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1995;126;503-506J Am Dent Assoc

GJ Christensendentures

Relining, rebasing partial and complete

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C H R I S T E N S E Ns p a c e s a n d / or p r o s t h e s i s o c c l u -s i o n d o e s n o t t o u c h o p p o s i n ga r c h t e e t h , a r e l i n e i s n e e d e d .E i t h e r a c h a i r s i d e r e l i n e , d e -s c r i b e d a b o v e , o r a l a b o r a t o r yr e l i n e i s i n d i c a t e d .When m a k i n g a n i m p r e s s i o nf o r a l a b o r a t o r y r e l i n e o f a nR P D , r e l a t i v e l y v i s c o u s i m p r e s -s i o n m a t e r i a l s s h o u l d b e u s e d t od i s p l a c e t i s s u e s i n a mannerl i k e c h e w i n g .P e r m a d y n e H i g h V i s c o s i t y( E S P E - P r e m i e r ) h a s a n e x c e l -l e n t s u c c e s s r e c o r d f o r t h i s p r o -c e d u r e . I t i s e s p e c i a l l y u s e f u l f o rr e l i n i n g b e c a u s e i t- c a n b e g r o u n d a w a y w i t h ab u r ;- a l l o w s s u b s e q u e n t l a y e r s o ft h e s a m e m a t e r i a l t o b o n d w i t h -o u t a d h e s i v e ;- i s h y d r o p h i l i c .S o f t t i s s u e a r e a s o f t h e RPDs h o u l d b e r e l i e v e d o f u n d e r c u t s .T h e d e n t u r e c o n t a i n i n g P e r m a -d y n e s h o u l d b e s e a t e d , b o r d e rm o l d e d a n d h e l d i n c o r r e c t p o -s i t i o n b y h a v i n g t h e p a t i e n tc l o s e t h e t e e t h t o g e t h e r i n ac o m f o r t a b l e , m o d e r a t e - l o a d ,c e n t r i c - o c c l u s i o n p o s i t i o n . S u c hi m p r e s s i o n s p l a c e l o a d o n e d e n -t u l o u s a r e a s a n d p r o v i d e n e a r -o p t i m u m f i t f o r r e l i n e d RPDs i fp r o p e r b o r d e r m o l d i n g h a s b e e nd o n e .R e b a s i n g s h o u l d b e a c c o m -p l i s h e d when r e s i n b a s e s d o n o te x t e n d w e l l i n t o s o f t t i s s u e r e -f l e c t i o n a r e a s o r when r e s i nb a s e s h a v e d e g e n e r a t e d .R e l i n i n g o r r e b a s i n g c o m p l e t ed e n t u r e s b e c o m e s n e c e s s a r ym a i n l y b e c a u s e o f t i s s u e c h a n g e sr e l a t e d t o b o n e r e s o r p t i o n . U s u a l -l y , m a n d i b u l a r d e n t u r e s r e q u i r em o r e f r e q u e n t r e l i n i n g t h a n m a x -i l l a r y d e n t u r e s .C r i t e r i a f o r r e l i n i n g o r r e b a s -i n g a r e- p o o r r e t e n t i o n o r s t a b i l i t y ;- c o l l a p s e o f v e r t i c a l d i m e n s i o n

o f o c c l u s i o n ;- l a c k o f d i s p l a y o f t e e t h d u r -i n g s p e ec h , i n di c a t i n g c o l l a p s eo f d e n t u r e s t o w a r d a l v e o l a rr i d g e s ;- d e g e n e r a t i o n o f d e n t u r eb a s e s ;- l a c k o f p r op e r d e n t u r e e x t e n -s i o n i n t o m u c o b u c c a l f o l d a r e a s .T h e s e c r i t e r i a a l s o a r e i n d i c a -t i o n s f o r t o t a l l y r e m a k i n g t h ed e n t u r e s . T h e d e t e r m i n e d m a g -n i t u d e o f t h e c l i n i c a l p r o b l e m i sr e l a t e d d i r e c t l y t o t h e d e c i s i o nt o r e l i n e , r e b a s e o r r e m a k e t h ec o m p l e t e p r o s t h e s i s . U s u a l l yl a b o r a t o r y r e l i n e s - r e b a s e s a r ei n d i c a t e d f o r c o m p l e t e d e n t u r e s .T h a t i s b e c a u s e o f t h e e a s e o fm a k i n g i m p r e s s i o n s i n s i d e o l dd e n t u r e s a n d t h e r e l a t i v es t r e n g t h a n d c o l o r s t a b i l i t y o fl a b o r a t o r y r e l i n e - r e b a s e m a -

I S u c c e s s f u l c h a i r s i d er e l i n i n g o f c o m p l e t ed e n t u r e s c a n b ea c c o m p l i s h e d b y t a k i n gs p e c i a l c a r e t o a v o i dm o v i n g t h e d e n t u r e so f f t h e a l v e o l a r b a s ed u r i n g t h e r e l i n ei m p r e s s i o n .

t e r i a l s when c o m p a r e d t o c h a i r -s i d e m a t e r i a l s . I m p r e s s i o n s f o rc o m p l e t e d e n t u r e r e l i n e s -r e b a s e s c a n b e made i n a n y o fmany c a t e g o r i e s o f m a t e r i a l s .A s i m p l e , e a s y a n d e f f e c t i v e

i m p r e s s i o n t e c h n i q u e f o r t h e s ep r o c e d u r e s u s i n g P e r m a d y n e( E S P E - P r e m i e r ) f o l l o w s .1 . Remove u n d e r c u t s f r o mt h e d e n t u r e i n t e r n a l a r e a s ,a l l o w i n g a t e c h n i c i a n t o r e m o v et h e d e n t u r e f r o m t h e s e t s t o n ec a s t l a t e r .2 . P l a c e a d h e s i ve o n t h e

i n t e r n a l a r e a s o f t h e d e n t u r e .P e r m a d y n e a d h e s i v e d r i e s w e l li n a b o u t 9 0 s e c o n d s .3 . I f t h e o l d d e n t u r e i s p o o r l ye x t e n d e d p e r i p h e r a l l y , make ap r i m a r y i m p r e s s i o n i n P e r m a -d y n e H i g h V i s c o s i t y , b o r d e rm o l d i n g a s s o o n a s t h e m a t e r i a lr e a c h e s t h e c o r r e c t v i s c o s i t y .A f t e r t h e i m p r e s s i o n m a t e r i a ls e t s , r e m o v e t h e i m p r e s s i o n a n dr e l i e v e a n y p r e s s u r e s p o t s ( i n d i -c a t e d b y d e nt u r e b a s e c o l o rs h o w i n g t h r o u g h t h e i m p r e s s i o nm a t e r i a l ) . P l a c e ne w a d h e s i v eo n a n y i n t e r n a l d e n t u r e b a s ea r e a s w h e r e t h e i m p r e s s i o nm a t e r i a l w a s r e m o v e d a n dr a p i d l y make a f i n a l w a s hi m p r e s s i o n , u s i n g P e r m a d y n eLow V i s c o s i t y . Do t h e b o r d e rm o l d i n g i m m e d i a t e l y t o r e d u c et h e c h a n c e o f i n c r e a s e dv i s c o s i t y o f t h e m a t e r i a l d u e t ot h e b e g i n n i n g s e t t i n g r e a c t i o na n d o v e r e x t e n s i o n o f t h e i m -p r e s s i o n . I f t h e d e n t u r e f i t w a sr e l a t i v e l y g o o d , o n l y P e r m a d y n eLow V i s c o s i t y s h o u l d b e u s e d ,i n s t e a d o f m a k i n g a p r i m a r yi m p r e s s i o n i n P e r m a d y n e H i g hV i s c o s i t y f i r s t .

D r . C h r H i t e n s e n I sco -fo un d e r a n dc u r r e n t l y seniorconsultant o fC l i n i c a l Re s e a rc hA s s o c i a t e s , 3707 N.Canyon R d . , Sultono 6 , P r o v o , U t a h ,84604, a n d I s amember of JADA'se d i t o r i a l board. Heh a s a master'sd e g r e e I n r e s t o r a t i v edntistry and adoctorate I neducation a n dpsychology. He I sboa rd c e r t i f i e d I nprosthodontics

4 . P o s t - d a ma r e a s c a n b ep l a c e d e i t h e rb y a d d i n g waxo r o t h e r f a v o -r i t e m a t e r i a l so n t h e i m p r e s -s i o n c l i n i c a l l y ,o r b y p l a c i n g ap o s t - d a m o nt h e c a s t .S u c c e s s f u lc h a i r s i d e r e -l i n i n g o f c o m -p l e t e d e n t u r e sc a n b e a c c o m -p l i s h e d b yt a k i n g s p e c i a lc a r e t o a v o i dm o v i n g t h ed e n t u r e s o f f

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7/31/2019 Rebase Para Dentaduras Parciales y Totales

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C H N I S I E N S [ N

t h e a l v e o l a r b a s e d u r i n g t h ereline i m p r e s s i o n . T y p i c a l l y ,m a x i l l a r y d e n t u r e s t e n d t omove f o r w a r d when r e l i n e dd i r e c t l y , b e c a u s e o f t h er e l a t i v e l y l o w r e s i s t a n c e o f t h es o f t t i s s u e b a s e t o f o r w a r dl o a d i n g .M a n d i b u l a r d e n t u r e s r e l i n e dd i r e c t l y can move a n y w h e r e i ft h e a l v e o l a r r i d g e s ar e m o d e r -a t e l y t o s e v e r e l y r e s o r b e d . H o w -ever, i f a l v e o l a r s u p p o r t i s a d e -q u a t e , d i r e c t c h a i r s i d e r e l i n i n g

w i t h l i g h t curing m a t e r i a l( D e n t s p l y T r i a d ) or a u t o curem a t e r i a l ( T o k u s o a n d o t h e r s )can b e s u c c e s s f u l i f proper carei s t a k e n a n d c o r r e c t m a t e r i a l sar e u s e d .Many c h a i r s i d e r e l i n e m a t e r -i a l s h a v e v e r y h i g h e x o t h e r m i cr e a c t i o n s , u n a c c e p t a b l e t a s t ea n d poor c o l o r r e t e n t i o n overt h e s e r v i c e p e r i o d . T h e y s h o u l db e a v o i d e d .P e r i o d i c a l l y r e l i n i n g a n d r e -b a s i n g r e m o v a b l e p a r t i a l a n d

c o m p l e t e d e n t u r e s i s necessaryt o ensure a c c e p t a b l e l o n g - t e r md e n t u r e f u n c t i o n a n d e s t h e t i c s .Many p r o d u c t s a n d t e c h n i q u e se x i s t , a n d d e n t i s t s must s e l e c tt h o s e m o s t a p p r o p r i a t e f o r t h e i rp r a c t i c e s . .

I n f o r m a t i o n a b o u t t h e p r o d u c t s m e n t i o n e d i nt h i s a r t i c l e i s a v a i l a b l e f r o m t h e a u t h o r .N e i t he r t h e a u t h o r n or t h e ADA h a s anyc o m m e r c i a l i n t e r e s t i n t h e p r o d u c t s m e n t i o n e d .T h e o p i n i o n s e x p r e s s e d or i m p l i e d are s t r i c t l y

those o f t h e a u t h o r a n d d o n o t n e s a r i l y r e f l e c tt h e o p i n i o n s or p o l i c i e s o f t h e A m e r i c a n D e n t a lA s s o c i a t i o n or i t s s u b s i d i a r i e s .

5 0 6 J A D A , V o l . 1 2 6 , A p r i l 1 9 9 5

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