Interim Denture Interim Complete Dental Prosthesis Clinical Steps Diagnostic Appointment Comprehensive Exam Extra oral Intra oral Address: Main complaint Esthetic concerns Other concerns Discuss (if present) current partial or complete dentures Patient expectations Treatment Plan Complete and sign Schedule for extractions Extractions should be phased 1) Posteriors in groups of no more than six at a time 2) anteriors Primary Impression Appointment Alginate primary impressions (approx 10 days after posterior extractions) Select trays Rim lock Ace-dent Series 2 Correct fit has 5mm to ¼ space all around Block out any loose teeth or large interproximal spaces Pour casts Alginate is not boxed Trim casts Outline the extension of tray Relief and block out if necessary Make and trim tray
Impression Appointment Try in custom trays Should not impinge Borders short of vestibule 1-2mm Mandibular secondary impression Single alginate wash- no border molding Thin alginate using ten percent more water to increase flow Maxillary secondary impression Single alginate wash- no border molding Thin alginate using ten percent more water to increase flow Pour casts Alginate is not boxed Remember mandibular MUST be a complete cast no horseshoes Trim casts Fabricate record bases Mounting Records Appointment
Try in record bases Should seat comfortably Post dam Determine position Carve in cast (if necessary to retain record base) Record position of post dam in patient record for later use to transfer to master cast before processing Maxillary wax rim Anterior teeth present Fan fold base plate wax Rim only in posterior following Campers Plane Anterior teeth mostly missing Fan fold base plate wax Place rim where teeth are missing While still soft, place in mouth and adjust for fullness Mark lip length, remove, and trim Check Parallel to inter pupillary line Campers plane Mandibular rim Fan fold baseplate wax If UDEMA, grind surface/add sticky wax to help adhere - While soft, place in mouth and adjust under maxillary rim - Mark edge lip at repose, remove, and trim posterior to ½ up Retromolar pad Place both in the mouth and evaluate, trim rims to occlude Vertical Dimension position Natural tooth contact if present No natural tooth contact or collapsed contact Resting position and profile Use "m" sound Compare with existing denture Record Horizontal position Use adhesive if necessary Use non-pressurizing recording material
Verify Facebow record Place facesbow fork (rivet head up) in the wax rims of the maxillary cast (be careful not to affect the jaw record portion of the rim) Make the face bow record Select Tooth Shade Mount maxillary cast using face bow Mount Mandibular cast using jaw record Get the teeth from the lab (Kenson teeth) Set teeth using remaining teeth as a guide Try In Appointment Only if necessary to evaluate anterior teeth Complete waxup Submit to lab for processing Trim and polish Insertion Appointment Evaluate internal surface with pressure indicating paste
Mandibular After tissue surface evaluate borders Maxillary After tissue surface evaluate borders Place dentures in together Check for base interference Evaluate occlusion Visually Indicating medium Repolish adjusted areas Patient instructions Homecare kit Reappoint for post insertion check 24 to 48 hours Instructions 1) Leave in until appointment next day (if you remove you may be too sore to place it back in) 2) Bleeding has stopped but your saliva will be tinged red for the rest of the day 3) You must drink and eat or you will risk becoming dehydrated Eat soft foods such as pudding, soup, ice cream etc 4) Initially your speech may be affected 5) Place an old pillow cover or towel over your pillow to prevent drooling and staining it