Complete denture

Relining, rebasing and repair of complete

denture
Relining: is the procedure used to resurface the tissue side of a denture with
a new base material thus producing an accurate adaptation to the denture
foundation area.
Relining is indicated when there is loss of retention or stability due to alteration or loss of
correct relationship to the supporting tissues. It cannot be done in the absence of optimum
vertical and centric relation and correct occlusal form of teeth.

Rebasing: is the laboratory process of replacing the entire denture base

material on an existing prosthesis.
Rebasing is indicated for porous denture base and incase of deficient acrylic during fabrication.
However, it is contraindicated in case of incorrect jaw relation.

Indications for Relining & Rebasing:

• Immediate dentures after 3-6 months where maximum residual ridge resorption
would have occurred.
• When the adaptation of the denture to the ridge is poor due to residual ridge
resorption
• Economical reasons where the patient cannot afford a new denture.
• Geriatric or chronically ill patients who cannot withstand physical and mental
stress of construction of new dentures
• when the tissue damage is excessive the treatment shifts from relining to
rebasing. Another thumb rule is that rebasing should be done if the vertical
dimension of the patient is changed. Relining is not sufficient for
these cases
•Rebasing can be done properly only in dentures with porcelain teeth.

Contraindications for Relining & Rebasing:

• When the residual ridge has resorbed excessively.

• Abused soft tissues due to an ill-fitting denture.
• Temporo-mandibular joint problems.
• Patient dissatisfied with the appearance of the existing dentures.
• Unsatisfactory jaw relationships in the denture.
• Dentures causing major speech problems.
• Severe osseous undercuts.

Advantages of relining &rebasing:

• Eliminates frequency of patient visits.

• Economical for the patient.
• Improves fit of the denture.
• A soft liner can be incorporated in this denture, if necessary.

Disadvantages of relining & rebasing:

• Likelihood of altering the jaw relationship during the process.

• Cannot correct aesthetics, or jaw relations.

• Cannot correct occlusal arrangement.

• Cannot be used when excessive resorption has occurred. Hence it cannot be a

substitute for new denture.

Relining procedure

Laboratory Procedures for relining:

Laboratory procedures for relining include articulator method, jig, and flask
methods. It is common for both relining and rebasing except for a few differences.
1-Flask method

•The poured impression along with denture is invested into the base of a flask

•A silicone mold material is painted over the denture prior to investing the body.
This is done to create a flexible mold. Flasking is completed as usual.

• Since silicone provides a flexible mold, the denture can be removed carefully
after opening the flask

• The denture base is trimmed as required (a portion of the tissue surface in relining
and the entire denture base in rebasing). And placed back into the mould .
• The invested stone present in the base of the flask is the cast for the denture. If it
is a maxillary denture, then the posterior palatal seal should be marked using a
sharp instrument on the invested stone.

• Separating medium is painted over the mold space of the denture.

• The resin is packed, cured, finished and polished as described in compression

molding technique.

• The finished dentures are remounted to check for occlusal disharmony.

Problem Areas

• Nodules on tissue surface of dentures.

• Incorrect occlusion.

Causes

• Air incorporated in silicone during mixing.

• Flasks do not fit properly
• Resin not trial packed adequately.
• Initial impression not related to proper jaw relation.
Solutions

• Do not whip air into mix during mixing resin.

• Use accurately fitting flasks.
• Eliminate all flash by trial closures.
• Make sure that impression is related to proper occlusal position.
• Examine impression for damage that may occur during transit.
Once the dentures are relined satisfactorily, they are inserted in the mouth with all
the necessary instructions.

Relining of mandibular complete denture (A) Denture flanges and tissue surface reduced by 2mm
with stops in the canine and molar region (B) Border molding with low fusing stick compound (C)
Final impression (D) The cast along with denture invested in the dental flask (E) Removal of low
fusing compound and impression material (F) Acrylic packed on the tissue surface of the denture
(G), (H), (I) Relined denture.
2-Articulator Method
Once the impression is received, a cast is poured immediately.
1)Maxillary cast is mounted on a semi- adjustable articulator with the help of a
face-bow transfer.
2) A jig can be used for this purpose, but additional occlusal adjustments will
be required later.
3)Mandibular denture is mounted using an inter-occlusal record.
4)If occlusal discrepancies exist, selective grinding is done before the denture with
the impression is separated from the casts.
5)The procedure is common for both relining and rebasing up to this stage. For
relining, the required amount of tissue surface of the existing denture is trimmed
away using an acrylic bur.
6) If rebasing is to be done, the denture base should be trimmed to just leave 2 mm
of acrylic around the existing teeth.
7) After trimming, the dentures are placed in the articulator and waxed up without
altering the vertical height.
3-Jig Method
Here the impression is boxed and a cast is poured. A reline jig is used in this
method. There are two types of jigs for this purpose:

- Hooper’s duplicator

-Jectron jig.

About these jigs (Hopper’s and Jectron)

• They function to maintain the occluso-mucosal relation.
• The cast along with the impression is mounted on the upper member of these
instruments.
• Hooper’s duplicator is an instrument that has two triangular parts connected by
three pillars in each corner. Whereas, Jectron Jig uses only two pillars
• A plaster index is made on the lower platform with the denture teeth penetrating
the depth of about 2 mm. When the plaster sets the indentations made by the
denture teeth act as a key into which the denture teeth can be repeatedly positioned
to maintain a fixed distance and relation between the cast and the occlusal surface.
• When the key has set, the top and the bottom members of the jig are separated.
Denture is removed from the cast.
• All of the impression material is removed from the denture and the denture is
prepared (trimmed) according to the treatment selected (relining or rebasing)

• If rebasing is selected, the entire denture base is removed from the teeth (if they
are porcelain), and all but a small connecting bridge of acrylic is removed (if the
teeth are plastic or acrylic).
• The trimmed dentures are then set into the plaster key and the top of the
instrument is replaced. The denture is waxed to the cast, processed and finished as
usual. The cured denture should be repositioned on the jig to correct the occlusion
prior to insertion.
• If relining is opted, auto-polymerizing resin is used on the tissue surface of the
denture and the upper member of the jig is closed. The denture is cured in a
pressure container of warm water at 15 psi for 30 minutes. Use of auto
polymerizing resin is controversial due to its irritation to the tissues but it avoids
the use of excess heat (required for heat curing resins), which may warp the
original base material.

Rebasing procedure of hooper duplicator

1-Rebasing procedure of hooper duplicator

1-A rebase may be done removing all of denture base material from the
teeth when resin is used. if porcelain teeth are used they may by removed from the
denture base by heating them with a waxing torch, this softens resin around the
teeth &permit their removal.

2-The teeth are then placed individually into the index in the bottom of the hooper
in a horseshoes of resin makes re-assembly duplicator; how ever leaving the teeth
&waxing easier

3-The hooper duplicator is assembled to be sure there are no interference between

the teeth &cast
4-The teeth are tacked to the index with sticky wax.

5-The hooper duplicator is assembled &the teeth are sealed to cast.

6-After the wax sealing the teeth to the cast has solidified. the hooper duplicator is
separated; the teeth will adhere to the cast; additional wax is then placed around
the teeth to secure the teeth more firmly to the cast

7-The new base is waxed in the same manner a complete denture. the hooper
duplicator is re-assembled to check the occlusal relationship before the cast is
removed

8-The cast is removed from the plaster mount on the hooper duplicator &is
invested is usual manner. After flask is separated &the wax flushed out, the mold
is coated with tin foil substitute in same manner as it was for complete denture, the
mold is then ready for packing &processing

9-The upper half of flask is shown as it appears before the flask is closed. the same
procedures are followed as used for packing complete denture

10-The rebased denture has been cured &recovered from the flask .

11-The cast is re-attached to the upper member of a hooper duplicator, mounting

plates facilitates accurate remounting.

12-The upper &lower member of the lopper duplicator don not fit together
accurately. this is due to the slight processing error which a company any
processing technique. the processing may be removed before the reline or rebased
denture is finished.

13-Tracing fluid, which essentially is the same as the marking fluid used by tool
&dry makers is painted onto occlusal index.
14-The hooper duplicator is then re –assembled &the paints on the teeth which
make premature contact are marked.

15-These points are then relieved with suitable stone. this process may have to
repeated several time before the hopper duplicator fit to gather properly.

15-The processing error have been removed &the hooper duplicator now fit
together accurately note that the posts of lower member are flush with the top of
the member.

16-The cast is removed from a hooper duplicator &then removed from the denture

17-The denture is trimmed &polished as the same manner as complete denture.

The completed rebase denture.

2-Flask method for rebasing

1-The poured impression along with denture is inserted into the base of flask.
2-Make a silicone mold painted over the denture to investing the body to
provide a flexible mold .
3-The denture can be removed carefully after opening the flask &denture base
is trimmed all the entire denture base &placed into the mold .
4-The invested stone present in lower half of flask is the cast for the denture.
5-Put a separating medium over the mold of denture &packing the acrylic resin
cured it.
6-Check the new base or new denture to ensure is found any premature
contact, or high spots to remove it &then finished &polished.
Problem area
1-The denture cannot be separated from the cast without the cast or it
self
2-Occlusal error may occure if the flask is not closed properly while
curing
3-Relined &rebased denture may not be retentive

Causes
1-Failure to remove denture under cute before impression making
2-Denture teeth not seated properly in to the indentations
3-Wax shrinkage withdrew teeth from indentation, resulting in lack of
occlusal contact
4-Occlusion not properly maintained while making the rebase
impression
4-Flask halves have a poor fit
5-Posterior palatal seal not placed in cast
6-Initial impression not adequate.

Solution
1-Remove undercut using bur prior to making the rebase impression
2-Seat the denture firmly
3-Add chips of cooled wax to the space between tooth ridge laps and
cast, in order to minimize wax shrinkage
4-Make rebase impression at proper ocluasl relationship.
Rebasing of mandibular denture. (A) Porosities in the mandibular denture (B),(C) Index of
occlusal surfaces of the mandibular denture (D) String of teeth cut away from the denture base
(E),(F) String of teeth placed in the index (G),(H) Wax up of new denture base (I)(J). Rebased
mandibular denture
Denture repair
Denture may fracture during the function, or may drop on a hard surface. So the
key of repairing is the accurate reassembling and alignment of the broken parts in
their original position.

The types of denture fractures:

1-Midline fracture.
2-Fracture of a portion of the denture.
3-Multiple fractures (more than two pieces).
4-Fracture of one or more teeth.
5- Fractures in canine area, premolar area tuberosity and retromolar pad area.

Causes of denture fracture:

1- Falling on the ground or the sink during cleaning.

2- No or insufficient relief in the midline.

3- Resorption of the residual alveolar ridge.

4- Incomplete polymerization of acrylic resin.

5- High occlusal load.

Basic procedure for fracture repair

1. Collect the broken pieces of denture carefully and secure with sticky wax. It
may be necessary to strengthen the joint by securing an old bur across the teeth
with sticky wax. On the fitting surface, block out with wax any large undercuts
that do not involve the fracture site to enable easy removal of the model later.

2. Before pouring the cast paint the fitting surface with separating medium, then
Cast a model to the fitting surface of the denture using plaster
mixed with anti-expansion solution.

3. When set, remove the denture from the new model, and then remove the wax
from the denture.
4. The polish surface of the fracture pieces is reduced to form a groove 8 to 10
millimeters wide along the fracture line. 4 to 5 millimeters of the groove are on
either side of the line.
5. Paint the model with separating medium, position the denture on the model and
secure with sticky wax.
6. Mix the acrylic and fill the gap, leaving a slight excess.

7. Place in a water pressure bath and cure for 15 minutes at 45°C with pressure.
8. After curing and removal of the denture from the model trim the
cured material to leave the original contour of the denture.
9. Smooth with sandpaper and polish.

Basic procedure for single tooth repair

1. Using a fissure bur, remove the tooth from the denture.

2. Enlarge the tooth socket to allow room for new acrylic, the area lingual to the
fracture tooth is reduced using a fissure bur, while labial portion of the tooth socket
is left intact to aid in repositioning the new tooth.

3. Position the new tooth in place using wax.

4. Mix a small amount of plaster and make a plaster key to fit around the tooth,
wax work and adjacent teeth and allow to set. Alternatively, use silicone putty.
5. Boil off the wax from the denture and plaster key.

6. Assemble the parts and secure with sticky wax.

7. Mix a small amount of self-curing acrylic to a runny consistency and fill the
void. Place in a water pressure bath and cure for 15 minutes at 45°C with pressure.

8. Remove the plaster key and trim the denture to its original contour.
9. Polish the repair.

Repairing of complete denture when there is missing labial or

lingual border

Often a piece of broken denture may be lost or may be impossible to position, for
this reason it may be necessary to replace this missing part.

-If small piece broken of the border can be fashioned by placing warmed molding
plastic on the remaining border and then re-contouring the missing area by
placement in the patient mouth. After proper re-contouring a cast is poured into the
denture. The molding plastic is removed and self-resin is used to fill the area of the
missing border. The resin is then cured and polished.

-If borders are missing from several areas of the denture or if a large piece is
missing, it may be necessary to make an impression over the fractured denture. An
oversized perforated tray is filled with irreversible hydrocolloid impression
material and then the broken denture is placed in the patient mouth to make an
impression over the denture. A cast is poured in the impression with the denture by
stone. After setting of stone and the impression has been removed, the cast will
reveal the area to be added. Self –cure resin is then used to replace these missing
areas.