Manuals_files/CD Manual 12.pdf - Removable Prosthodontics

Tissue Conditioning - 14
Placement of Temporary Resilient Liners (Tissue Conditioners)
Tissue conditioners provide one of the easiest means of improving the health of the
denture foundation tissues. These materials are also one of the most abused in the dental
office. It is often presumed that the mere presence of a temporary resilient liner will resolve
any mucosal problem. This section outlines a technique that can be used to reduce soft liner
adjustment time, while improving patient comfort and liner longevity. The technique
described has been used with tissue conditioners such as Lynal (Dentsply International Inc.,
Milford, DE), Visco-gel (Dentsply Ltd, Detrey Division, Surrey, England), and Tru-Soft
(Harry J. Bosworth Co., Skokey, IL), but it can be adapted to most other materials that are
available in similar powder/liquid formulations.
Technique:
1. Clean the denture prior to application of the soft liner. Use scalers, pumice on a wet
ragwheel, and an ultrasonic cleaner to eliminate gross debris and calculus. Disinfect the
denture by immersion in sodium hypochoride for at least 10 minutes prior to placement
of the liner. This will help to minimize the presence of microbes, which might
subsequently colonize the liner, thereby shortening liner lifespan. When relining
opposing dentures, reline the least stable denture first so that the more stable denture can
be used as reference for positioning the relined denture, using the occlusal contacts.
2. Determine if the denture base needs to be reduced prior to the placement of the liner.
Flanges that are excessively long or areas that are causing severe inflammation or frank
ulceration should be reduced. The entire denture bearing area should also be prepared to
provide room for the liner. Most materials require a minimal thickness of approximately
2 mm in order to provide sufficient resiliency to minimize tissue trauma. If the existing
occlusal vertical dimension is acceptable, and the thickness of the denture base will
allow, provide uniform relief of internal surface of the denture using pilot grooves,
acrylic burs and arbor bands. If there is insufficient occlusal vertical dimension
(excessive interocclusal rest space or freeway space), there may be room to place the
liner without reduction of the denture base. If the denture base is not reduced, the incisal
display will probably be increased once the liner has been placed. The esthetic
consequences of such a change should be evaluated and discussed with the patient.
3. Remove the glossy surface around the
denture periphery where the
conditioner will terminate on the
denture (at least 6 mm past the edge of
the flange). This helps ensure that the
conditioner will adhere to the denture
to minimize separation, leakage and
microbial colonization.