Extraction of teeth affected by periodontal disease and the preparation of an immediate denture (Case presentation) (19)

Our male patient aged 62 reported to our clinic with the following complaints:

• He had not reported for a dental check-up in years and suspected a problem with his old bridges.
• Some of his teeth were sensitive while others were decidedly sore on bite.
• He felt the bridges under his teeth were loose.
• He complained of foul breath.
• He was genuinely frightened and wanted to come to grips with problem was and see how it could be tackled.

Images on the initial condition:

At the first consultation session a panoramic radiograph was produced and the condition of the teeth thoroughly assessed.

Unfortunately his teeth proved beyond repair and had to be removed due to a large extent of horizontal and vertical bone resorption. The natural teeth, or preps, beneath his old bridges were “awash” with pus (chronic periodontitis) and became dental foci. Had his periodontal disease been treated several years earlier and the sub- and supragingival tartar removed at least twice a year, his gums, teeth and jawbone would not have fallen into such a state of disrepair.

During the first treatment session all 16 of his teeth were extracted and his mouth was cleansed of all dental foci. The gums were sealed with sutures, the removal of which was due 7 to 10 days after the intervention. An immediate denture was prepared in order for the patient to have teeth, be able to smile and eat, and have self-confidence without his quality of life being compromised during the healing period of at least 3 months.

What to know about immediate dentures?

Thorough cleaning is also important with immediate dentures. The denture should be removed after each meal and cleaned with a denture brush and food remains stuck beneath should be removed. The oral cavity should also be rinsed gently but thoroughly.

• Patients are advised to remove dentures overnight, clean them and store them in a well-ventilated area, ensuring that the wound in the mouth can “breathe” and heal.
• In the course of healing the anatomic relations are constantly changing. A few weeks on the denture will not fit the same way, it may swing or go loose seeing as the initial swellings recede in a few days causing the denture to go loose. Such instances may necessitate a reline at our clinic as the denture is also at a risk for breakage.
• If wearing the denture causes your gum to crack see our clinic immediately as this may easily be helped. The treatment may continue after 3 to 4 months’ healing.

The maxilla immediately after the extraction of teeth, the curettage of periodontal pockets and the removal of infected connective tissue and tartar, with a tensionless closure of the gums

 

The mandible immediately after the extraction of teeth and the “cleansing” of the bone with tensionless sutures placed in

 

Following tooth extractions the patient leaves with an upper and lower immediate denture.

The immediate dentures in the mouth following tooth extractions