What You Need To Know About Denture Relines & Rebases
What You Need To Know About Denture Relines & Rebases
By Dr. Hudnall DMD
In this article, we will discuss the various types of complete denture relines including soft denture relines and hard denture relines, laboratory-processed relines versus chairside relines, and denture rebases. I will give you some things to consider to keep you out of trouble and to aid your denture laboratory by providing the records that will produce the best outcome. I will also provide some convenient checklists to help make your life easier.
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What is a Denture Reline?
A dental reline is a process of adding new material to the inside surface of existing dentures in order to improve the denture’s contact with hard and soft tissue. The goal is to create denture stability while improving the fit, suction, and chewing ability of the person wearing them. When used with the correct indications, a reline can prolong the use of a set of dentures for many years.
There are several different types of reline materials, and each have ideal applications. Hard acrylic relines can be performed using laboratory processing methods or by using a material suitable for chairside curing. The latter may be an appropriate choice for a patient who is not able to go without their dentures while the laboratory is relining them.
What is the Biggest Benefit of a Chairside Reline?
The biggest benefit of a chairside reline is getting immediate results in a single dental visit — instant gratification. The drawbacks to a chairside reline include the need for the patient to endure a chemical reaction taking place in their mouth, voids in the reline acrylic, and a difference in color between the relined material and the denture base, a difference that usually becomes more apparent with time. Chairside relines often become brittle and may flake, necessitating additional procedures.
For these reasons, chairside relines are generally considered a temporary solution to buy additional time before new dental appliances are made. A chairside reline may be used as an economical solution to improve the fit of dentures that act as a spare set for emergencies.
Benefits of Laboratory-Processed Relines
Laboratory-processed relines require the patient to be without their dentures while the lab is working on them. The benefits of a laboratory-processed reline include reline material that is more seamless with the denture base material itself, and material that is free from bubbles and voids that can cause the dentures to not fit as well as possible.
Permanent Soft Relines
Permanent soft relines for dentures are appropriate in cases where the patient has an extremely resorbed ridge or a knife-edged ridge that makes wearing dentures particularly uncomfortable. The cushioning trait of the material softens the blow of minor movements and allows the patient to chew comfortably and without irritation. Because a soft reline can adapt without the irritation caused by hard, unforgiving acrylic, soft relines are an ideal choice for patients who have loose tissue or papillary hyperplasia in the palate. Soft relines require special home care in order to be properly cleaned, which means that it is especially important to read the manufacturer’s recommendations carefully. Some manufacturers don’t recommend using effervescent denture cleansers on soft relines because the reline will grow harder with time. Consider your patient and how they may care for their dentures at home when you are deciding between types of reline.
A Denture Rebase
A denture rebase is an extension of a laboratory-processed reline. A rebase is chosen when the denture acrylic is in less than ideal condition and needs to be replaced in order to extend the life of the dentures. When the dental lab encounters a case like this, all of the acrylic (except for a thin strip of acrylic holding the teeth) is replaced with new acrylic. This accomplishes two different things at once: It improves the fit of the dentures and it replaces defective, brittle, cracked, or discolored acrylic. It is the closest thing to making new dentures. This technique is best employed when the denture teeth are in good condition but the acrylic is not.
Which Procedure Is Right?
How do you decide what procedure is the right one for your patient? Consider this scenario: Your patient presents with an existing set of dentures that are not fitting well. The patient may complain that the dentures feel loose or that they get food under them when they eat. They have fond memories of how the dentures used to fit 10 years ago, when the dentures were new. They are looking to you for a solution. What do you do? Before committing to any procedure, take few moments to really listen and examine what is happening. Ask yourself what the root cause of their ill-fitting dentures may be. A reline or rebase is not the solution for every denture that doesn’t fit correctly, so a thorough examination can save you a lot of time and trouble, and can reduce the chances for poor outcomes or unrealistic expectations.
Consider the following checklist:
- Have the alveolar ridges resorbed an excessive amount giving the dentures no stability?
- Are the teeth excessively worn?
- Is the vertical dimension of occlusion appropriate for the patient to function properly?
- Is the bite uniform during full occlusion?
- Are the denture borders too short for adequate retention and stability?
- Would the patient be better served by an alternative treatment (new dentures, implants, etc.)?
Also, take a moment to examine every aspect of how the dentures look in the patient’s mouth. Notice things that are unique to the appearance of the dentures:
- Is the midline off?
- How much of the teeth show when the patient smiles?
- How are the lips supported both in frontal and profile views?
- Does the patient show pink acrylic when talking or laughing?
- Are the facial muscles properly supported or does the patient have a sunken-it appearance?
In some cases, the best option could be new dentures. A reline is an attempt to improve the fit of old dentures, but it is not a cure-all. It is not going to improve things the patient doesn’t like about the looks of the dentures or the wrinkles on their face. Old dentures need to be in reasonable condition and follow the contour of the tissue if they are to be relined successfully. Never lose sight of the fact that you are working with an old set of dental appliances. If the fit of the dentures was terrible before the reline, they will never fit like brand-new dentures after a reline. In fact, they will likely fit the same or even worse after they have been manipulated.
Once you have looked at all of these aspects, ask yourself if you truly believe that you can address the patient’s concerns by relining or rebasing the dentures. Then consider what type of reline material is best for your specific application. Is the solution a soft permanent reline, a hard reline, or a rebase? Discuss with the patient the projected outcome of the denture reline technique before doing anything.
How to Get the Best Results For a Dental Reline
If you have determined that a reline or a rebase will help, how do you aide your dental laboratory to achieve the best result possible? Afterall, the lab technician has never seen the patient. What records would they like to have in order to make the process run smoothly? I will give you a practical denture reline technique that works. The same technique works for soft processed relines and rebases.
- Examine the bite with the dentures in place.
- Remove any deep undercuts that would prevent the dentures from being separated from a laboratory model.
- Adjust borders that are too long or impinging on soft tissue.
- Work on one denture at a time, using the opposing denture to maintain the proper occlusion.
- Roughen the borders and the tissue side of the denture being relined or rebased with an acrylic bur.
- Create three tissue stops with modeling compound or heavy-body polyvinyl siloxane (one in the anterior and two in the second molar areas) to maintain the correct vertical dimension of occlusion (VOD).
- Insert one denture with the warm compound or polyvinyl siloxane in place and have the patient bite into maximum intercuspation. Allow the material to set. Then remove the denture from the mouth.
- Adjust the tissue stops to remove any undercuts. Reinsert and check for stability, proper occlusion, and position as it relates to the anatomy and facial features.
- If the borders of the denture are short or inaccurate, border mold the denture in the mouth using compound or rope wax to extend the borders.
- Try the denture back into the mouth. Be certain the denture is fully seated and resting only on the tissue stops. The denture must fit passively with the patient in occlusion.
- Dry the denture.
- Apply impression adhesive to the underside of the denture and inside borders.
- Add medium-body polyvinyl siloxane (PVS) impression material to evenly coat the inside of the denture and borders.
- Align the denture and fully seat it until the denture rests entirely on the tissue stops.
- Have the patient close into maximum intercuspation.
- Check that the midline is in the correct position.
- Verify that the lip position is the same as it was at the initial examination.
- If the appearance is not the same as what you observed at the initial examination in every way, allow the impression material to set completely, remove it, and start over.
- After the impression material has fully set, remove the denture from the mouth and trim away any excess impression material.
- Reinsert the denture with the impression.
- Repeat the process with the opposing denture.
Send the impressions with your written laboratory prescription to the dental laboratory for processing. Remember to include any information about the baseplate material that was originally used to make the denture, if you have it.
All denture products and materials are not identical in appearance and chemical properties. If you are aware that the denture was made from materials other than the universal standard Lucitone (i.e. Eclipse, Thermoflex, etc.), please contact Stomadent Dental Lab to discuss the best option for relining or rebasing the denture. Because we will be removing the interior surface or replacing the denture base entirely, dentures relined or rebased with materials other than the original type of material used to make the denture may yield less-than-satisfactory results.
Stomadent Dental Laboratory is your go-to source for laboratory-processed relines and rebases. We have the training, expertise, and the years of experience necessary to extend the life of your patient’s old dentures and turn them into new-looking dentures with an improved fit. Our dental lab offers same-day reline service within the Treasure Valley area. We are your partner for denture services! Get your starter kit from us today to see how beneficial working with our dental laboratory can be.
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