Using The Shatkin F.I.R.S.T. Hard Reline Material

Good morning and welcome to the Shatkin F.I.R.S.T.® Monday Morning Minute.

Good morning. I’m Dr. Todd Shatkin and welcome to this Monday Morning Minute. Today we want to talk about the proper technique for realigning, a lower or upper denture using the Shatkin F.I.R.S.T.® Hard Reline material. This is a new and improved material that we came out with about a year or so ago. And this product is really, really great because it sets up very nicely. It almost always picks up all of the housings, which we had a little bit of an issue with, with the old material, where occasionally one or two housings wouldn’t get picked up with the material. So this stuff is really nice. Okay.

It sets up very strong, very hard, and it bonds to the base of the denture much better than the old material also. The old material, we used to recommend putting like a bonding agent on the denture. We don’t need to do that with this. All we do is roughen the denture and it will bond very, very nicely.

Okay, so this is the Shatkin F.I.R.S.T.® Hard Reline material. And it’s a pink material and it comes in the mixing tube. So you just put it in your auto mix gun cartridge with the pink tip on it. And we also include some pens to mark the locations and the tissue before your surgery and a ruler to measure the vertical and all kinds of different things for your Reline. So that’s the Shatkin F.I.R.S.T.® Hard Reline kit.

The question then is how do we do a Reline? First and foremost, when you put the housings when you put the housings on your implants, make sure you put the blockout shims on first. The blockout shims are the little clear shims that you slide over the square part of the implant so that none of the acrylic gets underneath the housing.

So put the little shims on. Snap the housings on over the top of that. Make sure they’re snapped on all the way. Try your denture in and make sure it seats passively over those housings. Very passively. In other words, the housings are not going to hold up the denture at all. You want it to seat passively. If it’s held up at all, grind out some more of the denture and try it again. Make sure it’s seating passively over those implants and housings. The denture should go all the way down and the patient should be all bite together and the occlusion should be right on and all of that before you go to Reline it.

Okay, so you’ve got your shims, your housings, you’ve tried in your denture and made sure that it seats passively. Once you’ve confirmed that, take the denture out. Make sure it’s a little rough because that’s how this hard wheel line attaches to it. If it’s rough, if it’s a polished denture, it will not attach well. So you want to roughen it a little bit. If you’re extending it to the distal aspect of the denture, you want to make sure you want to roughen the distal portion of the denture as well. Okay?

So make sure the retro molar pad or wherever you’re going to Reline, make sure that’s rough. If you don’t want to Reline that area, do not roughen it. Leave it polished, and then that material will just flake right off. Okay? But if you’re relining the entire denture, wherever you roughen the denture, that acrylic will stick very firmly. Okay.

Now dry the internal of the denture very, very well. Next thing, take your gun and just dispense that Reline into the denture. And it’s okay to have it overflow a little bit. You’d rather have a little more than not enough. You can always trim it away and polish it. So you put it in the patient’s mouth for five minutes, have them bite for five minutes. Set a timer. We have timers in every operatory with our clocks. You can do it on your watch or your phone or whatever, but set a timer for five minutes, have the patient bite together and hold it for five minutes.

Now make sure your assistant is watching because patients have a tendency to open their mouth, fall asleep, all kinds of things can happen. And then the bite will be off. So make sure they’re biting and holding it for five minutes. Have your assistant I have my assistant just hold the chin there for five minutes. After five minutes, you should be able to snap the denture right out. All the housings will come out with the denture just like this. And you’ll just trim away any excess acrylic around the housings and around the periphery of the denture and polish the denture up. And then it’s good to go snap it in. Okay?

Now the most important thing is that the patient continue to wear the denture for the first 24 to 48 hours. That is critical because if you don’t do that, the tissue will grow up around the housings, because what happens is they get this histamine reaction in the first 24 to 48 hours after having the procedure done.

So the denture, what it is, it acts as a Band Aid and it keeps that tissue down. If the patient goes home and takes the denture out, falls asleep, they’re going to wake up the next morning with tissue surrounding the balls and squares of the implants. And then it’s a hassle because you have to get them back in. You have to laser that tissue away and then put the denture back in. But if they keep it in for 24 to 48 hours without removing it, that will not happen.

So that’s very, very important. If I do the procedure on a Friday, I normally won’t see the patient until Monday. That’s 72 hours. I say leave the denture in all weekend. I’ll see you Monday. Do not take it out. If they listen to you, everything’s going to be great on Monday. If they didn’t listen to you, you’re going to have a headache on your hands. So that’s the key to having a successful Reline of a denture. I’m Dr. Todd Shatkin and thanks for listening on this Monday morning minute.