Manuals_files/CD Manual 12.pdf - Removable Prosthodontics

Tissue Conditioning - 15
4. Mix the tissue conditioner according to the manufacturer’s instructions. Mix with a
stropping action against the mixing container. Do not use a vigorous stirring action
which can lead to the incorporation of bubbles that are difficult to eliminate from the
viscous mixture. In general, liners can be mixed slightly stiffer than recommended by
adding additional powder to the liquid component. This can be done to decrease the flow
from underneath a denture during setting, when an increase in the occlusal vertical
dimension is desired. Do not mix the liner thinner than suggested by the manufacturer, as
this can have deleterious effects on the physical properties and longevity of the liner.
5. Apply a smooth even layer to the denture, usually starting at the posterior and teasing the
material forward without incorporating air bubbles. Bring the tissue conditioner over
peripheries about 6 mm, so that saliva cannot get between the denture and the conditioner
in the area of the periphery. This will minimize the possibility of separation of the
conditioner from the denture. Excess can be removed later.
6. Place the denture intraorally, having an assistant help retract the commissures of the
mouth to avoid accidental removal of the liner during insertion. Insertion is easier if the
patient relaxes the cheeks and lips rather than opening maximally. Avoid touching the
material during initial placement.
7. Stabilize the denture and have the patient close lightly, until initial contact is felt or seen.
If occlusal contacts are uneven, have the patient open, and tilt, tip or bodily move the
denture into a position where stable even contacts can be obtained. Border mold the
peripheries, when the material begins to gain viscosity (about 3 minutes for most tissue
conditioners).
8. Use a cotton swab to remove any areas of
gross excess prior to initial set. This will
reduce the amount of trimming needed, and
make for a neater, more comfortable external
surface. Excess material most commonly
requires removal in the area of the lingual
vestibule and distobuccal flange of the
mandibular denture, and the retrozygomal
area and palate of the maxillary denture.
9. Remove after initial set (commonly 8-10
minutes) and trim with a hot scalpel blade. Heating the blade will allow the scalpel to cut
through the liner without sticking, and leave a cleaner, smoother surface, which will
enhance patient comfort. Do as little modification as possible at this time, as the material
will be sticky and adjustment will often result in a rough or ragged surface that is
uncomfortable and difficult to clean.
10. Clean the opposing denture and provide care instructions. Explain the temporary nature
of the material to the patient. Have the patient rinse the denture with water, after eating,
for the first 24-48 hours, and brush the liner with a soft tooth brush and a small amount of