Immediate Dentures: Records, Surgery Day and the First Year of Relines

An immediate denture is the one removable case where nobody sees the ridge before the denture is made. The impression still has teeth in it, and the denture has to seat over fresh sockets the same day. Then the ridge keeps changing under it for months.

Many surgery-day surprises start earlier, in the records and the cast surgery. Below: planning, records, digital options, ridge shrinkage, and the evidence on soft liners and the definitive reline.

Quick Answer

An immediate denture is built before the last teeth come out, so the lab needs a full-arch impression or scan with the teeth present, a verified bite, tooth selection, the teeth to extract and how much ridge to trim. It is seated right after extraction and stays in until a next-day check. Plan soft liners through the fastest shrinkage, in the first 3 to 6 months, then a definitive reline or a new denture once the ridge settles.

Conventional or Interim: Which Immediate Denture Are You Planning?

The Glossary of Prosthodontic Terms (10th edition, 2023) defines an immediate denture by timing alone: made to be placed right after the natural teeth are removed. How long it serves is a planning decision. The Glossary's interim prosthesis, used for a limited time and then replaced by a definitive one, describes one option.

A 2025 systematic review of 19 studies describes the common sequence: posterior teeth first, the rest after 2 to 3 months of healing (Sikri et al.).

What Records Does the Lab Need Before Extraction?

Impressions or scans with the teeth present

The working impression covers the whole denture-bearing area and the remaining teeth; Yeung et al. call an accurate record of the teeth essential for trimming the model and copying them. With very mobile teeth, Farrag et al. blocked the interdental undercuts with utility wax and border molded with green stick compound first. An intraoral scan removes the risk of pulling a tooth during the impression (Oh et al., 2019).

Bite and vertical dimension

Record bases, wax rims, a jaw relation record and a facebow follow standard denture steps (Yeung et al.). Record the vertical dimension carefully: as the ridge resorbs, immediate dentures settle and vertical dimension and overjet decrease (Tallgren et al., 1980).

Tooth selection and try-in

An immediate denture can copy the shade, shape and position of the natural teeth (Yeung et al.). The catch, notes the Foundation for Oral Rehabilitation, is that the remaining teeth prevent a full try-in, so the result is less predictable. Try in what the teeth allow.

How Much Ridge Should Be Trimmed on the Cast?

Cast surgery removes the stone teeth and shapes the ridge to approximate its form right after extraction. Over-trimming is the risk: the denture then presses on that area, which Yeung et al. check closely at the 24-hour visit. Where an undercut must be managed, they want the dentist, not the technician, to trim the cast, because trimming it helps plan the surgery.

Match the depth to the planned surgery; a 1976 comparison with labial plate and intraseptal alveoloplasty found simple extraction preserves the most ridge (Michael and Barsoum). In one case of Farrag et al.'s 2025 series, the casts were trimmed 2 mm buccally and 1 mm lingually, using the panoramic radiograph to estimate bone level; a clear thermoformed surgical guide made on them showed, by blanching, where bone needed reduction. If you graft the sockets, say so: grafting changed resorption in the trial below.

Can Immediate Dentures Be Made Digitally?

Yes, though the evidence is clinical reports and technique papers; we found no randomized trial against conventional immediate dentures.

• Hybrid, two visits: scans and bite at visit one, printed trial bases, teeth set and processed conventionally, then placement with a reline (Oh et al., 2019).
• Fully digital: teeth removed virtually, denture designed and milled with no conventional impression or stone cast (Fang et al., 2018).
• Guided surgery: ridge recontoured in CAD, then a printed alveoloplasty guide and verification stent (Badr et al., 2025).
• Analog borders: scans miss optimal border extensions, so borders are recorded separately, for example on a printed prototype (Alamri et al., 2025; Farrag et al., 2025).

The payoff comes later: the definitive denture can be made from a reline impression and new centric relation record (Neumeier and Neumeier, 2016), or in two appointments by reproducing the immediate denture's polished surface and tooth arrangement (Millet et al., 2020). More on milled and printed dentures in our history of dentures.

How Fast Does the Ridge Shrink After Extraction?

Fastest at first. A 2012 systematic review of 20 studies found 29% to 63% horizontal and 11% to 22% vertical loss after 6 months, rapid in the first 3 to 6 months, gradual after. A 2021 meta-analysis put mean clinical loss in non-molar sites at 2.73 mm horizontally and 1.71 mm mid-facially.

That trial enrolled 36 patients receiving maxillary immediate dentures after anterior extractions, measured on CBCT from day 10. Without grafting, height loss was 1.2 mm at 3 months and 2.1 mm at 1 year; width loss, 1.3 mm and 2.2 mm. More than half of the first-year loss came in the first 3 months. In an older study of 18 patients, resorption was fastest in the first 3 months, particularly the first 3 weeks, and the lower anterior ridge lost twice as much height as the upper (Tallgren et al., 1980).

What Happens on Surgery Day and in the First Weeks?

Yeung et al. extract, press the labial and palatal plates, suture over the interdental bone, check the intaglio with pressure-indicating paste, adjust and seat. The patient returns the next day, at 1 week for suture removal, then weekly until no new problem appears. Expect extra visits: in a 2025 study of 308 dentures followed 5 years, immediate dentures needed more appointments and adjustments and failed more often than standard ones (D'Souza et al.).

What to tell the patient, in writing (Holt, 1986)

• Leave the denture in until the next-day visit (Yeung et al.; Farrag et al.); a 2025 review cites 48 hours (Sikri et al.).
• Soreness, swelling and awkward speech and chewing are expected for days, sometimes weeks (Foundation for Oral Rehabilitation).
• Call when it loosens; the ACP says needing more adhesive is a reason to have the fit checked.
• After healing, do not wear it around the clock: the ACP does not recommend 24-hour wear.
• It may need a reline or a remake once the jaw has healed (ADA, MouthHealthy).

When Should You Reline, and When Should You Remake?

In the Glossary, a tissue conditioner is a resilient liner placed briefly to let tissue heal; a reline resurfaces the intaglio with new base material; a rebase replaces the entire base. A 2017 review names loss of surface integrity and roughness as the main problems of tissue conditioners, linked to denture stomatitis. Where an undercut limits the flange, Yeung et al. prefer a laboratory-added soft liner before delivery to a chairside one on surgery day.

Yeung et al. argue for relining when resorption compromises fit, retention, support or stability, not on a fixed date. Remake instead when the plan was interim or the esthetic result falls short (Foundation for Oral Rehabilitation).

How Do You Code and Schedule It?

The immediate denture, a later lab reline and a replacement denture carry separate codes; see our CDT Codes for Dental Lab Work: 2026 Cheat Sheet. If the reline falls in the next benefit year, see Year-End Dental Benefits: Phasing Around the Maximum; clinical need should set the date.

Immediate Dentures at Elegant Dental Laboratory

• Complete and immediate dentures, processed conventionally on printed or stone models, plus duplicate dentures and implant overdentures on two implants.
• Intraoral scans accepted for complete dentures, with design files kept; scans reviewed before production (submit a digital case).
• Every case made in house in Brooklyn by more than 35 technicians, no outsourcing, since 2007.
• Send a case: free pickup and delivery by our own drivers in all five New York City boroughs and 13 northern New Jersey counties, or a prepaid UPS label anywhere. Call 877-335-5221.

FAQ

When should an immediate denture get a hard reline?

When the ridge has stabilized and the fit has changed: sources describe 6 months or later, often 6 to 9 months.

Can the patient take the denture out the first night?

Published protocols say no: leave it in until the next-day visit. Some reviews cite 48 hours.

How much should the cast be trimmed?

Only as much as the planned surgery removes. One case series trimmed 2 mm buccally and 1 mm lingually, guided by a radiograph.

Can an immediate denture be made from intraoral scans?

Clinical reports describe fully digital and hybrid workflows. Scans miss functional borders, so many add a border-molded impression.

Should I graft the sockets under an immediate denture?

In one randomized trial, first-year buccal height loss was 0.7 mm with a graft and 2.1 mm without; the authors see most value when implants are planned.

Is an immediate denture temporary?

It can be either: a conventional immediate denture is relined and kept; an interim one is replaced after healing.

Reviewed by Gary Fingerman, founder and CEO of Elegant Dental Laboratory, Brooklyn, New York (founded 2007). Last reviewed: October 1, 2026. Study values are from published research and clinical reports; reline and remake timing should follow the clinical findings in each patient.