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Kenneth D. Rudd

A procedure for relining a complete or removable partial denture without the use of wax
Ali Bolouri, DMD, DDS,a and Sandra L. McCarthy, DDSb The Texas A & M University System, Baylor College of Dentistry, Dallas, Texas
Various procedures are used to reline removable dentures. Some of these involve the use of wax to seal the denture to the cast for flasking and processing. This necessitates the use of high temperatures for an extended period and involves the risk of warpage of the denture. It is also relatively time-consuming. This article describes a procedure that uses polyvinyl siloxane instead of wax. The procedure is more time efficient and decreases the risk of warpage of the denture. (J Prosthet Dent 1998;79:604-6.)

complete denture or a removable partial denture that receives its support from the underlying soft tissue must be relined periodically to maintain close adaptation to the soft tissue and to maintain optimal function without causing excessive trauma to the oral cavity. When doing a conventional relining procedure, an impression is obtained inside the prosthesis and the resultant cast is securely mounted in the articulator or reline jig. The tissue surface of the prosthesis is cleaned of impression material and the prosthesis is waxed to the cast and invested in the flask.1 The wax is softened by submerging the flask in warm water, then eliminated by flushing the opened flask with hot water. This extended exposure to high heat has been shown to release strains in the processed denture base that causes subsequent warpage.2 It can also cause separation of porcelain denture teeth from the acrylic resin. The water used to flush out the wax is recycled water and may also leave a thin film of wax on the denture surface, which can prevent adequate chemical bonding between the denture base and the new acrylic resin. After flushing, the flask must be allowed to return to room temperature, which involves considerable time. In this procedure, the use of wax is eliminated. Thus, the procedure saves time, eliminates the need for submitting the denture to excessive heat and the risk of distortion, and allows for a cleaner more thorough bond of the acrylic resin.

Fig. 1. Denture with reline impression on cast mounted in reline jig before removing complete denture from cast and occlusal index.

An articulator or reline jig may be used for this procedure. The reline jig was chosen to illustrate the procedure and occasionally an articulator is referred to as an alternate procedure. 1. Prepare the surface of the prosthesis for the reline. Use the impression material that is most appropriate for

Fig. 2. Denture removed from cast. Impression has been removed from denture and acrylic resin freshened with bur.

Professor, Department of Restorative Sciences. b Assistant Professor, Department of Restorative Sciences. 604 THE JOURNAL OF PROSTHETIC DENTISTRY

the conditions to adapt the internal surface of the denture to the denture-supporting tissues and reorient the occlusal surfaces to the opposing teeth.



Fig. 3. Posterior palatal seal carved into cast of maxillary complete denture.

Fig. 5. Reline jig is assembled. Wet cotton-tipped applicator is used to smooth and shape polyvinyl siloxane material at denture border.

Fig. 4. Heavy bodied polyvinyl siloxane impression material injected into vestibular sulcus of cast.

Fig. 6. Cast removed from reline jig and borders evaluated.

2. Box the impression with irreversible hydrocolloid3 so that the polished surface of the denture is not abraded or damaged and pour artificial stone to form a cast. 3. Remove the boxing material. Trim the cast with the denture still leaving a 2.0 to 3.0 mm land area around the denture. Index the base of the cast so that it may be reoriented to the articulator or reline jig before separation from the cast. 4. Use a reline jig or articulator to maintain the relationship of the denture to the cast. Place a sufficient amount of a mix of gypsum on the lower member of the jig and index the occlusal surfaces of the teeth into it. After the gypsum has set, mount the cast to the upper member of the reline jig making sure that the locknuts are fully screwed onto the posts before the gypsum has set (Fig. 1). An alternative procedure is to mount the prosthesis in an articulator against either the opposing denture or a cast of the opposing denture using the appropriate maxillomandibular records. (This procedure is preferred because it allows a selective grind-in procedure to be performed after processing.)
MAY 1998

5. When the gypsum is set, open the reline jig and remove the denture from the cast. Clean the impression material from inside the denture and freshen the internal surface of acrylic resin with a bur made for grinding acrylic resin (Fig. 2). When a maxillary complete denture is being relined, inscribe a new posterior palatal seal into the cast (Fig. 3). 6. Position the prosthesis into the occlusal index on the lower member of the reline jig. Use a syringe to inject a mix or heavy bodied polyvinyl siloxane material into the sulcus of the cast that represents the peripheral border of the denture (Fig. 4). When a mandibular prosthesis is being relined, also inject the lingual border sulcus on the cast. Orient the cast into the prosthesis by closing the reline jig and screwing the locknuts onto the posts before the final set of the impression material. 7. Use a cotton-tipped applicator wetted with water to remove gross excesses and shape the polyvinyl siloxane impression material at the denture border (Fig. 5). (The acrylic resin border of the denture should be embedded into the impression material 1.0 to 1.5 mm.)



Fig. 7. Complete denture flasked in conventional manner.

Fig. 8. Complete relined denture. Acrylic resin bonded without visible indication of interface between old and new.

8. After the material has set, remove the cast with the attached denture from the reline jig (Fig. 6). (Excess impression material may be trimmed off with a laboratory knife or other sharp instrument.) 9. Flask the prosthesis in a conventional manner4 (Fig. 7). (Covering the denture border with impression material helps to protect the acrylic resin from contamination with tinfoil substitute and gypsum by keeping these materials out of contact with the denture border resin.) 10. Pry the flask open immediately after the complete set of the gypsum that was used in the flasking process. Remove and discard the polyvinyl siloxane impression material. 11. Coat the cast with a separating medium, wet the border and the inside of the prosthesis with acrylic resin monomer, and pack the denture with a mix of acrylic resin. Process the flask assembly at temperatures recommended by manufacturer. Deflask, trim, and polish the prosthesis in the usual manner4 (Fig. 8). (Even though the properties of autopolymerizing acrylic resin have been improved to withstand the requirements for use as a reline material, the heat-curing acrylic resins still produce superior results, particularly if a method is used that does not expose the denture to high temperatures for long periods.)

cessitates the immersion of the flask in warm water to soften the wax and repeated washing of the flask and prosthesis with hot recycled water may leave a thin film of wax. It is also a time-consuming process, which additionally requires a cooling down period before packing the acrylic resin. The use of polyvinyl siloxane impression material in lieu of wax saves time and decreases the chance of warpage of the prosthesis.
1. Sharry JJ. Complete denture prosthodontics. 1st ed. New York: Blakiston Division, McGraw-Hill; 1962. p. 293. 2. Phillips RW. Skinners science of dental materials. 9th ed. Philadelphia: WB Saunders; 1991. p. 204. 3. Bolouri A, McKinney TW. Boxing impressions for complete denture relines. Compend Cont Dent Ed 1984;5:123-6. 4. Morrow RM, Rudd KD, Rhoads JE. Dental laboratory procedures, complete dentures. 2nd ed. St Louis: CV Mosby; 1986. p. 312-38. Reprint requests to: DR. ALI BOLOURI DEPARTMENT OF RESTORATIVE SCIENCES BAYLOR COLLEGE OF DENTISTRY TEXAS A & M UNIVERSITY SYSTEM PO BOX 660677 DALLAS, TX 75266-0677 Copyright 1998 by The Editorial Council of The Journal of Prosthetic Dentistry. 0022-3913/98/$5.00 + 0. 10/1/89039

The use of wax to provide the missing contours of the denture border and to seal the prosthesis to the cast ne-