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Rebase

Replacing entire denture base

Flasking, heat-cured acrylic

Usually porcelain teeth

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Reline

Resurfacing the tissue surface

Jig used to maintain vertical

dimension & occlusal contacts withcold-cure acrylic

Or

Reprocessing with heat cure

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Indications

Denture no longer fits residual ridge

Retention, stability are lacking

PLUS Occlusion is acceptable

Vertical dimension is acceptable

Denture teeth/gingival contours acceptable

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Determine Cause of Looseness

Pivoting on bony structures

- PIP

Occlusal interferences

- Tactile, articulating paper, remount

Inadequate posterior palatal seal

-Pull upward & outward on lingual ofcanines

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Evaluate Cause of Looseness

Coronoid interferences

Side to side movements, PI{ P

Flanges overextensions

Pull on the cheeks, lips, patient move

tongue

Tight pterygomandibular raphe

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Relines Will Only Solve Retention

Problems Related to Denture Base

Adaptation

Retention problems must be diagnosed

as to their cause

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Processed or chairside

Impression or functional technique

Hard acrylic or resilient

Permanent, temporary

Complete or partial dentures

Types of Relines

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Processed Acrylic Permanent

Complete Denture Relines

Make impression for least stable

denture first

Easier to stabilize the other denture

Reference for occlusion & vertical

dimension

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Impression TechniqueDifficult to reline without:

Encroaching on interocclusal space

Displacing the supporting tissues Altering occlusal contacts

USE CARE

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Positioning the DentureOVD & Occlusion

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Adjust Occlusion

Obtain stable occlusal contacts

Remount & adjustment may be required

Assess need for tissue conditioning

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Remove Tissue Undercuts

Allows impression to be removed fromcast without breaking cast or denture

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Clean the Denture

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Border Mold

Relieve borders 2 mm short of vestibule Border mold with compound

Maxillary posterior border at vibrating

line (indelible stick)

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Reduce Tissue Base

1 mm if acceptable interocclusal distance Use guide grooves

If interocclusal distance is excessive, relief

may not be required

Perforate denture with #4 round bur

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Impression MaterialPolyvinylsiloxane

Ease of use

Cleaning, removal from undercuts

Requires adhesive carried to the external

surface of denture borders

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Impression Procedure

Load carefully

Excessive material canreduce freeway space

Dry tissues

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Impression Procedure

Seat denture anteriorly

Slowly rotate posterior into place

Ensure denture is not too far forward

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Verifying Position

Patient closes lightly until first contact

If occlusal interdigitation is poor,physically move denture

Maintain position until set

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Evaluate Impression

Trim impression to posterior border

Place / mark the posterior palatal seal

Check retention, extension, periphery

Remove excess (occlusal, facial etc.)

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Check relations intraorally

Send to lab for processing

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Deliver ASAP, usually next clinic

Same day in practice, if possible

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RemountAdjust Occlusion

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Impression Technique

Advantages

Only two appointments needed

Tissues are captured at rest

(less possibility of distortion)

Allows for greater extension of peripheries

Allows placement of functional posterior

palatal seal

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Impression TechniqueDisadvantages

Possible alteration in VDO, occlusion,

facial support

No chance to test retention and comfort

under function

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Functional Relines

(Lynal, Visco-gel)

Similar procedure

Minor variations

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Functional Relines

Cannot extend borders greater

than 4 mm

Distorts too easily Grossly under extended, use

impression technique

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Functional Relines

Material requires greater thicknessfor accuracy

Usually need to reduce denture to

allow for thickness

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Variation in Accuracy of Materials

(Visco-gel> Coe-Comfort)

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Lynal

10 ml powder : 2 ml liquid, mix 30 sec

If borders short or too thin, add more

powder for increased viscosity

Thicker consistency can be formed into a

3 - 4 mm rope and placed around borders

L l

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Lynal

For tissue base, mix as per instructions Place intraorally

Remove excess with cotton swab prior

to set

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Set time: 8-10 minute

Lightly border mold

During setting, allow patient to: Talk

Swallow

Lightly occlude

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Remove Excess

Reduce material on flanges with

HOT scalpel or knife Remove from teeth, oral surfaces

Patient wears reline home

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Patient Returns in 24-48 Hours

A cast is poured within 2 hours

Otherwise, accuracy compromised

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Functional ImpressionAdvantages

Functionally molds peripheries

Ability to assess patient comfort and

retention prior to reline proper

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Functional ImpressionDisadvantages

Variability of materials, handling

characteristics Resiliency masks overextensions which

can subsequently irritate, when

converted to acrylic resin

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Functional Impression

Disadvantages Dimensional stability variable

Patient care

Pouring of casts

Can' t significantly increase borders

Do not use simultaneously as a tissue

conditioner

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Partial Denture Relines

Similar procedures

Ensure rests, direct and indirect

retainers are fully seated

Seat with pressure over the rests,

NOT the distal extension bases

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Partial Denture Relines

Allow no impression material under

rests or guiding planes

If so, remake impression

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Partial Denture

Clinical Remount

Block out undercuts on the

framework while RPD is in the

impression

Pour the model with the partial

denture in place