Relining & Rebasing

Contents
 Introduction
 Definitions
 Indications and contra indications
 Diagnosis
 Preliminary treatment
 Techniques
 Bibliography
INTRODUCTION
Materials used in complete denture prosthodontics are
vulnerable to certain changes,because the denture may
discolor or deteriorate and the artificial teeth can fracture
or become abraded.
Meticulous attention and care in the construction of
complete dentures will minimize adverse changes in the
supporting tissues and associated facial structures as well.
The clinical efforts that aim at prolonging the useful life of
complete dentures involve in refitting of the impression
surface of the denture by means of a reline or a rebase
procedure.
Definition
 Reline:- the procedures used to resurface
the tissue side of a denture with new
base material,thus producing an accurate
adaptation to the denture foundation
area.
 Rebase:- the laboratory process of
replacing the entire denture base material
on an existing prosthesis.
Treatment Rationale:
The denture foundation changes adversely as a result of
varying degrees and rates of residual ridge
resorbtion. These changes are insidious and rapid,
but they are progressive and inevitable, and are
usually accompanied by one or more features:
1. Loss of retention and stability.
2. Loss of vertical dimension of occlusion.
3. Loss of support of facial tissues.
4. Horizontal shift of dentures: incorrect occlusal
relationship.
5. Reorientation of occlusal plane.
Treatment Rationale:
The magnitude of observed clinical changes allows
a decision to be made as to whether the
prescribed resurfacing will necessitate a reline
or a rebase.
Observed clinical changes:
1. Loss of retention and stability.
2. Loss of vertical dimension of occlusion.
3. Loss of support of facial tissues.
4. Horizontal shift of dentures: incorrect occlusal
relationship.
5. Reorientation of occlusal plane.
Reline Minimal to moderate Moderate to maximal Rebase
Treatment Rationale:
The resultant spatial reorientation of the dentures
on their supporting tissues and occlusal surfaces
leads to changes in circum oral support and,
consequently, in the patient's appearance.
The changes in occlusal relationships also induce
more adverse stresses on the supporting
tissues,which weightens the risk of further ridge
resorbtion.
Diagnosis:
A through diagnosis of the changes must be made before any clinical
procedures are started. It is necessary to determine the nature of the
changes as well as their extent and location.
Patients who have worn dentures successfully for a long time often return
for their service because of looseness, soreness, chewing inefficiency,
or esthetic changes. These difficulties may have been caused by
1. An incorrect or unbalanced occlusion that existed at the time of
dentures were inserted.
2. Changes in the structures supporting the dentures that may or may not
have been associated with a disharmonious occlusion. So it is essential
that the cause of the difficulties must be corrected before the treatment
is started
Diagnosis:
Dentures with built in errors in occlusion may not need relining.
They may need only to have the occlusion corrected.
If the occlusion has induced a gradual loss of retention, tissue
rest followed by a new CR record with remounting and
regrinding will eliminate the cause and make the dentures
comfortable and serviceable without relining.a change in the
basal seat of the dentures usually is revealed by looseness,
soreness, inflammation, loss of Occlusal Vertical Dimension,
esthetics.
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 vertical dimension
should be suspected. Unsatisfactory changes in
esthetics indicates a loss of vertical dimension, even
though the teeth may seen to occlude properly. If
the supporting tissues are traumatized, surgical
correction to eliminate the hyperplasia may be
necessary before relining impressions are made.
 Diagnosis:
Shrinkage of the bone of the maxilla usually permits the upper denture to move
up and back in relation to its original position. However the occlusion also may
force the maxillary denture forward. The lower denture usually moves
downward and forward, but it may move down and back relative to the
mandible as shrinkage occurs.
Concurrently, the mandible moves to a higher position when the teeth are in
occlusion than it occupied with the teeth in occlusion before the shrinkage
occurred. This movement is rotary around a line approximately through the
condyles. This mandibular rotation can elicit severe damage in the denture
supporting tissues over a long period of unsupervised denture wear.
It also must be determined whether shrinkage of the jaws has been uniform
under both dentures or whether one ridge has been destroyed more than the
other. Greater shrinkage in one arch will change the orientation of the occlusal
plane. This will cause occlusal disharmony in eccentric occlusion, even though
the Occlusal Vertical Dimension has been re established by relining.
Indications: Relining & Rebasing
 Immediate dentures at three to six months after their
construction.
 When the residual alveolar ridge have resorbed and the
adaptation of the denture bases to the ridges is poor.
 When the patient cannot afford the cost of having the new
dentures constructed.
 when the construction of new dentures with the
accompanying series of appointments can cause physical or
mental stresses, such as for geriatric or chronically ill
patients.
General considerations:
A thorough examination of the patient and the existing dentures
must be accomplished before commencing therapy :
1. OVD should be satisfactory.
2. Co should coincide with CR.
3. The patients appearance must be acceptable to the patient
and the dentist. The size, shape, shade and arrangement of
the artificial teeth must be satisfactory.
4. The oral tissue must be in optimum health.
5. The posterior limit of the maxillary denture is correct.
General considerations: contd ………

6. The denture base extensions are adequate.

7. The denture base extensions ensure distribution of
masticatory forces over a large area as possible.
8. The inter occlusal distance is correct.
9. Speech is satisfactory with the existing teeth arrangement.
10. There are no hard or soft tissue conditions that would
preclude the technique, such as redundant tissue or severe
bony undercuts.
Contraindications:
1. When an excessive amount of resorbtion has taken
place.
2. When abused soft tissue are present.
3. When the patient has TMJ problems.
4. Denture with poor esthetics or unsatisfactory jaw
relations.
5. Dentures with major speech problem.
6. Severe osseous undercuts.
RELINING / REBASING

TECHNIQUES:-

Clinical Procedures:
Tissue Preparation:

Excessive hypertrophic tissue should be surgically removed.

The oral mucosa must be free of irritations.
Removal of the dentures from the mouth during sleep is a must
for several weeks before treatment commences.
The dentures should be left out of the mouth at least two to three
days before making the final impression.
Daily massage of the soft tissues is helpful to stimulate their
blood supply.
Denture preparation:
1. Pressure areas on the soft tissue surface of the
dentures should be relieved.
2. Minor occlusal disharmony is corrected by
selective grinding.
3. Small border inadequacies are corrected.
4. A correct posterior palatal seal area should be
established before the final impression.
Principal pitfalls:
1. Do not increase the OVD.
2. Multiple even contacts(maximum intercuspation) must be
present in centric relation.
3. Do not allow the maxillary denture to move forward during
impression making.
4. Ensure that centric occlusion and centric relation are
identical.
5. Ensure that accurate posterior palatal seal has been
established.
6. Equal thickness of final impression material should be
used.
Impression procedures:

The clinical relining or rebasing can be

achieved by-
1. Static impression technique.

Closed mouth Open mouth

2. Functional impression technique.

Static Impression Technique :
Closed mouth technique:
The dentures are used as impression trays, normally the
existing centric occlusion is employed to the denture with the
lining impression material or else the CR is recorded (in the
registration medium of choice) before the impressions are
made.
Open mouth technique:
Relining/rebasing of both maxillary and mandibular dentures
can be done at the same appointment.
The dentures are used as trays for making new impressions.
The existing CO is not utilised, and a new CR record is
obtained after the impressions are made.
Functional Impression technique:
This method is simple and practical. Often one may see
a variable hyperemia of mucosa accompanied by
sore spots in the denture bearing mucosa.
The denture is observed intraorally to asses the need
for peripheral reduction or extension, and a posterior
palatal seal extension is developed with modeling
compound on maxillary dentures.
If extensive ridge resorbtion and overt loss of V D of
occlusion have occurred, three compound stops may
be required on the impression surface of the denture
to reestablish proper occlusal relationship or to
improve the occlusal plane orientation.
Functional Impression technique:
A treatment liner is next placed inside the denture.
The lining material should flow evenly to cover the
denture with a thin layer.
If voids are evident, they should be filled with new mix
of liner material.
Unsupported liner material may occur on the borders,
and this indicates border molding with green stick
compound. Or else the material has a slumping
tendency when unsupported.
 Functional Impression technique:
Tissue conditioner materials are used.
This material sets in three stages.

Plastic Stage :Denture base responds to functional/parafunctional

stresses; fit is improved.

Elastic Stage : Stress is cushioned and tissue recovery takes place.

Firm Stage : Surface similar to polymerized resin, except it is

vulnerable to deterioration.
Functional Impression technique:
Precautions:
 Pour the cast when the material reaches the firm
stage.
 Peripheral or surface deterioration can occur.
 Voids con occur during placement of material in the
denture.
Denture Lining Materials
Denture lining materials are of several types and are
used for variety of reasons. Either the whole of the
denture base can be replaced with fresh heat curing
acrylic resin, or a lining of a self curing may be
applied to the fitting surface of the existing base.
Some times it is necessary to apply a very soft material
to the fitting surface of a denture in order to act as a
‘cushion’ which will enable traumatized soft tissue
to recover before recording an impression for a new
denture.
Classification:
The materials can be classified into 3 groups:

 Hard reline materials.

 Tissue conditioners.

 Soft lining materials.

Hard reline material:
The materials are used to provide a chair side reline to
the denture.
Composition:
The materials are generally supplied as a powder and
liquid which are mixed together.
There are two types according to the composition, they
are Type I and Type II . The major difference
between them is that the liquid in type I contains
MMA monomer, while in type II the liquid contains
BMA monomer. Both the materials are classified as
autopolymerizing resins.
Composition of typical hard reline materials.
Hard reline material:
Manipulation:
Relieve the fitting surface of the denture.
Mix powder and liquid in 1:2.5 to attain a fluid mix.
Applied to the fitting surface of the denture and seated
in patients mouth whilst still fluid.
The reline soon becomes rubbery and the impression of
the patients soft tissue is recorded.
The denture is allowed to bench cure after removal
from the patients mouth. Warm water will accelerate
the curing.
The relined denture is ready within 30 minutes.
Hard reline material:
Properties:
Type II is less irritant than Type I.
Both the types have lower glass transition temperature
(Tg). Therefore the plasticizer in Type I and higher
methyl acrylates in Type II are added. So this will
lead to increased dimensional stability in the relined
denture(particularly, if the denture has been relieved
in order to accommodate the lining.
Hard reline material:
Disadvantages:
Direct contact of the material in the oral cavity leads to
irritation and sensitization.
Reline materials are often porous due to air inclusions.
Easily colonized by microorganisms including
Candida albicans. Difficult to clean.
Increase in thickness of the denture and reducing the
free way space.
This material should be considered as semi permanent
solution to the problem of an ill fitting denture.
Tissue Conditioners:
Tissue conditioners are soft denture liners. They are used to
provide a temporary cushion which prevents the
masticatory loads from being transferred to the
underlying soft and hard tissues.
Traumatized soft tissue due to wearing an ill fitting denture.
Applied on dentures of patients who have undergone
surgery, extraction.
To fill the gap to assist with stabilization of the prosthesis at
the same time of the insertion of the immediate denture.
Used as a functional impression material.
Tissue Conditioners:
Requirements:
 Should remain soft during use in order to maintain
cushioning effect.
 Material should be resilient, that the masticatory
loads can be absorbed without causing permanent
deformation of the lining.
 When these materials are being used to obtain a
functional impression a degree of permanent
deformation ender load is required. This enables the
impression of the soft tissue to be altered during
normal function.
Tissue Conditioners:
Composition:
Supplied as powder and liquid components and are
mixed together.
Powder – polymethylmethacrylate – polymer beads.
Liquid - Ehtyl alcohol - solvent.
- Butylpthalyl butylglycolate - plasticizer.
The relative amounts of plasticizer and solvent vary
from one product to another. These variations
control the softness and elasticity of the set material.
Pigment may also be present to give a pink color.
Tissue Conditioners:
Composition: contd...
The liquid component contains no monomer and the powder has
no initiator. When the powder and the liquid are mixed
together, a purely physical process occurs. The solvent
dissolves the smaller polymer beads and the larger beads
become swollen with solvent and acts as a carrier for the
plasticizer. The final set material is gel like, with swollen
plasticized spheres being cemented together with a matrix
which is a saturated solution of polymer in a solvent /
plasticizer mixture. The softness of the material is due to the
use of higher methacrylate, ethyl methacrylate, coupled with
considerable quantities of plasticizer and solvent.
Tissue Conditioners:
Manipulation:
Powder and liquid mixed and applied to the fitting
surface of the denture.
This material undergoes through
Plastic stage - few hrs – few days.
Elastic stage - 1 – 2 weeks.
Firm stage - after 15 days.
Tissue Conditioners:
Properties:
These materials are soft and viscoelastic, therefore
these materials are able to perform the functions of
both a tissue conditioner and functional impression
material.
They do not permanently remain soft since the alcohol
and plasticizer are leeched rapidly into saliva.
The elastic nature of the material is time dependent.
They are non irritant due to the absence of acrylic
monomers from the liquid component.
Soft Lining Materials:
Soft or plasticized acrylic, vinyl polymers copolymers,
as well as natural and silicone rubber products have
been used as soft denture liners.
Suggested for patients with abused denture bearing
mucosa, areas of severe undercuts, or congenital or
acquired defects of the palate.
Some materials have an inhibitory effect on Candida
albicans.
They are of *Temporary / mouth cured soft liners.
*Permanent / processed soft liners.
Soft Lining Materials:
Desired Properties:
 High bond strength to the denture base.
 Dimensional stability of the liner during & after
processing.
 Permanent softness or resilience.
 Low water sorption therefore reduced leeching of
plasticizer and solvent into saliva.
 Color stability.
 Ease of processing.
 Biocompatibility.
Temporary Soft Lining Materials :
These materials are similar to the tissue conditioners.
These are used for short periods (up to several weeks)
to improve the comfort and fit of an old denture until
it can be remade or permanently relined.
They are not as soft as tissue conditioners, but they
retain their softness for a longer time.
They are also viscoelastic, give cushioning effect.
Oxygenating type of cleansers cause surface
degradation and pitting of the material.
Temporary Soft Lining Materials :
Used as a means of temporarily improving the fit of an ill-
fitting denture until a new denture is constructed.
As a diagnostic aid to ascertain whether the patient would
benefit from a permanent soft lining.
Both the tissue conditioners and temporary liners go hard.
When this occurs the surface is both rough and irregular,
increasing the risk of trauma.
Manipulation is similar to that as tissue conditioners.
Simple rinsing with water is better than using peroxide based
denture cleansers.by soaking the denture over night in
diluted sodium hypochlorite help to minimize infection
risk.
Permanent Soft lining Material:
Permanent soft lining materials are used for patients
who cannot tolerate a hard base.
If the patient has an irregular mandibular alveolar ridge
covered by a thin and a non resilient mucosa, it may
be very painful when a masticatory load is applied
through a hard base on to this type of supporting
tissue. In such cases, a permanent soft lining is done
to increase patient comfort and acceptance of the
denture.
Permanent Soft lining Material:
Requirements:
 Permanently soft.
 Cushioning effect.
 Prevent unacceptable distortions during service.
 Lining should adhere to the denture base.
 Non-toxic, non-irritant.
 It must prevent growth of harmful bacteria and
fungi.
Permanent Soft lining Material:

D e n tu re s o ft R e l i n e rs

A c ry l i c S ilic o n e P o ly p h o s p h a z in e

C o l d c u re H e a t c u re C o l d c u re H e a t c u re

C o n d e n s a ti o n A d d it io n
Permanent Soft lining Material:
Those products described as cold curing acrylic materials
temporary soft lining materials.
Heat curing acrylic materials are processed in the lab and are
normally applied to a new denture at the time of
production. They are supplied as powder and liquid.
Softness rely on the combined use of higher methacrylate
and a plasticizer. A typical powder consists beads of
polyethyl or polybutylmethacrylate along with some
peroxide initiator and pigments. The liquid consists of
butylmethacrylate and plasticizer . Powder & Liquid mixed
to for a dough which is heat processed simultaneously with
the hard acrylic base.
Permanent Soft lining Material:
A similar technique is used when applying a heat
curing silicone soft lining. These products are
supplied in a single paste which contains poly-
dimethylsiloxane polymer with pendent or terminal
vinyl groups through which cross linking takes
place. The liquid polymer is formulated into a paste
by adding inert fillers such as silica. The paste also
contains free radical initiator such as peroxide which
breaks down on heating to initiate cross linking
reaction. These vinyl groups undergo chain
extension cross linking. This results in elasticity of
the material.
Permanent Soft lining Material:
The two types of cold curing silicones elastomers are
used as soft lining materials. They are analogous to
addition and condensation curing impression
materials.
Condensation types are supplied as a paste & liquid.
The paste contains poly-dimethylsiloxane liquid
polymer and inert filler. The liquid contains a
mixture of cross linking agent, such as tetraethyl
silicate and a catalyst, an organo-tin compound such
as dibutyl-tin-diluarate. On mixing the paste and
liquid a condensation cross linking reaction takes
place.
Permanent Soft lining Material:
Alcohol is produced as a by product of this reaction.
Cross-linking causes the paste to be converted in to a
rubber.
The addition curing silicones are supplied as two
pastes which are proportioned and mixed using a
cartridge or a gun system. There is cross linking
between the two prepolymers.
Cold cured are cured at room temperature.
Permanent Soft lining Material:
Polyphosphazine fluoroelastomers are recently
available. They are supplied in sheet forms and are
manipulated in a similar to the heat cured silicone
products. Recommended curing is either at 74`C for
8hrs or 74`C for 2 ½hrs, followed by 100`C for
30min.
Permanent Soft lining Material:
Properties:
All types of soft lining materials are sufficiently soft on
insertion to give an adequate cushioning effect.
The softest of the four materials initially are the cold curing
acrylic materials.these products become harder faster due to
loss of alcohol and slow leeching of plasticizer.
The silicone materials remain permanently soft, modulus of
elasticity may decrease due to water absorption.
The durability of bond between denture ant the lining material is
adequate for the acrylic materials and the heat cured silicone
products.
2-3 mm of thickness is required for ideal cushioning effect.
CLOSED MOUTH RELINE TECHNIQUE

Maxillary Denture
Shaffer FW & Filler WH Relining tech:
Centric Relation: CR is recorded before the impression
is made, using modeling compound or wax.
Denture Preparation: the denture is prepared before
making the impression by relieving 1.5 – 2 mm
from the tissue surface. The borders are reduced 1 –
2 mm except the posterior border of the maxillary
denture.
Special suggestion: A large portion of the mid palatal
portion of the maxillary denture is removed for
visibility in positioning the denture during
impression making.
Shaffer FW & Filler WH Relining tech:

Border molding:the borders of the dentures are

reformed to their functional contours by low fusing
modeling compound.
Impression: Zinc oxide euginol is used as the
impression material. During the border molding and
impression making, the patient closes lightly into the
premade interocclusal record.
Shaffer FW & Filler WH Relining tech:

Advantages: The opening of the palatal portion will

allow better seating of the maxillary denture and
alleviate the increase in vertical dimension pitfall.
The premade interocclusal records helps
to position the dentures during impression making
and to orient the dentures on the articulator.
The two step technique will reduce the
possibility of moving of the maxillary denture
forward during the final impression making.
Shaffer FW & Filler WH Relining tech:

Disadvantages: The possibility of moving the

maxillary denture is still a major problem.
The wax interocclusal record is not an
accurate and safe record that the patient can close on
several times with out the possibility of damaging
the record.
This technique does not suggest any
solution for difficulties of relining both dentures at
the same time.
Hansen NJ relining method:
Centric relation: Existing CO and intercuspation are used as a
means to seat the dentures.
Denture Preparation: The denture is prepared before making the
impression by relieving 1.5 – 2 mm from the tissue surface.
The borders are reduced 1 – 2 mm except the posterior border
of the maxillary denture.
Special suggestion: A large part of palatal section is prepared to be
removed as follows:
1. The outline area should be indicated and deepened on the
polished surface up to half the thickness of the base.
2. Holes are drilled at 5 – 6 mm intervals inside the groove.

This procedure is suggested for easy removal of the palatal portion during
packing and processing.
Hansen NJ relining method:
Border molding:the borders of the dentures are
reformed to their functional contours by low fusing
modeling compound (green stick compound).
Impression: A wax that flows at mouth temperature,
such as Kerr’s impression wax(lowa wax) is the
material of choice in this technique. The impression
is made in two steps. The impression of the labial
flange and the crest of the alveolar ridge between the
canines is made as a second step.
Hansen NJ relining method:
Advantage: The two step impression technique will
reduce the possibility of extreme forward
movementof the maxillary denture.
Disadvantage:
1. Wax impression material is difficult to work with
and possibility of distortion exists.
2. Errors of existing centric occlusion can produce an
in accurate impression.
Christensen method for relining:
Centric relation: Existing CO and intercuspation are
used as a means to seat the dentures.
Denture Preparation: The denture is prepared before
making the impression by relieving 1.5 – 2 mm
from the tissue surface. The borders are reduced 1 –
2 mm except the posterior border of the maxillary
denture.
Christensen method for relining:
Special suggestion:The labial and palatal flanges of
the denture are perforated, these perforations will
decrease the pressure during impression making
procedure, thereby preventing displacement of
maxillary denture.
Border molding:the borders of the dentures are
reformed to their functional contours by low fusing
modeling compound (green stick compound).
Christensen method for relining:
Impression : No specific impression material is
suggested.
Advantages: Reduced movement of the maxillary
denture during impression making.
Disadvantages:
The possibility of moving the maxillary denture is
still a major problem.
This technique does not suggest any solution for
difficulties of relining both dentures at the same
time.
Relining by Jordan LG:
Centric relation: Existing CO and intercuspation are
used as a means to seat the dentures.
Denture Preparation: The denture is prepared before
making the impression by relieving 1.5 – 2 mm
from the tissue surface. The borders are reduced 1 –
2 mm except the posterior border of the maxillary
denture.
Relining by Jordan LG:
Special suggestions:
1. The denture periphery should be shortened to create a flat
border.
2. A large opening shoud be prepared in the palatal portion of
the denture.
3. Adhesive tape is attached over the buccal and labial
surfaces of both dentures 2mm away from the denture
borders.
4. With a knife edge stone, a fairly deep groove should be cut
into the buccal and labial surfaces of the dentures at the
junction of the impression material and filled with molten
base plate wax.
Relining by Jordan LG:
Border molding: Border molding has not been
suggested, but during impression making it has been
emphasized that a slight amount of impression
material should be left on the flattened borders.
Impression: Zinc oxide euginol is suggested for the
first step of impression making, and impression
plaster for the second step (palatal portion).
Relining by Jordan LG:
Advantages: The opening of the palatal portion will
allow better seating of the maxillary denture and
alleviate the increase in vertical dimension pitfall.
The two step technique will reduce the
possibility of moving of the maxillary denture
forward during the final impression making.
Disadvantages: Though it has been suggested that the
patient should not seat the denture by closing on it,
the existing errors of CO may produce some pressure
points and a faulty impression can result.
CLOSED MOUTH RELINE TECHNIQUE

Mandibular Denture
Gillis RR Relining technique:
Centric Relation: The existing CO(intercuspation) is
used as a means to seat the mandibular denture
during secondary impression. The occlusion is
corrected during the establishment of a new occlusal
vertical dimension.
Denture preparation: if required, not mandatory.
Gillis RR Relining technique:
Special suggestions:Loss of VD is corrected by luting
softened modeling compound to the occlusal surface
of the mandibular posterior teeth. The patient is
directed to repeatedly pronounce the word “m”. The
record is chilled, trimmed and slightly heated before
returning it into the patients mouth. The procedure is
repeated until the OVD is established to operators
satisfaction. Then a lower work impression should
be made. After pouring an inpression and mounting
the lower denture on an articulator, the lower denture
should be removed and cleaned.
Gillis RR Relining technique:
Any excessive undercuts should be removed. The
denture is luted to the maxillary denture in maximum
intercuspation. Softened modeling compound is
placed inside the mandibular denture and the
articulator closed against the lower cast to contact
the incisal guide pin. With this procedure, the
amount of VD indicated by the thickness of the
compound on the surfaces of the mandibular teeth is
transferred to the base of the mandibular denture.
The mandibular denture at this stage is used as a tray
for making the final impression.
Gillis RR Relining technique:
Impression: Green stick compound for border molding, and zinc
oxide euginol for making the secondary impression are
suggested.
Advantages:
1. The loss of VD can be compensated during the relining
procedures.
2. The error in CO can be reduced during the laboratory stages.
Disadvantages:
1. Time consuming, both laboratorial and clinical standpoint..
2. The procedure for establishing OVD is highly questionable.
 OPEN MOUTH
IMPRESSION TECHNIQUE:
Relining for maxillary and mandibular dentures at
the same time.
After the maxillary and mandibular impressions are
made, a new centric record is established.
All in single appointment.
CO Boucher’s technique:
Centric relation: Utilizing both dentures as recording
bases, the jaw relation record is established after
making the secondary impressions of both the
dentures.
Denture preparation: A posterior palatal seal is
formed in modeling compound on the maxillary
denture before any other changes are made on the
tissue side of the denture. 1mm space is provided
inside the denture for the impression material. The
borders are shortened 1mm to allow space for
impression material to form a new border.
CO Boucher’s technique:
Special suggestion: The lower denture is prepared for
the reline impression in exactly the same way as a
trey would be prepared for making a new denture.
The buccal surfaces of the lingual flanges are ground to
minimize the pressure against the mylohyoid ridges
and between the tissues of the floor of the mouth and
the buccal sides of the lingual flanges. The lingual
flange between the premylohyoid eminences is
shortened by 1mm.
CO Boucher’s technique:
The labial flange between the buccal notches is
shortened by 1mm. Two grooves are cut on the
buccal sides of the lingual flange to facilitate the
removal of the retromylohyoid eminence after the
cast is poured.
A modeling compound handle formed over the lower
anterior teeth, facilitates handling the denture when
it is carried to the mouth. Adhesive or masking tape
is adapted over the polished surface of both dentures,
and the teeth.
CO Boucher’s technique:
Border molding: If flanges are inadequate, the borders
should be corrected with modeling compound.
Impression: Zinc oxide euginol is suggested i.e.,
exactly 15 sec after the denture has been placed in
the mouth, the patient is asked to pull his lip down
and to open hos mouth wide. These actions mold the
impression material over the border of the denture.
The upper denture is laid aside until the lower
impression has been made.
CO Boucher’s technique:
Advantages:
1. Special trimming of the denture and making room
for the impression material will facilitate the making
of a reasonable impression during the selective
pressure impression technique without any occlusal
interference.
2. A separate interocclusal record using already made
impressions as the recording bases will allow the
operator to concentrate on recording the jaw
relation.
3. It is possible to verify CR record.
4. The inter occlusal record, is reliable.
CO Boucher’s technique:
Disadvantages:
1. Although this technique seems simple, the
performance of the procedures is not easy.
2. This technique requires more clinical and
laboratory time.
Winkler’s technique :
 Patient must be educated concerning the procedures
and especially about not wearing dentures overnight.
 Old denture should be closely examined and errors
of occlusion corrected, until satisfactory centric
occlusion is achieved which should coincident with
centric relation.
 The basal surface of the denture is reduced to allow
room for the tissue conditioning material.
 The surface is dried before the placement of the
material.
Winkler’s technique :
 A minimum thickness of the tissue conditioning
material is placed over the tissue surface of the
denture and evenly distributed.
 The denture is then inserted in the mouth with proper
antero-posterior relationship.
 The patient is instructed to tap the teeth together
lightly, to position the denture, and to hold the teethe
together lightly for three minutes.
 Then the patient is engaged in conversation or to
read out loudly for additional 5 min.
Winkler’s technique :
 The denture is removed from the patients
mouth and excess is removed from the
polished surface.
 The basal surface is inspected. If any pressure
spots seen, must be relieved and more
material is added by brush on technique.
 Voids must be avoided during the loading of
material. If seen remove and add fresh mix.
 Over extended borders must be removed.
Winkler’s technique :
 Then reinserted in the patients mouth, and the patient
is sent. And called after 15 days ie. After the
material has attained the firm stage.
 The material is reviewed periodically, never allow
the material to become a source of irritation.
 When the tissue has returned to normal healthy state,
the patient is scheduled for impression making.
 At this time a zinc-oxide euginol impression or a
light bodied polysulfide rubber wash impression also
can be made.
Winkler’s technique :
Laboratory Procedure:
 The impression is boxed and the cast is poured in
artificial stone.
 Mount the cast on a semi adjustable articulator using
a face-bow transfer record.a jig can also be used.
Even though it is easier than the articulator, it is less
accurate, especially when additional occlusal
adjustments are required.
 Relate the mandibular denture to the maxillary
denture, which is already on the articulator using an
interocclusal record.
Winkler’s technique :
 If any occlusal discrepancy exists, it should be
corrected before separating the impressions from the
casts, by using selective grinding procedure.
 The procedures of relining and rebasing are same
until this stage. During the laboratory phase of a
rebasing procedure, all of the old denture base is
replaced by new material without changing the
arrangement of teeth.
 when the dentures are finished, plaster plaster
remount casts are made and the maxillary cast
mounted on the articulator.
Winkler’s technique :
Insertion procedure:
 A pressure indicating paste is used to locate pressure
areas. They are carefully relieved by grinding with
mounting stones.
 A new interocclusal record is used to mount the lower
denture in centric relation.
 Mounting must be verified before adjusting the
occlusion.
 the occlusion must be perfected at the correct OVD
using selective grinding procedure.
 Before dismissing the patient the occlusion is again
checked.
Conclusion
 Resurfacing and replacement of the denture base of a
complete denture is a complicated procedure requiring
astute clinical judgment and skill if the therapy is to be
successful. Often, the fabrication of new dentures utilizing
a sound technique should be the treatment of choice,
especially when the denture bases are under-extended;
when there has been a gross loss in the occlusal vertical
dimension, and when centric relation and centric occlusion
do not coincide Utilization of fluid resins (tissue
conditioning material) presently seems to be the material
of choice to ensure success with restoration of masticatory
efficiency