RELINING COMPLETE DENTURES WITH THE USE OF

A FUNCTIONAL IMPRESSION

KENNETH M. TUCKER, D.D.S.

Veterans Administration Hospital, Oklahoma City, Okla.

T HE PHRASE, “REHABILITATION OF DENTURES,” has been used to describe relin-

ing procedures in prosthodontics. l This service is not a cure-all, nor is it an im-
possible task when the dentures are serviceable. Dentures that were made improp-
erly or with poor esthetics cannot be improved by relining and should be remade.
Relining procedures cannot be slighted or hurried in any way. Relining entails
more than filling the denture with an impression material, instructing the patient to
close the teeth together, and then sending the denture to the dental laboratory tech-
nician with instructions “to finish.”
Many dentists prefer to remake a denture rather than reline it. All of us have
memories of unpleasant experiences with relines. Therefore, there may be some
logic to this type of reasoning.
Chase1 stated, “While a relining procedure is none too satisfactory from any
standpoint, it must be done in certain circumstances.” Ostrem2 aptly described the
role of the dentist when he wrote, “Relining complete dentures is an obligation of
dentists and a real service to denture patients.”
Many methods and materials have been used to reline dentures. A technique
that I have found to be successful was suggested by Krajicek* and uses a tissue-
conditioning material? and an autopolymer acrylic resin.

THE USE OF THE TISSUE CONDITIONER

The concept of returning oral tissues to a normal status before making of

impressions is not new. For many years dentists have advised their patients not
to use their dentures for a certain length of time (usually 48 hours) before the
impressions are made. Unquestionably, this is the best method of returning tissues
to a normal condition. However, most patients will not comply ; they do not want
to be without their dentures for even short periods of time.
Tissue-conditioning material is used to return the oral tissues to a normal con-
dition when needed and to develop the impression for the relining procedure. The
‘Krajicek, D. D.: Personal communication, 1963.
tHydro-Cast Tissue Treatment and Functional Impression Material, Kay-See Dental Mfg.
Co., Kansas City, MO.
1354
Volume 16
Number 6
RELINING WITH FUNCTIONAL IMPRESSION 1055

impression incorporates all the natural movements and relations of the jaws and
adequately meets the requirements as listed by Boucher,” Fisher,4 and Roberts.5

PREPARATION OF THE DENTURES

Denture borders that are short are properly formed with an autopolymer
acrylic resin. Borders that have been properly extended are reduced to provide
space for the treatment material. Occlusal disharmonies must be corrected.
The resin of the basal surface of the denture is reduced by at least 1 mm.
This relief provides space for the treatment material so that the vertical dimension
of occlusion will not be increased.
All undercuts in the denture base must be eliminated, with special emphasis
given to the labial flanges of the maxillary denture. This will facilitate removing
the denture from the master cast. The basal surface of the denture is thoroughly
cleansed before applying the treatment material.

(‘ONl)ITIONlNG THE TISSUES AND MAKING TIIE IMPRESSION

The tissue-conditioning material is mixed according to the manufacturer’s

directions, poured into the denture, and evenly distributed over the basal surface
and borders. The patient is instructed to rinse the mouth to remove excess saliva,
and the denture is placed in the mouth when the treatment material ceases to flow.
Care must be taken that the denture is properly oriented in an anteroposterior
position. The patient is instructed to tap the teeth together lightly, to position the
denture, and to hold the teeth together lightly for a period of three minutes. Then,
the patient is engaged in conversation or instructed to read out loud for an addi-
tional five minutes.
The denture is removed from the mouth, and excess material that has ac-
cumulated on the polished surfaces is removed. The basal surface is inspected to
be certain that there is full coverage by the treatment material. The acrylic resin
will show through the treatment material where there is impingement of tissue
caused by overextention of the border or areas of pressure. These pressure spots
are relieved with a denture bur, and more material is added by a brush-on technique.
The patient is dismissed and instructed to continue normal usage of the den-
tures. The material can be changed every two or three days if needed. The condi-
tion of the tissues dictates the number of changes needed. The rationale for tissue
conditioning with this material has been adequately described by Chase.6
In some instances, the tissue-conditioning material will not need to be re-
placed. In this situation, new conditioning material should be placed in the denture
and the patient instructed to eat a meal before the master cast is poured.
A successful method involves preparing the denture and placing the treatment
material in it in the middle of the morning. Then the patient is dismissed with
instructions to return after lunch has been eaten.

POURING THE CAST AND OCCLUSAL 3f.4TRIX

The impression is boxed and the cast is poured in artificial stone. The boxing
material is removed from the cast and the denture and cast are mounted on a
1056 TUCKER
N 0“ember-De%Sr: ?9%

duplicating instrument that has a definite stop which will maintain the vertical di-
mension of occlusion. A tripod duplicator* and a treatment jig+ have both been
used successfully. However, the treatment jig is more convenient when inspecting
the flanges and in processing.
A matrix is made of the occlusal surfaces of the teeth before the denture is
removed from the master cast. Plaster is placed on the lower member of the dupli-
cating instrument and the upper half, with the mounted cast and denture attached,
is closed into position. The teeth are lightly lubricated to facilitate their separation
from the matrix.
After the plaster has set, the instrument is opened, the denture is removed
from the cast, and the treatment material is removed from the denture. The borders
and basal surface of the denture can be further reduced to create additional space
for the acrylic resin.
The master cast is painted with a tinfoil substitute, which is allowed to dry,
and then a second coating is applied. The denture is attached into the occlusal
matrix with sticky wax.

PROCESSING THE RELINED DENTURE

Autopolymerizing acrylic resin is mixed according to the manufacturer’s in-

structions. The basal surface of the denture must be absolutely clean. The acrylic
resin is applied evenly to the basal surface of the denture and placed into the under-
cuts of the master cast. The duplicating instrument is closed completely so that the
master cast will be correctly positioned back within the denture. The flanges of the
denture are inspected, and voids are corrected by adding acrylic resin if necessary.
The closed duplicating instrument is secured with a heavy elastic band. A more
satisfactory cure can be obtained by placing the duplicating instrument in a pres-
sure curing unit for 30 minutes and maintaining a pressure of 30 to 35 pounds.
After curing, the denture is removed from the master cast and finished. Fol-
lowing placement of the denture, the patient is seen after 24 hours and later for
other necessary adjustments.

SUMMARY

A method for relining complete dentures has been described. This method uses
a tissue-conditioning material for the impression, and an autopolymer acrylic resin
to replace the impression material.
Some of the advantages of this method are : ( 1) abused tissues can be re-
turned to a normal condition before the impression is made, (2) a “functional im-
pression” that incorporates the natural movements and relations of the jaws is
developed by the patient, and (3) the use of an autopolymer acrylic resin and
pressure curing conserves time and produces a well-cured material.
I would like to express my sincere appreciation to Dr. Dayton D. Krajicek, Mission,
Kansas, for his assistance in the preparation of this article.

*Hooper Duplicator, Hanau Engineering Co., Inc., Buffalo, N. Y.

tHydro-Cast Treatment Jig, Kay-See Dental Mfg. Co., Kansas City, MO.
\‘olume 16
Number 6 RELINING WITH FUNCTIONAL IMPRESSION 105i

REFERENCES

1. Chase, W. W.: Adaptation of Rubber-Base Impression Materials to Removable Denturf

Prosthetics,. J. PROS. DENT. 10:1043-1050, 1960.
2. Ostrem, C. T. : Relining Complete Dentures, J. PROS. DENT. 11:204-213, 1961.
3. Boucher, C. 0. : Impression Building, D. Survey 22:2062-2068, 1946.
4. Fisher, R. D. : Six Fundamental Rules for Making Full Denture Impressions, J. PROS. DmT.
1:135-144, 1951.
5. Roberts, A. I.: Principles of Full Denture Impressions Making and Their Application it1
Practice, J. PROS. DENT. 1:213-228, 1951.
6. Chase, W. W.: Tissue Conditioning Utilizing Dynamic Adaptive Stress, J. PROS. DEXT.
11:804-815, 1961.
921 N.E. 13TH ST.
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