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Relining and Rebasing of Removable Partial Dentures

Prof. Dr. S. Venugopal.

Indications for relining a distal extension RPD

Loss of tissue support that causes rotation
and settling of the distal extension base. Loss of occlusal contact causing difficulty in mastication

The need for relining a distal extension base is detected by

By applying pressure on the extreme distal end of
the denture base and watching the anterior indirect retainer as it lifts off.

Loss of occlusal contact is detected by having the

patient close on two strips of blue casting wax. If the occlusal contact between the artificial dentition is weak or lacking; while natural teeth in opposition are making firm contact, then the RPD needs relining.

The need for relining a bounded case of a RPD is detected by

Unpleasant appearance, due to space

that may develop between the denture base and underlying tissues. Lack of tissue contact and patients discomfort. Entrapment of food debris.

I. Laboratory Relining

Closed mouth technique: in bounded

cases Open mouth technique : in distal extension cases

Closed mouth technique

Procedure: The tissue surface of the denture base is relieved to accommodate the impression material. The impression material is mixed and applied to the tissue surface and the PD is seated in the patients mouth making sure that the impression material is kept away from the occlusal rests. The patient is asked to close in centric occlusion until complete setting of the material. An overall alginate impression is made, cast poured, then the RPD is flasked, processed and reline material is added.

Open mouth technique

functional reline impression

technique

II. Intra-oral (chair side) relining

Advantages Saves time. The patient does not leave his denture. N.B. After relining occlusal corrections should be done. If minor adjustments are required it could be carried out intraorally. However, occlusal adjustments for distal extension PDs may be accomplished more accurately by remounting procedures.

Removable Partial Overdentures

Prof. Dr. S. Venugopal.

Definition
It is a removable prosthesis that is retained
and supported by some of the natural teeth or roots under its base. If the natural roots or teeth are replaced by an implant it is called an implant supported partial denture

Indications
1. In cases where the chosen abutment teeth show improper
2.
crown/root ratio, so reduction of the natural crown is done to improve the C/R ratio. In cases that provide poor prognosis if restored by conventional removable partial denture; for example: Flat ridge Few remaining natural teeth. Remaining healthy roots. Long span, edentulous ridge. A case contra-indicated for fixed partial denture

Indications
3. Excessive wear of the teeth, which may result
4. 5.
from erosion, abrasion or attrition Loose teeth that can be devitalized and reduced in favor of C/R ratio and their presence maintain the level of alveolar bone. Patients with congenital defects are cosmetically and functionally inadequate as regards dental and alveolar arch relationships. Removable partial overdenture gives excellent (superb) results.

Contraindications
When other prosthesis give and provide In cases of bad oral hygiene, where the
superior and efficient and more beneficial results. patient can't afford the least routine ways, that keeps and maintains the health of the remaining natural teeth.

When the interarch space is insufficient.

Advantages
Good stability as its support is mainly from the teeth

rather than the edentulous ridge. Provides more load distribution, which minimizes the trauma of soft tissues and bone resorption. It needs minimum adjustment and modification, as it is highly supported and stable. Preservation of proprioceptors in the periodontal membrane of the remaining roots, so the jaw relation will be easily recorded. Easily accepted and used, so the patient is satisfied and feels normal especially during mastication.

Disadvantages
It can interfere with the inter-arch space, as it
is more bulky (especially if not perfectly constructed).

More time consuming and more expensive. Needs more clinical and laboratory steps.

Attachments in Removable partial overdentures Increases retention, stability and support. Distribution of masticatory load between

abutment and tissues. Caries control. Splinting of questionable abutments

Implant supported Removable partial Overdentures

Indications Partially edentulous cases with unilateral or bilateral free end saddle cases. Long span cases with few remaining teeth. To help periodontally involved teeth. In cases of resected mandible.

Repair of Removable Partial Dentures

Prof. Dr. S. Venugopal.

Broken clasp arm

It may be replaced by wrought wire clasp
embedded in the resin or attached to the metal base by soldering.

In cases where a rigid clasp is needed a new

clasp assembly may be cast and attached to the framework by soldering

Broken occlusal rest

A new clasp assembly is made and
soldered to the denture framework.

Addition of a new tooth

In cases where the last tooth is an abutment supporting a clasp arm: Cut off the clasp arm and prepare the adjacent tooth to receive the new clasp. Cast the new clasp and attach it to the framework by soldering, then add the artificial tooth to replace the lost natural tooth.

Addition of a new tooth

If the lost tooth is not the main abutment: If the denture base is resin simply make retentive means in the acrylic resin and add the tooth. If the denture base is metal, this necessitates both casting a new component and attaching it by soldering or creating retentive means for the attachment of an acrylic resin extension.

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