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Question:
Impression for Dentures: Based on the changes of bone and jaws structures that are clearly explained in your articles, I would like to know if once all teeth were extracted, and after allowable healing time lapsed, should the dentist take a new impression? ... Visitor from NV
Answer:
I'm not sure that I understand your question.
When I do an immediate denture, I take impressions and measurements before any teeth are extracted. Then, it takes several weeks to produce a wax model of where the teeth will be in the transitional denture.
My laboratory "removes" 1 side of the upper and lower teeth on the models (upper left and lower left in new teeth and upper and lower right in present teeth) and replaces them with the new denture teeth as an ideal smile. That way, the patient and I can see how the new teeth will look in relation to your present teeth.
After the patient's approval for esthetics, shade, tooth shape, etc. I have the denture made at the lab. When I receive the completed denture, I remove all of the teeth and give the patient the transitional denture the same day.
It is usually not a perfect fit, since all the lab does is remove the teeth from the model and make the denture framework to the imagined bone that will be left after surgery. To accommodate this not-perfect fit, I use a soft denture liner the day of the surgery to provide a perfect fit to the bone.
I have the patient keep this in overnight and see him or her the next day and I remove and clean the denture and check the surgical area. I then have them wear this soft lined denture for several months and change the soft liner as needed.
When I am satisfied that the bone has healed and remolded, I reline this denture in hard acrylic and this becomes the final denture.
The idea I got from your question is that the dentist extracts the teeth, lets you heal, then makes the denture. While this is acceptable, I prefer to have the patient have teeth at all times, let the tissues heal with the soft liner which is also a tissue conditioner, and then reline.
Hope I have answered your question.
Corinne Scalzitti, DMD, MAGD
Austin Reconstructive Implant Dentistry
Texas Periolase
3900 RR 620 South
Austin, Texas TX 78738
(512) 263-3330
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