The document discusses relining and rebasing removable dentures. Relining involves adding material only to the denture-bearing surface to compensate for minor ridge changes, while rebasing replaces the entire denture base material. Common indications for these procedures include residual ridge resorption causing looseness or sore spots. Clinical techniques described include closed-mouth, open-mouth, and chairside methods. Laboratory techniques involve using an articulator, jig, or flask. Materials used include hard and soft denture liners. The document provides details on various techniques and materials used for relining and rebasing removable dentures.
3. • Techniques-
Clinical Procedures
Laboratory Procedures
• Relining & rebasing removable partial dentures
• A technique for relining bar-retained
overdentures
• A conservative approach to rebasing an
implant-retained fixed complete denture
• Linear dimensional change of heat-cured acrylic resin
complete dentures after reline and rebase
• Summary
• References
11. Diagnosis
Diagnosing the problems that have occurred is essential to
determine the choice of treatment.
Tissue changes may be due to:
Incorrect or unbalanced occlusion-for such cases , correction
of occlusal disharmony is sufficient.
Changes in supporting structures – If vertical dimension is
changed rebasing is required or else relining would be
sufficient
24. Hard reline materials:
• The materials are used to provide a chair side reline to the denture.
• Composition:
The materials are generally supplied as a powder & liquid which are
mixed together..
There are two types according to the composition, they are Type I &
Type II.
As methyl methacrylate is replaced by higher methacrylates( n-
butyl), the Tg becomes progressively lower, as a result less
plasticizer is required & effect of leaching can be minimized.
27. Short term
liners
They are used to provide a
temporary cushion which prevents
masticatory loads from being
transferred to the underlying hard
and soft tissues.
Used as an adjunct in tissue
conditioning of abused/ irritated
denture supporting tissues for a
shorter period of time .
Long term
liners
Permits wider distribution of forces and
absorption of impact forces that are
involved in functional and parafunctional
movements
Materials mostly used as a
therapeutic measure for patients who
cannot tolerate the stresses induced
by dentures
Used in patient who suffer from chronic
pain , soreness or discomfort due to
prolonged contact between the rigid
denture bases materials and underlying
tissues.
28. Short term soft liners (tissue
conditioners )
• Soft , resilient material
• Used as temporary liners
38. Closed Mouth Relining Techniques-
Maxillary Dentures
Technique A (Shaffer And Filler )
Centric relation : existing centric relation is recorded
Denture preparation : all the undercuts are relieved and
1.5-2mm from the tissue surface except the posterior
border of maxillary dentures
39.
40. Impression making
zinc-oxide eugenol impression paste
patient closes lightly into the premade
interocclusal record.
Exposed part impression made with quick-
setting plaster.
42. Advantages of Technique A
The opening of the palatal portion
The premade interocclusal record
helps
• To position the dentures during the impression
making
• To orient the dentures on the articulator
Allow better seating of
the maxillary denture
Alleviate the increase
in vertical dimension.
43. Disadvantages :
The possibility of moving the maxillary denture
forward
No solution for difficulties of relining both
dentures at the same time.
The wax interocclusal record is not an accurate &
safe record that the patient can close on several
times without possibility of damaging the
records.
45. Special suggestions :
palatal portion is deepened on the polished surface upto half
the thickness of the denture base
Holes are drilled at 5 to 6mm intervals inside this groove.
This helps in easy removal of the palatal portion during
packing and processing.
Border molding : green stick compound
46. Impression :
IOWA wax is the material of choice.
The impression is made in two steps.
The impression of the labial flange & the crest of
the alveolar ridge between the canines
is made as a second step
47. Advantage :
The two step impression technique will reduce the
possibility of extreme forward movement of the
maxillary denture.
Disadvantages :
possibility of distortion
Errors of existing centric occlusion can produce on
inaccurate impression.
48. Technique C : Christensen (1971 )
Centric relation –
Existing centric
relation and
intercuspation
Denture preparation –
same as in techniques
A and B
Special suggestions :
the labial and palatal
flanges of denture are
perforated.
49. Border molding – Green stick compound
Impression – no specific impression material
recommended.
The occlusal relationship is preserved by relining &
finishing the maxillary denture first so that it will
control the position of mandibular denture.
patient is cautioned to use slight force & only tap
the teeth together , inc. occlusal pressure may
squeeze too much of impression material out of
dentures resulting in sore points.
Advantages – nothing to be emphasized.
Disadvantages – the same as in technique A and B.
50. Technique D – by Jordan
Centric relation :existing centric
occlusion is used to seat the
maxillary denture.
Denture preparation :Same as in
other techniques
51. Special suggestions :
Large opening should be made in the palatal
portion of the maxillary denture.
Adhesive tape is attached over the buccal and
labial surfaces
Apply a thin layer of POP or ZOE paste on the
basal surface of denture leaving slight excess on
flattened borders.
52.
53.
54. When impression material hardens
remove denture from mouth
remove excess material
Reseat the denture in the mouth and apply plaster of Paris to
the open area
box and pour the cast
55.
56. A buccal groove is cut into the denture base and filled
with wax as is the palatal area.
57.
58.
59. Border molding – not suggested
Impression – plaster of Paris or zinc oxide –
eugenol for the first step,
plaster of Paris for the second step (palatal
portion)
Advantage – same as technique A
Disadvantage – pressure points and a faulty
impression can result due to errors in centric
occlusion.
60. Closed-mouth relining technique
– mandibular denture
Hazards in relining a maxillary complete denture
are greater than relining a mandibular complete
denture
61. Technique E :
Centric relation – the existing centric occlusion
(intercuspation)
Denture preparation – not specified
65. IMPRESSION- modelling compound & ZoE is used
ADVANTAGES-
The loss of VD can be compensated for during the relining
procedures.
The error in centric occlusion can be reduced during lab stages.
DISADVANTAGES- Time consuming
66. Open-mouth impression
technique (Boucher’s
technique)
Impressions are made independently.
The dentures are used as special trays.
After impressions are made, a new
centric relation record is accomplished.
In this technique the maxillary and
mandibular dentures are relined at the
same time.
67. Technique F :Boucher’s
Technique
A posterior palatal seal is formed in modeling
compound.
The borders are shortened and 1mm of space is
provided on the tissue side
A modeling compound handle is attached for the
lower denture.
Adhesive tape is placed over the polished
surfaces.
68.
69. Tissue surface is reduced to allow room for tissue
conditioner. Borders are also reduced by 1-2 mm.
70. Minimum required material is used for coating the tissue
surface. Denture is inserted and patient is guided in
retruded position .
After some time denture is taken out and examined for
denuded areas , over and under extensions , and are
corrected.
71. After corrections of deficiencies denture is reinserted , patient is
dismissed and recalled after 3 -5 days.
On next appointment denture is checked for denuded area , and
corrected.
Material is renewed every week , till healing is complete.
72. After healing , tissue conditioner is removed and replaced
with new material.
Patient is instructed to wear the denture for 30 mins or to
have a light meal . If impression is free of any pressure areas
it can be taken as final impression, and should be poured
immediately.
Alternatively final wash can be taken with ZOE or light body
polysulfide.
73. Border molding is done with green stick
compound.
Final impressions are made with zinc oxide
eugenol or elastomers.
A centric record is made using the impressions
as record bases.
74. Advantages-
A separate interocclusal record using already made
impression allow operator to concentrate on centric
recording.
Centric record can be verified.
Fast setting interocclusal record is reliable.
Disadvantages-
Procedures are lengthy and difficult to perform.
75. Chair side relining
Instruct the patient to leave the dentures out of mouth at
least 8 out of 24 hours , preferably at night for 4 or 5
days.
Necessary denture preparation are made.
The relining or impression material are mixed
according to manufacturer's instruction, and loaded to
the denture with an even coating of 2 or 3 mm to the
entire tissue surface.
Seat the denture with labial flange in the labial vestibule
first and then seat the posterior of the denture with a
superior and slight posterior motion.
76. After seating the denture, it may be necessary to
stabilize the maxillary denture
With one hand and guide the mandible to centric
relation with the other.
When the teeth are in the correct anteroposterior
relation, make the patient to do functional movements
by supporting the denture with the middle and index
finger
77. Repeat the closure several times and border mold the
peripheries.
Remove the dentures and rinse the mouth. Then reseat
the denture again, and repeat the closing and border
molding procedure.
When the resin begins to generate heat, remove the
denture and place it in warm water for 20 min.
After resin has cured, trim and polish. Then the
opposing denture is relined in a similar manner.
Now the occlusion is refined
78. Disadvantages:
Chemical burns on the mucosa
Porosity
Bad odor
Poor color stability
If the denture was not positioned correctly, the material
could not be removed easily for repeat.
79. Laboratory procedure :
The laboratory procedures of relining a denture include :
Articulator method
Jig method
Flask method
89. After curing the relined denture , remove from the cast ,
& finish and polish it.
Cured in pressure container
- 20 psi for 30 minutes
Relined denture
90. Jig method
Here the impression is boxed & a cast is poured . A reline
jig is used in this method. There are two types of jig for
this process:
Hooper duplicator Jectron jig
91. Procedure
Denture seated on lower
Member of jig
Mounting stone smoothened with
spatula
Use modelling clay to block out the denture, & seat the denture in stone patty on lower
member of the relining jig.
After the stone index has set , paint the index cast with separating medium, & mount the
cast to the upper member of the jig.
95. Application of separating media Moistening with monomer
Seat the denture in stone index.
Paint the cast with tinfoil substitute
Moisten the resin surface of the denture with an autopolymerising monomer.
96. Resin mixed & placed on
cast
Resin placed in denture
97. Jig assembled & locknuts
tightened
Jig separated & denture
Examined for voids
Cure the relined denture in a pressure container of warm water at 15 psi for 30
minutes.
Separate the jig , remove the relined denture , & finish A polish it.
99. Problem Probable cause Solutiom
Voids in resin of
relined denture
Autopolumerising
resin not placed
throughout the
interior of denture
Place resin over entire
tissue surface of
denture &
cast:adequate volume
of material should be
used.
Completed reline
shows line between
denture base & added
resin
Denture resin not
thoroughly cleaned
prior to adding
autopolymerising
resin
Aerosol of oil in
compressed air
Resin mix too dry
when placed in
denture
Grind surface of
denture to receive
new resin ; thorougly
remove all traces of
impression material
Donot use air blast to
remove resin
grindings if
contaminated with oil
Pack resin at proper
stage before it begins
to set
Relining Procedures
100. Problem Probable cause Solution
Relined denture is
porous
Relined denture not
cured in pressure pot
Cure relined denture in
pressure pot for 30 min
at 15-20 psi
Relined denture not
retentive
Posterior palatal seal
not placed in cast
Initial impression not
adequate
Scrape posterior palatal
seal in cast prior to
adding resin
Examine reline
impression carefullyfor
damage in transit
101. Rebasing with jig method
Hooper Duplicator used to rebase the denture
102. Procedure
Mount the denture on its cast in a reline jig or
articulator .
Open the jig or articulator , carefully remove the
denture from the cast.
103. Removal of porcelain teeth
Using alcohol torch Using Spatula
If the teeth are porcelain , heat each tooth with the hot spatula,
& remove it from the denture.
104. Place each tooth in its corresponding indentation.
If the denture teeth are resin , cut them from the denture base in
units with a bur, & seat them in indentations.
Adapt a layer of baseplate wax to the cast, assemble the jig & close
the articulator,& wax the denture teeth to the wax
Porcelain teeth replaced back A layer of baseplate wax
adapted to the cast
105. If sufficient space is there
Baseplate wax is removed
If it is less pieces of wax can
be added
Completed wax-up on jig
106. Complete the wax-up on the jig , or articulator , remove
the cast , & flask and process it.
Replace the cured denture on the jig, or articulator, check
& correct the occlusion , then finish & polish the denture.
108. Problem Probable cause Solution
Denture cannot be
separated from the
cast without breaking
cast or denture
Undercuts in denture
not removed before
making impression
Remove undercuts
from denture with bur
prior to making
rebase impression
Rebased denture
occlusion is in error
Denture teeth not
seated properly in
indentations
Wax shrinkage
withdrew teeth from
indentations, resulting
in lack of occlusal
contact
Occlusion not
properly related by
rebase impression
Flask halves fit
together poorly
Seat denture teeth
firmly in indentations
Add chips of cooled
wax to space between
tooth ridge laps &
cast to minimize wax
shrinkage
Make rebase
impression at proper
occlusal relationship
Use flasks that fit
together accurately
without rocking
Jig or articulator rebasing method
109. Flask method
Procedure
Pour a cast in the denture as described earlier.
Half –flask the denture in an accurate denture
flask.
Paint silicon mould material over the denture.
111. Complete flasking the denture
Open the flask after the flasking stone has set. The resilient silicone
will allow the denture to be withdrawn without damage
Remove the porcelain or resin teeth from the denture as described for
the jig method.
Replace the teeth in silicon mould
Flask opened
Porcelain teeth removed &
Replaced in silicone mold
112. Resin teeth replaced, Cure denture
Place the posterior palatal seal in maxillary cast
Paint the cast & investing stone with tinfoil substitute
Pack denture resin in the mold, & cure , finish & polish the denture
Correct processing errors after the remounting procedure
113. Laboratory Steps for Rebasing
Complete denture base material is removed from the teeth if they
are porcelain. In case of acrylic teeth, a small connecting bridge is
preserved.
Post-dam may be scored on the cast.
A new base plate wax is adapted on the cast and it is sealed with
teeth by using extra bite wax by closing upper and lower member
of duplicator in previous position.
It is sealed with cast and separated from the duplicator then
processed to replace denture base material.
141. Fig. 5.-The smooth, accurate, muscle-trimmed impression in modeling
composition.
Fig. 6 .-Bases prepared for the application of impression wax (Iowa
Formula).
142.
143. A technique for relining bar-retained
overdentures
The supporting structures for a bar-retained overdenture are the
soft tissue that covers the posterior residual ridge and a rigid
anterior bar.The difference in the support characteristics of these
structures leads to minor movement of the overdenture.
This rotational movement increases when posterior residual ridge
resorption occurs, and the overdenture loses its posterior vertical
support and should be relined,
Making impression for relining a Bar – retained overdenture is
difficult due to undercuts under bar.
144. This article describes a technique for relining a mandibular
bar retained overdenture that allows recording the soft
tissue beneath the bar and makes it possible to replace or
modify the retentive bar attachment simultaneously with the
reline procedure. (J Prosthet Dent 2014)
TECHNIQUE
•1. Remove the retaining screws of the retentive bar and
insert the appropriate implant analogs to the retentive
abutments extraorally.
147. Attaching bar to apical ends of each analog
with autopolymerizing acrylic resin.
148. Assembled analogs.
Remove the retaining screws of the retentive bar,
Set the assembled analogs aside for use in the future steps.
149. Select & screw an appropriate ball abutment on the
platform of each implant intraorally, place the retentive
cap on top of each ball, & make reline impression .
Use each ball attachment & its retentive cap as atransfer
impression coping & overdenture as a closed impression
tray.
150. Intraoral view of ball attachments.
Retentive caps and directional rings are
positioned on ball attachments
intraorally.
154. • Pour the definitive cast in ADA Type III stone and after 1 hour,
remove the reline impression. Remove the balls, and screw the bar
onto the implant analogs
Definitive cast with bar
attachment.
155. Reline the implant overdenture by using conventional
laboratory procedures.
156. A conservative approach to rebasing an
implant-retained fixed complete denture
• After years of service, the acrylic resin base of an implant-retained
fixed complete dental prosthesis may need to be replaced because of
the wear of the acrylic resin teeth.
• This article presents a safe approach to removing acrylic resin while
preserving the integrity of the framework. The technique involves
heating the prosthesis to beyond the glass transitional temperature of
the acrylic resin to allow the resin to be safely peeled off the
framework.
160. Place the block in a burnout oven
Partially softened acrylic resin has almost
rubbery consistency and can easily be
peeled from metal framework.
161. Complete removal of acrylic resin base and
denture teeth in 1 piece.
Leave the block to bench cool & clean the
framework with a toothbrush & ultrasonic
cleaning is done.
162. Fit of framework is verified on
definitive cast.
Proceed with maxillomand.
Records & evaluation of tooth
arrangement
Proceed with the prosthesis
delivery in a conventional
manner.
164. Summary
• Relining & rebasing are not adequate substitution for new
dentures. However, rebased or relined dentures should be
given the same care as new dentures & patients should be
recalled as often as necessary for examination of the
tissue & the jaw relation
165. References
• Essentials of complete denture prosthodontics -
Sheldon Winkler
• Prosthodontic Treatment for edentulous patients –
George A. Zarb etal. 13th
edition
• Boucher’s prosthodontic treatment of edentulous
patients- Carl.O. Boucher ; 10th
edition
• Dental laboratory procedures – Complete dentures –
Rudd & Morrow
• Complete denture Prosthodontics - John j Sharry
166. • Christensen FT ;Relining techniques for complete
dentures. J Prosthet Dent.October.1971
• Relining the complete dentures. J Prosthet Dent.
December, 1972.
• Boucher CO ;the relining of complete dentures. J Prosthet
Dent 1973;30;521-526
• Jordan LG relining the complete denture. J Prosthet Dent
1972;28;637-641
• Linear dimentional change of heat cured acrylic resin
complete dentures after reline & rebase. J Prosthet
Dent 1998;80:238- 245
167. • A conservative approach to rebasing an
implant-retained fixed complete denture j
Prosthet Dent 2014;112:672-675
• A technique for relining bar-retained
overdentures j Prosthet Dent 2014
• RELINING REMOVABLE PARTIAL DENTURES FOR FIT
AND FUNCTION J Prosthet Dent 1954