Whilst we all have received training in fabricating complete details, I wanted to share a few great tips on relining dentures so that you can exceed your patient’s expectations, as well as provide the ideal prosthetic outcome.
What Do We Mean When We Say ‘Relining Dentures’?
This is the process to resurface the tissue side of a denture using a new material so that no spaces exist between the actual denture contour and the altered tissue contour. By periodically carrying out an assessment and correction we can ensure that the prosthesis is a good fit long-term.
1. Carefully Analyse The Borders
If this is the first time for the patient to have a reline and they have been wearing their denture for more than 10 years there is every likelihood that the borders will have to be molded. If the denture seems to slide easily you should stabilize the palate first. This can be done by placing three areas, each a quarter size, of material so that it is triangulated. If you imagine that you are using the existing denture as your custom tray you shouldn’t go too far wrong.
From my experience, I would say that a heavy body vinyl polysiloxane should be used for the borders and a light body wash then used for the impression of supporting tissues.
2. Use An Acrylic Bur To Create An Ideal Surface For The Adhesive
You need to create a surface which the adhesive will stick to. Firstly, if you find that there is a healing soft-tissue liner you should remove it to the best of your ability. I would then Microtech or use an acrylic bur. This will roughen up the borders and give a fresh surface to allow the adhesive to stick.
3. Placing The Impression Adhesive And The Heavy Body Material
I find that doing the right and left sides first, then finishing with the posterior border is a good segmented approach.
4. Don’t Be Heavy Handed With The Impression Material
If you keep in mind the rule, ‘less is more’ you should be going in the right direction. When you are at the border molding stage of relining dentures, start by expressing onto the rim only the thickness of the mixing tube and allow it to start to set. Use a thin spatula to make sure that it cannot be moved easily. Once you actually place it in the mouth and start the muscle molding process you will see that it holds its shape better.
However, if you skip this step and place it straight into the mouth it may fall off the border meaning you need to start over.
5. Carefully Place Three Vents In The Denture Bass
If I am working on the maxillary denture, I will place one vent by the incisive foramen and then two more vents in the tuberosity region. I especially like to this when the anterior ridge has a flabby tissue. This process of venting means that the tissue will not compress as much.
If I am working on the lower, the vent holes would be on the retromolar pads and one vent hole in the midline of the interior space.
6. Pay Special Attention To The Light-Body Material
I give a lot of consideration to the amount of light-body material I use as well as the way that I seat the denture for the impression. It’s important to first put pressure on the posterior borders and remove excess material. Failing to do this will mean that the posterior border will fall toward the tongue and you will have impression material which is too thick, something which the patient will notice.
7. Time For The Patient To Bite Down
At this point, I have the patient bite down to maintain the vertical dimension of occlusion. Before the final impression, I use a bite registration material so that I can again check the vertical dimension.
8. Impress The Upper First Then Leave This While Impressing The Lower
For the last step in relining dentures, I impress the upper first and leave this while impressing with the light-body on the lower. I stay with the patient during this time to ensure they do not open even by the slightest amount.
How successful the final result is will depend much on the processing procedures in the lab. If the same lab that successfully created the original denture also performs the relining there is every chance it will be a great success,