Lecture 5- Relines and rebases

What is reline used for?

To only solve the problem of the fit

If a patient has ridge resorption, relining can be used to

Close the gap between existing denture and ridge

What is relining?

Resin is added to the existing denture base

What is rebasing?

All the denture base is replaced (all pink acrylic)

Why might relining be necessary?

1. Residual ridge resorption

2. Ill-fitting denture causes tissue problems (conventional)

3. More cost effective than making a whole new denture

What are the two types of relines

1. Direct- intraorally

2. Indirect- done in lab

What are some indications for direct (intraoral) relines?

1. To improve denture fit

2. For immediate dentures during healing

3. To aid in healing tissue (tissue conditioning)

4. Used for RPDs

What is a CON for direct intraoral relines?

Technique sensitive so not used in every case, must be precise

What is a PRO for direct intraoral relines?

Soft relines have a limited life span, it is temporary so easy to adjust

What is a contraindication for a direct (intraoral) reline?

Denture problem is not related to the fit

What is an indication for using soft reline material for an interim denture?

If it’s still in the early stages <2 months and there are rapid changes in the fit, use lynal. This is because majority of the absorption occurs during this tie

You can use a tissue condition and treatment reliner called

Caulk Lynal. It is a powder and a liquid, you want to create a peanut butter consistency

What do you do during the relining appointment?

Place the lynal in the intaglio 7-10 min, trim the rough areas. The whole appointment should take ~30 min

Lynal hardens over time and starts to chip. This varies with each patient. You want to ensure what?

You cleanse the oral flora well

What are some indications for direct hard relines?

1. Reline for RPD

2. Interim dentures after ridge has matured

3. New denture if lack of fit

Direct hard relines material that mixes just like lynal

Astron- requires light cure

Apply astron and let it set for ~10min. If you like it, cure it! If you don’t like it?

You can peel/remove it and redo. It is convenient for a hard denture

What are some indications for indirect (lab) RELINES?

1. Recently made dentures that require better extensions

2. Refitting immediate dentures

3. Refitting older dentures

What are some indications for indirect (lab) REBASE?

This is where you are replacing the whole acrylic.

1. Lack of proper fit, otherwise denture okay

2. Discolored base material

3. Fractured base material with previous repairs

What are some components to check if the fit is okay regarding an indirect rebase?

1. Adequate VDO

2. Acceptable occlusion

3. Acceptable esthetics

What are some contraindications for indirect (lab) RELINES & REBASES?

1. If you need to modify tooth position

2. There is a major occlusal discrepancy

3. If you need to alter the VDO

4. You have severely inadequate/deficient extensions

5. Unrealistic expectation of patient regarding outcome

Should you be selective or indiscriminative when relining dentures?

Selective

What impression material should you use for the border molding

Impregum

What impression material should you use for the final impression on the upper?

Light body permadyne

What impression material should you use for the final impression on the lower? Why?

2/3 light body permadyne

1/3 impregum

This will help increase its viscosity

How do you take the final impression for the reline or rebase?

Use the denture as the impression tray, remove any undercuts from intaglio, and provide 1mm of relief inside denture to create room for the impression material

If your denture is underseated, what does that mean?

You need to increase the vertical dimension

If your denture is overseated, what does that mean?

You need to decrease the vertical dimension

What are some problems that can happen with relines?

It can change the VDO or the position of the anterior teeth

How can you solve the problems that occur with the relines?

1. Try in the final impression

2. If incorrect, redo the impression

3. Making a new denture if the reline is incorrect costs $$

What are your reline options for removable partial dentures?

Do them directly with light cured resin (astron hard) and use only the framework to seat the prosthesis

A 71-year-old edentulous patient presents with maxillary and mandibular complete dentures that are 10 years olf and complains that “my dentures are too loose, I am having difficultly chewing my food and my dentures ahve been relined about 2 years ago".” After your examination and diagnosis, you confirmed that the dentures are ill-fitting, presence of generalized tissue inflammation on edentulous ridges, IPH on the palate, the VDO is not correct, and the denture teeth are worm. What is your treatment plan for this patient?

Direct soft reline followed by new maxillary and mandibular dentures

The disadvantages of direct soft liners include:

Both being hard to polish and they are temporary

T/F: Rebasing of the denture is indicated in situations where the entire base of the denture needs to be replaced

True

When treatment planning for a reline or rebase, direct or indirect reline, the following important criteria of the existing dentures needs to be evaulated.

1. Retention

2. Stability

3. Support

4. Esthetics

5. Extensions and

6. ?

7. ?

VDO and occlusion

The following is/are indications of a direct reline (hard or soft)

All of the options