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Relines and Rebases. Improving the Adaptation of Existing Dentures. Rebase. Replacing entire denture base Flasking, heat-cured acrylic Usually porcelain teeth. Reline. Resurfacing the tissue surface Jig used to maintain vertical dimension & occlusal contacts with cold-cure acrylic Or

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Relines and Rebases

Improving the Adaptation of Existing Dentures


Rebase l.jpg
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 with cold-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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Contraindications

Complaints of a loose denture

DOES NOT,

in itself, constitute evidence of

a lack of fit and stability


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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 of canines


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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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Types of Relines Denture Base Adaptation

  • Processed or chairside

  • Impression or functional technique

  • Hard acrylic or resilient

  • Permanent, temporary

  • Complete or partial dentures


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Processed Acrylic Permanent Complete Denture Relines Denture Base Adaptation

  • Make impression for least stable denture first

  • Easier to stabilize the other denture

    • Reference for occlusion & vertical dimension


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Impression Technique Denture Base Adaptation

Difficult to reline without:

  • Encroaching on interocclusal space

  • Displacing the supporting tissues

  • Altering occlusal contacts

    USE CARE


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Positioning the Denture Denture Base AdaptationOVD & Occlusion


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Adjust Occlusion Denture Base Adaptation

  • Obtain stable occlusal contacts

  • Remount & adjustment may be required

  • Assess need for tissue conditioning


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Remove Tissue Undercuts Denture Base Adaptation

Allows impression to be removed from cast without breaking cast or denture


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Clean the Denture Denture Base Adaptation


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Border Mold Denture Base Adaptation

  • 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 Denture Base Adaptation

  • 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 Material Denture Base AdaptationPolyvinylsiloxane

  • Ease of use

  • Cleaning, removal from undercuts

  • Requires adhesive carried to the external surface of denture borders


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Impression Procedure Denture Base Adaptation

  • Load carefully

  • Excessive material can reduce freeway space

  • Dry tissues


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Impression Procedure Denture Base Adaptation

  • Seat denture anteriorly

  • Slowly rotate posterior into place

  • Ensure denture is not too far forward


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Verifying Position Denture Base Adaptation

  • Patient closes lightly until first contact

  • If occlusal interdigitation is poor, physically move denture

  • Maintain position until set


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Evaluate Impression Denture Base Adaptation

  • 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 Denture Base AdaptationSend to lab for processing


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Deliver ASAP, usually next clinic Denture Base AdaptationSame day in practice, if possible


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Remount Denture Base AdaptationAdjust Occlusion


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Impression Technique Denture Base AdaptationAdvantages

  • 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 Technique Denture Base AdaptationDisadvantages

  • Possible alteration in VDO, occlusion, facial support

  • No chance to test retention and comfort under function


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Functional Relines Denture Base Adaptation(Lynal, Visco-gel)

  • Similar procedure

  • Minor variations


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Functional Relines Denture Base Adaptation

  • Cannot extend borders greater than 4 mm

  • Distorts too easily

  • Grossly under extended, use impression technique


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Functional Relines Denture Base Adaptation

  • Material requires greater thickness for accuracy

  • Usually need to reduce denture to allow for thickness


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Variation in Accuracy of Materials Denture Base Adaptation

(Visco-gel> Coe-Comfort)


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Lynal Denture Base Adaptation

  • 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


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Lynal Denture Base Adaptation

  • 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 Denture Base Adaptation

  • Lightly border mold

  • During setting, allow patient to:

    • Talk

    • Swallow

    • Lightly occlude


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Remove Excess Denture Base Adaptation

  • 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 Denture Base Adaptation

  • A cast is poured within 2 hours

  • Otherwise, accuracy compromised


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Functional Impression Denture Base AdaptationAdvantages

  • Functionally molds peripheries

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


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Functional Impression Denture Base AdaptationDisadvantages

  • Variability of materials, handling characteristics

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


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Functional Impression Denture Base AdaptationDisadvantages

  • 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 Denture Base Adaptation

  • 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 Denture Base Adaptation

  • Allow no impression material under rests or guiding planes

  • If so, remake impression


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Partial Denture Denture Base AdaptationClinical Remount

  • If required, a new cast must be made

  • Make an alginate impression with the RPD in place


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Partial Denture Denture Base AdaptationClinical Remount

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

  • Pour the model with the partial denture in place


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