0:03 foreign [Music]
0:21 Ing and re-pacing of complete Danger
0:23 many students had requested for this
0:26 topic you know this topic comes as a
0:28 short note in the theory exam it is
0:32 often asked in the grand fiber and many
0:35 mcqs are framed from this topic we will
0:38 be discussing step by step the clinical
0:40 as well as the laboratory procedure of
0:43 relining and rebasing so stay tuned till end
0:50 first of all what is re-learning you
0:52 know after a few years when the redress
0:55 option takes place or in case of the
0:57 immediate danger patient complains of
1:00 the loose dangers okay so the procedure
1:04 used to resurface the tissue site of the
1:07 danger with a new base material that
1:10 produces an accurate adaptation of the
1:13 danger Foundation area
1:22 the second is the re-basing you know
1:25 rebasing is the laboratory procedure or
1:28 the process of replacing the entire
1:31 denture base material on an existing
1:34 prosthesis now in the relining we were
1:36 just resurfacing the tissue side but in
1:39 rebasing we will be replacing the entire
1:47 next comes the indications where we will
1:50 realign or rebase the danger now first
1:53 of all the immediate danger in immediate
1:55 dangerous at three to six months after
1:57 their construction the tissue
2:00 modification takes place and the dangers
2:03 become loose they need to be realigned
2:05 second is the poor adaptation where the
2:08 residual alveolar Rich has resolved and
2:10 the adaptation of the Denture basis to
2:13 The Ridges is poor then we go for relining
2:15 relining
2:18 now the geriatric or the chronically ill
2:19 patient you know when the construction
2:22 of new dangers with a series of
2:25 appointments it can cause physical or
2:27 mental stress to the patient and we
2:29 cannot construct new dentures
2:32 last but very important when the patient
2:35 cannot afford the cost of having the new
2:38 Dentures then also we have to opt for relining
2:45 contraindications you know the
2:48 conditions the situations where we will
2:50 have to fabricate new dangers we cannot
2:53 go for the re-landing the first is the
2:55 unsatisfactory jaw relation when the
2:57 occlusion vertical Dimension is not
3:00 satisfactory or when the uh complete
3:02 denture occlusion it does not coincide
3:05 with the Centric relation okay then
3:06 we'll have to go for the new Dentures
3:09 second is the poor Aesthetics when the
3:11 size shape shade or the arrangement of
3:14 the artificial teeth is not acceptable
3:16 it's not satisfactory
3:19 third is the abused soft tissue the oral
3:22 tissue has to be in optimum health for
3:25 relearning or the relining has to be
3:28 delayed until the tissues they recover
3:31 next comes the excessive amount of
3:33 resorption if it has taken place then
3:35 also we will go for the fabrication of
3:37 new denture
3:39 last but very important the dangers with
3:42 the major speech problem phonetics okay
3:45 that cannot be altered with relining so
3:48 we will have to fabricate new dangers in
3:53 now let us discuss the step-by-step
3:55 procedure of doing the relining and the rebasing
4:03 four steps are involved okay in the
4:06 relaying in the rebasing first is the
4:08 tissue preparation second is the danger
4:11 preparation the existing danger needs to
4:13 be modified third is the impression
4:15 making that is the clinical procedure
4:19 and last is the laboratory procedure to
4:21 get the modified denture foreign
4:30 okay first in the tissue preparation the
4:32 hypertrophic tissue needs to be
4:34 identified and it should be surgically
4:37 removed okay the dangers can be used as
4:40 a surgical splint also in these cases
4:43 second the oral mucosa it should be free
4:46 of any area of irritation you know that
4:48 has to be ruled out and that has to be
4:50 recovered before we go for the final impression
4:52 impression
4:54 third patients should be asked that
4:56 dentist should be left out of the mouth
4:59 for at least two to three days before we
5:01 make the final impression
5:04 last and very important you you can ask
5:06 the patient to do the daily massage of
5:09 the soft tissues this is helpful to
5:17 step number two is the danger
5:20 preparation okay in this first uh the
5:22 pressure areas on the tissue surface of
5:25 the danger needs to be identified we can
5:28 use pressure indicating paste for it and
5:31 these need to be relieved second is the
5:34 minor occlusial disharmonies that has to
5:36 be corrected by The Selective grinding
5:39 okay third is the Border area if the
5:41 Border area there is any inadequacy or
5:44 short then it should be extended and
5:45 corrected with the help of the green
5:47 stick compound
5:50 last and very important is the posterior
5:53 marital seal area adequate and correct
5:55 posterior palatal seal area should be
5:58 established before we go for the final impression
6:05 step number three that is the clinical
6:08 step impression making for the relining
6:10 okay in this we have three techniques
6:13 first is the static impression technique
6:15 second is the functional impression
6:18 technique and third is the chair side
6:21 technique in the static impression
6:23 Technique we further have two options
6:25 first is the open mouth impression
6:27 technique and second is the closed mouth
6:30 impression technique let us discuss them
6:36 first is the closed mouth impression
6:38 technique that is the static impression
6:40 technique it is the most common
6:42 impression or the clinical technique for
6:45 relining of complete denture in our clinics
6:46 clinics
6:48 for this the first step is the danger
6:51 preparation all large undercuts of the
6:54 danger are to be relieved second on the
6:56 tissue surface the acrylic resin needs
6:59 to be relieved by one to two millimeter
7:01 the Escape holes they are drilled
7:03 especially for the maxillary danger bases
7:05 bases
7:07 second Comes The Border molding the
7:09 borders are to be reformed by the low
7:11 fusing green stick compound the
7:13 posterior palatal seal is achieved with
7:15 a low fusing compound
7:18 third coming to the final impression if
7:20 we talk about the materials we can use
7:23 zinc oxide neutral impression paste we
7:26 can go for light body silicons or we can
7:29 go for the mouth temperature waxes
7:32 while making the impression patient is
7:35 asked to close in the existing Centric
7:38 occlusion and the intercarpition you
7:40 know this existing cro is used to
7:43 stabilize the danger or we can also go
7:46 for the bags interocclusion record which
7:55 second is the open mouth impression
7:57 technique this is less commonly used
7:59 this is just like a normal impression
8:01 technique that we make in the complete
8:04 danger in this the Dentures they are
8:06 used as the special trays for making the
8:09 New Impressions okay the existing
8:11 Centric occlusion is not used and the
8:14 new Centric relation occlusion record is
8:16 obtained after the impressions are made
8:19 okay if we compare it with a closed
8:21 mouth impression technique the closed
8:23 mouth real line technique is preferred
8:26 when the static impression method is used
8:32 after the static next is the functional
8:34 impression technique
8:37 this technique was suggested by Winkler
8:39 the material used for functional
8:41 impression technique are the tissue
8:44 conditioners or the treatment liners
8:46 they come in the powder and the liquid
8:49 form the powder and the liquid they are
8:51 mixed and they are applied on the tissue
8:53 side of the danger
8:55 before going for the impression the
8:57 patient's mandible is guided into
9:01 Centric relation to stabilize the danger
9:04 there are three physical stages of the
9:06 tissue conditioners okay that will allow
9:09 us to use them with different objectives
9:12 first is the plastic stage when the
9:14 Denture base it responds to the
9:16 functional and the parafunctional
9:19 stresses so the fit is improved okay the
9:21 tissue conditioner when they are applied
9:23 onto the Denture they are in the plastic
9:25 stage and it lasts for few hours to few days
9:27 days
9:30 is the elastic stage in this the stress
9:32 is cushioned and the tissue recovery
9:35 takes place it lasts for one to two weeks
9:36 weeks
9:40 third is the form stage okay when the
9:42 surface is similar to the polymerized
9:43 resin surface
9:48 okay and it will last for 15 days this
9:50 is the form stage when our realign
9:53 impression is ready after we have
9:55 achieved the form stage the wash
9:57 impression with zinc oxide digital
10:00 impression paste or light body material
10:01 is made
10:03 then the stone cast is poured immediately
10:05 immediately
10:07 new Centric relation occlusion record
10:11 should be considered if necessary foreign
10:14 foreign technique
10:20 it makes use of the acrylic resin the
10:22 self-cure acrylic resin or any other
10:24 plastic material that could be added to
10:27 the danger directly and allow to sit in
10:28 the mouth
10:31 okay this is not at all a recommended technique
10:33 technique
10:34 this is the limitations of this
10:37 technique is that first it can produce a
10:39 chemical burn on the mucosa due to the
10:41 monomer present in the acrylic
10:44 second the material it remains porous
10:47 and it develops a bad odor
10:50 third there is poor color stability of
11:00 once we have made the impression now we
11:03 will proceed to the lab procedure you
11:05 know the process of replacing the
11:07 impression material with the acrylic
11:09 raisin is same either for the static or
11:12 the functional impression and if we
11:14 compare the realigning versus the
11:17 rebasing the difference between the two
11:20 isn't just the amount of the old danger
11:22 base that needs to be removed and
11:26 replaced for re-pacing the entire danger
11:29 bases eliminated except for the teeth
11:32 and maybe just two millimeter adjoining
11:34 the Denture base especially when the
11:41 the different methods that can be used
11:43 to replace the impression material with
11:46 the acrylic raisinart first is the
11:48 articulator method second is The Jig
11:52 method and third is the flask method so
12:00 now first is the articulator method what
12:03 is that the impression is not separated
12:05 and the master cast is port
12:08 the first step second a layer of plaster
12:11 is added on the lower member and the
12:14 Denture is settled in the stone mix the
12:17 teeth will penetrate into that stone mix
12:19 for about two millimeter
12:21 okay and the occlusion plane should be
12:23 parallel to the floor
12:26 third the cast is then attached or
12:28 mounted to the upper member
12:31 then all the impression material is
12:34 removed okay the Denture trimming is
12:36 done now at this point we will elect
12:39 whether we are going for rebasing or
12:42 re-landing Okay so this will differ in
12:43 the amount of the trimming that we are
12:45 doing for the danger
12:48 after this the separating media will be
12:50 applied like let it be cold muscle or
12:53 tin foil then we will plan that whether
12:56 we are going for the relining with auto
12:59 polymerizing resin or heat curation if
13:02 Auto polymerizing resin then the cold
13:04 cure resin is packed in the articulator
13:07 it is allowed to sit in the pressure
13:11 container at 15 to 20 psi for 30 minutes
13:14 and for the heat cure resin the danger
13:18 will be waxed up okay it will be removed
13:21 it will be flast and then it will be
13:24 processed once we have got the danger we
13:27 will do the finishing and polishing foreign
13:36 which is used to maintain the mechanical
13:40 positional relationship between a piece
13:43 of work and a tool or we can say the
13:46 position between the components during
13:48 the assembly or the alteration just like
13:51 an articulator okay it is just an
13:53 alternative to the articulator that's it
13:56 so the procedure the lab procedure will
13:59 just be similar to that of an articulator
14:00 articulator
14:04 or we can also alternatively use hoopers
14:06 duplicated that is also a kind of Zig
14:10 only which can be used uh similar to a zinc
14:17 third is the flask method for doing the
14:20 lab procedure in this first we will be
14:22 doing the beading and boxing of the
14:25 realigned impression the mastercast is poured
14:26 poured
14:29 then what we will do the danger with the
14:32 cast is embedded in a flask
14:36 okay the flask is warmed so that the
14:38 green stick which is present in it
14:40 becomes softened before we open the flask
14:41 flask
14:44 then the flask is opened and the
14:47 impression material is removed we can
14:49 see that the two parts of the flask one
14:52 contains the master cast embedded in it
14:54 and second contains the realigned
14:56 impression with the danger
14:59 okay now after removing the impression
15:01 material the separating media will be applied
15:02 applied
15:05 then the heat cure resin it is packed in
15:08 the mold and it is processed once the
15:10 processing is done the danger will be
15:17 with this we come to the end of this
15:19 topic I'm sure now there are no more
15:22 doubts regarding this topic
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