This document discusses the process of tissue conditioning, which uses temporary denture liners to improve the health of irritated oral tissues before creating new dentures. Tissue conditioning involves repeatedly applying a soft tissue conditioner to existing dentures every 2-3 weeks until the tissues appear healthy. The conditioner improves comfort and allows the tissues to adapt to the denture borders. Once the tissues are healthy, new dentures can be fabricated.

1. 4. Tissue Conditioning John Beumer III, DDS, MS Division of Advanced Prosthodontics, Biomaterials and Hospital Dentistry UCLA School of Dentistry This program of instruction is protected by copyright ©. No portion of this program of instruction may be reproduced, recorded or transferred by any means electronic, digital, photographic, mechanical etc., or by any information storage or retrieval system, without prior permission.

2. Tissue Conditioning Inflamed oral mucosa Healthy oral mucosa

3. At the first clinical appt. the patients existing dentures are evaluated for fit and occlusion. If they are found inadequate they can be adapted with temporary denture liners and the occlusion is reestablished using tooth colored cold cure acrylic. Soft tissue conditioning is necessary to improve the health of the soft tissues prior to fabrication of new dentures. The procedure is repeated every 2-3 weeks until the soft tissues appear healthy . Soft tissue conditioner Tissue Conditioning

4. Indications: Discomfort Abused tissues Lack of retention Loss of vertical dimension Loss of vertical dimension Papillary hyperplasia Tissue Conditioning

5. Tissue Preparation: Clinical examination Tissue treatment liner Oral hygiene instructions Surgical procedures as necessary Leave dentures out at night Repeated applications of treatment liner Epulis Fissuratum Candida Tissue Conditioning

6. Tissue Conditioning Procedure Check the flange extensions and shorten as necessary Resin may need to be removed from the bearing surface

7. Tissue Conditioning Procedure Mix material to a smooth creamy consistency taking care to avoid incorporation of air bubbles into the mix. Apply a smooth even layer of the material to the surface of the denture . Before inserting the denture, immerse it into the water bath for a few seconds. Follow the manufacturer’s mixing instructions

8. Tissue Conditioning Procedure Have patient close into centric relation Verify the Vertical Dimension of Occlusion (VDO) Check the midline Wait 10-15 minutes, remove and evaluate the new liner Carefully trim the excess material

9. Gross occlusal discrepancies should be corrected at this appointment Restore VDO in patients with collapsed occlusion. In this patient this has been accomplished by applying tooth colored acrylic resin to the occlusal surfaces and reestablishing centric relation and VDO . Occlusal Adjustment

10. Tissue Conditioning Life span of the material: 2-4 weeks depending upon oral hygiene and oral flora instruct patient not to soak the denture in polident or other denture denture cleansers Note deterioration

11. Healthy Tissues The patient is now ready to proceed with fabrication of new dentures.