Prosthodontics Quiz on Soft Lining Materials

Immediate Dentures

• Immediate dentures are dentures placed immediately after tooth extraction.
• Four treatment options exist for patients losing all their teeth:
  • Extraction of all teeth, waiting 6-8 months for extraction sites to heal, then creating definitive dentures.
  • Converting existing partial dentures to immediate full dentures.
  • Creating immediate removable dentures.
  • Placing implants and then fitting immediate dentures supported by implants.

Stress Reducing Materials for Complete Dentures

• Conditions for success of immediate dentures:

  • Maintain a healthy relationship between the mouth and surrounding tissues.
  • Restore chewing function.
  • Maintain aesthetics.
  • Protect supporting tissues.
  • Fully restore speech, breathing, and digestive functions.

• Benefits of immediate dentures:

  • Avoid alveolar bone resorption due to the immediate application of the denture.
  • Preserve the patient's lost function and stimulate bone tissue.
  • Halt the onset of oral bleeding while promoting wound healing and blood clotting.
  • Allow improved contours of the alveolar bone.

• Drawbacks of immediate dentures:

  • Lab-fabricated dentures cannot precisely duplicate the tooth, surrounding tissue, and bone form.
  • Immediate dentures cause more tissue irritation.
  • These are more difficult to manage compared to other types of dentures, but this problem may likely resolve with appropriate aftercare.
  • Patients with various medical conditions like anemia, blood diseases, kidney failure, cardiovascular diseases, and diabetes should avoid immediate dentures.
  • Difficult to make a precise centric relation record in post-extraction cases.
  • Aesthetical issues may arise during use as the prosthesis is not fabricated and tried in prior to installation into the patient's mouth, unlike other denture types.

• Conditions for postponing immediate dentures:

  • Post-extraction swelling caused by trauma.
  • Patients with acute kidney or heart problems.
  • Those with poor oral hygiene should delay immediate prosthesis placement.
  • Radiotherapy patients should delay their immediate prosthesis for at least a year.

• Essential Considerations in Diagnosis and Treatment Planning:

  • Informing the patient about the denture responsibilities.
  • Explaining limitations and challenges of the procedure to the patient (written documentation if required).
  • Advising the patient about the planned relining or replacement of the dentures in around six months.

Classification of Immediate Dentures

• A systematic breakdown of types of immediate dentures (image shows types).

Types of Complete Immediate Dentures

• Conventional full immediate dentures.
• Conventional partial immediate dentures.
• Open-faced immediate dentures.
• Closed/half-closed vestibulum immediate dentures.

Advantages of Open-Vestibular Immediate Dentures

• Correct positioning of the teeth.
• Easy positioning of the denture base.
• Eliminates the need for tissue adjustments.

Disadvantages of Open-Vestibular Immediate Dentures

• Problems with retention and support.
• Problems with maintaining oral aesthetic harmony.
• Potential for complications resulting from inadequate oral bone structure to maintain support and retention.

Closed/Half-Closed Vestibular Immediate Dentures

• Retention and support of these dentures are elevated.
• The denture base design is more refined.
• These types are sometimes better for patients.

Delayed (or Delayed-Immediate) Dentures

• Dentures are fabricated after a healing period for the mouth (1-2 days following extraction).
• The patient receives a trial prosthesis at this stage, which will help them acclimate to the new dentures.

Controlled (or Stepwise) Immediate Dentures

• The process is done in steps so that patients are not inconvenienced.
• The procedure is conducted in stages, first by extracting the back teeth.
• This way, a partial denture can be made first and then a complete denture later.

Steps in making Immediate Dentures

• Gathering a model of the patient's teeth.
• Having a test fit of the dentures.
• Adjusting the jaw alignment with an articulator machine.
• Polishing and finishing the fabrication of the device.
• Adjusting any necessary components.

Methods of Fitting Immediate Dentures in the Open Vestibule

• Precise tooth positioning.
• Simple denture fitting process
• Avoids tissue alterations
• Adequate bone width needed for retention and proper support.

Methods of Fitting Immediate Dentures in the Closed/Half-closed Vestibule

• Good retention and support because of better design.
• More suitable for patients depending on the state of their oral health.

Tissue Conditioning Materials

• These materials are temporary soft liners.
• Suitable for a duration of 1 week to 10 days.
• Loss of suppleness and increased pressure on the tissues occur with extended usage.

Indications of Permanent Soft Liners

• Patients experiencing aged- or disease-related oral problems.
• Patients with compromised bone structure from previous or ongoing diseases.
• Patients needing additional care following previous or ongoing treatment.

Indications of Temporary Soft Liners

• Maintaining patient comfort and preventing tissue irritation.
• Preventing inflammation during healing.
• Protecting periodontal structures that may be affected by inflammation.

Ways for Using Tissue Conditioning Materials

• Applying the material to affected areas of the mouth.
• Adjusting the material to ensure it fits well with the contours of the mouth while minimizing impact on sensitive areas.

Disadvantages of Soft Liners

• Hardening over time.
• Difficulty in bonding with the denture base.
• Concerns about device stability during usage.
• High cost of the material.

Problems with Tissue Conditioning Materials

• Alcohol loss
• Porosity
• Hypersensitivity

Clinical Application of Tissue Conditioner Materials

• Preparation of the mouth and affected soft tissue.
• Applying the substance to the surface of the denture (ensuring a proper fit).
• Positioning the appliance.
• Post-application care and guidelines.