Tissue conditioners are temporary denture liners composed of polyethylmethacrylate and aromatic esters that form a gel when mixed. They have several uses: as adjuncts for tissue healing by protecting irritated tissues before denture fabrication; as temporary obturators over existing dentures; to stabilize denture bases and surgical splints; and to diagnose the effects of resilient denture liners. Tissue conditioners are applied by reducing the denture base, mixing the three components, and molding the material to the denture tissues. They require gentle cleaning to prevent tearing but only provide temporary relief due to loss of plasticizers over 4-8 weeks.

1. TISSUE CONDITIONERS

2. Index
Introduction
Composition
Uses 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 conditioner
Care and Maintenance
Conclusion
References

3. Introduction
In 1967 Kydd and Mandley stated that tissue lining materials
permit wider dispersion of forces and hence, aid to decrease the
force per unit area transmitted to the supporting tissues.
For practical purposes, denture base materials are made of
rigid materials.
The dentist must recognize that the prolonged contact of these
bases with the underlying tissues is bound to elicit changes in the
tissues.
Mucosal health may be promoted by hygienic and therapeutic
measures and tissue-conditioning techniques may be applied
when appropriate.

4. Composition
Tissue conditioners are composed of polyethylmethacrylate and
a 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 ethyl
alcohol having a greater affinity for the polymer.

5. Uses of Tissue Conditioners
Tissue treatment
Temporary obturator
Baseplate stabilization
To diagnose the outcome outcome of resilient liners
Liners in surgical splints
Trial denture base
Functional impression material

6. Adjuncts for Tissue Healing
Advantage of using tissue conditioner is that they prepare the
selected oral structures to withstand all the stress from the
prosthesis.
Tissue conditioners are generally used to preserve the residual
ridge.
Also used to heal irritated hyperemic tissues prior to denture
fabrication.

7. Temporary Obturator
Tissue conditioners may be added as a temporary obturator
over existing complete or partial denture.
This may be done directly in mouth or indirectly after an
impression of the surgical area has been made.

8. Stabilization of Baseplates & Surgical Splints or Stents
When undercuts are present on an edentulous cast, an acrylic
temporary denture base cannot be used as it may get locked into
the undercut and break the cast during removal.
In such cases tissue conditioners of stiffer consistency may be
used to stabilize the record bases and prevent breakage of the
cast.

9. Adjuncts to an Impression or as a Final Impression Material
These materials are used when it is difficult to determine the
extent of the denture base due to presence of movable oral
structures.
These materials record the extension of the denture in a
dynamic form that will later help in preparing an impression tray
for the final impression.

10. Adjunct to determine the
Potential Benefits of a Treatment Modality
Sometimes patients with well constructed dentures develop
chronic soreness and find it difficult to wear the dentures
comfortably.
Tissue conditioners can be used to determine if this problem can
be resolved with the use of resilient liner.

11. Procedure for Applying Tissue Conditioners
The following steps must be considered while applying
tissue conditioners on a denture.
Preparation of the dentures
The tissue part of the denture base, which crosses an
undercut, should be reduced.
The tissue surface of the denture, which covers the
crest of the ridge, should be reduced by 1 mm.

12. It should be remembered that the dentures should allow
sufficient room for the placement of the tissue conditioner in order
to promote the recovery of displaced and traumatized tissues.
Mixing & placement of the tissue conditioner
Tissue conditioners are available as three component systems
Polymer(Powder)
Monomer(Liquid)
Liquid plasticizer(Flow control)
The mixing ratio can be changed according to consistency
required. A ratio of 1.25 parts of polymer, 1 part monomer and
0.5cc plasticizer is usually recommended. The plasticizer should
be added to the monomer.
The ingredients are mixed to form a gel, which is applied in
sufficient thickness to the tissue surface of the denture.
The denture is inserted and border movememts are carried out
to mould the setting material.

13. Care & maintenance
Tissue conditioners should not be cleaned by scrubbing with a
hard brush in order to prevent tearing of the material. The use of
soft brush under running water is recommended.
The greatest virtue of tissue conditioners is their versatility and
ease of use.
The biggest flaw is that they are also misused.
Their longevity against wear is very limited and they tend to
harden and roughen within 4 to 8 weeks due to the loss of
plasticizer. Hence, they require observation.

14. Conclusion
Although tissue conditioners can be easily used but the
prolonged contact of these bases may elicit changes in the
underlying tissues, they may traumatize the oral tissues.

15. References
Boucher’s Prosthodontic Treatment For Edentulous Patients –
George A. Zarb, Charles L. Bolender, Gunnar E. Carlsson
Essentials of Complete Denture Prosthodontics – Sheldon
Winkler
Prosthodontics for Elderly – Ejvind Budtz, Jorgensen, Dr. Odont