CH 11B: Reline, Rebase, Repairs Flashcards
RELINES
Replacement of the inner 1mm of the denture base
tissue surface only
REBASES
Replacement of the entire denture base,
saving only the teeth
The lifespan of a denture ____years
7-10 years
You must decide _____ (prior/after) to final reline/rebase impression whether the VDO will be maintained or increased.
You must decide PRIOR to final reline/rebase impression whether the VDO will be maintained or increased.
In what scenario will you maintain the VDO for a reline/rebase impression?
Maintain if the VDO is still acceptable
In what scenario will you increase the VDO for a reline/rebase impression?
Increase if …
-the occlusion shows signs of wear
-loss of vertical
, but is still serviceable.
Maximum permissible increase in VDO during reline/rebase procedure
1-2 mm maximum
What will you do if you need to increase the VDO >2mm during reline/rebase procedure?
If >2mm increase in VDO is needed,
remake denture
The impression for a reline/rebase procedure is NOT seated in occlusion.
T/F
F
The impression for reline or rebase procudure is seated in occlusion. (Adjust CO=CR to establish a stable occlusion)
This is also known as a CLOSED MOUTH POSITION and is required.
The border impression for a reline/rebase procedure is Functional.
T/F
T
Preparation of the denture for Reline:
1) Reduce denture borders by about 2-3mm to allow for border molding material.
2) Reduce all interior acrylic by ~1.5 mm (to make room for final impression material) except for 3 tissue stops at the CURRENT VDO.
3) Remove any tissue conditioner or old reline material
For a Reline, reduce denture borders by about ____ to allow for border molding material.
2-3mm
For a Reline, reduce all interior acrylic by ______mm to make room for final impression material, except for 3 tissue stops at ______ (MIP, VDO)
~1.5 mm
the CURRENT VDO
Location of tissue stops:
NOTE: 3 tissue stops are made at the CURRENT VDO
- One in Anterior-but not on incisive papilla
- Two in Posterior-anterior to tuberosities (U) or retromolar pads (L)
Steps to INCREASE VDO via a reline or rebase of a complete denture?
- Add grey or green compound tissue stops to the appropriate vertical.
- Maximum 1-2 mm.
- 3 tissue stops are made at the CURRENT VDO
- Once vertical has been established, next reduce borders of ‘tray’(i.e denture)
- border mold functionally (in occlusion)
During reline/rebase procedure CR bite is taken with Aluwax to orient denture. T/F
T
CR bite with Aluwax to orient denture
When is the Mechanical post dam scored?
- After flasking and boil out
- and before the new acrylic is packed.
What holds VDO in the Clinic?
- Articulator
- Pin
What holds VDO in the lab during Jig reline?
- Jig
- Levelling screw
What holds VDO in the lab during Flask Reline?
- Flask
- Land of flask
To hold the VDO in the lab during reline/rebase procedure, both flask and jig require _____.
occlusal index
Without an incisal pin, or leveling screw, there is no way to maintain VDO after the impression material is removed. T/F
T
Repairs
Replacing teeth or portions of denture base
Small well circumscribed
voids with sharp margins can on the impression can be fixed with ____ (XLV wash impression /disclosing wax)
disclosing wax
Outline of Post dam for reline/rebase is drawn on _____ (cast/impression)
impression
because cast does not yet exist
For reline/rebase procedure, the cast is separated/retrieved after being poured PRIOR to making the Occlusal index. T/F
F
DO NOT SEPARATE until occlusal
index is made
When repairing a denture with a broken tooth, the residual portion of broken tooth is
ground away and the denture base is perforated to make space for the new (repair) tooth
F
-DO NOT perforate the denture base
- Tooth is luted on facial with sticky wax
- Space is created on lingual for repair acrylic
- Repair acrylic using “salt and pepper” technique
When repairing a denture with a broken tooth; the tooth is luted on facial with _____ wax
sticky wax
When repairing a denture with a broken tooth, space is created on ________(buccal/lingual) aspect of the denture for repair acrylic
Space is created on lingual for repair acrylic
Time and pressure for curing repair acrylic
20 lb psi for 20 min
Craze line was discovered in overdenture at first denture recall. Will you recommend reline, repair or rebase?
Rebase
Weak repair site which is liable to re-fracture (eg. craze line, midline fracture etc) is
an indication for a Rebase
Repair site is NOT widened on intaglio side. T/F
T
How will you assess a Denture Base Fracture at Overlay Abutment Site?
- check occlusion and proper height of abutments
before addressing the repair
Denture Base Fracture at Overlay Abutment Site will need a _____ (reline/rebase) as a definitive treatment.
Rebase
Overdenture repair site likely to re-fracture & will
need a Rebase as a follow-up for definitive treatment
Why are Incipient or Complete Midline Fractures first repaired?
We repair it in order to take a final impression for the
Rebase
Rebase as a follow-up for definitive treatment
Pt dropped the denture and fractured the denture border. Will you recommend reline, repair or rebase?
Repair
Border is NOT likely to re-fracture
Chief Concern: Whistle-pathognomonic
-Problem?
Maxillary teeth set too far
lingually (offset correctly with mandibular teeth)
Chief Concern : Whistle-pathognomonic
-Repair?
Reset upper teeth;
lower may or may not require reset depending on offset/ crossbite
Chief Concern: Lisp-pathognomonic
“so” sounds like “show”
-Problem?
Maxillary teeth set too far
buccally (offset correct with
mandibular teeth)
Chief Concern: Lisp-pathognomonic
“so” sounds like “show”
-Repair?
Add wax to linguals of upper
denture teeth process
Chief Concern: Cheek biting/ Tongue biting
-Problem?
Maxillary teeth and mandibular teeth set edge to edge regardless of B/L position on the ridge
Chief Concern: Cheek biting/ Tongue biting
-Repair?
Reset upper or lower posteriors
as appropriate
e.g if monoplane lower set to crest of ridge, then reset monoplane upper posterior teeth with correct offset
Chief Concern: T sounds like D
-Problem?
Maxillary anterior teeth too lingual
Chief Concern: T sounds like D or D sounds like T
-Repair?
Reset upper and/or lower as appropriate incorporating all equally critical factors (overlap, over-jet, lower crest of ridge, upper incisive papilla, lip support)
Chief Concern: D sounds like T
-Problem?
Maxillary anterior teeth too
labial
“Pick-Up” Impression
an impression that incorporates a prosthesis, framework, copings, or attachments for the purpose of making a cast as a relationship record within the arch
(GPT v9)
When a denture requires a reline, rebase, repair, what questions do we need to ask?
- How old is the denture?
- How old is the liner (if any)?
- Are you allergic to any (denture) materials?
- How did the break/damage occur?
- Ask about and evaluate the occlusion.
If an IMMEDIATE DENTURE is not retentive at the insertion appointment, the material used
to increase retention is:
tissue conditioner (super-soft liner)
-We never use soft liners at an insertion appointment (for either an immediate or an
interim denture) only super-soft liners, because they are tissue conditioners. The soft liners are not soft enough.
What would you do for 5 year old
denture that needs a reline if you
know the average denture lasts
about 7 years?
- Type: Pressure cured (COLD) Hard
- Where: Lab
- Life span: ~1-3yrs
- Since you want the denture to last for 2yrs, you want to pressure cure it. However, since the denture is 5yrs old, HEAT might degrade the denture.
- *So, use Cold pressure cure
What would you do if a brand new
denture fractures from a fall?
Plan Repair (splint) then rebase heat-cured hard.
Rebase* is the definitive treatment
Length of service: 1 week
Procedure: reline
What is the consistency of the material used and the type of cure?
- Consistency: super-soft
- Type of cure: self-cured
Length of service: 1 month (4weeks)
Procedure: reline
What is the consistency of the material used and the type of cure?
- Consistency: soft
- Type of cure: self-cured
Length of service: 1 year
Procedure: soft reline
What is the consistency of the material used and the type of cure?
- Consistency: soft
- Type of cure: pressure-cured
Length of service: 1 year
Procedure: hard reline
What is the consistency of the material used and the type of cure?
- Consistency: Hard
- Type of cure: self-cured
Length of service: 3 yrs
Procedure: Reline
What is the consistency of the material used and the type of cure?
- Consistency:Hard
- Type of cure: Pressure-cured
Length of service: 7 yrs
Procedure: Rebase
What is the consistency of the material used and the type of cure?
- Consistency:Hard
- Type of cure: Heat-cured
What would you do for 5 year old lower
denture that needs a reline if the lower ridge is SEVERELY RESORBED, as a last resort (i.e. you can’t do any surgical procedure)?
Silicone based soft Heat-cured reline.
- Procedure: Reline
- Consistency:Soft
- Type of cure: Heat-cured
Note: Silicone does not contain plasticizers and due to the lower degree of cross-linking compared with their heat activated counterparts, they cannot survive long term.
Which dentures have lower allergenicity, Analogue or Milled?
Milled
Since they contain PMMA, are 20% denser and have less free monomer.
Note: PMMA has Negligible free monomer
Monomer used in Milled dentures
PMMA
Monomer used in printed dentures
Urethane methacrylate
