Denture relines.
A reline replaces the fitting surface of a denture to match a ridge that has changed. It restores fit without remaking the prosthesis. Tick Reline under Procedure.
Why relines are needed
Alveolar bone resorbs continuously after extraction, quickly at first and more slowly thereafter but never stopping. A denture that fitted accurately when made will progressively lose adaptation to a ridge that is changing shape beneath it.
The consequences are loss of retention, instability, sore spots where the denture rocks, and altered occlusion as the prosthesis settles.
Relining is maintenance rather than repair, and patients should expect it periodically.
Hard or soft
A hard reline restores fit with conventional acrylic and is the usual answer for a denture that has simply lost adaptation.
A soft or resilient reline is indicated where the underlying tissue cannot tolerate load — a thin, atrophic or tender ridge, prominent bony undercuts, or a patient with a history of persistent sore spots. It cushions the load rather than transmitting it directly.
Soft liners have a finite life. They harden, they can harbour candida, and they need replacing periodically. Tell the patient that at the outset.
Chairside or laboratory
A chairside reline is quicker and keeps the denture with the patient, but the materials are less durable, the result is less accurate and the monomer can irritate tissue.
A laboratory reline produces a considerably better result — properly processed acrylic, an accurate fit, and a finished surface — at the cost of the patient being without the denture while it is processed.
For a definitive reline on a prosthesis expected to serve for years, the laboratory route is generally the right one.
Taking the reline impression
The denture itself is the tray. Relieve the fitting surface enough to make room for the impression material without altering the occlusal relationship, remove any undercuts that would lock it in, and border mould as you would a custom tray.
The critical point is that the denture must be seated in its correct position while the material sets, with the occlusion closed into the correct relationship. A reline impression taken with the denture displaced records and then fixes that displacement permanently.
Check the occlusion after the impression is taken and before sending.
When a reline is the wrong answer
Where the teeth are substantially worn, where the vertical dimension has been lost, where the tooth arrangement is wrong or unaesthetic, or where the base is damaged or repeatedly repaired, relining preserves problems rather than solving them.
Consider a rebase where the arrangement is good but the base is not, or a remake where neither is. See denture rebases.
Tissue conditioning first
Where the denture-bearing tissue is inflamed, distorted or hyperplastic from wearing an ill-fitting prosthesis, a reline impression records the distortion and fixes it permanently.
A period of tissue conditioning — a soft temporary liner, and often reduced wearing time — allows the tissue to recover its true form before the definitive impression is taken.
This takes days to a few weeks and it materially improves the result. Relining onto inflamed tissue is one of the more common reasons a reline disappoints.
What to put on the prescription
Tick Reline under Procedure and specify hard or soft. Note anything about the tissue that prompted the choice.
Say whether the occlusion needs adjusting at the same time, and flag any existing damage to the base or teeth so it can be addressed rather than processed around.
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