RELINING & REBASINGRELINING & REBASINGCOMPLETE DENTURESCOMPLETE DENTURESRELINING & REBASINGRELINING & REBASINGCOMPLETE DENTURESCOMPLETE DENTURES

Improving the Adaptation of Existing Improving the Adaptation of Existing DenturesDentures

Improving the Adaptation of Existing Improving the Adaptation of Existing DenturesDentures

RebasingRebasing RebasingRebasing

• Replacing entire denture base.Replacing entire denture base.

• Flasking, heat-cured acrylic.Flasking, heat-cured acrylic.

• Usually porcelain teeth.Usually porcelain teeth.

• Replacing entire denture base.Replacing entire denture base.

• Flasking, heat-cured acrylic.Flasking, heat-cured acrylic.

• Usually porcelain teeth.Usually porcelain teeth.

ReliningRelining ReliningRelining

• Resurfacing the tissue surface. Resurfacing the tissue surface.

• Jig used to maintain OVD & occlusal contacts with Jig used to maintain OVD & occlusal contacts with chemical-cold-cure / light-cure acrylic resin.chemical-cold-cure / light-cure acrylic resin.

OrOr

• Reprocessing with heat cure resin.Reprocessing with heat cure resin.

• Resurfacing the tissue surface. Resurfacing the tissue surface.

• Jig used to maintain OVD & occlusal contacts with Jig used to maintain OVD & occlusal contacts with chemical-cold-cure / light-cure acrylic resin.chemical-cold-cure / light-cure acrylic resin.

OrOr

• Reprocessing with heat cure resin.Reprocessing with heat cure resin.

IndicationsIndicationsIndicationsIndications

Denture no longer fits residual ridge. Denture no longer fits residual ridge.

Retention, stability are lacking.Retention, stability are lacking.

PLUSPLUS• Occlusion is acceptable.Occlusion is acceptable.• Vertical dimension is acceptable.Vertical dimension is acceptable.• Denture teeth / gingival contours acceptable.Denture teeth / gingival contours acceptable.

Denture no longer fits residual ridge. Denture no longer fits residual ridge.

Retention, stability are lacking.Retention, stability are lacking.

PLUSPLUS• Occlusion is acceptable.Occlusion is acceptable.• Vertical dimension is acceptable.Vertical dimension is acceptable.• Denture teeth / gingival contours acceptable.Denture teeth / gingival contours acceptable.

Contraindications Contraindications Contraindications Contraindications

Complaints of a loose denture Complaints of a loose denture DOES NOT DOES NOT in itselfin itself::

- constitute evidence of a lack of fit and stability.- constitute evidence of a lack of fit and stability.

Complaints of a loose denture Complaints of a loose denture DOES NOT DOES NOT in itselfin itself::

- constitute evidence of a lack of fit and stability.- constitute evidence of a lack of fit and stability.

Determine Cause of LoosenessDetermine Cause of LoosenessDetermine Cause of LoosenessDetermine Cause of Looseness

• Pivoting on bony structures Pivoting on bony structures - PIPPIP

• Occlusal interferences Occlusal interferences - Tactile, articulating paper, remountTactile, articulating paper, remount

• Inadequate posterior palatal sealInadequate posterior palatal seal- Pull upward & outward on lingual of caninesPull upward & outward on lingual of canines

• Pivoting on bony structures Pivoting on bony structures - PIPPIP

• Occlusal interferences Occlusal interferences - Tactile, articulating paper, remountTactile, articulating paper, remount

• Inadequate posterior palatal sealInadequate posterior palatal seal- Pull upward & outward on lingual of caninesPull upward & outward on lingual of canines

Evaluate Cause of LoosenessEvaluate Cause of Looseness Evaluate Cause of LoosenessEvaluate Cause of Looseness

• Coronoid interferences Coronoid interferences – Side to side movements, PIPSide to side movements, PIP

• Flanges overextensionsFlanges overextensions – Pull on the cheeks, lips, patient move tonguePull on the cheeks, lips, patient move tongue

• Tight pterygo-mandibular rapheTight pterygo-mandibular raphe

• Coronoid interferences Coronoid interferences – Side to side movements, PIPSide to side movements, PIP

• Flanges overextensionsFlanges overextensions – Pull on the cheeks, lips, patient move tonguePull on the cheeks, lips, patient move tongue

• Tight pterygo-mandibular rapheTight pterygo-mandibular raphe

Relines Can Only Solve Retention Problems Relines Can Only Solve Retention Problems Related to Denture Base AdaptationRelated to Denture Base Adaptation

Relines Can Only Solve Retention Problems Relines Can Only Solve Retention Problems Related to Denture Base AdaptationRelated to Denture Base Adaptation

Retention problems must be:Retention problems must be:

- diagnosed as to their cause- diagnosed as to their cause

Retention problems must be:Retention problems must be:

- diagnosed as to their cause- diagnosed as to their cause

• Processed or chairsideProcessed or chairside• Impression or functional techniqueImpression or functional technique• Hard acrylic or resilientHard acrylic or resilient• Permanent, temporaryPermanent, temporary• Complete or partial denturesComplete or partial dentures

• Processed or chairsideProcessed or chairside• Impression or functional techniqueImpression or functional technique• Hard acrylic or resilientHard acrylic or resilient• Permanent, temporaryPermanent, temporary• Complete or partial denturesComplete or partial dentures

Types of RelinesTypes of RelinesTypes of RelinesTypes of Relines

Processed Acrylic Permanent Processed Acrylic Permanent Complete Denture RelinesComplete Denture Relines

Processed Acrylic Permanent Processed Acrylic Permanent Complete Denture RelinesComplete Denture Relines

• Make impression for least stable denture first. Make impression for least stable denture first.

• Easier to stabilize the other denture. Easier to stabilize the other denture. – Reference for occlusion & vertical dimension.Reference for occlusion & vertical dimension.

• Make impression for least stable denture first. Make impression for least stable denture first.

• Easier to stabilize the other denture. Easier to stabilize the other denture. – Reference for occlusion & vertical dimension.Reference for occlusion & vertical dimension.

Impression TechniqueImpression TechniqueImpression TechniqueImpression Technique

Difficult to reline without:Difficult to reline without:• Encroaching on inter-occlusal space. Encroaching on inter-occlusal space. • Displacing the supporting tissues.Displacing the supporting tissues.• Altering occlusal contacts.Altering occlusal contacts.

USE CAREUSE CARE

Difficult to reline without:Difficult to reline without:• Encroaching on inter-occlusal space. Encroaching on inter-occlusal space. • Displacing the supporting tissues.Displacing the supporting tissues.• Altering occlusal contacts.Altering occlusal contacts.

USE CAREUSE CARE

Positioning the DenturePositioning the DentureOVD & OcclusionOVD & Occlusion

Positioning the DenturePositioning the DentureOVD & OcclusionOVD & Occlusion

Adjust Occlusion Adjust Occlusion Adjust Occlusion Adjust Occlusion

• Obtain stable occlusal contacts. Obtain stable occlusal contacts.

• Remount & adjustment may be required.Remount & adjustment may be required.

• Assess need for tissue conditioning.Assess need for tissue conditioning.

• Obtain stable occlusal contacts. Obtain stable occlusal contacts.

• Remount & adjustment may be required.Remount & adjustment may be required.

• Assess need for tissue conditioning.Assess need for tissue conditioning.

Remove Tissue Undercuts Remove Tissue Undercuts Remove Tissue Undercuts Remove Tissue Undercuts

Allows impression to be removed from the:Allows impression to be removed from the:

- cast without breaking cast or denture.- cast without breaking cast or denture.

Allows impression to be removed from the:Allows impression to be removed from the:

- cast without breaking cast or denture.- cast without breaking cast or denture.

Clean the DentureClean the DentureClean the DentureClean the Denture

Border MoldBorder MoldBorder MoldBorder Mold

• Relieve borders 2 mm short of vestibule.Relieve borders 2 mm short of vestibule.

• Border mold with compound.Border mold with compound.

• Maxillary posterior border at vibrating line Maxillary posterior border at vibrating line (indelible (indelible stick).stick).

• Relieve borders 2 mm short of vestibule.Relieve borders 2 mm short of vestibule.

• Border mold with compound.Border mold with compound.

• Maxillary posterior border at vibrating line Maxillary posterior border at vibrating line (indelible (indelible stick).stick).

Reduce Tissue BaseReduce Tissue BaseReduce Tissue BaseReduce Tissue Base

• 1 mm if acceptable intero-cclusal distance: 1 mm if acceptable intero-cclusal distance: – Use guide grooves.Use guide grooves.

• If inter-occlusal distance is excessive, relief may not be If inter-occlusal distance is excessive, relief may not be required.required.

• Perforate denture with #4 round bur.Perforate denture with #4 round bur.

• 1 mm if acceptable intero-cclusal distance: 1 mm if acceptable intero-cclusal distance: – Use guide grooves.Use guide grooves.

• If inter-occlusal distance is excessive, relief may not be If inter-occlusal distance is excessive, relief may not be required.required.

• Perforate denture with #4 round bur.Perforate denture with #4 round bur.

Impression Material Impression Material Poly-vinyl-siloxanePoly-vinyl-siloxane

Impression Material Impression Material Poly-vinyl-siloxanePoly-vinyl-siloxane

• Ease of use.Ease of use.

• Cleaning, removal from undercuts.Cleaning, removal from undercuts.

• Requires adhesive carried to the external Requires adhesive carried to the external surface surface of denture borders.of denture borders.

• Ease of use.Ease of use.

• Cleaning, removal from undercuts.Cleaning, removal from undercuts.

• Requires adhesive carried to the external Requires adhesive carried to the external surface surface of denture borders.of denture borders.

Impression ProcedureImpression ProcedureImpression ProcedureImpression Procedure

• Load carefully.Load carefully.

• Excessive material can reduce freeway space.Excessive material can reduce freeway space.

• Dry tissues.Dry tissues.

• Load carefully.Load carefully.

• Excessive material can reduce freeway space.Excessive material can reduce freeway space.

• Dry tissues.Dry tissues.

Impression Procedure Impression Procedure Impression Procedure Impression Procedure

• Seat denture anteriorly.Seat denture anteriorly.

• Slowly rotate posterior into place. Slowly rotate posterior into place.

• Ensure denture is not too far forward.Ensure denture is not too far forward.

• Seat denture anteriorly.Seat denture anteriorly.

• Slowly rotate posterior into place. Slowly rotate posterior into place.

• Ensure denture is not too far forward.Ensure denture is not too far forward.

Verifying PositionVerifying PositionVerifying PositionVerifying Position

• Patient closes lightly until first contact Patient closes lightly until first contact

• If occlusal interdigitation is poor, If occlusal interdigitation is poor, physically move denturephysically move denture

• Maintain position until setMaintain position until set

• Patient closes lightly until first contact Patient closes lightly until first contact

• If occlusal interdigitation is poor, If occlusal interdigitation is poor, physically move denturephysically move denture

• Maintain position until setMaintain position until set

Evaluate ImpressionEvaluate ImpressionEvaluate ImpressionEvaluate Impression• Trim impression to posterior border.Trim impression to posterior border.• Place / mark the posterior palatal seal.Place / mark the posterior palatal seal.• Check retention, extension, periphery.Check retention, extension, periphery.• Remove excess (occlusal, facial etc).Remove excess (occlusal, facial etc).

• Trim impression to posterior border.Trim impression to posterior border.• Place / mark the posterior palatal seal.Place / mark the posterior palatal seal.• Check retention, extension, periphery.Check retention, extension, periphery.• Remove excess (occlusal, facial etc).Remove excess (occlusal, facial etc).

Check relations intraorallyCheck relations intraorallySend to lab for processingSend to lab for processing

Check relations intraorallyCheck relations intraorallySend to lab for processingSend to lab for processing

Deliver ASAP, usually next clinical Deliver ASAP, usually next clinical appointment appointment

Same day in practice, if possibleSame day in practice, if possible

Deliver ASAP, usually next clinical Deliver ASAP, usually next clinical appointment appointment

Same day in practice, if possibleSame day in practice, if possible

RemountRemountAdjust OcclusionAdjust Occlusion

RemountRemountAdjust OcclusionAdjust Occlusion

Impression Technique Impression Technique AdvantagesAdvantages

Impression Technique Impression Technique AdvantagesAdvantages

• Only two appointments needed.Only two appointments needed.• Tissues are captured at rest Tissues are captured at rest

(less possibility of distortion).(less possibility of distortion).• Allows for greater extension of peripheries.Allows for greater extension of peripheries.• Allows placement of functional posterior palatal seal.Allows placement of functional posterior palatal seal.

• Only two appointments needed.Only two appointments needed.• Tissues are captured at rest Tissues are captured at rest

(less possibility of distortion).(less possibility of distortion).• Allows for greater extension of peripheries.Allows for greater extension of peripheries.• Allows placement of functional posterior palatal seal.Allows placement of functional posterior palatal seal.

Impression Technique Impression Technique DisadvantagesDisadvantages

Impression Technique Impression Technique DisadvantagesDisadvantages

• Possible alteration in VDO, occlusion, facial support.Possible alteration in VDO, occlusion, facial support.• No chance to test retention and comfort under function.No chance to test retention and comfort under function.

• Possible alteration in VDO, occlusion, facial support.Possible alteration in VDO, occlusion, facial support.• No chance to test retention and comfort under function.No chance to test retention and comfort under function.

Functional Relines Functional Relines (Lynal, Visco-gel)(Lynal, Visco-gel)

Functional Relines Functional Relines (Lynal, Visco-gel)(Lynal, Visco-gel)

• Similar procedureSimilar procedure

• Minor variationsMinor variations

• Similar procedureSimilar procedure

• Minor variationsMinor variations

Functional Relines:Functional Relines:

Functional Relines:Functional Relines:

• Limitations:Limitations:• Cannot extend borders greater than 4 mm. Cannot extend borders greater than 4 mm.

• Reline material distorts too easily. Reline material distorts too easily.

• If grossly under extended:If grossly under extended:

- use impression technique.- use impression technique.

• Limitations:Limitations:• Cannot extend borders greater than 4 mm. Cannot extend borders greater than 4 mm.

• Reline material distorts too easily. Reline material distorts too easily.

• If grossly under extended:If grossly under extended:

- use impression technique.- use impression technique.

Functional Relines Functional Relines Functional Relines Functional Relines

• Material requires greater thickness for accuracyMaterial requires greater thickness for accuracy

• Usually need to reduce denture to allow for thicknessUsually need to reduce denture to allow for thickness

• Material requires greater thickness for accuracyMaterial requires greater thickness for accuracy

• Usually need to reduce denture to allow for thicknessUsually need to reduce denture to allow for thickness

Variation in Accuracy of Materials Variation in Accuracy of Materials Variation in Accuracy of Materials Variation in Accuracy of Materials

(Visco-gel > Coe-Comfort)(Visco-gel > Coe-Comfort)(Visco-gel > Coe-Comfort)(Visco-gel > Coe-Comfort)

LynalLynal LynalLynal

• 10 ml powder : 2 ml liquid, mix 30 sec.10 ml powder : 2 ml liquid, mix 30 sec.

• If borders short or too thin, add more powder for If borders short or too thin, add more powder for increased viscosity.increased viscosity.

• Thicker consistency can be formed into a 3 - 4 mm Thicker consistency can be formed into a 3 - 4 mm rope and placed around borders.rope and placed around borders.

• 10 ml powder : 2 ml liquid, mix 30 sec.10 ml powder : 2 ml liquid, mix 30 sec.

• If borders short or too thin, add more powder for If borders short or too thin, add more powder for increased viscosity.increased viscosity.

• Thicker consistency can be formed into a 3 - 4 mm Thicker consistency can be formed into a 3 - 4 mm rope and placed around borders.rope and placed around borders.

LynalLynal LynalLynal• For tissue base, mix as per instructions.For tissue base, mix as per instructions.

• Place intra-orally.Place intra-orally.

• Remove excess with cotton swab prior to set.Remove excess with cotton swab prior to set.

• For tissue base, mix as per instructions.For tissue base, mix as per instructions.

• Place intra-orally.Place intra-orally.

• Remove excess with cotton swab prior to set.Remove excess with cotton swab prior to set.

Set time: 8 - 10 minute Set time: 8 - 10 minute Set time: 8 - 10 minute Set time: 8 - 10 minute

• Lightly border mold. Lightly border mold.

• During setting, allow patient to:During setting, allow patient to:– Talk.Talk.

– Swallow.Swallow.

– Rinse mouth.Rinse mouth.

– Lightly occlude.Lightly occlude.

• Lightly border mold. Lightly border mold.

• During setting, allow patient to:During setting, allow patient to:– Talk.Talk.

– Swallow.Swallow.

– Rinse mouth.Rinse mouth.

– Lightly occlude.Lightly occlude.

Remove Excess MaterialRemove Excess MaterialRemove Excess MaterialRemove Excess Material

• Reduce material on flanges with Reduce material on flanges with HOTHOT scalpel scalpel or knife.or knife.

• Remove from teeth, Polished / oral surfaces.Remove from teeth, Polished / oral surfaces.

• Patient wears reline home.Patient wears reline home.

• Reduce material on flanges with Reduce material on flanges with HOTHOT scalpel scalpel or knife.or knife.

• Remove from teeth, Polished / oral surfaces.Remove from teeth, Polished / oral surfaces.

• Patient wears reline home.Patient wears reline home.

Patient Returns in 24-48 HoursPatient Returns in 24-48 HoursPatient Returns in 24-48 HoursPatient Returns in 24-48 Hours

• A cast is poured within 2 hours.A cast is poured within 2 hours.

• Otherwise, accuracy compromisedOtherwise, accuracy compromised

• A cast is poured within 2 hours.A cast is poured within 2 hours.

• Otherwise, accuracy compromisedOtherwise, accuracy compromised

Functional Impression:Functional Impression:

AdvantagesAdvantages

Functional Impression:Functional Impression:

AdvantagesAdvantages

• Functionally molds peripheries.Functionally molds peripheries.

• Ability to assess patient comfort and retention prior Ability to assess patient comfort and retention prior to reline proper.to reline proper.

• Functionally molds peripheries.Functionally molds peripheries.

• Ability to assess patient comfort and retention prior Ability to assess patient comfort and retention prior to reline proper.to reline proper.

Functional Impression Functional Impression DisadvantagesDisadvantages

Functional Impression Functional Impression DisadvantagesDisadvantages

• Variability of materials, handling characteristics.Variability of materials, handling characteristics.

• Resiliency masks overextensions which can Resiliency masks overextensions which can subsequently irritate, when converted to acrylic subsequently irritate, when converted to acrylic resin.resin.

• Variability of materials, handling characteristics.Variability of materials, handling characteristics.

• Resiliency masks overextensions which can Resiliency masks overextensions which can subsequently irritate, when converted to acrylic subsequently irritate, when converted to acrylic resin.resin.

Functional ImpressionFunctional Impression DisadvantagesDisadvantages

Functional ImpressionFunctional Impression DisadvantagesDisadvantages

• Dimensional stability variable:Dimensional stability variable:– Patient care.Patient care.– Pouring of casts.Pouring of casts.

• Can' t significantly increase borders.Can' t significantly increase borders.

• Do not use simultaneously as a tissue conditioner.Do not use simultaneously as a tissue conditioner.

• Dimensional stability variable:Dimensional stability variable:– Patient care.Patient care.– Pouring of casts.Pouring of casts.

• Can' t significantly increase borders.Can' t significantly increase borders.

• Do not use simultaneously as a tissue conditioner.Do not use simultaneously as a tissue conditioner.

Partial Denture RelinesPartial Denture RelinesPartial Denture RelinesPartial Denture Relines

• Similar procedures.Similar procedures.

• Ensure rests, direct and indirect retainers are fully Ensure rests, direct and indirect retainers are fully seated.seated.

• Seat with pressure over the rests, Seat with pressure over the rests, NOTNOT over the over the distal extension bases.distal extension bases.

• Similar procedures.Similar procedures.

• Ensure rests, direct and indirect retainers are fully Ensure rests, direct and indirect retainers are fully seated.seated.

• Seat with pressure over the rests, Seat with pressure over the rests, NOTNOT over the over the distal extension bases.distal extension bases.

• Allow no impression material under rests or Allow no impression material under rests or guiding planes.guiding planes.

• If so, remake impression .If so, remake impression .

• Allow no impression material under rests or Allow no impression material under rests or guiding planes.guiding planes.

• If so, remake impression .If so, remake impression .

Partial Denture Partial Denture Clinical Remount Clinical Remount Partial Denture Partial Denture

Clinical Remount Clinical Remount

• If required, a new cast must be made.If required, a new cast must be made.

• Make an alginate impression with the RPD in place. Make an alginate impression with the RPD in place.

• If required, a new cast must be made.If required, a new cast must be made.

• Make an alginate impression with the RPD in place. Make an alginate impression with the RPD in place.

Partial Denture Partial Denture Clinical RemountClinical Remount Partial Denture Partial Denture

Clinical RemountClinical Remount

• Block out undercuts on the framework while RPD is Block out undercuts on the framework while RPD is in the impression.in the impression.

• Pour the model with the partial denture in place.Pour the model with the partial denture in place.

• Block out undercuts on the framework while RPD is Block out undercuts on the framework while RPD is in the impression.in the impression.

• Pour the model with the partial denture in place.Pour the model with the partial denture in place.