Relines, Rebases, Repair Flashcards
reline
replacement of the inner 1 mm of denture base
so replacement of the tissue surface only **
rebase
entire denture base is replaced
repair
just about anything
- replacement of teeth
- addition of border
- reposition of broken denture base segments
what differes in reline or rebase?
lab steps
steps to perform both reline and rebase are the same
what must you decide prior to a final reline/ rebase impression
IF THE VDO WILL BE MAINTAINED OR INCREASED
maintain if possible
increase if the occlusion shows signs of ware and loss of vertical
what are signs of repair needed?
several - main ones
- replacement of teeth
- addition of borders - including PPS
- Reposition of broken denture base segments
after assessment of the VDO - what would indicate the need to increase VDO?
- if the occlusion is beginning to show signs of wear and loss of vertical, but still servicable
maximum amount you can increase VDO with rebase/reline?
1-2 mm is MAXIMUM
if 2mm or more is needed – need to remake the denture
what must be done each time border molding is added or the final impression is placed?
A FUNCTIONAL impression technique must be used.
this is known as CLOSED MOUTH POSITION
Before you ever do something to a prostheses?
Check occlsuion with prosthesis and without
adjust CO=CR to establish a STABLE OCCLUSION
then seat the impression for reline or rebase TO THIS OCCLUSION
steps for reline or rebase to MAINTAIN VDO
- Reduce the interior by 1mm to make room for the new impression material except for 3 tissue stops – that are placed at the current vdo!!
location of tissue stops
- anterior - but not on incisive papilla
- 2 in the posterior – but anterior to the tuberosities on upper or retromolar pads on lower
* need to have sufficient room for final impression material and do not want to increase the VDO with material
in prep for reline or rebase what do you reduce or remove
REDUCE – denture border by about 2-3 mm to allow for compound border molding (think as if it as a record base and taking final impressiosn)
- REMOVE – any tissue conditioner or old reline material and freshen up the denture base for mechanical adhesion
steps for reline or rebase to INCREASE VDO
add grey or green tissue stops to the apprpriate vertical.
MAX of 1-2 mm
put them in same locations
1. at anterior offset of incisive papilla and
- two in posterior but anterior to the tuberosity on maxilla and rmp on lower
once establish the vertical … then what
reduce the borders – treat it like it is an existing custom tray and border mold FUNCTIONALLY (IN OCCLUSION) place compatible adhesive and let it cure before taking impression
after you border mold FUNCTIONALLY (in occlusion) then…
make the final impression using MUCOSTATIC impression material such as light boddied rubber base
CR record in reline rebase?
YES — after the impression is set you trim flash and re-seat in order to take CR with Auluwax to ORIENT the denture
what holds vertical/ VDO during reline/rebase
- articulator = pin
- jig = leveling screw
both flask and jig require an occlusal index
when reline/rebase the upper what must you do?
technique?
step after?
SCORE the post dam – drawn on impression because a cast does not yet exist – after separation - then we can put onto cast
this is a mechanical post dam technique and must document the tissue depths so cast can be scored AFTER FLASKING
then bead box and pour
when do you separate after beading and boxing?
AFTER FLASKING because the vertical has not yet been held!!!
if rebases - most of the time it will be placed where?
FLASK
importance of the land of the flask?
HOLDS THE VERTICAL - just like a pin does on articulator.
so the land of flask acts as a vertical stop.
after and occlusal index is made what can be done?
CAN SEPARATE CAST FROM DENTURE – + impression between upper and lower can be made
postdam cut into flask when?
AFTER FLASKING AND BOIL OUT
BEFORE NEW ACRYLIC IS PACKED .
how fix broken tooth?
space is created on lingual for acrylic repair
tooth is luted on facial with sticky wax
SALT AND PEPPER TECHNIQUE
20 lbs psi for 20 minutes – pressure cooker
FIGURE OUT WHY BROKE
incipient midline fracture?
indication for REBASE
common on the mandible
where do you NOT widen the fracture?
where do you?
on intaglio
you prepare and bevel the repair site by adding horizontal barbell perpendicular to fracture on polished facial and palatal aspect
do relines do anything for fractures?
NOO – only replace the inner 1 mm of denture
what is placed in groove prior to acrylic placement?
pin or metal mesh reinforcement
+ pin to stabliz
fractured denture border? likely to re-fracture?
replaced with COMPOUND INTRA-ORALLY
block out undercuts’ cast pored to support denture and repair site– now we have area we can add repair acrylic to
20psi for 20 minutes
UNLIKELY to refracture
Very common fracture on mandible?
denture base fracture at overlay abutment site
be sure to check occlusion and proper height of abutments before addressing the repair
denture base fracture at overlay abutment site repair technique?
have to temporarily repair so then have a denture we can rebase with
so reposition parts bench side and parts are splinted on temporary cast with tongue blades and sticky wax – across arch stabilization with sticky wax and heavy gauge wire
pressure cured repair at 20 psi for 20 minutes
temporary repair cast made of?
dental stone or silicone putty
overdenture repair sire liklihood of re-fracture?
YES – so temporary repair and then need to REBASE as a follow up DEFINITIVE TREATMENT
post dam augmentation? how do you know?
NO RETENTION – add compound in posterior in shape of post dam - hear the retention
indicated when all other aspects of denture are acceptable but denture lacks retention due to insufficient post dam
post dam augmentation steps
compound is added INTRA-ORALLY and FUNCTIONALLY to the post dam AND to the distobuccal areas bilaterally
repair cast created
compound removed and denture re-seated
after repair cast is created what do you get?
gap between denture and repair cast so we can add the repair acrylic and psi 20 for 20 minutes
T/F postdam augmentation and reline can be done at the same time?
TRUE – simultaneously
CC of whistle?
problem?
repair?
Problem is maxillary teeth are set too far lingually
reset upper teeth - lower may nor require resent depending on offset/crossbite
CC of lisp?
“so sounds like show”
problem?
repair?
Problem is maxillary teeth are set too far buccaly
add wax to linguals of upper denture teeth
CC of T sounds like D or D sounds like T
problem?
repair?
T sounds like D = MAXILLARY ANTERIOR TEETH too lingual
D sounds like T = MAXILLARY ANTERIOR TEETH TOO LABIAL
reset upper and or lower according to everything – overlap, overjet, crest of ridge, papillas, lip support, etc.
occlusion or not for reline/rebase.repair
if you need a bite or impression then yes! - sometimes repair doesnt need this so depends on whether you need to orient the prosthesis back to patients dentition
Reline = YES
Rebase = YES
Repair = +/-
‘pick-up’ impression?
if need impression on a repair
an impression that incorporates a prosthesis, framework, copings. or attachemtns for the purpose of making a cast as relationship record within the arch
pouring the cast with the prosthesis still embedded in the alginate – produces a cast with a precise fit.
removes prosthesis along with impression
length of service needed is a function of?
lifespan of the prosthesis
when deciding to reline or rebase what is critical?
determining the length of service
two main questions to use when determining what material to use
- what is the problem
2. how long must the solution last?
heat cured hard reline will last how long?
7 years – so if pt. needs a reline and is wearing denture for 5 years don’t do this one – we would hesitate to do this – could introduce heat damage too
use pressure cooker- 1-3 years
definitive treatment if a brand new denture fractures from a fall?
REBASE
repair first – to make rebase
heat cured hard rebase
eclipse material
same as triad material
methylmethacrylate- free ** light cured resin for fabricating denture bases
is vovclar / ivocap rigid? esthetic? type of material?
MMA injectable and is rigid and esthetic
more dense than flasking - so less free monomer
Triad rigid? esthetic? type of material?
Light cured resin
it is rigid
NOT esthetic
eclipse
rigid? esthetic? type of material?
Light cured resin – urethane dimethacrylate
both rigid and esthetic
flexite
rigid? esthetic? type of material?
Nylon, acetyl, polyether
NOT rigid but it is esthetic – partials
Avadent
rigid? esthetic? type of material?
digital dentures* uses prepolymerized puck PMA
less free monomer - situations in allergies
both rigid and esthetic
