Post on 03-Apr-2018
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Rebase
Replacing entire denture base
Flasking, heat-cured acrylic
Usually porcelain teeth
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Reline
Resurfacing the tissue surface
Jig used to maintain vertical
dimension & occlusal contacts withcold-cure acrylic
Or
Reprocessing with heat cure
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Indications
Denture no longer fits residual ridge
Retention, stability are lacking
PLUS Occlusion is acceptable
Vertical dimension is acceptable
Denture teeth/gingival contours acceptable
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Determine Cause of Looseness
Pivoting on bony structures
- PIP
Occlusal interferences
- Tactile, articulating paper, remount
Inadequate posterior palatal seal
-Pull upward & outward on lingual ofcanines
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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
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Relines Will Only Solve Retention
Problems Related to Denture Base
Adaptation
Retention problems must be diagnosed
as to their cause
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Processed or chairside
Impression or functional technique
Hard acrylic or resilient
Permanent, temporary
Complete or partial dentures
Types of Relines
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Processed Acrylic Permanent
Complete Denture Relines
Make impression for least stable
denture first
Easier to stabilize the other denture
Reference for occlusion & vertical
dimension
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Impression TechniqueDifficult to reline without:
Encroaching on interocclusal space
Displacing the supporting tissues Altering occlusal contacts
USE CARE
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Positioning the DentureOVD & Occlusion
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Adjust Occlusion
Obtain stable occlusal contacts
Remount & adjustment may be required
Assess need for tissue conditioning
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Remove Tissue Undercuts
Allows impression to be removed fromcast without breaking cast or denture
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Clean the Denture
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Border Mold
Relieve borders 2 mm short of vestibule Border mold with compound
Maxillary posterior border at vibrating
line (indelible stick)
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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
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Impression MaterialPolyvinylsiloxane
Ease of use
Cleaning, removal from undercuts
Requires adhesive carried to the external
surface of denture borders
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Impression Procedure
Load carefully
Excessive material canreduce freeway space
Dry tissues
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Impression Procedure
Seat denture anteriorly
Slowly rotate posterior into place
Ensure denture is not too far forward
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Verifying Position
Patient closes lightly until first contact
If occlusal interdigitation is poor,physically move denture
Maintain position until set
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Evaluate Impression
Trim impression to posterior border
Place / mark the posterior palatal seal
Check retention, extension, periphery
Remove excess (occlusal, facial etc.)
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Check relations intraorally
Send to lab for processing
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Deliver ASAP, usually next clinic
Same day in practice, if possible
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RemountAdjust Occlusion
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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
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Impression TechniqueDisadvantages
Possible alteration in VDO, occlusion,
facial support
No chance to test retention and comfort
under function
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Functional Relines
(Lynal, Visco-gel)
Similar procedure
Minor variations
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Functional Relines
Cannot extend borders greater
than 4 mm
Distorts too easily Grossly under extended, use
impression technique
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Functional Relines
Material requires greater thicknessfor accuracy
Usually need to reduce denture to
allow for thickness
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Variation in Accuracy of Materials
(Visco-gel> Coe-Comfort)
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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
L l
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Lynal
For tissue base, mix as per instructions Place intraorally
Remove excess with cotton swab prior
to set
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Set time: 8-10 minute
Lightly border mold
During setting, allow patient to: Talk
Swallow
Lightly occlude
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Remove Excess
Reduce material on flanges with
HOT scalpel or knife Remove from teeth, oral surfaces
Patient wears reline home
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Patient Returns in 24-48 Hours
A cast is poured within 2 hours
Otherwise, accuracy compromised
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Functional ImpressionAdvantages
Functionally molds peripheries
Ability to assess patient comfort and
retention prior to reline proper
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Functional ImpressionDisadvantages
Variability of materials, handling
characteristics Resiliency masks overextensions which
can subsequently irritate, when
converted to acrylic resin
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Functional Impression
Disadvantages Dimensional stability variable
Patient care
Pouring of casts
Can' t significantly increase borders
Do not use simultaneously as a tissue
conditioner
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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
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Partial Denture Relines
Allow no impression material under
rests or guiding planes
If so, remake impression
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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