But these reasons are not among them. If you go along with the patient’s “diagnosis” in order to keep them happy, the opposite is going to happen. You will be accused of ruining their perfect-fitting custom denture. Before this happens, you need to have a frank conversation with your patient. If they really want to address their concerns, they need a new denture that is fabricated in a modern dental lab using the latest tools and materials.
Denture relines are not a cure-all. A reline is an attempt to improve the fit of an old denture. However, the old denture needs to be in reasonable condition and follow the contour of the tissue if it is to be relined successfully. Never lose sight of the fact that you are still working with an old denture. If the fit of the dental appliance was terrible before the reline, it will never fit like a brand new denture after a reline.
As dental professionals, if we are to improve the clinical fit of a denture with a laboratory-processed reline, we must provide the denture laboratory with accurate records. This involves looking closely at the appearance of the denture in the patient’s mouth before doing anything to prepare the denture for a reline.
If the denture rests solely on the palate due to excessive shrinkage of the alveolar ridge, a denture reline is not a viable option. If the midline is off significantly or the patient shows gums, these things are not going to go away with a denture reline. Since the denture lab technician did not have the luxury of seeing the denture in the patient’s mouth prior to the impression, they rely on the dentist or denturist to provide them with accurate records.
Performing Denture Relines
If you have determined that a denture reline is likely to improve the fit for the patient, proceed to roughen the inside of the denture. Then, adjust the denture to relieve over-extended flanges. Using rope wax or stick compound, border mold the denture to allow the muscle attachments to be visualized in the impression. Paint the inside of the denture and the borders with an adhesive, then allow it to dry according to manufacturer’s recommendations. Next, use a medium- or light-body impression material, such as poly-vinyl siloxane or rubber base, to cover the inside surfaces and borders of the denture. There is a point where more impression material is not better. It will either be impossible for you to fully seat the denture or the excess material will flow into the patient’s throat.
It is absolutely critical to fully seat the denture in the mouth correctly, paying particular attention to centric occlusion, the location of the midline, and the amount of acrylic “gum” that is showing. All of these things must be the same as what you observed at the initial examination in every way. If they are not, allow the impression to set, remove the set impression material from the denture, and start over. Doing this is the one thing that can change the outcome of a denture reline treatment. If the denture impression wasn’t seated correctly, the vertical dimension of the processed reline will be increased and the bite will not be correctly aligned with the opposing teeth. It may be loose or shift when the patient bites down, and the midline may or may not be off. In the event that this happens, the denture reline will not be successful.