Relines and Rebases

Improving the Adaptation of Existing

Dentures
Is the procedures used to resurface the tissue
side of a denture with new base material, thus
producing an accurate adaptation to the
denture foundation area.

Relining : is the process of adding new base
material to the tissue surface of an existing
denture in a quantity sufficient to fill the space
which exists between the original denture
contour and the altered tissue contour.

Rebasing:
Is the process of replacing the entire denture
base material on an existing prosthesis. Only
the original teeth and their arrangement
remain.

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
Reprocessing with heat cure

Indications
Denture no longer fits residual ridge
Retention, stability are lacking
PLUS
Occlusion is acceptable
Vertical dimension is acceptable
Denture teeth/gingival contours acceptable


Contra indications
Complaints of a loose denture
DOES NOT,
in itself, constitute evidence of
a lack of fit and stability

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
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
Retention problems must be diagnosed
as to their cause

Processed or chairside
Impression or functional technique
Hard acrylic or resilient
Permanent, temporary
Complete or partial dentures

Types of 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
Difficult to reline without:
Encroaching on interocclusal space
Displacing the supporting tissues
Altering occlusal contacts

USE CARE

Positioning the Denture
OVD & Occlusion
Adjust Occlusion
Obtain stable occlusal contacts
Remount & adjustment may be required
Assess need for tissue conditioning
Remove Tissue Undercuts
Allows impression to be removed from
cast without breaking cast or denture
Clean the Denture
Border Mold
Relieve borders 2 mm short of vestibule
Border mold with compound
Maxillary posterior border at vibrating
line (indelible stick)
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
Ease of use
Cleaning, removal from undercuts
Requires adhesive carried to the external
surface of denture borders
Impression Procedure
Load carefully
Excessive material can
reduce freeway space
Dry tissues
Impression Procedure
Seat denture anteriorly
Slowly rotate posterior into place
Ensure denture is not too far forward
Verifying Position
Patient closes lightly until first contact
If occlusal interdigitation is poor,
physically move denture
Maintain position until set
Evaluate Impression
Trim impression to posterior border
Place / mark the posterior palatal seal
Check retention, extension, periphery
Remove excess (occlusal, facial etc.)
Check relations intraorally
Send to lab for processing
Deliver ASAP, usually next clinic
Same day in practice, if possible
Remount
Adjust Occlusion
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
Possible alteration in VDO, occlusion,
facial support
No chance to test retention and comfort
under function

Functional Relines
(Lynal, Visco-gel)
Similar procedure
Minor variations
Functional Relines
Cannot extend borders greater
than 4 mm
Distorts too easily
Grossly under extended, use
impression technique
Functional Relines
Material requires greater thickness
for accuracy
Usually need to reduce denture to
allow for thickness
Variation in Accuracy of Materials
(Visco-gel> Coe-Comfort)
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
Lynal
For tissue base, mix as per instructions
Place intraorally
Remove excess with cotton swab prior
to set
Set time: 8-10 minute
Lightly border mold
During setting, allow patient to:
Talk
Swallow
Lightly occlude
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
A cast is poured within 2 hours
Otherwise, accuracy compromised

Functional Impression
Advantages
Functionally molds peripheries
Ability to assess patient comfort and
retention prior to reline proper
Functional Impression
Disadvantages
Variability of materials, handling
characteristics
Resiliency masks overextensions which
can subsequently irritate, when
converted to acrylic resin
Functional Impression
Disadvantages
Dimensional stability variable
Patient care
Pouring of casts
Can' t significantly increase borders
Do not use simultaneously as a tissue
conditioner
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 Relines
Allow no impression material under
rests or guiding planes
If so, remake impression
Partial Denture
Clinical Remount
If required, a new cast must be made
Make an alginate impression with the
RPD in place
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