Relining & Rebasing

RELINING AND REBASING
Sanjeevini G S
II MDS
1
CONTENTS
 Introduction
 Definitions
 Indications
 Contraindications
 General considerations
 Techniques
 Review
 Conclusion
 References
2
INTRODUCTION
• The residual ridges have been described as plastic in nature, always

changing in topography and morphology
• The net result is a denture that becomes unstable and eventually
loosens to the point where the denture wearer feels uncomfortable.
• These changes cannot be entirely avoided, & the need for servicing
complete dentures to keep pace with the changing foundations involves
a reline or rebase procedure.
3
Essentials of complete denture prosthodontics by Sheldon winkler 3rd edition
DEFINITIONS
Reline : 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.
Rebase : the laboratory process of replacing the entire denture base
material on an existing prosthesis
4
Glossary of prosthodontic terms - 9
INDICATIONS
Immediate dentures 3-6 months.
Resorbed residual alveolar ridges
When the patient cannot afford.
Physical or mental stress.
Essentials of complete denture prosthodontics by Sheldon winkler 3rd edition 5

CONTRAINDICATIONS
Excessive resorption.
Abused soft tissues.
Tmj problems
Poor esthetics
Unsatisfactory jaw
relationships.
Major speech problem.
Severe osseous
undercuts
6
Essentials of complete denture prosthodontics by Sheldon winkler 3rd edition
GENERAL CONSIDERATIONS
Satisfactory VDO
CO should coincide CR
Acceptable appearance
Optimum oral tissue health
Correct posterior limit of maxillary dentures

GENERAL CONSIDERATIONS
Adequate denture base extensions
Satisfactory speech
Correct interocclusal distance
Masticatory forces distributed over as large area
No existing hard or soft tissue conditions

REASONS FOR RELINING
Evennes
Retention Restore
s of Alleviate
& Stability Appearance VD
occlusal pain
pressure
Clinical dental prosthetics - H R B Fenn, second edition. 9

TREATMENT RATIONALE
George A. Zarb, Charles L Bolender et al.; Prosthodontic treatment for edentulous patients:Complete Dentures
10
and Implant supported prostheses; 13th edition.
DIAGNOSIS
• An incorrect or unbalanced occlusion that existed when the

dentures were inserted.
• Changes in the structures supporting the dentures that are
now associated with a disharmonious occlusion.
11
12
13
Swenson’s complete denture; 5th edition
RELINING TECHNIQUES
Clinical method
Laboratory method
Static method
Articulator method
Open mouth
Jig method
Closed mouth
Functional method Flask method
Chairside method
14
V Rangarajan & T V Padmanabhan; Textbook of Prosthodontics; 2nd edition
TISSUE PREPARATION
• Excessive hypertrophic tissue surgically removed.

• Oral mucosa free of irritation.
• Dentures should be left out of the mouth at least 2-3 days.
• Daily massage of the soft tissues stimulate blood supply.
Essentials of complete denture prosthodontics by Sheldon winkler 3 rd edition 15

DENTURE PREPARATION
• Relieve pressure areas.

• Correct minor occlusal disharmony.
• Correct small border inadequacies.
• Establish correct pps area Stick compound and
autopolymerizing acrylic.

PRINCIPAL PITFALLS
• Do not increase the VDO.

• Multiple even contacts should be present in centric relation.
• Do not permit the maxillary denture to move forward during
impression making.
• Ensure that centric relation and centric occlusion are identical.
• Ensure that an accurate posterior palatal seal has been established.
• An equal thickness of final impression material should be used.

CLOSED-MOUTH MAXILLARY DENTURE
Technique A
 Centric relation : Modeling compound/wax.
 Denture preparation : Relieve undercuts & 1 .5 -2 mm of tissue
surface. 1-2mm of border reduced.

 Special suggestion : Large part of the
palatal portion is removed.
 Border molding : Low-fusing
modeling compound.
 Impression : Zoe, pt closes lightly
into the premade interocclusal record.
Impression of the palatal section is
made with plaster
19
Shaffer F W, William H;Relining complete dentures with minimum occlusal error;vol 25; 366-370
Advantages : (1) Opening of the palatal portion will allow better seating &
alleviate the increase in vd pitfall.
(2) Interocclusal record helps to position the dentures & to orient the dentures
on the articulator.
(3) 2 step impression technique will reduce the possibility of moving the
maxillary denture forward during impression making.
Disadvantages : (1) Possibility of moving the maxillary denture forward.
(2) Wax interocclusal record is not an accurate record.
(3) This technique does not suggest any solution for difficulties of relining both
dentures at the same time.

Technique B
o Centric relation : Existing centric occlusion and intercuspation.
o Denture preparation : same as for technique A.
o Special suggestion : Holes are drilled at 5- to 6-mm intervals on the palatal
section.
o Border molding : Low-fusing modeling compound
o Impression : Kerr’s impression wax (Iowa wax), 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.

Advantage : The two-step impression technique will reduce
the possibility of extreme forward movement of the
maxillary denture.
Disadvantages : (1) Wax impression material is difficult to
work with and the possibility of distortion exists.
(2) Errors of existing centric occlusion can produce an
inaccurate impression.

Technique C
• Centric relation : Technique B.
• Denture preparation : Techniques A and B.
• Special suggestion : Labial & palatal flanges of the denture are
perforated to decrease the pressure inside the denture during impression-
making, thereby preventing displacement of denture.
• Border molding : Techniques A and B.
• Impression : No specific impression material.
• Advantages : Nothing to be emphasized.
• Disadvantages : Techniques A and B.

Technique D
• Centric relation : Existing centric occlusion.
• Denture preparation : Same as in the other techniques.
• Special suggestions : (1) Denture periphery shortened.
(2) A large opening should be prepared in the palatal portion.
(3) Adhesive tape is attached over the buccal & labial surfaces of
both dentures 2 mm away from the denture borders.
(4) Fairly deep groove should be cut into the buccal & labial
surfaces of the dentures at the junction of the impression
material & filled with baseplate wax.

• Border molding : Not suggested, but during the impression making
slight amount of impression material should be left on the flattened
borders.
• Impression : Pop or zoe for the first step & pop for the second step.
• Advantages : Technique A.
• Disadvantage : Existing errors of centric occlusion may produce
some pressure points and a faulty impression can result.

MANDIBULAR DENTURE
• It is generally agreed that the hazards in relining a

maxillary complete denture are greater.
• Factors to be considered : Ridge relations, ridge form, and
the characteristics of the mucosa covering the ridges.

• Centric relation : Existing centric occlusion. The occlusion is
corrected during the establishment of a new vdo.
• Denture preparation : Not specified.
• Special suggestion : Loss of vd is corrected by luting softened
modeling compound to the occlusal surfaces of the posterior
teeth. Patient is directed to pronounce “m”. The procedure is
repeated until the vdo is established. Then a lower work
impression should be made.

• After pouring the impression and mounting the lower
denture on an articulator, the lower denture should be
removed and cleaned.
• Any excessive undercuts should be removed. The denture
is luted to the maxillary denture.
• 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 surface 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.

• Impression : Modeling compound at the early stage & zoe
for making the secondary impression.
• Advantages (1) The loss of vd can be compensated for
during the relining procedures.
(2) The error in centric occlusion can be reduced during the
laboratory stages.
• Disadvantages (1) Time consuming.
• (2) The procedure for establishment of vdo is highly
questionable.

OPEN-MOUTH
TECHNIQUE
• Both dentures at the same time.

• Also, it has been emphasized that in this technique the impressions are
made independently, without utilizing the existing centric occlusion.
• Dentures are used as the trays for making the secondary impressions.
• After the impressions are made, a new centric relation record is
accomplished.

Centric relation : Jaw relation is recorded after secondary impressions.
Denture preparation : pps area is formed in modeling compound
before any other changes are made on the tissue side of the denture.
1mm of space is provided inside the denture for the new impression
material.
• The borders are shortened 1 mm to allow space for the impression
material to form a new border.

• Special suggestion : buccal surfaces of the lingual flanges are ground to
minimize the pressure against the mylohyoid ridges & between the tissues
of the fom & the buccal sides of the lingual flanges.
• The lingual flange between the premylohyoid eminences & labial flange
between the buccal notches is shortened by 1 mm.
• Two grooves are cut on the buccal sides of the lingual flanges to facilitate
removal of the retromylohyoid eminences 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
surfaces of both dentures and over the teeth

• Border molding If the flanges are inadequate, the borders should
be corrected with modeling compound.
• Impression Zoe Exactly 15 seconds after the denture has been
placed in the mouth, the patient is asked to pull his upper lip
down and to open his 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.

Advantages (1) 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 the centric relation record if necessary.
(4) The interocclusal record, which is made with quick-setting plaster.

Disadvantages (1) seems simple, the performance of the
procedures is not easy.
(2) This technique requires more clinical & laboratory time.

FUNCTIONAL & CHAIRSIDE
TECHNIQUE
• Simple and practical

• Treatment liner is next placed inside the denture.
• The lining material should flow evenly to cover the whole
impression surface and the borders of the denture with a
thin layer
38
DENTURE LINERS
Hard or Heat
soft cured or
(resilient self
) cured
Short Resin
term or based or
long silicone
term based.
39
Based on depth of penetration
Type A—soft
Type B—extra soft
Based on their method of processing
–– Mouth cured or chairside soft liners – does not last
beyond a few weeks.
–– Processed soft liners – lasts up to a year.
40
PERMANENT SOFT LINING
MATERIALS
1. Natural Rubber 4. Silicone Elastomers

2. Vinyl Copolymers (a) Silicone-based soft
3. Soft Acrylics lining materials that
polymerize in room
(a) Acrylic-based soft temperature
lining materials that
polymerize in room (b) Silicone-based soft
temperature lining materials that
polymerize with heat
(b) Acrylic-based soft
lining materials that 5. Fluoropolymers
polymerize with heat 6. Polyelastomeric systems 41
REQUIREMENTS
1. Good bonding to the denture base.

2. Should be biocompatible.
3. Should be hygienic and not become foul smelling.
4. Should maintain its resilience for a long period.
5. Should have good dimensional stability.
6. Should inhibit bacterial growth.
7. Low water sorption (max. 20 μg/mm3).
8. Easy to process.
42
COMPOSITION
Highly plasticized acrylic resins, supplied as a powder and a

liquid.
• Powder : Poly (ethyl methacrylate) or one of its
copolymers.
• Liquid : Aromatic ester (butyl phthalate butyl glycolate) in
ethanol or an alcohol of high molecular weight.
43
44
45
46
47
48
DISADVANTAGES
• Inadequate bonding.
• High volume change (up to 40%).
• Loose their softness as plasticizer is leached
from the liner.
• Reduces the denture base strength.
• Trimming, cutting, adjusting and polishing is
difficult.
• Disagreeable taste and odor and they cannot be
cleaned as effectively.
• Promote fungal growth. 49
CHAIRSIDE RELINERS (HARD SHORT-
TERM LINER)
ADA Sp. No. 17 : 75 °C.

They often contain low
molecular weight
polymers, plasticizers or
solvents to increase their
fluidity.
50
Failure for several reasons
• The materials often have produced a chemical burn on the
mucosa.
• The resulting material was often porous and subsequently
developed a bad odor.
• Color stability was poor.
• If the denture was not positioned correctly, the material could
not be removed easily to start again
51
Recent development : VLC resin systems, these materials
can be partly polymerized at the chairside using handheld
curing lights, but require a more powerful light chamber
device for complete curing
52
RELINING/REBASING MATERIALS
• Zinc oxide-eugenol paste.

• Composition or black gutta percha.
• Plaster of Paris containing starch.
• Cold cure acrylic.
Clinical dental prosthetics - H R B Fenn second edition 53

LAB METHODS – ARTICULATOR
METHOD
Box the denture with impression material before pouring cast.
54
Dental laboratory procedures; rudd & morrow; 2nd south asia edition
• Pour artificial stone into the
boxed denture impression to
form a cast
• After the stone has set. remove

the cast with the denture in
place, & index the base &
Paint with separating medium.
Dental laboratory procedures; rudd & morrow; 2nd south asia 55

edition
• Adapt clay to the lingual region,
palatal section, facial surfaces of the
teeth & denture, exposing the
occlusal third of the denture teeth.
• Mix artificial stone, and place a patty

of stone on the lower member of the
articulator.
56
57
• With an acrylic bur in a
handpiece, remove a thin
layer of resin from the
interior surface.
• Reduce the borders 2-3
mm with a bur.
• Deepen frena notches.
• Blow off acrylic
grindings with a stream
of air.
58
• Place the pps in the maxillary casts.
• Paint the cast with tinfoil substitute.
• Mix resin & add resin to the interior
of the denture.
• Place additional resin on the cast,
taking care to fill the borders of the
cast.
• Seat the denture into the
indentations, and close the
articulator, expressing the excess
resin.
• Cure the relined denture
• After curing, finish and polish it.
59
60
JIG METHOD
• Box the denture and pour a

cast.
• Use modeling clay to block
out the denture, and seat the
denture in a stone patty on the
lower member of the reline
jig/Hooper duplicator.
• After the stone index has set,
paint the indexed cast with a
separating medium, and
mount the cast to the upper
member.
61
Dental laboratory procedures; rudd & morrow; volume 1
• Lift the denture from
the cast.
• A stream of air can
sometimes be used to
remove the denture.
• Remove all impression
material from the
denture, and prepare
the surface.
• Seat the denture in the
stone index.
62
• Paint the cast with tinfoil
substitute.
• Moisten the resin surface of the
denture with monomer.
• Mix the autopolymerizing resin,
and place it on the cast and denture.
• Assemble the reline jig & secure it
with locknuts.
63
• Cure the relined denture in a pressure container of warm
water at 15 psi for 30 minutes.
• Separate the jig, remove the relined denture, finish and
polish.
64
FLASK METHOD
• Denture is checked for

extensions
• Remove thin layer from the
tissue surface
• Borders are reduced by 2-3mm
• Border moulding & secondary
impression made.
65
• Flasking
• Scoring of pps
66
• Remove impression
• Heat cure packing
• Cure, trim & polish
67
TROUBLESHOOTING
Problem Probable cause Solution

Voids Resin not placed Place resin throughout
throughout denture using adequate
volume
Line b/t denture & added Impurities in the denture Clean thoroughly
resin base
Old or dry resin Correct stage
Porous denture Not cured properly 30mins @ 15-20 psi
Not retentive Pps not placed Cast scoring
Initial impression not Examine impression
adequate carefully
68
R E B A S I N G – A RT I C U L ATO R M E T H O D
• Mount the denture on its cast in articulator
69
Dental laboratory procedures; Rudd & Morrow; 2nd south asia edition
• Open the articulator, and remove the
denture from the cast .
• If the teeth are porcelain, heat each
tooth with a hot spatula, and remove
it from the denture.
• Place each denture tooth in its
corresponding indentation
70
• If the denture teeth are resin, cut them from the denture base in units with a bur,
and seat them in their indentations.
• Adapt a layer of baseplate wax to the cast, close the articulator, and wax the
denture teeth to the wax.
• Complete the wax-up on articulator, remove the cast, and flask and process it .
• Replace the cured denture on the articulator, check and correct the occlusion;
then finish and polish.
71
72
FLASK METHOD
• Pour a cast in the denture.

• Half-flask the denture in an accurate denture
flask.
• Paint silicone mold material over the
denture.
• Complete flashing the denture.
• Open the flask after the flashing stone has
set.
• The resilient silicone will allow the denture
to be withdrawn without damage
73
• Remove the porcelain or resin teeth from the denture.
• Replace the teeth in the silicone mold.
• Place a posterior palatal seal in the maxillary cast.
74
• Paint the cast and investing stone with tinfoil substitute.
• Pack denture resin in the mold, and cure, finish, and polish.
• Correct processing errors after the remounting procedure
75
76
TROUBLESHOOTING
Problem Probable cause Solution

Nodules Incorporated air Mix carefully
Incorrect occlusion Ill-fitting flask Accurate fitting flasks
Inadequate resin Pack until flash is
eliminated
Not related to proper JR Relate properly
77
VIDEO
78
www.youtube.com
CONCLUSION
Decision to maintain a denture should always be considered

prior to remaking a new one unless indicated.
This especially holds true in a developing country like ours
where the burden of additional costs and appointments
associated with a new denture fabrication can offset the
motivation of patients from seeking treatment at all.
79
Let’s give dentures another chance; journal of Nepalese prosthodontic society; jan-June 2020; vol 1;49-53
REFERENCES
• George A. Zarb, Charles L Bolender et al.; Prosthodontic treatment for

edentulous patients:Complete Dentures and Implant supported prostheses;
13th edition
• Clinical dental prosthetics - H R B Fenn second edition
• Glossary of prosthodontic terms - 9
• Essentials of complete denture prosthodontics by Sheldon winkler 3rd edition
• V Rangarajan & T V Padmanabhan; Textbook of Prosthodontics; 2nd
edition
• Swenson’s complete denture; 5th edition
•. 80
REFERENCES
• Dental laboratory procedures; rudd & morrow; 2nd south asia

edition
• Relining rebasing partial and complete dentures christensten
JADA, vol. 126, april 1995
• Shaffer F W, William H;Relining complete dentures with
minimum occlusal error;vol 25; 366-370
• Let’s give dentures another chance; journal of nepalese
prosthodontic society; jan-june 2020; vol 1;49-53
• www.youtube.com
81
THANK YOU
82

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RELINING AND REBASING

• The residual ridges have been described as plastic in nature, always

Reline : the procedures used to resurface the intaglio of a

Immediate dentures 3-6 months.

Resorbed residual alveolar ridges

When the patient cannot afford.

Physical or mental stress.

Essentials of complete denture prosthodontics by Sheldon winkler 3rd edition 5

Optimum oral tissue health

Correct posterior limit of maxillary dentures

Essentials of complete denture prosthodontics by Sheldon winkler 3rd edition 7

Adequate denture base extensions

Correct interocclusal distance

Masticatory forces distributed over as large area

No existing hard or soft tissue conditions

Clinical dental prosthetics - H R B Fenn, second edition. 9

• An incorrect or unbalanced occlusion that existed when the

• Excessive hypertrophic tissue surgically removed.

Essentials of complete denture prosthodontics by Sheldon winkler 3 rd edition 15

• Relieve pressure areas.

Essentials of complete denture prosthodontics by Sheldon winkler 3rd edition 16

• Do not increase the VDO.

Essentials of complete denture prosthodontics by Sheldon winkler 3rd edition 17

Essentials of complete denture prosthodontics by Sheldon winkler 3rd edition 18

Essentials of complete denture prosthodontics by Sheldon winkler 3rd edition 20

Essentials of complete denture prosthodontics by Sheldon winkler 3rd edition 21

Essentials of complete denture prosthodontics by Sheldon winkler 3rd edition 22

Essentials of complete denture prosthodontics by Sheldon winkler 3rd edition 23

Essentials of complete denture prosthodontics by Sheldon winkler 3rd edition 24

Essentials of complete denture prosthodontics by Sheldon winkler 3rd edition 25

• It is generally agreed that the hazards in relining a

Essentials of complete denture prosthodontics by Sheldon winkler 3rd edition 26

Essentials of complete denture prosthodontics by Sheldon winkler 3rd edition 27

Essentials of complete denture prosthodontics by Sheldon winkler 3rd edition 28

Essentials of complete denture prosthodontics by Sheldon winkler 3rd edition 29

Essentials of complete denture prosthodontics by Sheldon winkler 3rd edition 30

• Both dentures at the same time.

Essentials of complete denture prosthodontics by Sheldon winkler 3rd edition 31

Essentials of complete denture prosthodontics by Sheldon winkler 3rd edition 32

Essentials of complete denture prosthodontics by Sheldon winkler 3rd edition 33

Essentials of complete denture prosthodontics by Sheldon winkler 3rd edition 34

Essentials of complete denture prosthodontics by Sheldon winkler 3rd edition 35

Essentials of complete denture prosthodontics by Sheldon winkler 3rd edition 36

Essentials of complete denture prosthodontics by Sheldon winkler 3rd edition 37

• Simple and practical

1. Natural Rubber 4. Silicone Elastomers

1. Good bonding to the denture base.

Highly plasticized acrylic resins, supplied as a powder and a

ADA Sp. No. 17 : 75 °C.

• Zinc oxide-eugenol paste.

Clinical dental prosthetics - H R B Fenn second edition 53

Box the denture with impression material before pouring cast.

• After the stone has set. remove

Dental laboratory procedures; rudd & morrow; 2nd south asia 55

• Mix artificial stone, and place a patty

• Box the denture and pour a

• Denture is checked for

Problem Probable cause Solution

• Mount the denture on its cast in articulator

• Pour a cast in the denture.