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Immediate Dentures

When patients lose their natural teeth, we have to determine which option is the most suitable for them to transition to partial or complete dentures.  The following options give a brief summary of the transition to dentures when you require extraction of some or all natural teeth.

 

Immediate Dentures:

The most common way to transition from natural teeth to a complete denture is with an immediate placement.  Impressions, bites and other necessary information are taken. The denture is then fabricated on a model of the ridge in which the teeth have been removed.  These procedures are done prior to the extraction of the natural teeth.  The denture is placed immediately after extractions by the dentist.  The denture acts somewhat like a bandage for the extraction sites.  The patient is seen at the denture clinic the following day for a check-up.  During the following weeks and months, the bone and tissue around the extraction sites will heal and slowly form a ridge.  These changes will cause the fit of the denture to decline.  As such, this type of denture requires a temporary liner at or around the 6-week mark and a permanent reline around the 12-month mark.  The cost of initial temporary liner is included in the cost of the denture and the permanent reline is charged for when it is performed.

Advantages:

  • Dentures are inserted right away, no time without teeth

  • Extractions sites are protected, and patients can begin light chewing function typically within a week.

Disadvantages:

  • Denture is built on a model with the teeth trimmed off, not an actual capture of the ridge after teeth are extracted thus decreasing accuracy

  • A “Try-In” of the denture cannot be performed as the natural teeth are still present during fabrication

  • Tooth positions are often compromised due to the presence of the large bony structures that surround the natural teeth

Post-Immediate Dentures:

We begin the fabrication of these dentures following the initial healing of extraction sites. The minimum amount of healing time prior to impressions is usually 1 week.  Ideally, the mouth is left longer to heal, increasing the advantages of this option (4-6 weeks).  Once the denture fabrication starts, we try to get through the appointment and fabrication process efficiently to get the denture inserted as soon as possible.  Unless the entire healing period has passed (6-12 months), these dentures typically still require the same linings as an immediate denture; temporary and eventual permanent.  The timing and necessity of these linings are dependent on the amount of healing that occurred prior to the fabrication of the denture.  The temporary and permanent reline are charged for if/when they are performed.

Advantages

  • More accurate initial fit of the denture

  • A “try-In” appointment can be done to verify the esthetics and technical aspects of the denture

Disadvantages:

  • Patient must go through initial healing and denture fabrication time with no teeth, presenting concerns from an esthetic and functional stand point

  • This tends to be a less desirable option to many patients due to the required span of time with no teeth or denture in the mouth. 

 

Interim/Definitive Dentures:

In this option, we fabricate an interim immediate denture that is placed immediately after extractions and worn through the entire healing period.  Just like the other scenarios, a temporary lining is used to keep it fitting during that time.  At the end of the healing period (usually around 12 months), we fabricate a new denture on the healed ridges.  This gives the patient the combined advantages of having a denture right away and eventually all the advantages of building the denture on the healed ridge.

Advantages

  • Initial denture is placed immediately after extraction, any modifications required on this denture have no bearing on the long-term denture

  • A new denture is constructed after healing is complete. This will ensure proper fit and tooth position.  A try-in will also be performed to give a preview of the denture and allow for modification of esthetics prior to completion.

  • The interim denture could act as a backup in the future when having maintenance done, travelling etc.

Disadvantages

  • Overall cost of this treatment is approx. 20% more than immediate/reline option