Complete Denture Relining, Adjustments, and Repairs: A Comprehensive Guide

Denture Delivery, Adjustments, and Corrections

Achieving Balanced Bite

Following denture delivery, adjustments and corrections are often necessary to ensure a comfortable and functional fit. This includes:

• Checking the denture's articulation with articulator paper.
• Making occlusal corrections to ensure proper bite alignment.
• Modifying denture contours for optimal aesthetics and function.
• Eliminating areas of overpressure to prevent sore spots and ulcers (trimming sharp edges).

Patient Education and Follow-Up

Patients should be educated on proper denture care and maintenance, including:

• Learning to chew with their new dentures, avoiding pushing the prosthesis with the tongue, and chewing on both sides.
• Starting with soft foods and gradually progressing to harder textures.
• Wearing the dentures for 2 hours before an appointment to identify pressure points.
• Practicing phonetics training to adjust to speaking with dentures.
• Maintaining proper hygiene by cleaning the dentures with water, soap, and a brush after each meal to prevent candida and stomatitis.
• Sleeping without the dentures to allow the gums to rest and prevent complications.

Follow-up appointments are typically scheduled at 7 days, 30 days, and 1 year post-delivery.

Relining Dentures

What is Relining?

Relining is the process of adding new material to the tissue surface of the denture to fill the space between the gums (or alveolar ridge) and the denture base, without changing the position of the teeth.

Materials Used

• Impression materials
• Auto-curable resin
• Tissue conditioners

Indications for Relining

• Immediate dentures requiring relining after 3-6 months
• Resorption of the alveolar ridges
• Economic constraints preventing new denture fabrication
• Fissures and fractures in the denture base
• Patients with poor health who may not be suitable candidates for new dentures

General Conditions for Relining

• Proper vertical dimension of occlusion (VDO)
• Maximum intercuspation (IC) in centric relation (CR)
• Acceptable aesthetics
• Appropriate extension to the deepest part of the vestibule
• Adequate interocclusal distance
• Clear speech articulation

Techniques for Relining

1. Open Mouth Technique

Used when occlusion needs modification (altered interocclusal relationship). This technique involves:

• Making intermaxillary and facebow records.
• Taking an impression of the opposing arch with alginate while holding the denture with reline material until it sets.
• Sending the denture and impressions to the lab for relining with the same resin material as the original denture (e.g., acrylic).

2. Closed Mouth Technique

Used when the occlusion is correct and does not require modification. This technique involves:

• Removing existing resin from the tissue surface of the denture.
• Creating a peripheral seal (functional impression).
• Applying a separating agent to the external surfaces of the denture.
• Functionalizing the reline material for 7-8 minutes.
• Trimming any excess soft material.
• Placing the denture back in the mouth for 2-3 minutes to allow the material to set.
• Taking an impression while the patient occludes in centric relation.
• Sending the denture to the lab for final relining, replacing the temporary material with the final resin.

3. Tissue Conditioning (Temporary Relining)

A clinical procedure used to prepare the supporting tissues before final relining. Indicated for:

• Residual ridges in poor condition
• Presence of ulcers or painful areas

This technique involves:

• Removing resin from the tissue surface and peripheral edges.
• Applying a separating agent.
• Creating a peripheral seal.
• Placing the tissue conditioner and having the patient occlude until the material sets.
• Trimming excess material.
• Reviewing the tissue conditioner after 7 days. If intact, send to the lab; if worn, take a new impression.

Denture Breakage and Repair

Repair Technique

• Ensure the fracture line fits perfectly without any material loss.
• Create dovetail retentions for the new repair material (avoid touching the edges, focus on the breaking line).
• Fix the fragments with a metal stick (splint) using wax and glue the fractured area.
• Cast the tissue surface of the denture with plaster after applying a separating agent.
• Incorporate the repair resin (auto-curable or thermo-curable).
• Consider using metal mesh reinforcements to increase resistance to future breakage.
• Cure the resin (e.g., in a pot of boiling water).
• Remove the cast and plaster key after curing.
• Polish the prosthesis with burs and rubbers to remove excess material and achieve a smooth finish.

Note: There may be a slight color difference between the new and old resin, but this is generally not a significant concern.