The Art of Denture Relining
Karl F. Leinfelder, DDS, MS; Douglas A. Terry, DDS; and Mark E. Connelly, DDS
Mastering the art of complete or partial dentures requires developing a balance between function, comfort, and esthetics.1 Although the fabrication of complete denture prostheses is somewhat complex, requiring multiple detailed procedures, the result can be generally quite acceptable. Many times after prosthetic completion an imbalance in these three criteria can occur over time. Gradual physiologic changes of the soft tissues as well as resorption of the underlying osseous structure can cause the denture to lose its original stability and retention.2 Assuming that the occlusal and vertical dimensions of the denture are acceptable, it is possible to regain tissue adaptation and retention of the supporting structures by relining the denture base.
This can be achieved through an indirect technique in the laboratory or directly in the patient’s mouth. The indirect technique includes the generation of an impression, stone cast, and then applying new denture base material to the internal aspect of the denture. The direct method of denture relining is accomplished by means of making an intraoral impression within the denture using a chairside lining material that bonds to the inner surface of the denture.3-5
Each of these methods poses potential challenges. The indirect technique is performed in a laboratory with special curing equipment, which means that the patient must go without the denture for a period of time. Other concerns associated with the indirect technique include dimensional change (warping) in the denture base6,7 and potential errors in occlusion. However, conventional laboratory-processed liners exhibit a greater degree of material polymerization from elevated temperatures and pressures that suggest improved physical and mechanical properties of the materials.4 The direct lining method an be more patient-friendly and faster than the laboratory method; however, chairside relining systems in the past were characterized by technical shortcomings of the material. Challenges associated with these materials have included poor bonding of the reline material to the denture base; surface porosities that commonly lead to build-up of food stuffs and bacteria that can result in a bad odor; chemicaburns; heat generation; mucosal irritation; color instability; and an unpleasant taste.6-10 Finally, the intraoral lining method can be characterized by short-term longevity.
Continue reading at http://www.dentalaegis.com/id/2007/05/the-art-of-denture-relining