial ones.

Advantages

• Improved aesthetics
• Swelling control
• Pain and edema reduction
• Enhanced healing through medication placed in the base
• Maintained phonation
• Increased mastication
• Reduced alveolar resorption

Disadvantages

• Increased operative risk (e.g., bleeding)
• Potential occlusion problems
• More frequent maintenance and adjustments

The patient's physiological state is crucial for successful immediate denture treatment.

Treatment Plan

1. First Clinical Appointment: Take alginate impressions and prepare the impression boxing. Lab work: Prepare individualized trays and obtain study casts.
2. Second Clinical Appointment: Take final impressions using a simple, dissociated, or combined technique.
3. Third Clinical Appointment: Record intermaxillary relationships, including occlusal plane, upper fox plane, and lower teeth height. Take facebow and intermaxillary records. Lab work: Arrange teeth in two phases, first assessing posterior teeth and then preparing for the immediate denture.
4. Fourth Clinical Appointment: Assess teeth and take a pick-up impression. Lab work: Wax-up, flasking, and curing.
5. Fifth Clinical Appointment: Deliver the prosthesis and perform extractions.

Patient Recommendations

• Avoid removing the denture for 24 hours.
• Take antibiotics and anti-inflammatory medication as prescribed.
• Maintain a soft and cold diet.
• Apply cold compresses to the area on the first day.
• Be patient during the adjustment period.

Follow-up Appointments

• 24 hours: Occlusal and tissue adjustments
• 7 days: Suture removal and further adjustments
• 3 months: Possible reline or new denture fabrication