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Reline

Addition of Material to the tissue side


of a denture to improve its
adaptation to the supporting
mucosa.
Rebase

Replacement of the entire denture


base material to improve its
adaptation to the supporting
mucosa
Reline Indications

 Loss of retention
 Instability
 Food under denture
 Abused mucosa
Reline: General Considerations
 Optimal tissue health
 Reasonable CR/CO
 Adequate vertical dimension
 Adequate peripheral extensions
Evaluate Dentures
Is Reline necessary????
1. Are patient’s expectations realistic?
2. Check and correct peripheral border
extensions
3. Check posterior palatal seal depth and
extension
4. Evaluate occlusion in centric and eccentric
excursions and correct major discrepancies
5. Inform patient just because denture is loose
does not indicate RELINE is necessary.
Is Reline necessary????

If after modifications, the “fit and


bite” seem improved, let the patient
try the denture for one week…if
there is no improvement, then
reline.
Is reline Necessary?
Overextension

Irritation of Peripheral Borders


Is reline Necessary?
Overextended borders

Borders corrected
Is reline necessary?
Error in CO on one
side, will break the
seal on the
opposite side
Is reline necessary?

Correct eccentric excursions


Diagnosis-Occlusal disharmony

1. Loss of stability and retention


2. Irritation and inflammation on one
side
3. Teeth stained on one side
Reline Contraindications

1. Worn out dentures


2. Vertical dimension loss greater
than 7 mm
3. Significant mucosal inflammation
4. Poor denture esthetics
5. Denture related speech problems
Contraindications
•Severe tooth wear
•Severe vertical overlap
with tooth wear (posterior
tooth concept)
•Severe occlusal wear (CD
evaluation)
Patient and denture pre-requisites for
relining
1. Tissues must be in normal healthy state
2. The denture must be able to be
stabilized by border refining
3. There must be reasonable centric
occlusion in harmony with centric
relation
4. There must be at least correctable rest
vertical dimension and occluding vertical
dimension
5. Absence of speech defects (possibly
whistling can be corrected)
Pre-requisites for relining

Recognition of abused tissues, with


superimposed candidiasis.
Initiate Tissue Recovery Program
(Lytle)

 Intermittent hot and cold rinses


 Massage tissues
 Relieve pressure areas
 Correct faulty occlusions and denture
borders
 Minimize stress by
 Soft diet
 Removal of denture at night
 Use tissue conditioners
Complete Denture Exam
 Healthy Tissues!!
Before selecting method
 Check RVD and
OVD
 Check speaking
space, freeway
space
 Assess lip support
Controlled pressure technique
 Pros:
 One appointment technique and delivery
 Cons:
 No evaluation period
 Remount required

 Limited orientation

 Limited leeway for correction


Indications
 Denture more than 2 years old
 Some occlusal errors exist
 Loss of VDO
 Controllable occlusal discrepancies
exist
 Lack of posterior peripheral
extension and correct palatal seal
Functional impression technique
 Pros:
 Permits an evaluation period
 Self adjusting
 Remount procedures may not be required
 Cons:
 Multiple appointments required
 Time sensitive liner (14-21 days)
 Indications:
 Older patient may have lack of coordination
 Fairly new denture (~18 months)
 Immediate dentures
Controlled pressure technique
Technique procedure for CUD
1. Remove denture 24-48 hours prior to
reline appointment.
2. Evaluate occlusal and rest vertical
dimension. If VD is to be increased 3-4
mm, place compound stops in base of CUD
(3-5 mm in diameter).
3. Record horizontal and vertical overlaps of
maxillary anterior teeth.
4. Reduce peripheral borders 2mm if VD is
unaltered; otherwise less reduction is
required. Remove any excessive
undercuts.
 If loss of VDO is
greater than 4 to 5
mm…..place stops.
CUD Reline

1. Check extensions 2. Indicate amount of


peripheral reduction required

3. Border Reduction 4. Tissue Conditioner preparation:


Peripheral reduction + Tissue
CUD Reline

5. Border Molding 6. Palatal surface vented


Completed after B. M.

7. Seat denture until wash


comes through vents 8. Final Impression
CUD Reline
 Incorrect seating.
Improper plane of
orientation:
 Not contacting teeth
 Excess material
 No vents
 Place ZnO wash
 Have patient close
in CR.
CUD Reline

Trim
excess wax
beyond
anterior
line

ZnO wash. Posterior


palatal seal area
using impression Reline final
wax impression
Final Impression with PVS Final Impression with Rubber base
post palatal seal combination
 Identify in
impression, before
pouring it up.

 Identify on
impression so
technician can
scribe the seal
CLD Reline
Complete
Denture method-
ZnO

Border
molding Rubber Base
completed Reline
Reline
Roughened
border to blend
new acrylic with
old. Won’t show
finishing line

After
processing:
Relined cast: Do
Note junction
not separate
line
Reline

Trimmed and polished


Delivery of Reline

Examine:
•Peripheral extensions
Delivery of Reline
 Pressure Indicator
Paste (PIP)
 Ask the patient to
bite on cotton rolls
for 5 min.
Remount records
 Green stick
compound
 CR record
 Record: short of
tooth to tooth
contact
Reline Delivery

•Remount on articulator
•Check stability of foundation
•Check occlusion
Warning
1. Do not carry out CUD and CLD Relines at the
same time, as both horizontal and vertical
relationships cannot be accurately
maintained
2. Gross occlusal discrepancies are likely to
occur and will not adequately be
compensated for through normal remount
and selective grinding procedures.
3. It is best to do the CUD first because the
CLD allows more latitude in repositioning the
denture to compensate for changes.
Remount at impression stage
when major occlusal corrections
are anticipated
Reline

 Centric relation at impression stage


 Premature contact
Reline-Remount at Impression Stage
What do you do with this?
 Remake denture!!!
We may have to “float” denture
Floating the denture
 Technician does
this
On occasion, we may have to reset
teeth
 Indication to reset
teeth: Premature
contact

 Teeth reset
Indications for Functional
impression technique
 Geriatric patient
 Medically compromised patient
 Lack of retention: New denture
 Reasonably good occlusion
Tissue Recovery Program
1. Removal of the prosthesis at night
2. Initiation of oral hygiene measures:
rinses, brushing, bubble gum
3. Location and removal of acrylic base
pressure areas.
4. Correction of base extensions
5. Correction of occlusal disharmony
6. Use of a resilient tissue conditioner.
Functional impression Procedure

1. Reduce periphery 1-2 mm


2. Relieve undercuts
3. Mix tissue conditioner according to
instructions
4. Spread uniform layer over surface
of denture
5. Insert and have patient close in
centric relation
6. With teeth in light contact, carry
out border molding procedures
7. Allow denture to remain in mouth
until material looses its tackiness
(7-10 min)
Reline

•Reline material: Pink/white


•Apply Vaseline (very slight
coating)
•Mix according to instructions
Reline
 Seat reline
impression
 Check on
extensions and
patient border
mold
 Have patient close
teeth in CR
gently!! 7-10 min
Reline

1. Remove denture from


mouth
2. Trim conditioner
Reline
1. Evaluate
peripheral roll
2. Can add on, grind
add on
3. Functional
impression
technique: Tissue
surface
adaptation
Reline
 We must trim
tissue conditioner

 Unacceptable

 Acceptable
Reline

•Examine after 1 week


•Place posterior palatal seal
after 1 week
Functional impression technique
CLD Reline
1. Identify pressure area
2. Correct pressure area
3. Relieve pressure spots
4. Re-impress

1 2

3 4
CLD Reline F. I. T.

 After one week:


 Borders corrected
with impression wax
CLD Reline

Finished reline

Centric occlusion,
Delivery
Reline: Pitfalls
 Improper diagnosis
 Increasing VDO excessively
 Patient does not like appearance of denture
 Relining for loss of minor retention

 Inadequate relief
 Loss of orientation
 Impression thickness
 Occlusal discrepancies

 Inadequate posterior palatal seal


RPD Relines
1. Similar to an altered cast impression
2. Materials of choice are Zinc Oxide wash
or impression wax
3. Shoe extension must be cleaned of
impression material
4. If reline is to be sent to dental lab. some
distance away, then an over impression
must be taken with reline in place in
mouth and cast poured
5. If reline is sent to local lab., then a wax
impression is ideal
Reline RPD’s

ZnO wash

Wax or ZnO wash


Relining with wax

 Altered cast
 Clean shoe extension
Chairside Direct Relines
(From Smith and Bolender)

 There are several materials


available such as:
1. Flexacryl
2. Truliner
3. Triad
Direct relines: Indications

1. Where no longer than 6 weeks is


required
2. Around overdenture abutments
3. Border additions
4. RPD base areas
Direct Relines: Contraindications
1. For long term service (deteriorate in oral
environment)
2. Poor impression materials, which are not accurate
and cause tissue displacement
3. Difficulty of material in adhering to denture base
4. Tissue surface is rough and presents porosity
5. Color stability is of short duration
6. If denture is not properly positioned, correction is
difficult
7. Tissue irritation may be caused by lysis of the local
monomer