Reling and Rebasing of Complete Denture
Uploaded by
Zahraa S. AbdullahReling and Rebasing of Complete Denture
Uploaded by
Zahraa S. AbdullahRelining
and
Rebasing
INTRODUCTION
Both biological supporting tissues and materials
used in complete denture fabrication are
vuleerable to time-dependent changes.
When denture needs to be refitted, it usually
indicates undermined retention , sore spots,
and variable denture bearing tissue hyperemia.
The relining and rebasing of complete dentures
involves solving all of the problems encoutered
in the construcion of new dentures , except
positioning individual teeth.
:RELINING
a procedure to resurface
the tissue surface of the
denture by adding new Accurate Adaptation
base material to make the
denture fit more
accurately. Resurface tissue side
Loose dentures
If a new thin layer of resin is added to the denture base, the resurfacing is called a
reline.
:REBASING
The laboratory process of replacing the
entire denture base material on an existing
prosthesis.
If more material is added when extensive refitting and polymerized material is
necessary, this is called a rebase.
INDICATIONS
Adaptation of the denture bases to the ridges is poor due to •
.resorption of the residual alveolar ridges
Patients with complaint of looseness or instability of dentures •
.following a long-standing history of comfort and satisfaction with the dentures
.Three to 6 months after construction of immediate dentures •
For geriatric or chronically ill patients when the construction of new dentures can •
.cause physical or mental stress
.When the patient cannot afford the cost of new denture •
.Porous and discoloured denture base (rebasing is indicated) •
.With porcelain artificial teeth (rebasing is indicated) •
CONTRAINDICATIONS:
Excessive ridge resorption – make new dentures •
.
Presence of abused soft tissues – relining/rebasing is not indicated •
until the tissues recover and return as closely as possible to normal form
.
TMJ problems – until accurate diagnosis and treatment of the problem has •
been accomplished
.Dentures with poor aesthetics or unsatisfactory jaw relationships •
.Dentures with major speech problem •
.Presence of severe osseous undercuts •
STEP BY STEP
PROCEDURE
STEP 1- Tissue preparation
STEP 2- Denture preparation
STEP 3- Impression making
STEP 4- Lab procedure
STEP 1 - TISSUE PREPARATION
Hypertrophic tissue
should be removed
No areas of irritation
Dentures should be left
out of mouth for 2-3
days
Daily massage of soft
tissue
STEP 2 - DENTURE PREPARATION
1. Pressure area should be relieved
2. Occlusal disharmony corrected
3. Border area should be extended and corrected
4. Adequate Posterior palatal seal area should be established
STEP 3
IMPRESSION MAKING
STATIC FUNCTIONAL
CHAIRSIDE
IMPRESSION IMPRESSION
TECHNIQUE
TECHNIQUE TECHNIQUE
Open mouth
Closed mouth
CLOSED MOUTH IMPRESSION
DENTURE PREPARATION )1
a) All undercuts are relieved
b) Tissue surface is relieved 1-2mm
C) The denture flanges are reduced so that 2-3 mm of space exists between
the flanges and the depth of the vestibules to provide
space for the border molding material
2) BORDER MOLDING AND TISSUE STOPPERS
At this point, space for the impression material has been created
but, the plane of occlusion has been changed and the vertical
dimension of occlusion has been overly reduced by approximately
1—1.5 mm. This loss can be regained by adding 3- 4 "stops." Small
tissue stops are created with spots of heavy-bodied vinyl
polysiloxane material about 3 mm in diameter.
The stops are placed in the canine and second molar areas, the
denture is gently seated, and the patient is closed into the CR
position at the proper OVD. Border molding is now completed, as
with a conventional impression, with the exception that the
vertical dimension of occlusion and centric occlusion positions
must not be compromised.
Or use Green stick wax
Four to six holes are placed into the maxillary denture,
spaced approximately 12 mm apart through the palate
of the denture with a round bur . These holes provide
escape vents to minimize hydraulic pressure buildup
during the wash impression.
IMPRESSION )3
a) ZnOE paste / light body
mouth temp wax
b) Patient is asked to close in
existing centric occlusion
IMPRESSION )3
• To decide which denture to reline first, usually
the less stable of the two is relined first.
• If there is no significant difference between the
stability- or retention of the opposing dentures,
then the maxillary denture is often selected.
Advantages
Less chances of increased vertical dimension as patient closes •
in
.centric occlusion
.Takes less time •
.Chances of denture moving forward during impression are less •
Disadvantages
Existing errors in centric occlusion can produce pressure •
points and
.an inaccurate impression
Hydrostatic pressure in palate during impression making and •
packing of acrylic can still cause increase in vertical dimension
OPEN MOUTH IMPRESSION
• Impression of maxillary denture is made followed by mandibular.
• New CR record is made using interocclusal check methods.
interocclusal check methods
Aluwax is softened and loaded on the
occlusal surface of the mandibular trial
denture.
The patient is asked to retrude the
mandible and bite. Once the wax
hardens, the assembly is transferred to
the articulator and centric relation
verified.
Advantages
Selective pressure impression is made without any occlusal •
.interference
Operator need not worry about jaw relation while making •
.impressions, as a separate record is made
.The CR record is verifiable •
Disadvantages
Chances of increase in vertical dimension even though tissue •
.stops are provided
.High possibility of denture moving forward •
.Demanding and laborious technique •
• Requires more clinical and laboratory time.
FUNCTIONAL IMPRESSION TECHNIQUE
– Material used ✓
TISSUE CONDITIONERS
The areas of the
denture (like occlusal
surface), which are not
to be contacted by the
fluid resin, are painted
with a lubricant
The powder and liquid of the soft
liner are mixed according to the
manufacturer’s instructions and
allowed to polymerize in the
mixing cup.
While the material is creamy and
fluid, it is poured onto the tissue
surface of the denture, covering
the entire denture base area
When material stops flowing and
reaches a dough stage, it is
inserted in the patient’s mouth
and the patient is instructed to
close in centric, maintaining
vertical dimension.
Active and passive methods of border moulding are
performed and the patient is also instructed to perform
functional movements like swallowing, speaking, smiling
until the impression reaches a more stable rubberlike
state, which will normally take about a minimum of 15
min.
After removal from the
mouth, the excess tissue
conditioner is trimmed, voids
are corrected with new
material and procedure is
Repeated.
The patient is asked to use the denture with the
conditioning material. This will further functionally
mould the material.
When the patient returns after 3–5 days, the
underextensions, denuded areas and pressure
spots are corrected by trimming and/or adding new
material.
The material is changed periodically till the tissues
return to a state of health and then the patient is
scheduled for final impressions.
A ZOE impression paste or light-body wash
impression is then made over the conditioning
material and verified.
CHAIRSIDE TECHNIQUE
✓Makes use of acrylic resin or other plastic material that
could be added to the denture and allowed to set in the
mouth.
✓ Not recommended
Limitations
I. Produce a chemical burn on mucosa
II. Material remains porous and develop bad odour
STEP – 4 LAB PROCEDURE
RELINING VS REBASING
The difference is the amount of old denture base removed and
replaced . For Rebasing, the entire denture base is eliminated except
the teeth and may be 2mm adjoining the denture base
LAB PROCEDURE
ARTICULATOR METHOD
JIG METHOD
FLASK METHOD
ARTICULATOR
METHOD
Master cast is poured .1
Layer of plaster on the lower member & denture .2
is settled in stone mix
Cast is attached to the upper member .3
All impression material is removed .4
Denture trimming is done accordingly .5
reline/rebase
6. Seperating media is applied
7. Autopolymerizing resin - packed in the articulator,
allowed to set in pressure container at 15-20psi for 30
min
8. Heat cure resin wax up, flasked & processed
9. Finished and polished
JIG METHOD
JIG - A device used to maintain mechanically a positional
relationship between a piece of work and a tool or between the
components during assembly or alteration.
Procedure is similar to that of an articulator
Hooper's duplicator can also be
used, similar to a jig
FLASK
METHOD
1. Beading & boxing of relined impression
2. Master cast is poured
3. Denture with the cast is embedded in a
flask
4. Flask is warmed to soften the green stick
before opening
5. Flask is opened, impression material is
removed
6. Seperating media is applied
7. Heat cure resin is packed in mould and
processed.
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