Immediate dentures are prosthetic devices placed immediately after the extraction of natural teeth. They are custom-made beforehand using impressions taken of the mouth while the natural teeth are still present. The primary purpose of this appliance is to provide the patient with teeth on the same day as the surgery, ensuring they do not have to go without a smile during the healing period. Immediate dentures are not designed for long-term use and cannot be considered a permanent solution for tooth replacement. They are an interim device that serves a specific function during the months following the removal of teeth.
The Role of Immediate Dentures
The main function of immediate dentures is to offer aesthetic continuity and preserve the patient’s appearance right after the extractions. This immediate replacement helps maintain self-confidence and allows for continued social interaction without the embarrassment of missing teeth. The dentures are inserted directly over the extraction sites, acting as a bandage to protect the healing gum tissue.
This protective barrier helps to control post-operative bleeding and can reduce the risk of a painful complication like dry socket. By providing a template for the soft tissues, the dentures also assist in shaping the gums as they heal, which can contribute to a more favorable contour for the final prosthetic. While they restore some degree of function, allowing the patient to speak and eat soft foods, their masticatory efficiency is limited compared to a conventional denture.
The initial placement process involves taking dental impressions and measurements before the teeth are removed. The appliance is then fabricated in a lab and delivered at the time of the surgery. This careful pre-planning ensures the patient leaves the dental office with a full set of teeth, initiating the transition to a life with dentures. The immediate set gives the patient a chance to begin adapting to the feel and function of a prosthetic while the mouth undergoes significant changes.
Mandatory Adjustments and Relines
Immediate dentures are inherently temporary because the underlying oral structures change dramatically in the months following tooth removal. The primary physiological process driving this change is alveolar bone resorption, which is the body’s natural breakdown and reabsorption of the jawbone that no longer supports teeth. This bone loss begins immediately after the extraction and is most rapid during the first few weeks to months.
The gums also shrink and reform as the extraction sockets heal, leading to a reduction in the volume and shape of the residual ridge. As the jawbone and gum tissue shrink, the immediate denture, which was fitted to the original contours, becomes progressively loose and ill-fitting.
To address the rapidly changing fit, mandatory adjustments and relines are required throughout the healing phase. A reline involves adding new material to the tissue-fitting surface of the denture to fill the space created by the tissue shrinkage. Initially, a soft reline material, which is more pliable and comfortable over healing tissues, is often used.
Over time, as the healing slows, a hard reline may be performed to improve the fit and stability of the immediate denture. These relines are typically necessary multiple times during the first six to twelve months post-extraction. These adjustments are a temporary fix to maintain comfort and function until the tissues stabilize enough to move on to a final prosthetic.
Transitioning to Definitive Dentures
The period of wearing the immediate denture concludes when the underlying bone and soft tissue changes have largely stabilized. This stabilization typically occurs between six and twelve months after the extractions. Once the mouth is fully healed, the patient is ready to transition to a definitive, or conventional, denture.
The definitive denture is intended to be the long-term tooth replacement solution and is crafted using new impressions of the fully healed gums and jaw. This allows for a far more precise fit, offering enhanced stability, comfort, and retention compared to the immediate set. The final prosthetic is custom-made for the stable oral anatomy, ensuring it conforms intimately to the final shape of the residual ridge.
Definitive dentures are often made with higher quality materials and can be designed for improved aesthetics and durability. While the immediate denture served as a necessary placeholder and healing aid, the conventional denture is engineered for optimal long-term function. The transition ensures the patient receives a prosthetic that is specifically tailored to their stable oral structures, minimizing the need for frequent future adjustments.