**Complete Dentures**
Preclinical
**Maintenance,**
**Relines &**
**Repairs**
**Complete Denture Maintenance**
**Procedures**
* **Recall Examination – Annual**
* **Occlusal Correction**
✓ Chairside adjustment
✓ Laboratory adjustment
* **Denture Reline**
✓ Chairside, soft
✓ Chairside, hard
✓ Laboratory, soft
✓ Laboratory, hard
o Reline
o Rebase
* **Denture Repair**
✓ Fractured denture base
✓ Broken or missing tooth
**Complete Denture Maintenance**
**Recall Examination**
1. Update Medical and Dental History
2. Extra-oral Examination of Dentures
3. Intra-oral Examination
4. Reinforce Instructions to the Patient
**Recall Examination**
1. **Update Medical and Dental History**
Common Complaints
* Mandibular denture
* Discomfort
* Poor retention and stability
* Lack of support
* Maxillary denture
* Poor retention and stability
* Pain on chewing
* Aesthetics and phonetics
* Gagging
**Factors under control of Dentist**
Discomfort may be secondary to:
* Open occlusal vertical dimension
* Inaccurate centric relation record
* Lack of occlusal balance
* Poor denture base adaptation
* Inappropriate denture base extensions
Retention and stability compromised by:
* Occlusal discrepancies
* Poor denture base adaptation
* Inadequate denture base extensions
**Factors beyond control of Dentist**
Retention and stability also affected by:
* Moderate to severe resorption
* Unfavourable floor of mouth posture
* Retruded tongue position
* Reduced salivary flow
* Poor neuromuscular control
**Recall Examination**
**2. Extra-oral Examination of Dentures**
1. Sharp projections and acrylic nodules
2. Sharp edges
3. Over-extension into bony undercuts
4. Hand relate dentures to confirm stable
occlusion
**Recall Examination**
**3. Intra-oral Examination**
**A.** **Check denture bearing area**
i. Sharp projections & acrylic nodules
ii. Sharp edges
iii. Stomatitis, fungal infections
**B.** Check extension, retention and stability
**C.** Evaluate aesthetics
**D.** Evaluate phonetics
**E.** Evaluate occlusion
i. Occlusal vertical dimension
ii. Centric occlusion
iii. Eccentric movements
**Blue circle** - typical appearance of
inflamed area beneath an ill-fitting denture
**Green circle** – outside denture bearing
area, probably an apthous ulcer. Need to
observe over time.
**Recall Examination**
of Western Australia
**3. Intra-oral Examination**
A. **Check denture bearing area**
i. **Sharp projections & acrylic nodules**
ii. **Sharp edges**
iii. **Stomatitis, fungal infections**
B. **Check extension, retention and stability**
C. **Evaluate aesthetics**
D. **Evaluate phonetics**
E. **Evaluate occlusion**
i. **Occlusal vertical dimension**
ii. **Centric occlusion**
iii. **Eccentric movements**
**Adequate clearance for frena (1 – 2 mm)**
**Decubitus**
**an ulcer due to local**
**interference with circulation**
**Overextension into**
**bony undercuts**
**Recall Examination**
**3. Intra-oral Examination**
A. Check denture bearing area
i. Sharp projections & acrylic nodules
ii. Sharp edges
iii. Stomatitis, fungal infections
**B. Check extension, retention and stability**
C. Evaluate aesthetics
D. Evaluate phonetics
E. Evaluate occlusion
i. Occlusal vertical dimension
ii. Centric occlusion
iii. Eccentric movements
Check retention
Check stability
**Recall Examination**
**3. Intra-oral Examination**
A. Check denture bearing area
A. Sharp projections & acrylic nodules
B. Sharp edges
C. Stomatitis, fungal infections
B. Check extension, retention and stability
**C. Evaluate aesthetics**
D. Evaluate phonetics
E. Evaluate occlusion
i. Occlusal vertical dimension
ii. Centric occlusion
iii. Eccentric movements
* Form, colour & contour of teeth
* Midline
* Lip line
* Smile line
* Buccal corridor
**Recall Examination**
**3. Intra-oral Examination**
A. Check denture bearing area
A. Sharp projections & acrylic nodules
B. Sharp edges
C. Stomatitis, fungal infections
B. Check extension, retention and stability
C. Evaluate aesthetics
**D. Evaluate phonetics**
E. Evaluate occlusion
i. Occlusal vertical dimension
ii. Centric occlusion
iii. Eccentric movements
Whistle on “S” Sound: This issue is caused by the absence of sufficient space for the tongue between upper bicuspids. The solution is to remove and relocate the denture bicuspids toward the buccal or, if there is adequate room, grind out more area for the tongue.
Lisping on “S” Sound: This concern is essentially the opposite of the whistling “S” in that its cause is too much room for the tongue between the upper bicuspids. To test for this, add a piece of wax palatal to the bicuspids and check phonetics.
Indistinct “Th” and “T” sounds can be corrected by thinning out the palatal area of the anterior.
**Recall Examination**
**3. Intra-oral Examination**
A. Check denture bearing area
A. Sharp projections & acrylic nodules
B. Sharp edges
C. Stomatitis, fungal infections
B. Check extension, retention and stability
C. Evaluate aesthetics
D. Evaluate phonetics
E. **Evaluate occlusion**
i. Occlusal vertical dimension
ii. Centric occlusion
iii. Eccentric movements
**Recall Examination**
**4. Instructions to Patient**
* Careful daily removal of biofilm in oral cavity and on dentures
* Mechanical (non-abrasive)
* Chemical
* Annual professional ultrasonic cleaning
* Never place dentures in boiling water
* Do not place in sodium hypochlorite for periods longer 10 minutes
* Whilst out of mouth, store dentures in clean water to avoid warping
* Denture adhesives, properly used, can improve retention and stability and help seal even well-
fitting dentures
* Dentures should not be worn 24/7
* Patients who wear dentures should be checked annually for fit & function, evaluation for oral
lesions and bone loss, and for assessment of oral health status
Felton et al 2011
# Complete Denture Maintenance
## Procedures
* **Recall Examination – Annual**
* **Occlusal Correction**
✓ **Chairside adjustment**
✓ **Laboratory adjustment**
* **Denture Reline**
✓ **Chairside, soft**
✓ **Chairside, hard**
✓ **Laboratory, soft**
✓ **Laboratory, hard**
o **Reline**
o **Rebase**
* **Denture Repair**
✓ **Fractured denture base**
✓ **Broken or missing tooth**
---
* Only possible for minor occlusal discrepancies
* Articulating paper used to identify areas of heavy contact
**Occlusal Correction**
**Chairside Adjustment**
Occlusal Adjustments for Intercuspal Position
THE UNIVERSITY OF
WESTERN
AUSTRALIA
Oral Health Centre
of Western Australia
**Occlusal Correction**
**Chairside Adjustment**
Occlusal Adjustments for Excursive movements
**Complete Denture Maintenance**
**Procedures**
* Recall Examination – Annual
* **Occlusal Correction**
✓ Chairside adjustment
✓ **Laboratory adjustment**
* Denture Reline
✓ Chairside, soft
✓ Chairside, hard
✓ Laboratory, soft
✓ Laboratory, hard
o Reline
o Rebase
* Denture Repair
✓ Fractured denture base
✓ Broken or missing tooth
**Occlusal Correction**
**Laboratory Adjustment**
**Incorrect MMR**
**THE UNIVERSITY OF**
**WESTERN**
**AUSTRALIA**
**Oral Health Centre**
**of Western Australia**
**Anterior primary contact**
**Premature posterior contact**
**Anterior open bite**
**Centrelines do not coincide**
**Occlusal Correction**
**Laboratory Adjustment**
**Incorrect MMR**
THE UNIVERSITY OF
**WESTERN**
**AUSTRALIA**
Oral Health Centre
of Western Australia
Dentsply
**Occlusal Correction**
**Laboratory Adjustment**
**Incorrect MMR**
THE UNIVERSITY OF
**WESTERN**
**AUSTRALIA**
Oral Health Centre
of Western Australia
**Occlusal Correction**
**Laboratory Adjustment**
**Incorrect MMR**
THE UNIVERSITY OF
WESTERN
AUSTRALIA
Oral Health Centre
of Western Australia
**Occlusal Correction**
**Laboratory Adjustment**
**Incorrect MMR**
THE UNIVERSITY OF
**WESTERN**
AUSTRALIA
Oral Health Centre
of Western Australia
**Occlusal Correction**
**Laboratory Adjustment**
Incorrect MMR
THE UNIVERSITY OF
**WESTERN**
**AUSTRALIA**
Oral Health Centre
of Western Australia
**Occlusal Correction**
**Laboratory Adjustment**
**Incorrect MMR**
THE UNIVERSITY OF
**WESTERN**
**AUSTRALIA**
Oral Health Centre
of Western Australia
**Occlusal Correction**
**Laboratory Adjustment**
Incorrect MMR
**THE UNIVERSITY OF**
**WESTERN**
**AUSTRALIA**
Oral Health Centre
of Western Australia
**Complete Denture Maintenance**
**Procedures**
* **Recall Examination – Annual**
* **Occlusal Correction**
✓ Chairside adjustment
✓ Laboratory adjustment
* **Denture Reline**
✓ Chairside, soft
✓ Chairside, hard
✓ Laboratory, soft
✓ Laboratory, hard
o Reline
o Rebase
* **Denture Repair**
✓ Fractured denture base
✓ Broken or missing tooth
**Denture Reline**
* **The University of Western Australia**
* **Oral Health Centre of Western Australia**
* **Indications**
* lack of stability
* lack of retention
* **Timing Within Treatment Plan**
* denture insert (e.g. corrective)
* after short-term (e.g. post-extraction)
* after long-term (e.g. resorption)
* **Areas**
* posterior extension / seal
* peripheral extension
* alveolar changes
**Denture Reline**
**Assessment**
**THE UNIVERSITY OF**
**WESTERN**
**AUSTRALIA**
**Oral Health Centre**
**of Western Australia**
**Complete Denture Maintenance**
**Procedures**
* Recall Examination – Annual
* Occlusal Correction
* ✓Chairside adjustment
* ✓Laboratory adjustment
* **Denture Reline**
* ✓**Chairside, soft**
* ✓Chairside, hard
* ✓Laboratory, soft
* ✓Laboratory, hard
* o Reline
* o Rebase
* Denture Repair
* ✓Fractured denture base
* ✓Broken or missing tooth
* Usually a self-curing plasticised acrylic
* Often used immediately after surgery
* Can be used to improve stability and promote healing under an ill-fitting denture prior to impression-making
* Difficult to attain an even thickness
* Short service life (~ 6 weeks)
* Short term use only
**Denture Reline**
**Chairside, Soft**
Materials
**Ufi Gel SC**
VOCO
**GC RELINE**
**INTRODUCTORY KIT**
THE UNIVERSITY OF
**WESTERN**
**AUSTRALIA**
Oral Health Centre
of Western Australia
**COE-SOFT**
**COE-SOFT**
**GC**
**CG**
**Denture Reline**
**Chairside, Soft**
**Ufi Gel**
<img src="image1.jpg" width="100%" />
**Denture Reline**
**Chairside, Soft**
**Ufi Gel**
THE UNIVERSITY OF
**WESTERN**
**AUSTRALIA**
Oral Health Centre
of Western Australia
Complete Denture Maintenance
**Procedures**
* Recall Examination – Annual
* Occlusal Correction
✓ Chairside adjustment
✓ Laboratory adjustment
**• Denture Reline**
✓ Chairside, soft
**✓ Chairside, hard**
✓ Laboratory, soft
✓ Laboratory, hard
o Reline
o Rebase
* Denture Repair
✓ Fractured denture base
✓ Broken or missing tooth
**Usually a self-curing acrylic resin**
* **Has no cushioning effect**
* **Provides a longer service life than the**
**chairside soft reline material (~6 months)**
**Denture Reline**
**Chairside, Hard**
**Materials**
---
**THE UNIVERSITY OF**
**WESTERN**
**AUSTRALIA**
**Oral Health Centre**
**of Western Australia**
---
**Ufi Gel hard**
---
**GC RELINE**™
**CHAIRSIDE HARD DENTURE LINER**
**STANDARD PACKAGE**
**GC RELINE**
**CE**
**GC**
---
**COE-RECT**™
**DENTURE RELINE**
**AND REPAIR MATERIAL**
**PROFESSIONAL PACKAGE**
**COE-RECT**
**COE-RECT**
**GC**
**Denture Reline**
**Chairside, Hard**
**Base Reduction**
**THE UNIVERSITY OF**
**WESTERN**
**AUSTRALIA**
**Oral Health Centre**
**of Western Australia**
**Denture Reline**
**Chairside, Hard**
**THE UNIVERSITY OF**
**WESTERN**
**AUSTRALIA**
**Oral Health Centre**
**of Western Australia**
**Denture Reline**
**Chairside, hard**
**THE UNIVERSITY OF**
**WESTERN**
**AUSTRALIA**
**Oral Health Centre**
**of Western Australia**
**Denture Reline**
**Chairside, Hard**
THE UNIVERSITY OF
WESTERN
AUSTRALIA
Oral Health Centre
of Western Australia
**Denture Reline**
---
**Chairside, Hard**
**THE UNIVERSITY OF**
**WESTERN**
**AUSTRALIA**
**Oral Health Centre**
**of Western Australia**
**Denture Reline**
**Chairside, Hard**
Potential problems
* Bony undercuts
* Separation of materials
* Bubbles/porosities
* Long-term outcome
# Complete Denture Maintenance
**Procedures**
* Recall Examination – Annual
* Occlusal Correction
✓Chairside adjustment
✓Laboratory adjustment
* **Denture Reline**
✓Chairside, soft
✓Chairside, hard
✓**Laboratory, soft**
✓Laboratory, hard
o Reline
o Rebase
* Denture Repair
✓Fractured denture base
✓Broken or missing tooth
Usually a heat cured silicone
* Correct laboratory process results in a more even thickness of material
* Generally requires a two stage cure
* Costs more
* Has a longer service life (~3 years)
* May suffer from adhesion problems
* Staining is often an issue
**Denture Reline**
**Laboratory, Soft**
**Molloplast B**
THE UNIVERSITY OF
**WESTERN**
**AUSTRALIA**
Oral Health Centre
of Western Australia
Molloplast B
Molloplast B
**Complete Denture Maintenance**
**Procedures**
* Recall Examination – Annual
* Occlusal Correction
✓ Chairside adjustment
✓ Laboratory adjustment
**Denture Reline**
✓ Chairside, soft
✓ Chairside, hard
✓ Laboratory, soft
✓ Laboratory, hard
o Reline
o Rebase
* Denture Repair
✓ Fractured denture base
✓ Broken or missing tooth
Usually a heat-cured polymethyl methacrylate
* Applied as a thin lining to the intaglio surface of the denture
* Costs more, lasts longer
* The bulk of the denture base is the original acrylic and is subjected to a second heat-curing cycle and possible distortion
**Denture Reline**
**Laboratory, Hard Reline**
THE UNIVERSITY OF
WESTERN
AUSTRALIA
Oral Health Centre
of Western Australia
Base reduction
Base reduction
**Denture Reline**
**Laboratory, Hard Reline**
THE UNIVERSITY OF
WESTERN
AUSTRALIA
Oral Health Centre
of Western Australia
Covering teeth
Vaseline
**Denture Reline**
**Laboratory, Hard Reline**
THE UNIVERSITY OF
WESTERN
AUSTRALIA
Oral Health Centre
of Western Australia
**Denture Reline**
**Laboratory, Hard Reline**
**THE UNIVERSITY OF**
**WESTERN**
**AUSTRALIA**
**Oral Health Centre**
**of Western Australia**
**Denture Reline**
**Laboratory, Hard Reline**
THE UNIVERSITY OF
WESTERN
AUSTRALIA
Oral Health Centre
of Western Australia
**Denture Maintenance**
**Laboratory, Hard Reline**
THE UNIVERSITY OF
WESTERN
AUSTRALIA
Oral Health Centre
of Western Australia
# **Complete Denture Maintenance**
## **Procedures**
* Recall Examination – Annual
* Occlusal Correction
✓ Chairside adjustment
✓ Laboratory adjustment
* **Denture Reline**
✓ Chairside, soft
✓ Chairside, hard
✓ Laboratory, soft
✓ **Laboratory, hard**
o Reline
o Rebase
* Denture Repair
✓ Fractured denture base
✓ Broken or missing tooth
Usually a heat-cured polymethyl methacrylate
* Replaces most of the denture base material
* Costs even more but lasts even longer
* Less likely to undergo dimensional change during
processing
**Denture Reline**
**Laboratory, Hard Rebase**
THE UNIVERSITY OF
**WESTERN**
**AUSTRALIA**
Oral Health Centre
of Western Australia
**Complete Denture Maintenance**
**Procedures**
**Recall Examination – Annual**
**Occlusal Correction**
✓Chairside adjustment
✓Laboratory adjustment
**Denture Reline**
✓Chairside, soft
✓Chairside, hard
✓Laboratory, soft
✓Laboratory, hard
o Reline
o Rebase
**Denture Repair**
✓Fractured denture base
✓Broken or missing tooth
**Denture Repair**
Oral Health Centre
of Western Australia
**Fractured Denture Base**
Method 1
Denture Repair
Fractured denture base
**Denture Repair**
**Fractured Denture Base**
**Method 1**
THE UNIVERSITY OF
WESTERN
AUSTRALIA
Oral Health Centre
of Western Australia
**Denture Repair**
**Fractured Denture Base**
Method 1
THE UNIVERSITY OF
WESTERN
AUSTRALIA
Oral Health Centre
of Western Australia
Denture Repair
Fractured Denture Base
Method 1
**Denture Repair**
**Fractured Denture Base**
**Method 1**
THE UNIVERSITY OF
WESTERN
AUSTRALIA
Oral Health Centre
of Western Australia
**Denture Repair**
**Fractured Denture Base**
Method 2
THE UNIVERSITY OF
**WESTERN**
**AUSTRALIA**
Oral Health Centre
of Western Australia
Repair resin
**Denture base**
**Denture base**
**Gap width:**
**3 mm or less**
Larident Star Hydroflask-
209750
**Complete Denture Maintenance**
**Procedures**
* <font color="#9B9B9B">Recall Examination – Annual</font>
* <font color="#9B9B9B">Occlusal Correction</font>
✓ <font color="#9B9B9B">Chairside adjustment</font>
✓ <font color="#9B9B9B">Laboratory adjustment</font>
* <font color="#9B9B9B">Denture Reline</font>
✓ <font color="#9B9B9B">Chairside, soft</font>
✓ <font color="#9B9B9B">Chairside, hard</font>
✓ <font color="#9B9B9B">Laboratory, soft</font>
✓ <font color="#9B9B9B">Laboratory, hard</font>
* <font color="#9B9B9B">Reline</font>
* <font color="#9B9B9B">Rebase</font>
* **Denture Repair**
✓ <font color="#9B9B9B">Fractured denture base</font>
✓ **Broken or missing tooth**
**Denture Repair**
**Broken or missing tooth**
**THE UNIVERSITY OF**
**WESTERN**
**AUSTRALIA**
**Oral Health Centre**
**of Western Australia**
**Denture Repair**
**Broken or Missing Tooth**
THE UNIVERSITY OF
WESTERN
AUSTRALIA
Oral Health Centre
of Western Australia
**Denture Repair**
**Broken or Missing Tooth**
THE UNIVERSITY OF
WESTERN
AUSTRALIA
Oral Health Centre
of Western Australia
**Thank**
**You**
Any questions? Contact me
Dr Ian Lander
ian.lander@uwa.edu.au
