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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
Relines and Rebases

Improving the Adaptation of Existing Dentures

rebase
Rebase
  • Replacing entire denture base
  • Flasking, heat-cured acrylic
  • Usually porcelain teeth
reline
Reline
  • Resurfacing the tissue surface
  • Jig used to maintain vertical dimension & occlusal contacts with cold-cure acrylic

Or

  • Reprocessing with heat cure
indications
Indications

Denture no longer fits residual ridge

Retention, stability are lacking

PLUS

  • Occlusion is acceptable
  • Vertical dimension is acceptable
  • Denture teeth/gingival contours acceptable
contraindications
Contraindications

Complaints of a loose denture

DOES NOT,

in itself, constitute evidence of

a lack of fit and stability

determine cause of looseness
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
evaluate cause of looseness
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
relines will only solve retention problems related to denture base adaptation
Relines Will Only Solve Retention Problems Related to Denture Base Adaptation

Retention problems must be diagnosed as to their cause

types of relines
Types of Relines
  • Processed or chairside
  • Impression or functional technique
  • Hard acrylic or resilient
  • Permanent, temporary
  • Complete or partial dentures
processed acrylic permanent complete denture relines
Processed Acrylic Permanent Complete Denture Relines
  • Make impression for least stable denture first
  • Easier to stabilize the other denture
    • Reference for occlusion & vertical dimension
impression technique
Impression Technique

Difficult to reline without:

  • Encroaching on interocclusal space
  • Displacing the supporting tissues
  • Altering occlusal contacts

USE CARE

adjust occlusion
Adjust Occlusion
  • Obtain stable occlusal contacts
  • Remount & adjustment may be required
  • Assess need for tissue conditioning
remove tissue undercuts
Remove Tissue Undercuts

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

border mold
Border Mold
  • Relieve borders 2 mm short of vestibule
  • Border mold with compound
  • Maxillary posterior border at vibrating line (indelible stick)
reduce tissue base
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
impression material polyvinylsiloxane
Impression Material Polyvinylsiloxane
  • Ease of use
  • Cleaning, removal from undercuts
  • Requires adhesive carried to the external surface of denture borders
impression procedure
Impression Procedure
  • Load carefully
  • Excessive material can reduce freeway space
  • Dry tissues
impression procedure20
Impression Procedure
  • Seat denture anteriorly
  • Slowly rotate posterior into place
  • Ensure denture is not too far forward
verifying position
Verifying Position
  • Patient closes lightly until first contact
  • If occlusal interdigitation is poor, physically move denture
  • Maintain position until set
evaluate impression
Evaluate Impression
  • Trim impression to posterior border
  • Place / mark the posterior palatal seal
  • Check retention, extension, periphery
  • Remove excess (occlusal, facial etc.)
impression technique advantages
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
impression technique disadvantages
Impression Technique Disadvantages
  • Possible alteration in VDO, occlusion, facial support
  • No chance to test retention and comfort under function
functional relines lynal visco gel
Functional Relines (Lynal, Visco-gel)
  • Similar procedure
  • Minor variations
functional relines
Functional Relines
  • Cannot extend borders greater than 4 mm
  • Distorts too easily
  • Grossly under extended, use impression technique
functional relines31
Functional Relines
  • Material requires greater thickness for accuracy
  • Usually need to reduce denture to allow for thickness
variation in accuracy of materials
Variation in Accuracy of Materials

(Visco-gel> Coe-Comfort)

lynal
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
lynal34
Lynal
  • For tissue base, mix as per instructions
  • Place intraorally
  • Remove excess with cotton swab prior to set
set time 8 10 minute
Set time: 8-10 minute
  • Lightly border mold
  • During setting, allow patient to:
    • Talk
    • Swallow
    • Lightly occlude
remove excess
Remove Excess
  • Reduce material on flanges with HOT scalpel or knife
  • Remove from teeth, oral surfaces
  • Patient wears reline home
patient returns in 24 48 hours
Patient Returns in 24-48 Hours
  • A cast is poured within 2 hours
  • Otherwise, accuracy compromised
functional impression advantages
Functional Impression Advantages
  • Functionally molds peripheries
  • Ability to assess patient comfort and retention prior to reline proper
functional impression disadvantages
Functional Impression Disadvantages
  • Variability of materials, handling characteristics
  • Resiliency masks overextensions which can subsequently irritate, when converted to acrylic resin
functional impression disadvantages40
Functional ImpressionDisadvantages
  • Dimensional stability variable
    • Patient care
    • Pouring of casts
  • Can\' t significantly increase borders
  • Do not use simultaneously as a tissue conditioner
partial denture relines
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
partial denture relines42
Partial Denture Relines
  • Allow no impression material under rests or guiding planes
  • If so, remake impression
partial denture clinical remount
Partial Denture Clinical Remount
  • If required, a new cast must be made
  • Make an alginate impression with the RPD in place
partial denture clinical remount44
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
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