CONTENTS

 Introduction
 Definition
 Indications
 Contraindications
 Preparatory Phase
 Procedure
 Conclusion
 Bibliography
 INTRODUCTION
• Resorption of the residual ridge is inevitable and progressive.
Additionally, the denture base changes over time due to distension and
abrasion of the acrylic resin. The net result is a denture that becomes unstable
and eventually loosens to the point where the denture wearer feels
uncomfortable and inconvenienced.
• These changes cannot be entirely avoided, and the need for servicing
complete dentures to keep pace with the changing foundations becomes
mandatory which involves a refitting of the impression surface of the denture
by means of a reline or rebase procedure.
• Hence relining is performed for minimal or moderate tissue changes and a
thin layer of acrylic is added to existing denture base following impression
procedures. Rebasing is performed for more extensive tissue changes and the
entire denture base is changed following impression procedures. The clinical
and laboratory procedures involved in both relining and rebasing is similar and
they will be considered together.

DEFINITION
 Reline: The procedures used to resurface the tissue side of a removable
dental prosthesis with new base material, thus producing an accurate
adaptation to the denture foundation area (GPT8).
 Rebase: The laboratory process of replacing the entire denture base material
on an existing prosthesis (GPT8).

INDICATIONS
 Adaptation of the denture bases to the ridges is poor due to resorption of
the residual alveolar ridges.
 Patients with complaint of looseness or instability of dentures following a
long-standing history of comfort and satisfaction with the dentures.
 Three to 6 months after construction of immediate dentures.
 For geriatric or chronically ill patients when the construction of new
dentures can cause physical or mental stress.
 When the patient cannot afford the cost of new denture.
 Porous and discoloured denture base (rebasing is indicated).With
porcelain artificial teeth rebasing is indicated.
CONTRAINDICATIONS
 Excessive ridge resorption - make new dentures.
 Presence of abused soft tissues relining/rebasing is not indicated until the
tissues recover and return as closely as possible to normal form
 Temporomandibular joint problems - until accurate diagnosis and
treatment of the problem has been accomplished, relining or rebasing is
contraindicated.
 Dentures with poor aesthetics or unsatisfactory jaw relationships.
 Dentures with major speech problem.
  Presence of severe osseous undercuts.

PREPARATORY PHASE
 TISSUE PREPARATION
• Oral mucosa should be free of any irritation.
• The dentures should be left out of the mouth at least 2 or 3 days before
making the final impression.
• Any excessive hypertrophic tissue should be surgically removed.
• Removal of dentures at night and massaging of soft tissues
 DENTURE PREPARATION
• Border extension is checked and corrected.
• Undercuts are relieved.
• Occlusal disharmony is corrected by selective grinding.
• Pressure spots are adjusted
• Accurate posterior palatal seal established Procedure
1. Impression making
 Static and functional methods of relining and rebasing involve impression
making clinically using the existing denture followed by conversion of
the impression material to denture base material in the laboratory. .
Static Methods
 Open-mouth Techniques
Proposed by Boucher in 1973.Dentures are used as special tray for
making the final impression.
Tissue stops are prepared in the denture using low fusing compound to
maintain vertical dimension, occlusal plane and aesthetic position of anterior
teeth.
 The tissue surface and borders of the denture are trimmed by 1 mm .Borders
are moulded with low-fusing green stick compound Final impression is
made with ZOE impression paste. Impression of maxillary denture is made
followed by mandibular.
New CR record is made using interocclusal check methods.

Denture base marked for trimming - 1 mm

Advantages
 Selective pressure impression is made without any occlusal interference.
 Operator need not worry about jaw relation while making impressions, as a
separate record is made
 The CR record is verifiable.
Disadvantages
 Chances of increase in vertical dimension even though tissue stops are
provided
 High possibility of denture moving forward. Demanding and laborious
technique. Requires more clinical and laboratory time.
 Open mouth technique- border moulding with greenstick
 Closed-mouth techniques
• Dentures are used as special tray for making the final impression.
• The tissue surface and borders of the denture are trimmed by 1-2 mm,
except for posterior border of maxillary denture (similar to described in
open-mouth technique).
• Borders are molded with low-fusing green stick compound.
• Final impression is made with ZOE impression paste.
• The patient closes in centric occlusion on the opposing denture during
border molding and impression making
• Advantages
o Less chances of increased vertical dimension as patient closes in
centric occlusion.
o Takes less time o Chances of denture moving forward during
impression are less.
•


1.
 Disadvantages
Existing errors in centric occlusion can produce pressure points and an inaccurate
impression.
Hydrostatic pressure in palate during impression making and packing of acrylic
can still cause increase in vertical dimension.
To alleviate the above disadvantages, the following modifications were
suggested:
Making a new CR record before making the impressions and then asking the patient
to close in the CR record as the impressions are made.
Palatal portion is modified to reduce hydrostatic pressure during impression
making and packing (Outline of the area is grooved on polished surface holes
are drilled at 5-6 mm intervals on the groove)
Labial and buccal flanges of denture are perforation decrease pressure during
impression making and packing.

2.

3.
4. Use of impression wax instead of ZOE impression paste to make final impression,
but wax is difficult to work with and there is possibility of distortion.
 PERFORATION OF DENTURE AT LABIAL AND BUCCAL FLANGES,
PALATAL AREA (5-6mm INTERVALS ON THE GROOVES)
. FUNCTIONAL TECHNIQUE
o Simple, practical and popular method.

o Introduced by Winkler o Tissue conditioners are used as an impression material.

The method is similar to tissue conditioners procedure. The areas of the denture (like
occlusal surface), which are not to be contacted by the conditioning material, are
painted with a lubricants for ease of removal.
o The powder and liquid of the soft liner are mixed according to the manufacturer's
instructions and allowed to polymerize in the mixing cup.
o When the material is creamy and fluid, it is poured onto the tissue surface of the
denture, covering the entire denture base area o Armentarium:
o 1- mixing spatula o 2-droppler for monomer o 3-mixing jar o 4-powder measure o
5-polymer o 6-monomer o 7-lubricant
Application of lubricant on polished and occlusal surface o When material stops flowing
and reaches a dough stage, it is inserted in the patient's mouth
o patient is instructed to close in centric, maintaining vertical dimension.
o Active and passive methods of border molding are performed and also instructed
to perform functional movements like swallowing, speaking, smiling until the
impression reaches a more stable rubber-like state, which will normally take about
a minimum of 15 min.
o After removal from the mouth, the excess tissue conditioner is trimmed, voids are
corrected with new material and procedure is repeated . The patient is asked to use
the denture with the conditioning material. This will further functionally mold the
material
o Recall and maintenance is similar to that described for 'tissue conditioners'.
o When the patient returns after 3-5 days, the under extensions, denuded areas and
pressure spots are corrected by trimming and/or adding new material.
o The material is changed periodically till the tissues return to a state of health and
then the patient is scheduled for final impressions. A ZOE impression paste or
light-body wash impression is then made over the conditioning material and
verified. This method is similar to the 'functional reline technique' of making
complete denture impressions.
CHAIRSIDE TECHNIQUE
o Auto polymerizing acrylic resins are used for relining dentures directly in the
mouth. They are added to the denture base after necessary trimming, and allowed to
polymerize in the mouth. This is called instant chairside reline.
o Disadvantages
• Material is porous and has an unpleasant odor
• The excess monomer that leaches out may also irritate the mucosa.
• The exothermic heat produced can burn the mucosa.
• Poor color stability.
• If not positioned correctly, it can lead to gross discrepancies.
• Because of all these problems, this technique is not recommended except for
replacing a very small part of the denture
LABORATORY PROCEDURES
• Differentiating feature: is in the amount of old denture base removed and
replaced. For rebasing the entire denture base is eliminated excepting the teeth and
may be 2 mm of adjoining denture base.
• METHODS:
• FLASK METHOD
• The relined impression is poured with dental stone.
• The master cast is poured around the impression similar to the original master cast
made by beading and boxing This cast provides the surface against which the denture
is relined by embedding it in a processing flask.
• The flask is warmed to soften the impression compound before opening it to
remove the impression material .
• Separating medium is applied on the plaster and stone molds, and heatpolymerized
denture base resin is packed into the mold.
• The flask is closed and clamped to ensure maintenance of occlusal vertical
dimension. The acrylic is then processed. After processing, the flask is cooled slowly
and the denture is retrieved from the stone mold, finished and polished.
ARTICULATOR METHOD
o A master cast is poured similar to the previous method. The cast is not separated
from the impression.
o A layer of plaster is arranged in platform fashion on the lower member of the
articulator.
o Then the cast with the relined impression is placed on the wet plaster platform
such that the teeth penetrate the plaster surface to a depth of 2 mm and the
occlusal plane is parallel to the floor. This forms an index or key of the teeth on
the plaster platform which allows repositioning of the teeth maintaining the
distance and relation with the cast
o Once the plaster platform sets, additional plaster is placed on the base of the cast
and it is mounted on the upper member of articulator.
o When the mounting sets, the articulator can be opened and the denture with
impression is separated from the cast. At this point one may elect to rebase or
reline the denture. It differs only in the amount of trimming of denture.
o The denture base is waxed , cast and denture are removed from the mounting,
flasked and processed with heat-cure denture base acrylic resin.
JIG METHOD
o Definition: Jig is a device used to maintain mechanically the correct positional
relationship between a piece of work and a tool or between components during
assembly or alteration (GPT8).
o Procedure is similar to that using an articulator. Seat the occlusal surface of the
denture on the plaster platform on lower member of relining jig.
o stone index is made o mount the denture with the cast to the upper member in
reline jig similar to articulator method.
o Open the jig, remove the teeth from denture base and adapt baseplate wax on the
cast and wax the denture
o After processing, replace the cured denture, check and correct occlusion using the
indentation made in the jig during mounting of denture.
o Alternatively a Hooper's duplicator can also be used. It is similar to the Jig method.
INSERTION, RECALL AND MAINTENANCE
o The insertion procedure for a relined or rebased denture is similar to evaluating any
new complete denture during its insertion. Since patient is an old denture wearer,
much time need not be spent on patient instructions. Recall and maintenance is also
similar.

o
 CONCLUSION
Changes like resorption of alveolar ridge, abrasion of acrylic cannot be entirely avoided,
and the need for servicing complete dentures to keep pace with the changing foundations
becomes mandatory which involves a refitting of the impression surface of the denture by
means of a reline or rebase procedure.
 BIBLIOGRAPHY
• Textbook Of Prosthodontics V Rangarajan and TV Padmanabhan, Second Edition