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Relining and Rebasing

            Final Year BDS
             31 – 05 - 2012
Relining
    The procedure used to resurface the tissue side
    of a denture with new base material, thus
    producing an accurate adaptation to the denture
    foundation area.
                            Or
    Relining is the procedure used to resurface the
    tissue side of a denture with new base material.




2   AMZ                                      June 1, 2012
Rebasing
    Rebasing is a process of replacing all the base
    material of a denture. Only the original teeth and
    their arrangement remain.
                             Or
    The laboratory process of replacing the entire
    denture base of an existing prosthesis.




3   AMZ                                       June 1, 2012
Objectives
    The main objectives of relining or rebasing are to:

     Re-establish the correct relation of the

     denture to basal tissue.

     Restore stability and retention

     Restore lost occlusal and maxillo-mandibular

     relationship.



4   AMZ                                          June 1, 2012
Common Indications for
    Relining and Rebasing
     Imperfection in the denture base
       Defects in the impression surface of the
          denture due to
           Improper handling of the tissues during
            impression making.
           Processing defects
            
                Porosities, shrinkage/contraction, gaseous, gr
                anular.
               Warpage/crazing of the material
       Defects in the polished surface
5   AMZ                                                June 1, 2012
Common Indications for
    Relining and Rebasing
     Alveolar resorption

       Continued resorption of the residual alveolar ridge

          under the complete denture.

     Decreased occlusal vertical dimension

       Due to faulty techniques

     Immediate dentures

       Regular periodic relines are required

6   AMZ                                              June 1, 2012
Common Indications for
    Relining and Rebasing
     Socioeconomic constraints

       New denture costs are unaffordable

     Physical/ mental state of the patient.

       Chronically ill patients

       Geriatrics

       Mentally compromised individuals




7   AMZ                                        June 1, 2012
Contraindications
     Excessive resorption of the alveolar ridge
     Highly inflamed/ abused soft tissues
     Poor, unacceptable esthetics
     TMJ problems
     Unsatisfactory jaw relation
       Horizontal, vertical and orientation relations
     Severe osseous undercuts which require
      surgical correction
     Severe speech problems

8   AMZ                                                  June 1, 2012
General Complaints
      After a period of successful denture wear the patient
        complains of
       Looseness
           Ill-fitting dentures with loss of stability and
           retention
       General soreness and inflammation
       Chewing inefficiency over a period of time
       Aesthetic problems.
           Decreased chin nose distance
           Prominence of chin


9   AMZ                                                June 1, 2012
Selection of the patient
      Satisfactory OVD
      CO should coincide with CR.
      Satisfactory esthetics
      Healthy oral tissues
      Adequate denture base extensions
      Adequate load distribution on the basal seat
      Satisfactory speech
      Suitable/healthy soft tissues with out undercuts




10   AMZ                                              June 1, 2012
Materials
     1.        PMMA
           •      Heat cured acrylic resin
           •      Cold cured acrylic resin
     2.        Modifications of PMMA
           •      Butyl meth acrylate
     3.        Soft liners/ tissue conditioners
           •      Plasticized acrylic resin
                     •   Chemically activated…. short term denture liners
                     •   Heat activated…. long term denture liners
           •      Vinyl resins
           •      Silicone materials
                    Chemically activated
                    Heat activated


11   AMZ                                                                    June 1, 2012
Techniques

      Clinical procedures

      Laboratory procedures

      Chair side relining technique




12   AMZ                               June 1, 2012
Clinical procedures:
The clinical procedures for both relining and
rebasing can be achieved by the use of one of the
following methods:

      The static impression technique.

      The functional impression technique.

The clinical procedures of relining and rebasing
includes both tissue and denture preparations.
1.Tissue Preparation:
Tissue Rest:
1. Instruct the patient to leave the old dentures
   out of the mouth at least 8 hours preferably
   at night.
2. The dentures should be left out of the mouth
   at least two to three days before making the
   final impression.
3. Massage of the soft tissues two or three
   times a day to stimulate the blood supply
   and aid recovery.
B) Use of Tissue Conditioner
1. Extensive tissue abuse
2. Pt. cannot leave the dentures out for tissue
   recovery.
3. Transmission of masticatory forces to the
   supporting mucosa are equalized by eliminating
   isolated pressure spots typical of a loose, ill
   fitting denture.
4. The material is renewed periodically every 3 to
   7 days.
5. When the tissues had returned to a clinically
   discernible healthy state, the patient is
   scheduled for making the impression.
c) Surgical management:
Excessive hypertrophic tissue should be surgically
  removed. The denture can be used as a surgical
  splint.
Denture Preparation
1. Balanced occlusion to ensure that uneven
   contact does not bring about a bodily shift
   or tilt of the denture when the patient is
   asked to close together.
2. Reduction of sharp and overextended
   borders.
3. Pressure areas in the tissue surface of the
   dentures should be relieved.
Clinical procedures
        Preparation for the impression
        Adjustment of occlusion
        Jaw relation records




18   AMZ                                  June 1, 2012
Laboratory procedures

      Articulation method
      Reverse flasking method
      Jig method




19   AMZ                         June 1, 2012
20   AMZ   June 1, 2012

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Relining and rebasing

  • 1. Relining and Rebasing Final Year BDS 31 – 05 - 2012
  • 2. Relining The procedure used to resurface the tissue side of a denture with new base material, thus producing an accurate adaptation to the denture foundation area. Or Relining is the procedure used to resurface the tissue side of a denture with new base material. 2 AMZ June 1, 2012
  • 3. Rebasing Rebasing is a process of replacing all the base material of a denture. Only the original teeth and their arrangement remain. Or The laboratory process of replacing the entire denture base of an existing prosthesis. 3 AMZ June 1, 2012
  • 4. Objectives The main objectives of relining or rebasing are to:  Re-establish the correct relation of the denture to basal tissue.  Restore stability and retention  Restore lost occlusal and maxillo-mandibular relationship. 4 AMZ June 1, 2012
  • 5. Common Indications for Relining and Rebasing  Imperfection in the denture base  Defects in the impression surface of the denture due to  Improper handling of the tissues during impression making.  Processing defects  Porosities, shrinkage/contraction, gaseous, gr anular.  Warpage/crazing of the material  Defects in the polished surface 5 AMZ June 1, 2012
  • 6. Common Indications for Relining and Rebasing  Alveolar resorption  Continued resorption of the residual alveolar ridge under the complete denture.  Decreased occlusal vertical dimension  Due to faulty techniques  Immediate dentures  Regular periodic relines are required 6 AMZ June 1, 2012
  • 7. Common Indications for Relining and Rebasing  Socioeconomic constraints  New denture costs are unaffordable  Physical/ mental state of the patient.  Chronically ill patients  Geriatrics  Mentally compromised individuals 7 AMZ June 1, 2012
  • 8. Contraindications  Excessive resorption of the alveolar ridge  Highly inflamed/ abused soft tissues  Poor, unacceptable esthetics  TMJ problems  Unsatisfactory jaw relation  Horizontal, vertical and orientation relations  Severe osseous undercuts which require surgical correction  Severe speech problems 8 AMZ June 1, 2012
  • 9. General Complaints After a period of successful denture wear the patient complains of  Looseness  Ill-fitting dentures with loss of stability and retention  General soreness and inflammation  Chewing inefficiency over a period of time  Aesthetic problems.  Decreased chin nose distance  Prominence of chin 9 AMZ June 1, 2012
  • 10. Selection of the patient  Satisfactory OVD  CO should coincide with CR.  Satisfactory esthetics  Healthy oral tissues  Adequate denture base extensions  Adequate load distribution on the basal seat  Satisfactory speech  Suitable/healthy soft tissues with out undercuts 10 AMZ June 1, 2012
  • 11. Materials 1. PMMA • Heat cured acrylic resin • Cold cured acrylic resin 2. Modifications of PMMA • Butyl meth acrylate 3. Soft liners/ tissue conditioners • Plasticized acrylic resin • Chemically activated…. short term denture liners • Heat activated…. long term denture liners • Vinyl resins • Silicone materials  Chemically activated  Heat activated 11 AMZ June 1, 2012
  • 12. Techniques  Clinical procedures  Laboratory procedures  Chair side relining technique 12 AMZ June 1, 2012
  • 13. Clinical procedures: The clinical procedures for both relining and rebasing can be achieved by the use of one of the following methods: The static impression technique. The functional impression technique. The clinical procedures of relining and rebasing includes both tissue and denture preparations.
  • 14. 1.Tissue Preparation: Tissue Rest: 1. Instruct the patient to leave the old dentures out of the mouth at least 8 hours preferably at night. 2. The dentures should be left out of the mouth at least two to three days before making the final impression. 3. Massage of the soft tissues two or three times a day to stimulate the blood supply and aid recovery.
  • 15. B) Use of Tissue Conditioner 1. Extensive tissue abuse 2. Pt. cannot leave the dentures out for tissue recovery. 3. Transmission of masticatory forces to the supporting mucosa are equalized by eliminating isolated pressure spots typical of a loose, ill fitting denture. 4. The material is renewed periodically every 3 to 7 days. 5. When the tissues had returned to a clinically discernible healthy state, the patient is scheduled for making the impression.
  • 16. c) Surgical management: Excessive hypertrophic tissue should be surgically removed. The denture can be used as a surgical splint.
  • 17. Denture Preparation 1. Balanced occlusion to ensure that uneven contact does not bring about a bodily shift or tilt of the denture when the patient is asked to close together. 2. Reduction of sharp and overextended borders. 3. Pressure areas in the tissue surface of the dentures should be relieved.
  • 18. Clinical procedures  Preparation for the impression  Adjustment of occlusion  Jaw relation records 18 AMZ June 1, 2012
  • 19. Laboratory procedures  Articulation method  Reverse flasking method  Jig method 19 AMZ June 1, 2012
  • 20. 20 AMZ June 1, 2012