Immediate dentures are prosthetics inserted immediately after the removal of natural teeth, allowing the patient to avoid a period without teeth while the mouth heals. This restorative method offers immediate aesthetic improvement and function following extractions. The instantaneous replacement of teeth helps maintain confidence and speech while the gums and bone tissue recover. The process requires extensive preparation and fabrication before the surgical date to ensure the custom appliance is ready for immediate placement.
The Planning and Fabrication Phase
The immediate denture process begins with a comprehensive consultation to determine the treatment plan and identify the specific teeth scheduled for removal. During this phase, the dental professional takes precise impressions, or molds, of the remaining teeth and the surrounding gum tissue. These detailed impressions create an accurate replica of the patient’s mouth for the dental laboratory.
The lab technician uses these models to fabricate the denture. They physically trim the model to simulate the removal of the teeth and the future shape of the gum line. This technique allows the technician to build a denture that approximates the healed tissue contours, ensuring it will fit on the day of surgery. Color matching for the denture teeth and the acrylic base is completed during planning appointments to maintain a natural appearance.
Accurate bite registration is accomplished before the extractions, recording how the upper and lower jaws meet. This registration is transferred to an articulator in the lab, a mechanical device that mimics jaw movements. The completed denture is a custom-fitted appliance ready for placement immediately after the teeth are extracted, avoiding the delay associated with conventional denture fabrication.
The Day of Extraction and Immediate Insertion
On the day of the procedure, the remaining natural teeth are removed, typically under local anesthesia or sedation. Immediately following the extractions, the custom-fabricated denture is seated into the mouth, which is why it is called an immediate denture. The immediate placement of the prosthetic acts like a surgical bandage over the open extraction sites.
This function helps control post-operative bleeding and minimizes swelling in the surrounding soft tissues. Patients are instructed not to remove the denture for the first 24 hours to allow the tissues to begin the initial healing phase under the compression of the appliance. Removing the denture too soon can lead to rapid swelling of the gums, which may make re-insertion difficult or impossible.
Post-operative instructions focus on managing initial discomfort and bleeding, often involving pain medication and avoiding activities like forceful spitting or drinking through a straw. The denture must remain in place during this initial period to protect the surgical sites and promote blood clot formation. A follow-up appointment is scheduled within 24 to 48 hours for the dental professional to remove the denture and check the healing tissues.
The Healing Period and Necessary Adjustments
The months following immediate insertion are marked by significant changes in the mouth, primarily due to the natural remodeling of the jawbone and gum tissue. Once the teeth are removed, the alveolar ridge, the bone that supported the teeth, begins to resorb and shrink rapidly. This bone and tissue shrinkage causes the immediate denture to become progressively looser and less stable over time.
Because of tissue change, frequent follow-up appointments are necessary to adjust the denture and maintain a comfortable fit. Within the first few weeks, a temporary soft reline is applied to the inside surface of the denture. This soft, pliable material fills the gaps created by the shrinking gums, improving the seal and providing a cushion over the healing tissues.
Multiple soft relines, or tissue conditioners, may be needed during the first six months as the residual ridges continue their rapid change in shape and volume. This phase requires ongoing modification because the immediate denture was made before the final contours of the healed tissues were established. The goal is to stabilize the fit until the healing process is substantially complete, which can take six to twelve months.
Once the soft tissues have matured and bone remodeling has slowed significantly, the dental professional performs a permanent, or hard, reline. This procedure involves taking a new impression inside the existing denture and sending it to a lab to replace the temporary lining with a durable, rigid acrylic material. This hard reline transitions the immediate denture into a definitive, long-term prosthetic.