RELINING & REBASING IN

COMPLETE DENTURES
Dr Gayathri Gangadharan
Table of contents
  Introduction
 Definition
 Treatment Rationale
 Diagnosis
 Indications & Contraindications
 Tissue Preparation
 Denture Preparation
 Denture lining materials
 Techniques
 Review of literature
 Conclusion
Introduction
 Both biological supporting tissues and materials used
in complete denture fabrication are vulnerable to time-
dependent changes.
 When denture needs to be refitted, it usually indicates
undermined retention, sore spots, and variable denture
bearing tissue hyperemia.
 The relining and rebasing of complete dentures
involves solving all of the problems encountered in
the construction of new dentures, except positioning
individual teeth.
Definitions
RELINING
 It is the process of adding some material to the

tissue side of a denture to fill the space between the

tissue and the denture base. (Winkler)
Or
 The procedures used to resurface the intaglio of a

removable dental prosthesis with new base

material, thus producing an accurate adaptation to
the denture foundation area (GPT-9)
REBASING
 It is a process of replacing all the base material of

a denture. (Winkler)
Or
 The laboratory process of replacing the entire

denture base material on an existing prosthesis.

(GPT-9)
Treatment Rationale
 The foundation that supports a denture changes adversely as a
result of varying degrees and rates of residual ridge resorption.
 These changes may be insidious or rapid, but they are
progressive and inevitable and are accompanied by:-
o Loss of retention and stability.
o Loss of vertical dimension of occlusion.
o Loss of support for facial tissues.
o Horizontal shift of dentures:- Incorrect occlusal relationships.
o Reorientation of occlusal plane.
 Reline- minimal to moderate changes
 Rebase-moderate to maximal changes
Diagnosis
 An examination of the oral mucosa that supports
the dentures will disclose the state of its health.
 When the tissue is badly irritated, occlusal
disharmony associated with loss of vertical
dimension should be suspected.
 Unsatisfactory changes in esthetics indicates a loss
of vertical dimension, even though the teeth may
seem to occlude properly.
 If the supporting tissues are traumatized, surgical
correction to eliminate the hyperplasia may be
necessary before relining impressions are made.
 Greater shrinkage in one arch will change the
orientation of the occlusal plane. This will cause
occlusal disharmony in eccentric occlusion, even
though occlusal vertical dimension has been re
established by relining.
Reasons for relining
 To Improve Retention & Stability:-
 Loss of fit will make the maintenance of peripheral
seal impossible and will greatly impair the retentive
effects of adhesion & cohesion.
 To Restore the Vertical Dimension:-
 If the vertical dimension to which a denture was
made is reduced, masticatory efficiency is
impaired, but the previous efficiency can usually be
restored by relining.
 To Restore the Evenness of Occlusal Pressure:-
 When there is any alteration in the fit of the dentures,
there will be some alteration of the pressure transmitted
to the tissues when the teeth are brought into occlusion.
 To Relieve Pain:-
 If a denture has been worn with comfort and then
becomes painful, it is usually due to the alteration in the
supporting tissues allowing the dentures to tilt, rock or
move, and transmit undue pressure on one area.
Indications
 Immediate dentures at 3-6 months after their original construction.
 When the residual alveolar ridges have resorbed and the
adaptation of the denture bases to the ridges is poor.
 Persistent denture sore mouth.
 Congenital or acquired oral defect (Acquired defect due to surgery
for malignancy, trauma, congenital defects like cleft palate)
 The need for promotion of mucosal healing.
 Irregular foundation: Sharp knife edge residual ridge, maxillary or
mandibular tori, prominent mylohyoid ridge.
 Single denture opposing natural teeth.
 Radiation therapy for tumors of face and neck
Contraindications
 Excessive amount of resorption
 Unsatisfactory jaw relationships
 Centric occlusion out of harmony with centric
relation
 Poor esthetics and speech problems
 Undiagnosed and untreated TMJ problems
 Incorrect occlusal arrangement
Pretreatment procedures- tissue preparation

The oral mucosa

should be free of
Excessive
areas of irritation.
hypertrophic tissue
Tissue rest or use of
should be surgically
tissue conditioner is
removed .
must to make
mucosa healthy

Dentures should be
Daily massage of
left out of mouth for
soft tissue
at least 2-3 days
Pretreatment procedures- denture preparation

Pressure areas on Minor occlusal

the tissue surface disharmony is
should be corrected by
corrected selective grinding

Small border Corrected

inadequacies are posterior palatal
corrected with seal must be
green stick established with
compound green stick
compound
Principal pitfalls
 Do not increase the occlusal vertical dimension.
 Multiple even contacts should be present in centric
relation.
 Do not permit the maxillary denture to move
forward during impression making.
 Ensure that CR and CO are identical.
 Ensure that an accurate PPS has been established.
 An equal thickness of final impression material
should be used.
DENTURE LINING MATERIALS
Denture lining materials
They are used to refit the surfaces of complete
dentures

The earliest resilient liners were made from natural

rubber

The first synthetic resin used as liner, a polyvinyl

resin, was developed in 1945

In 1958, silicon based liners were introduced

Help condition traumatized / abused tissues

Types of resilient liners
 Natural rubbers.
 Vinyl co-polymers.
 Hydrophilic polymers.
 Silicone based compounds.
1.Room temperature polymerized
condensation silicone rubber
2.γ- methacrylate propyl trimethoxy silane heat
polymerized silicone rubbers (molloplast B)
 Acrylic based compounds.
 Treatment liners (soft conditioners)
Classification
The materials can
be classified into
3 groups

Hard reline Tissue Soft lining

materials conditioners materials

Short term

Long term
Hard reline materials
These materials are used to provide a chair side reline
to the denture .
Composition :-
Supplied as powder & liquid
There are 2 types according to the composition –
Type I & Type II
Major difference between type I & II is that Type I
contains MMA monomer while Type II contains
BMA monomer .
Composition
Tissue conditioners
 Available as powder-liquid
 as preformed sheets of acrylic gel
 Powder- PEMA or copolymers
 Liquid –ethyl alcohol ( solvent )
-plasticizers- aromatic esters (dibutyl
phthalate / benzoyl benzoate )
Functions of plasticizer

Plasticizer usually are large molecular species.

Their distribution minimizes the entanglement
of the polymeric chains .

Permits individual chains to slip over each

other. This slipping motion provide rapid
changes in the shape of soft liner.

Provides cushioning effect

 These are mixed at chair side , placed in denture
fitting surface & then in patient’s mouth.
 Gelation of tissue conditioner –
physical process; no chemical reaction or
release of monomer , hence no tissue reaction.
Temporary nature of the tissue conditioner

 Leaching of alcohol & plasticizers

 Have to be replaced with fresh mix every 2-3 days
 Surface more prone to deterioration &
contamination
 Fouling by microorganisms
 Further irritating the already abused tissues
Temporary / short term / treatment soft liners

 These liners are intended for use as a part of

treatment for abused tissues until the tissues
revert to normalcy, permitting tissue changes
during healing.
 Remain elastic longer than tissue conditioners but
begin to deteriorate.
 Treatment resilient liners are used for a few days
up to a week; hence, these are also called
temporary soft reline materials.
Composition
Permanent/ long term soft liners
 These reline materials are used for extended
period from 6 months to 5 years.
 The addition of oils and plasticizers as copolymers
makes them resilient.
 When heat processed, they become hard, but they
are flexible in the oral cavity.
 Though termed permanent soft liners, these
materials need to be changed as they become
hard after extended use.
 Types of long term soft liners :
1. Autopolymerized silicone
2. Heat-polymerized silicone
3. Autopolymerized acrylic resin
4. Heat-polymerized acrylic resin
5. Vinyl resin
Composition

 Silicone-based lining materials are basically made

of dimethylsiloxane polymers . They do not contain
any plasticizer to produce softening effect.
 The PMMA liners are supplied as powder-liquid
systems
Powder- PMMA with acrylic copolymers & 60-
80% plasticizers
the plasticizers are not bound to the resin matrix
 Over a period of time, the plasticizers leach out
from the matrix. The liner tends to progressively
loose its flexibility and eventually becomes rigid.
 These hydrophilic polymers are a mixture of poly
(ethylene glycol methacrylate ) with diacetins
 The liquid contains MMA with aromatic esters and
ethanol.
 To reduce the amount of plasticizers, ethyl, n-
propyl, and n-butyl may be used instead of PMMA
to improve the flexibility.
 The vinyl resin liners are derived from polyvinyl
chloride (PVC) and polyvinyl acetate. These are
less used as they are prone to leaching and loss of
flexibility.
 Silicone liners with their inherent elastic properties
retain their flexibility without the use of plasticizers
for prolonged period.
 Chemically activated silicones are supplied as two-
component systems, which undergo condensation
polymerization.
 Heat-activated silicones are supplied as single-
component systems such as pastes or gel.
Relining procedures
Relining
procedures

Clinical Laboratory
procedures procedures

Functional Chair side Articulator

Static methods
methods technique method

Open mouth
Jig method
technique

Closed mouth Flask method

technique
CLINICAL PROCEDURES
STATIC METHOD- Open mouth technique – Carl .O.Boucher

Explains a method for relining maxillary & mandibular dentures at

the same time.

Impressions are made independently without utilizing the existing

centric occlusion.

Dentures are used as special trays for making the secondary

impression.( material of choice – ZnOE)

After the maxillary & mandibular impressions are made , a new

centric relation record is accomplished .

All these procedures are done in one appointment .

Open mouth technique

ADVANTAGES DISADVANTAGES

 Selective trimming helps to make  Difficult procedure

a selective pressure impression.  It requires more clinical &
 Making a separate inter-occlusal laboratory time
record will allow the operator to
concentrate on recording the jaw
relation
 It is possible to verify the centric
relation record if necessary
 The inter-occlusal record is
reliable
STATIC METHOD- Closed mouth technique

 Maxillary and mandibular relining should be done

separately.
 Various techniques are :
1. Technique A
2. Technique B
3. Technique C
4. Technique D
 Technique A requires recording a new centric relation
record using modeling wax or compound.
 Technique B, C & D use the existing centric relation
record in the existing denture.
Technique A- Shafer F.H & Miller W.H (1971)

 Centric relation: - a new centric relation record is

made using wax or modelling compound
 Denture preparation: -

•large undercuts are relieved

•borders are reduced 1-2 mm except the posterior
border of maxillary denture
 A part of the palate of the maxillary denture is

removed to aid in the proper positioning of the

denture when the final impression for the reline is
made.
 Border molding:- The borders of the dentures are
reformed to their functional contours by using low-
fusing modelling compound.
 Impression:- Zinc oxide-eugenol impression paste
is suggested as the impression material
 Light jaw closure on the interocclusal record is
maintained with the mandible in centric relation
until the final impression material has set.
 A fast-setting impression plaster fills the palatal
opening in the denture.
ADVANTAGES
 The opening of the palatal
portion will allow better seating
of the maxillary denture
 The premade interocclusal
record helps to position the
dentures
DISADVANTAGES
 The possibility of moving the
maxillary denture
 The wax inter-occlusal record is
not an accurate and safe record
 Relining of both dentures at the
same time
Technique B- Hansen N.J (1964)
 Centric relation: Existing centric occlusion and
intercuspation are used as a means to seat the dentures.
 Denture preparation : The same as for technique A.

 A large part of the palatal section is prepared to be

removed as follows:
•outline of the area should be indicated and deepened on
the polished surface up to half the thickness of the
base.
•Holes are drilled at 5- to 6-mm intervals inside this
groove
 This procedure is suggested for easy removal of the
palatal portion during packing and processing
 Border molding : Low-fusing modelling
compound (green stick) is suggested for border
molding.
 Impression: Impression wax is material of choice
in this technique
ADVANTAGES DISADVANTAGES

 It will reduce the possibility of  Wax impression material is

extreme forward movement of difficult to work with and the
the maxillary denture possibility of distortion exists.
 Errors of existing centric
occlusion can produce an
inaccurate impression.
Technique C- Christensen F.T (1971)

 Centric relation :The same as in technique B.

 Denture preparation : The same as in techniques
A and B.
 The labial and palatal flanges of the denture are
perforated.
 Border molding : The same as techniques A and
B.
 Impression: No specific impression material
recommended
 Pt is cautioned to use light force and only tap the
teeth together as occlusal pressure may squeeze too
much of impression material out of dentures
resulting in sore points.
Technique D- Jordan L.J(1972)

 Centric relation : The existing centric occlusion is

used to seat the maxillary denture.
 Denture preparation : The same as in the other
techniques.
 Impression : Plaster of Paris or zinc oxide eugenol
is suggested for the first step of impression making,
and plaster of Paris for the second step (the palatal
portions).
Position the denture in mouth with light upward and
slightly distal pressure to seat the denture.

Patient is directed into centric jaw relation and allowed to

gently tap the posterior teeth together to refine occlusion.

Manipulate lips and cheeks to produce proper border

registration.
 After impression making, a deep groove is cut into
labial and buccal surfaces of the denture at the junction
of the impression material and is filled with molten
wax.
 The wax at the edge of the denture is used to record
the sulcus
 Advantages – same as in technique A
 Disadvantages - the existing errors of centric occlusion
may produce some pressure points and a faulty
impression can result.
 Reseat the
denture in mouth
When impression & apply PoP to
material hardens the open area

Remove denture
from mouth,
remove excess
material
Closed mouth relining technique- mandibular
denture

Technique E- Gillis R.R (1960)

 Centric Relation:- Existing centric occlusion used

to seat dentures.

Loss of vertical
dimension is corrected by
luting softened modeling
compound to the occlusal
surfaces of posterior teeth
The record is chilled,
The patient is directed to
trimmed and slightly
repeatedly pronounce the
heated before returning it
letter ‘m’
to the patient’s mouth
 Lower wash
impression is Excessive
made and undercuts are
poured removed

Mounted on The denture is

articulator & luted to the
denture is maxillary in
removed is maximum
cleaned. intercuspation
 The amount of
vertical dimension
Softened modeling indicated by the
The mandibular
compound is placed thickness of the
denture at this stage
inside the compound on the
is used as a tray for
mandibular denture surface of
making the final
& articulator is mandibular teeth is
impression.
closed. transferred to base of
the mandibular
denture.
Advantages Disadvantages

 The loss of vertical dimension  Time consuming.

can be compensated for during  The procedure for establishment
relining procedures of occlusal vertical dimension is
questionable
FUNCTIONAL IMPRESSION TECHNIQUE

This technique is based

on the use of tissue
Patient is asked to not Old dentures are
conditioners for treating
wear the dentures examined for occlusal
the inflamed denture
overnight before relining errors and corrected until
foundation mucosa as
appointment C.O coincide with C.R
well as for making
impressions
CHAIR SIDE TECHNIQUE
 Leave the denture out for 3-5 days . Do necessary
denture preparation
 Relining material is mixed acc. to manufacturers
instructions and loaded to denture with an even
coating of 2 or 3 mm to entire tissue surface.
 Seat the denture in labial flange in labial vestibule
first and then seat the posterior of denture
 Do functional movements
 When resin begins to generate heat, place it in
warm water for 20 minutes.
 Do relining of opposing denture and finally correct
the occlusion
Disadvantages

 The materials often produce a chemical burn on the

mucosa.
 The result often was porous and developed a bad
odour.
 Colour stability was poor.
 If the denture was not positioned correctly, the
material could not be removed easily to start again
LABORATORY PROCEDURES
ARTICULATOR METHOD
Denture impression is poured in dental
stone
 Modeling clay is adapted on denture,
blocking out all the denture surfaces,
except occlusal surfaces of the teeth.

Stone is placed on the

lower member and
smoothed with
spatula. Denture is settled
in the stone mix.
Cast is attached to the upper member of Modeling clay removed from denture
the articulator with dental stone. surface
 All impression material must be
removed from the denture.

Thin layer of resin must be removed

from the inferior of the denture with the
acrylic bur.
 Borders are reduced 2-3mm with
bur.

Frena notches are deepened with

Straight fissure bur.
 Resin grindings removed with
stream of air

Posterior palatal seal is placed in the

cast, unless provided in impression
 Paint cast with tinfoil substitute

Mix autopolymerizing resin and place in

denture. Avoid air entrapment
 Place resin on cast and in border
reflections

Denture is seated in indentations,

and articulator is closed
 JIG METHOD

Stone index formed on lower

member of duplicator or jig.

Denture mounted on its cast in a reline jig with

stone and secured with locknuts
 Porcelain teeth replaced in their
indentations in the stone index

Adapt a layer of base plate wax to

cast and assemble the jig
 Wax-up the denture teeth to base plate
wax, remove cast, flask and process
with heat cure denture base resin.

Cured denture replaced on jig to check

occlusion, then finished and polished
FLASK METHOD

Denture is half flasked

Silicone mold material painted

on denture and teeth.
 Flask is opened

Porcelain teeth Resin teeth

REBASING
Definition
 A process of refitting a denture by the replacement
of the denture base material
 Rebasing is similar to relining except that there is
extensive replacement of the denture base material.
Indications & contraindications
 Similar to relining
 When tissue damage is excessive , the treatment
shifts from relining to rebasing.
 Rebasing should be done if the vertical dimension
of the patient is changed.
 Rebasing can be done properly only in dentures
with porcelain teeth.
Laboratory procedures
 Similar to relining – articulator, jig & flask method.
 Differs only in denture trimming prior to wax-up
 Denture trimming: after articulating or flasking ,
the denture is removed from the cast & the entire
denture base area is trimmed leaving just 2mm of
acrylic around the porcelain teeth.
 The acrylic is retained to preserve the positions of
the denture teeth, following which wax-up is done
 Processing , similar to relining.
REVIEW OF LITERATURE
 A comb inati on t echni que f or rel ining remo vabl e pro sthes es.
Se l ecm an, A . , & Ahuj a , S. ( 2017)

 A combined technique of using both the acrylic-

based and the silicone-based soft lining material
was proposed in this article. This technique for
overcoming the disadvantages of both the acrylic-
and silicone-based lining materials used in
combination shows promise to treat specific
complex reline cases requiring incremental layering
and short recall intervals.
 The acrylic lining material is applied first as it bonds to
the denture base. Subsequent layers of acrylic based
lining material is applied until the desired border
contours are achieved. A layer of resilient silicone
lining material is applied over the primed ABRL to
improve surface quality, sorption, and solubility,
resulting in less frequent maintenance intervals. This
technique is especially indicated when the tissue
contours are difficult to achieve in one application for a
transitional prosthesis requiring extended wear.
Oral health-related quality of life of edentulous patients after complete dentures relining

Krunic, N., Kostic, M., Petrovic, M., & Igic, M. (2015).

 The aim of this study was to determine the level of

patients’ satisfaction before and after relining upper
dentures with soft and rigid liners. The patients (n = 24)
were divided into two study groups. Maxillary denture
relining of the first group of patients was performed with
hard acrylic based resins while in the second group of
patients complete denture was relined with a silicone-
based soft liner. They were asked the questions from the
specifically adapted the Oral Health Impact Profile
Questionnaire for edentulous patients before and three
months after relining dentures.
 After relining the patients showed a higher degree of
satisfaction with their dentures in all the tested domains
(masticatory function, psychological discomfort, social
disability and retention and hygiene). The patients with soft
denture relines were more satisfied. It was concluded that
relining of maxillary complete dentures significantly
positively impacts the quality of life of patients in all the
tested domains (masticatory function, psychological
discomfort, social disability, pain and oral hygiene). Better
results were achieved using a silicone-based soft liner, which
recommends it as the material of choice for relining dentures.
Conclusion
 Resurfacing and replacement of the denture base of
a complete denture is a complicated procedure
requiring sharp clinical judgment and skill if the
therapy is to be successful.
 Relined or rebased dentures should be given the
same care as new dentures, and the patient should
be recalled as often as necessary for examination of
the tissues and the jaw relations.
REFERENCES
 Shaffer, F. W., & Filler, W. H. (1971). Relining complete dentures with minimum occlusal
error. The Journal of Prosthetic Dentistry, 25(4), 366–370. doi:10.1016/0022-
3913(71)90225-3 
 Hansen NJ: Rebasing and relining complete dentures: A technique. Dent Clin North Am
1964;8:693-704
 Jordan, L. G. (1972). Relining the complete maxillary denture. The Journal of Prosthetic
Dentistry, 28(6), 637–641. doi:10.1016/0022-3913(72)90114-x 
 Rudd K.D., Morrow M.R. : Dental laboratory procedures, complete dentures. 1 st edition 1986
 Phillips Science of Dental Materials. 10th edn, 1999.
 Winkler S. : Essentials of complete denture prosthodontics. 2nd edn, 2000.
 Swenson’s Complete denture: 5th edition.
 Selecman, A., & Ahuja, S. (2017). A combination technique for relining removable
prostheses. BDJ, 222(11), 841–843. doi:10.1038/sj.bdj.2017.490
 Krunic, N., Kostic, M., Petrovic, M., & Igic, M. (2015). Oral health-related quality of life of
edentulous patients after complete dentures relining. Military Medical and Pharmaceutical
Journal of Serbia, 72(4), 307–311. doi:10.2298/vsp1504307k