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13 views

Pros 10

Uploaded by

Kezhan Salh
Copyright
© © All Rights Reserved
We take content rights seriously. If you suspect this is your content, claim it here.
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Prosthodontic 2nd.year 2024 Dr.

Kaml Karim

Relining and rebasing


Patients who have worn dentures successfully for a period of time may return
for further service because of looseness, soreness, chewing in efficiency or
esthetic changes, these difficulties may be caused by

1-changes in one or both of the structures that support the dentures.


2-incorrect or unbalanced occlusion that existed the time in which the dentures
were inserted.
3.Materials used in the prosthodontics of the complete denture are liable to be
changed.
some dentures that have lost the correct relationship to their supporting tissues
maybe either relined or rebased.

Relining :- the procedures used to resurface the tissue side of the denture with
new material layer, this will produce an accurate adaptation to the denture
foundation area.

Rebasing :- the laboratory process of replacing the entire denture base material
on an existing prosthesis, without changing the dental arch, and the occlusal
relationship.

Both procedures involve making anew impression in the existing denture but
the indication for either procedure depends on extends of the adverse clinical
changes observed.

Relining Rebasing
(Minimuml to moderate changes) (Moderate to maximum changes)

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Prosthodontic 2nd.year 2024 Dr.Kaml Karim

Observed clinical changes include (The indications for relining or


Rebasing):-
1-loss of retention and stability.
2- loss of vertical dimension of occlusion.
3- loss of support for the facial tissues.
4- incorrect occlusal relationship.
5-re-orientation of the occlusal plane.

Contraindications for relining or rebasing:-


1-when there is an increased vertical dimension (insufficient inter arch space)
2-disharmony between the centric jaw relationship and centric occlusion.
3-poor esthetic and incorrect position of the teeth.
4-in some cases when both the maxillary and the mandibular dentures need a
relining or a rebasing procedure, this situation may incase the occlusal vertical
dimension which causes an insufficient inter arch space.

Relining can be achieved into two way:


1. Direct (chair side in the clinic).
2. Indirect (At the lab).

The chair side (direct) relines technique:-


Several attempts have been made to produce an acrylic or other plastic material
that can be added to the denture and allowed to set in the mouth to produce an
instant chair side reline.

These have met with failure for several reasons because:-


1-the material has often produced a chemical burn on the mucosa exothermic
reaction.
2-colour stability is very low and there is bad odor due to the porosity of the
material in this technique since no flaking procedure is used.
3-liability for errors and wrong positioning of the denture is great with difficulty
in correction and removing of the set material to start again.
4-improvement in the denture requirement is very little and low.

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Prosthodontic 2nd.year 2024 Dr.Kaml Karim

Clinical procedure for Indirect relining:-


The impression technique used can be mucostatic (opened mouth) or functional
{closed mouth} impression technique

1-the denture should be left out of the mouth at least for 24hrs before
impressions are made.
2-evaluate the denture flanges, if they are over extended they should be
shortened until they are of the correct length and thickness, if they are short.
They must be extended to the correct length with a molding compound
(tracing stick compound).
3-all undercuts on the tissue side of the denture base must be removed, any
pressure area is relieved and the entire tissue surface of the denture base is
reduced approximately (1mm) to allow a space for the impression material.
4-four stoppers are placed on the alveolar groove of the denture (tissue surface)
at the canine and the second molar areas.
5-border molding procedure can be accomplished by tracing stick compound.
6-mix a suitable quantity of impression material the denture is used as a special
tray here by using final impression material as zinc-oxide eugenol paste to be
distributed evenly on the tissue surface of the denture then inserted in the
patient mouth carefully in position and do border molding.
7-insert the opposing denture.
8-ask the patient to close his teeth together lightly in centric relation and do
border molding until the material is set. This technique is called closed mouth
impression technique; care must be taken not to displace the reline denture in
forward direction this can be reduced by making 2 holes on each side of the
labial flange to provide an escape way for the excess impression material.
9-remove the denture with the impression, inspect the impression surface and
borders, check for retention and stability, vertical dimension, esthetic
requirements if everything is correct, pouring of the impression and the
laboratory part of the procedure start.

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Prosthodontic 2nd.year 2024 Dr.Kaml Karim

Laboratory procedure for Indirect relining:-


1-beading and boxing of the impression, then pouring the boxed impression
with stone material.
2-the denture and the cast are not separated at this point but any excess of the
impression material on the teeth or on the facial surface of the base is
removed, then the denture is flasked in the usual manner.
3-we do wax elimination by heating in the boiling water for 5minutes then
separating is done and all the impression material is cleaned from the cast and
the denture base.
4-painting the cast with a separating medium (cold mold seal).
5-paint the surface of the denture with cotton pellet moistened with monomer.
6-mix the acrylic resin and place it in the flask.
7-curing for 9hours at 165F.
8-The denture is de flasked and the cast is removed from the denture, then
polish the denture and remount the cast.
9-the maxillary and mandibular dentures are remounted on the articulator by
means of the face bow transfer and an interocclusal centric relation is
recorded, after the occlusion has been perfected, the relined denture is ready to
be inserted in the patient mouth.

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Prosthodontic 2nd.year 2024 Dr.Kaml Karim

Rebasing:-

Rebasing procedure is the same as those for the relining with some differences:-
1-impression is made and a cast is poured in the denture as in the relining
procedure.
2- The denture with the cast is mounted on an instrument such as" Hooper
duplicator" that maintain the relationship of the teeth to the cast.
3-the old denture is destroyed and removed.
4-the original teeth are rewaxed in their previous positions on the cast.
5-the denture is then processed in the laboratory as described for relining.

Note:-A Hanau articulator makes a satisfactory instrument for rebasing instead


of Hooper duplicator.

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