10.59987/ads/2013.3-4.273-277
The aim of the present clinical report was to describe the use of a patient’s extensive fixed prosthesis, where the supporting teeth were hopeless, for fabricating an interim immediate complete denture. The present procedure was used to replicate the vertical dimension, phonetic and aesthetic of the existing fixed prostheses as part of an immediate denture and a final complete denture.
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Annali di stomatologia
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Immediate denture fabrication: a clinical report
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Immediate denture fabrication: a clinical report
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                                                                                                               Case report



    Immediate denture fabrication: a clinical report




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                                                                      na
    Sergio Caputi, MD, DDS                                        ture show numerous advantages as preservation of fa-
    Giovanna Murmura, MD, DDS, PhD                                cial appearance and height, muscular tone, phonetic




                                                                    io
    Laura Ricci, DDS                                              and reduction of post-extraction pain (3).
    Giuseppe Varvara, DDS, PhD                                    Several procedures have been described in the literature
    Bruna Sinjari, DDS, PhD                                       in order to construct an intermediate or transitional pros-
                                                                  thesis, to reduce the time required for its fabrication and




                                                                 az
                                                                  to provide a fast and economical service (4-7). Khan et
    Department of Medical, Oral                                   al. (1992) fabricated an immediate transitional complete
    and Biotecnological Sciences,                                 denture in one appointment using self polymerizing,
    "Gabriele d'Annunzio" University of Chieti-Pescara, Italy     tooth-colored acrylic, and visible light-cured resins (8);




                                                              rn
                                                                  however, multiple extractions performed in the same ap-
                                                                  pointment may be traumatic, complicating the adaptation
    Corresponding author:                                         of the patient to the newly fabricated denture (1). In a re-
    Sergio Caputi                                                 port, a speedy economical interim immediate denture us-




                                                           te
    Department of Medical, Oral                                   ing a vacuum-forming machine without conventional lab-
    and Biotecnological Sciences,                                 oratory procedures was also reported (9). A less traumat-
    "Gabriele d'Annunzio" University                              ic immediate complete denture placement was evaluated
    Via dei Vestini, 31
    66100 Chieti, Italy
                                                        In        in another clinical study, where the remaining teeth were
                                                                  cut off the gingival margins instead of extracting them at
    E-mail: scaputi@unichi.it                                     the time of prosthesis insertion, performing the placement
                                                                  procedures in a clean, blood-free environment, whereas
                                                                  the roots were extracted at a later time (10).
                                              ni
    Summary                                                       The treatment outcome is not always predictable as the
                                                                  prostheses cannot be completely assessed before
    The aim of the present clinical report was to de-             achievement (11). One of the most important issues to be
    scribe the use of a patient’s extensive fixed pros-           considered in immediate denture fabrication may be the
                               o

    thesis, where the supporting teeth were hopeless,             difficulty to assess the occlusal vertical dimension (OVD)
    for fabricating an interim immediate complete den-            and centric relation after extraction of the posterior teeth.
                           izi


    ture. The present procedure was used to replicate             Indeed in a clinical report, Gilboa et al (2009) per-
    the vertical dimension, phonetic and aesthetic of             formed a procedure to fabricate an immediate complete
    the existing fixed prostheses as part of an immedi-           overdenture using several teeth retained an interim pro-
    ate denture and a final complete denture.                     visional fixed partial denture until the complete denture
            Ed




                                                                  was finished. In this procedure the posterior occlusion
    Key words: immediate complete denture, dental                 was maintained during the healing period and the trau-
    prosthesis, vertical dimension.                               ma of multiple extractions at one visit was avoided (12).
                                                                  Recently, Gooya et al. (2013) described the use of a
                                                                  patient’s fixed prosthesis for fabricating, in one appoint-
    Introduction                                                  ment, an interim immediate partial denture, where three
    C




                                                                  remaining teeth were maintained to preserve OVD and
    The immediate denture is a dental prosthesis construct-       retentive clasps were used to improve temporary pros-
CI




    ed to replace the lost dentition, associated structures of    thesis retention. The Authors concluded that in this pro-
    the maxillae and mandible and inserted immediately            cedure the occlusion, OVD, and facial support was
    following removal of the remaining teeth. Generally, two      maintained during the healing period (1).
    types of immediate dentures are described in the litera-      The purpose of this report was to describe a technique for
    ture: conventional immediate dentures and interim im-         fabrication of an interim immediate denture using patient’s
    mediate dentures (1). In the traditional type, the interim    current fixed partial denture, preserving patient original in-
©




    prosthesis is fabricated to immediately place after the       formation: phonetic, esthetic, facial height and OVD.
    extraction of natural teeth and can be used as the de-
    finitive or long-term prosthesis. The interim type is used
    for a short time after tooth extraction. After the achieve-   Clinical report
    ment of healing period, the immediate denture may be
    relined or replaced with the newly fabricated final den-      A 67-year-old woman with a fixed partial maxillary pros-
    ture (2). It was reported that the interim immediate den-     thesis extended from the upper second right premolar

    Annali di Stomatologia 2013; IV (3-4): 273-277                                                                         273
    S. Caputi et al.


                                                                   and first left molar was evaluated for the treatment. The
                                                                   patient presented no significant medical history but was
                                                                   a heavy smoker and no occlusal or temporo-mandibu-
                                                                   lar disease. Clinical examination and radiographic as-
                                                                   sessment (Figs. 1, 2) revealed an unrestored mouth




                                                                                                                              li
                                                                   with generalized severe chronic periodontitis of the
                                                                   teeth supporting fixed prosthesis, that were considered




                                                                        na
                                                                   hopeless. Therefore, the operator decided to use the
                                                                   patient’s current prosthesis for the fabrication of an in-
                                                                   terim immediate denture. The patient, who signed the
                                                                   informed consent, accepted a treatment plan for an im-




                                                                      io
                                                                   mediate maxillary denture.
                                                                   It was proceeded to register the face bow, record rim to
                                                                   duplicate the patient original maxilla-mandibular rela-
    Figure 1. Initial clinical examination of the patient with a




                                                                   az
                                                                   tionship, and take an irreversible hydrocolloid impres-
    fixed denture from the second upper right premolar to first    sion (Kromopan, LASCOD S.p.A, Siesto Fiorentino,
    left molar.
                                                                   Italy). Stone casts were poured and mounted on a




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    Figure 2. Radiographic evaluation of the residual teeth.


    274                                                                            Annali di Stomatologia 2013; IV (3-4): 273-277
    Immediate denture fabrication: a clinical report


    medium value articulator (Sam 2P, SAM, Präzision-                 original one taken before. The pressure areas were de-
    stechnik GmbH, Fussbergstrasse, Gauting, Germany).                tected and occlusion adjusted. When the occlusal over-
    The wax up anatomic corrections were made to give a               load was present, it was proceed in empting it further.
    pleasant tooth arrangement.                                       Then, a hard denture reline material (Tokuso Rebase,
    The casts were then duplicated with an alginate im-               J. Morita, USA, Inc, Irvine, California, USA) was used to




                                                                                                                              li
    pression material (Kromopan, LASCOD S.p.A, Siesto                 rebase the prostheses, inviting the patient to close in
    Fiorentino, Italy). Self polymerizing resin (Palavit 55,          maximum occlusion obtaining the same level of the




                                                                          na
    Kulzer GMBH & co, Wehrheim, Germany), was pre-                    OVD tattoo. Thus, the prosthesis was slightly emptied
    pared in a shade that matches the patient dentition and           in correspondence of the post extractive sites and re-
    poured into maxillary dental arch impression (8) (Fig.            lined with a sofreliner material (Sofreliner Tough, J.
    3), polymerized, polished and then finished. The acrylic          Morita USA, Inc, Irvine, California, USA) to obtain more




                                                                        io
    resin arch was reseated in the impression, and the                stability and durability during tissue healing. After 15
    maxillary cast poured in dental stone. The resin plaque           days, the material was eliminated and replaced with a
    was build up applying to the entire maxillary cast a pink         new one. The alveolar resorption was periodically mon-
                                                                      itored and the prostheses relined after an adequate




                                                                     az
    self-ploymerizing resin (Paladur, Kulzer, Wehrheim,
    Germany) and its monomer was alternatively added to               healing period.
    have the entire denture base. The maxillary denture               After one month, this prostheses was used as a cus-
    was separated from the cast, finished and polished, ob-           tomized individual tray to make the border moulding
    taining so the provisional total denture (Fig. 4).                and take the final impression with a polyvinyl siloxane




                                                                  rn
    The OVD was performed doing the vertical measure-                 material (Dimension Penta H Quick Tray, ESPE Ameri-
    ment of the face between any two arbitrary selected
    points that are conventionally located one above and




                                                               te
    one below the oral cavity in the midline with a black
    pen. Then, the teeth were extracted leaving in situ only
    the roots of the left and right canines which would help
    to prevent the bone resorption and to offer more reten-
    tion to the prostheses. The prosthesis was emptied a
                                                            In
    little and tried in the patient’s mouth to observe the oc-
    clusal contacts and if the OVD was equivalent to the
                               o              ni

                                                                      Figure 5. Provisional immediate denture used as a cus-
                           izi


                                                                      tomized individual tray.
            Ed




    Figure 3. Maxillary acrylic resin arch powered in dental stone.
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                                                                      Figure 6. Registrations of the face bow and the record rim
    Figure 4. Provisional immediate denture.                          using the actual immediate denture.


    Annali di Stomatologia 2013; IV (3-4): 273-277                                                                          275
    S. Caputi et al.


                                                                   vation of the original occlusal relationships and OVD.
                                                                   When a procedure for fabricating conventional immedi-
                                                                   ate denture was performed, careful evaluation of the
                                                                   vertical dimension of occlusion, centric relation and the
                                                                   placement of the teeth are essential factors for the suc-




                                                                                                                                    li
                                                                   cess of the treatment (14).
                                                                   In the present report, the OVD is not modified but it is




                                                                       na
                                                                   preserved the original one.
                                                                   It is almost well known that the maintenance of the origi-
                                                                   nal OVD and centric relation is fundamental for the suc-
                                                                   cess total removable prosthesis. Gooya et al. (2013)




                                                                     io
                                                                   suggested in a recent report to carefully select artificial
                                                                   teeth with the same cuspal inclination which, helps to
                                                                   match cuspal inclination with anterior and posterior guid-
    Figure 7. Final total denture.




                                                                  az
                                                                   ance and make an acceptable occlusal scheme (1).
                                                                   Whilst, in the present report anatomic wax up correc-
                                                                   tions were made to give a pleasant tooth arrangement
    ca, Norristown, Pennsylvania, USA) (Fig. 5). The regis-
                                                                   and maintain their height and dimensions in order to do
    trations of the face bow and the record rim were per-




                                                               rn
                                                                   not change the patient’s appearance and function.
    formed using the actual immediate denture (Fig. 6).
                                                                   In addition, the immediate denture made following the
    The impression was poured in dental cast and mounted
                                                                   described technique could be easily used to transfer
    on the articulator with the prosthesis. The permanent
                                                                   the record rim, face bow and take the final impression
    total denture was fabricated using the classical tech-




                                                            te
                                                                   (since it could be used as custom made impression
    nique but using patient’s original OVD, occlusion, pho-
                                                                   tray), for the final denture construction reducing time,
    netic and esthetic. At subsequent appointments, the
                                                                   visits and costs. Also to verify the integrity of the oc-
    teeth trial-in was directly performed and the final total
                                                                   clusal relationship the casts are not hand articulated in
    prostheses was delivered (Fig.7).
                                                         In        maximum intercuspal position as described recently
                                                                   (15), but mounted in a medium value articulator. The
                                                                   contraindications to this treatment procedure include
    Discussion
                                                                   the presence of symptomatic teeth or acute root infec-
                                                                   tions and in case of complete edentulous patients.
    The conventional immediate denture treatment requires
                                           ni
                                                                   The present clinical report presents a treatment proce-
    a series of appointments to perform the standard pro-
                                                                   dure that makes immediate denture placement more pre-
    cedures; indeed, after the extraction of remaining teeth
                                                                   dictable and less stressful. The delivery of the prosthesis
    and the any necessary adjunct surgery, the denture is
                              o

                                                                   is less traumatic because extractions are deferred. It pro-
    placed, tested for areas of excessive pressure, and ad-
                                                                   vides greater control over the prosthodontic aspects, and
    justed (12). Actually, when a conventional complete
                                                                   the convenience of performing the placement procedure
                          izi


    denture is fabricated, there is generally a period from
                                                                   in a clean, blood-free environment.
    several weeks to months of edentulism for healing after
                                                                   The procedure described, replicating the vertical di-
    teeth extraction (13).
                                                                   mension, phonetic and aesthetic of the existing fixed
    There is diminished predictability in a combined surgical
           Ed




                                                                   prostheses of patient, can be used to fabricated the in-
    and prosthodontic visit: surgery is performed, and difficul-
                                                                   terim immediate denture and a final complete denture.
    ties with extractions, bleeding, and /or pain control may be
                                                                   In addition, the complete removable prostheses ob-
    encountered; moreover, the appointments can become
                                                                   tained with this procedure can be used as a custom
    prolonged and stressful for both patients and dentist.
                                                                   tray for the final denture fabrication.
    In addition, the interim immediate denture is used in or-
                                                                   However, considering the introduction and successful
    der to preserve the esthetic, mastication, and the oc-
    C




                                                                   outcome of dental implants, further clinical studies
    clusal support (1). The procedure performed in this clin-
                                                                   could be needed to evaluate the use of present tech-
    ical report described an immediate denture fabrication
                                                                   nique to fabricate a removable implant supported provi-
CI




    technique, preserving much information as possible
                                                                   sional prostheses. A fixed or removable implant-re-
    from the patient’s original situation. Furthermore, reduc-
                                                                   tained denture should be favored as the final treatment
    ing the number of traditional technique visits, a com-
                                                                   of edentulous patients.
    plete denture was delivered after the extraction of teeth
    and the patient received the final new denture without
    the additional trauma of the surgery.
©




    During the mounting on the articulator in maximum inter-
                                                                   References
    occlusion position, the patient has to wait to have his
                                                                    1. Gooya A, Ejlali M, Adli AR. Fabricating an interim immedi-
    prostheses. In the initial period that the denture is worn,        ate partial denture in one appointment (modified jiffy denture).
    it will not reset on extraction sites or surgical wounds.          A clinical report. J Prosthodont.2013; 22:330-3.
    The functional advantages included the possibility to           2. Zarb GA, Bolender CL. Prosthodontic treatment for edentulous
    perform the denture adjustments, the use of pressure–              patients. 12th Ed. St.Louis:The C.V. Mosby Co. 2004; 8: 123-
    indicating materials in a blood-free field and the preser-         159.


    276                                                                              Annali di Stomatologia 2013; IV (3-4): 273-277
    Immediate denture fabrication: a clinical report


     3. Seals RR, Kuebker WA, Stewart KI: Immediate complete den-            1992; 67:747-748.
        tures. Dent Clin North Am 1996; 40:151-167.                      10. Woloch MM. Non traumatic immediate complete denture place-
     4. Racka TA, Esposito SJ. The “Jiffy” denture: a simple solu-           ment: a clinical report. J Prosthet Dent 1998; 80:391-3.
        tion to a sometimes difficult problem. Compend Contin Educ       11. Wyatt CCL. Immediate dentures. In MacEntee MI, ed. The
        1995; 16:914-6.                                                      complete denture: a clinical pathway. Chicago, IL: Quin-




                                                                                                                                      li
     5. Soni A. Trial anterior artificial tooth arrangement for an im-       tessence Publishing 1999; 99-107.
        mediate denture patient: a clinical report. J Prosthet Dent      12. Gilboa I, Cardash HS. An alternative approach to the im-




                                                                             na
        2000; 84:260-3.                                                      mediate overdenture. J Prosthodont 2009; 18:71-5.
     6. Cardash HS, Kaufman C, Helft M. An interim denture tech-         13. Bouma LO, Mansueto MA, Koeppen RG. A nontradition-
        nique. Quint Dent Tech 1983; 7:89-91.                                al technique for obtaining optimal esthetics for an imme-
     7. Swoope CA, Wisman LJ, Wands DH. Interim dentures. J                  diate denture: a clinical report. J Prosthodont 2001;
        Prosthet Dent 1984; 32:604-12.                                       10:97-101.




                                                                           io
     8. Khan X, Haeberle CB. One appointment construction of an          14. Passamonti G, Kottrajarus P, Gheewala RK, Clark RE,
        immediate transitional complete denture using visible light-         Maness WL. The effect of immediate denture on maxillo-
        cured resin. J Prosthet Dent 1992; 68:500-2.                         mandibular relations. J Prosthet Dent 1981; 45:122-6.
     9. Joffe EH: Simplified fabrication of the interim denture using    15. Gotlieb AS, Askinas SW. An atypical chairside immediate den-




                                                                        az
        a vacuum forming machine: a clinical report. J Prosthet Dent         ture: a clinical report. J Prosthet Dent 2001; 86:241-3.




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    Annali di Stomatologia 2013; IV (3-4): 273-277                                                                                  277
