IndexIntroductionCompositionUses of Tissue Conditioners Adjuncts for Tissue Healing Temporary Obturator Stabilization of Baseplates & Surgical Splints or Stents Adjunct to an impression or as a Final Impression Material Adjunct to Determine the Potential Benefits of a Treatment Modality Procedure for Applying Tissue Conditioners oPreparation of dentures oMixing and placement of the tissue conditionerCare and MaintenanceConclusionReferences
IntroductionIn 1967 Kydd and Mandley stated that tissue lining materialspermit wider dispersion of forces and hence, aid to decrease theforce per unit area transmitted to the supporting tissues.For practical purposes, denture base materials are made ofrigid materials.The dentist must recognize that the prolonged contact of thesebases with the underlying tissues is bound to elicit changes in thetissues.Mucosal health may be promoted by hygienic and therapeuticmeasures and tissue-conditioning techniques may be appliedwhen appropriate.
CompositionTissue conditioners are composed of polyethylmethacrylate anda mixture of aromatic ester and ethyl alcohol.Tissue conditioners are available as three component systems Polymer(Powder) Monomer(Liquid) Liquid plasticizer(Flow control)A gel is formed when these materials are mixed, with the ethylalcohol having a greater affinity for the polymer.
Uses of Tissue ConditionersTissue treatmentTemporary obturatorBaseplate stabilizationTo diagnose the outcome outcome of resilient linersLiners in surgical splintsTrial denture baseFunctional impression material
Adjuncts for Tissue HealingAdvantage of using tissue conditioner is that they prepare theselected oral structures to withstand all the stress from theprosthesis.Tissue conditioners are generally used to preserve the residualridge.Also used to heal irritated hyperemic tissues prior to denturefabrication.
Temporary ObturatorTissue conditioners may be added as a temporary obturatorover existing complete or partial denture.This may be done directly in mouth or indirectly after animpression of the surgical area has been made.
Stabilization of Baseplates & Surgical Splints or StentsWhen undercuts are present on an edentulous cast, an acrylictemporary denture base cannot be used as it may get locked intothe undercut and break the cast during removal.In such cases tissue conditioners of stiffer consistency may beused to stabilize the record bases and prevent breakage of thecast.
Adjuncts to an Impression or as a Final Impression MaterialThese materials are used when it is difficult to determine theextent of the denture base due to presence of movable oralstructures.These materials record the extension of the denture in adynamic form that will later help in preparing an impression trayfor the final impression.
Adjunct to determine thePotential Benefits of a Treatment ModalitySometimes patients with well constructed dentures developchronic soreness and find it difficult to wear the denturescomfortably.Tissue conditioners can be used to determine if this problem canbe resolved with the use of resilient liner.
Procedure for Applying Tissue ConditionersThe following steps must be considered while applyingtissue conditioners on a denture.Preparation of the denturesThe tissue part of the denture base, which crosses anundercut, should be reduced.The tissue surface of the denture, which covers thecrest of the ridge, should be reduced by 1 mm.
It should be remembered that the dentures should allowsufficient room for the placement of the tissue conditioner in orderto promote the recovery of displaced and traumatized tissues.Mixing & placement of the tissue conditionerTissue conditioners are available as three component systems Polymer(Powder) Monomer(Liquid) Liquid plasticizer(Flow control)The mixing ratio can be changed according to consistencyrequired. A ratio of 1.25 parts of polymer, 1 part monomer and0.5cc plasticizer is usually recommended. The plasticizer shouldbe added to the monomer.The ingredients are mixed to form a gel, which is applied insufficient thickness to the tissue surface of the denture.The denture is inserted and border movememts are carried outto mould the setting material.
Care & maintenanceTissue conditioners should not be cleaned by scrubbing with ahard brush in order to prevent tearing of the material. The use ofsoft brush under running water is recommended.The greatest virtue of tissue conditioners is their versatility andease of use.The biggest flaw is that they are also misused.Their longevity against wear is very limited and they tend toharden and roughen within 4 to 8 weeks due to the loss ofplasticizer. Hence, they require observation.
ConclusionAlthough tissue conditioners can be easily used but theprolonged contact of these bases may elicit changes in theunderlying tissues, they may traumatize the oral tissues.
ReferencesBoucher’s Prosthodontic Treatment For Edentulous Patients –George A. Zarb, Charles L. Bolender, Gunnar E. CarlssonEssentials of Complete Denture Prosthodontics – SheldonWinklerProsthodontics for Elderly – Ejvind Budtz, Jorgensen, Dr. Odont