Immediate Dentures

Dentures can help restore the appearance of your smileAn immediate denture is a denture which we fabricate BEFORE you have your teeth removed. An immediate denture provides you, the patient, with a denture prosthesis, i.e.-tooth replacement, as you leave our clinic immediately following all teeth extractions. Immediate dentures provide an immediate replacement for all upper or lower missing teeth. Further, following extractions, the fitting of an immediate denture will serve as a barrier to the fresh extraction sockets which will have to heal (a period of from 1 to six weeks). If an immediate denture is not included in the treatment plan, there is a significant delay to allow for healing of the tissues and then subsequent construction of a new denture. This can require from three to six weeks, all the while the patient has to live his or her life without any teeth in the upper or lower jaws.

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IMMEDIATE DENTURES require preparation for this procedure BEFORE your teeth are extracted.

The first step requires our making impressions of your existing teeth, jaw structures, and gums to create accurate laboratory duplicates of your jaw to allow for correct placement of the denture teeth after tooth removal. At your extraction appointment, your immediate dentures are inserted creating a natural smile you can be proud of.

What you should know about immediate dentures

In most cases, we have no way of checking the fit or appearance of the denture in your mouth prior to extractions because your existing teeth are still present and in the way. Esthetic compromises may be eminent in some cases to compensate for inadequate space, proper occlusion (bite, the way teeth come together) or structural concerns, etc. Immediate dentures can result in the following:

EXTRACTIONS—MEDICAL ISSUES

We can perform the extractions in our offices and any necessary bone grafting. We can also arrange for an oral surgeon to perform the extractions if there are extenuating circumstances. Many times the teeth requiring extraction are diseased and therefore posing a risk to patients who may be battling other systemic issues such as cardiovascular, pulmonary, diabetes, and any of the 120 +- systemic inflammatory diseases. Your medical/dental health history will be thoroughly reviewed prior to scheduling for extractions. Occasionally it is necessary to be placed on pre-operative antibiotics to clear ongoing inflection prior to extractions.

MECHANICAL ISSUES OF IMMEDIATE DENTURES

  • protrusion of lips and/or face, or inadequate support of the lips and cheeks.
  • sores and irritations (can be resolved with adjustments)
  • speech alterations (patients usually adapt after 6-8 weeks). Speech and or enunciation of certain words and vowels are dependent on the position of the upper and lower anterior (front) teeth. Thus accommodation and adjustments are required to eliminate any speech impediments.
  • need for relining – may only serve as a temporary denture

After Extraction

Great care should be taken to follow all postoperative instructions. Your gums and bone will recede after extraction, and regular check-ups and maintenance will monitor healing and reduce problems. Temporary linings or tissue conditioners will be required to create an optimal fit and may need to be adjusted or replaced a number of times during the healing period. A permanent reline will be required to ensure a comfortable and an exact fit after you have completed the healing process.

GRAFTING: When teeth and their roots are extracted, the remaining socket does not simply grow bone to fill in the socket. Instead, the walls of the socket simply ‘cave’ into the socket space. This will reduce the height and width of the remaining bony structure significantly. Therefore, the shape and volume of the remaining, i.e., residual ridge, is much smaller in dimension than it was prior to extractions. The loss of the bony mass creates a compromise to the patient in that there is much less bone available to support and retain the denture(s). This translates to a looser fit, dislodgement problems when speaking, eating, swallowing, singing, etc. It becomes a significant social compromise, as well.

The average bone loss following extraction amounts to roughly 40 to 60% loss of vertical height at the socket(s), and up to 50% loss horizontally, from cheek to tongue.

In order to minimize the loss of bone surrounding the sockets, both vertically and horizontally, we graft the sockets with bone at the time of extraction or shortly after.

We typically use bone which we purchase. There are several types and sources which we employ, and we thoroughly discuss this aspect prior to utilization. The result is that the bone placed into the sockets will be replaced over time with the patient’s own bone. The graft will also provide an excellent anchor for dental implants if you elect to have an implant supported prosthesis rather than just a suction based retention.

It is extremely efficient to prepare for the fabrication of an immediate denture, the extractions, and grafting procedures all within one appointment. In this way the patient accomplishes the most treatment in the shortest period of time and can begin to make the adaptation to a prosthesis.

Often, the opportunity exists to place dental implants at the time of extraction and grafting surgeries. This means that the patient bypasses significant healing time and can enjoy all the complete functionality, security, and social benefits from an implant supported prosthesis. The implant supported prosthesis allows for better correction of tooth position, and therefore, better esthetics, since the teeth can be placed where they should be, rather than limited to placement based on what the existing bone level can reasonably support.

Also, the best way to minimize and eliminate bone loss (due to disuse atrophy) and shrinkage is to replace a missing tooth root with a dental implant. These considerations are discussed below. As always, we are happy to schedule a consultation with us to discuss your individual needs. No referral is necessary.