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                    Complete dentures are fabricated when the patient 
                    has all of his or her teeth missing. It generally takes 4 or 
                    sometimes more appointments to make a set of standard 
                    dentures.
 The first appointment consists of an oral examination, 
                    sometimes X-Rays, and a set of impressions of the upper and 
                    lower edentulous (toothless) ridges (gums). These 
                    impressions are poured with plaster to form accurate models 
                    of the shape of the edentulous ridges.
 
 These first set of impressions are then used to make custom 
                    fitting impression trays for a second, more accurate 
                    impression at the second appointment.
 
 The third appointment is called the "wax try-in".  This is 
                    basically a trial stage where the teeth are placed in wax 
                    and look like real denture.
 
 This gives us the opportunity to see how the denture looks. 
                    If required any changes can be made for better results.  If 
                    the teeth look too long, or the patient clicks when talking, 
                    or the midline is wrong, we can send the denture back to the 
                    lab where a technician can melt the wax and reset the teeth 
                    to specification.
 
 At the fourth and final appointment the denture made in 
                    acrylic is delivered to the patient with proper 
                    instructions.
 
                    
                    Immediate dentures 
                    
                    Immediate dentures 
                    (sometimes called temporary dentures) are actually 
                    made BEFORE the natural teeth are extracted.  The patient 
                    walks into the office with natural teeth, and walks out with 
                    false teeth.  The teeth are extracted, and a prefabricated 
                    denture is inserted directly over the bleeding sockets.  The 
                    patient is still numb from the extractions, and nothing 
                    hurts until he gets home.  Generally, most patients do not 
                    complain of much pain after their teeth are extracted and 
                    the immediate denture is inserted.  The denture acts like a 
                    band aid and reduces pain.   
                    
                    The construction of an immediate denture 
                    requires only one or two preliminary appointments before the 
                    insertion date, depending on how many natural teeth the 
                    patient has left.  They usually work out reasonably well.  
                    When the patient leaves, he looks much better than when he 
                    walked into the office.  The bone that supported the 
                    original teeth is still intact, and the gum tissue is firm.  
                    For the first week or so, the denture remains stable and 
                    reasonably retained.  
                    
                    At the end of 4 to 6 months, the immediate 
                    denture must be relined with the same acrylic that the 
                    denture base was made from originally.  The longer you 
                    wait, (no more than 6 months), the longer you can expect the 
                    denture to remain tight before another reline is needed.   
                    
                    
                    Implant retained dentures 
                    
                    Implants are placed at strategic locations by 
                    a surgical process. Implants are basically titanium 
                    cylinders which are drilled into the bone. After 4-6 months, 
                    once they have osteointegrated with the bone they are able 
                    to support complete dentures .  
                    
                    A minimum of 2 implants need to be placed to 
                    support a lower denture which would not otherwise be 
                    tolerated by that patient. Implant retained lower dentures 
                    have special significance for people who cannot wear lower 
                    dentures. The addition of two implants in the front of the 
                    lower jaw can make it possible to retain a lower denture 
                    which would otherwise be impossible for the patient to 
                    tolerate. The image on the left below shows a pair of ball 
                    attachments on implants, and the denture that fits over them 
                    is shown in the image on the right. 
                    
                                                                           
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