soft tissue liners and tissue conditioners - Copy.pptx

presentation on soft tissue liners and tissue conditioners .

1. SOFT TISSUE LINERS AND TISSUE CONDITIONERS Presented by-Dr. Vaishali Shrivastava. Pg 2 nd year student. Dept. of prosthodontics ,crown & bridge & implantology. 1

2. CONTENTS- INTRODUCTION DEFINITIONS INDICATIONS, CONTRAINDICATIONS FOR RELINING AND REBASING CLASSIFICATIONS REQUIREMENTS FOR DENTURE LINERS HARD LINERS SOFT LINERS TISSUE CONDITIONERS CONCLUSION REFERENCES 2

3. INTRODUCTION Maintenance of the adaptation of the denture bases to the mucosa that covers the residual ridges is a critical part of a complete denture service. The residual ridges have been described as plastic in nature, always changing in topography and morphologically. resorption occurs most rapidly in the first six months following extraction of the teeth and seems to level off at about 12 months. Essentials of complete denture prosthodontics, Sheldon winkler 3 rd edition 3

4. definitions Relining is the process of adding some material to the tissue side of a denture to fill the space between the tissue and the denture base - (Sheldon winkler ) reline(1851): the procedures used to resurface the intaglio of a removable dental prosthesis with new base material, thus producing an accurate adaptation to the denture foundation area ( GPT9) Reline 4

5. Rebasing is a process of replacing all the base material of a denture. The purpose of such a process is to fill the space between the tissue and the denture base without changing the position of the teeth and the relation of the dentures (Sheldon winkler ) 5 Tissue conditioning : a procedure in prosthodontics usually performed by relining a removable complete denture, removable partial denture, or a maxillofacial prosthesis with a resilient resin and allowing a short duration of time for the patient’s soft tissue to heal (GPT9) definitions

6. 6 Tissue conditioner : 1. a resilient denture liner resin placed into a removable prosthesis for a short duration to allow time for tissue healing(GPT9) 2. used in functional removable relining procedures to evaluate denture function and patient acceptance prior to laboratory reline processing (GPT9 )

7. 7 INDICATIONS FOR RELINING AND REBASING 1.Immediate dentures at three to six months after their original construction 2. When the residual alveolar ridges have resorbed and the adaptation of the denture bases to the ridges is poor. 3. When the patient cannot afford the cost of having new dentures constructed. 4.When the construction of new dentures with the accompanying series of appointments can cause physical or mental stress, such as for geriatric or chronically ill patients Essentials of complete denture prosthodontics, Sheldon winkler 3 rd edition

8. 8 CONTRAINDICATIONS Excessive amount of resorption has taken place. When patients complain about TMJ problems. If denture have poor esthetics. If denture create major speech problem. Essentials of complete denture prosthodontics, Sheldon winkler 3 rd edition

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11. 11 Open mouth technique Closed mouth technique

12. 12 • Proposed by Boucher in 1973. • Dentures are used as special tray for making the final impression. After impression a New Centric Relation is recorded. Open mouth technique

13. 13 Closed mouth technique Integral Step for a Closed-Mouth Reline Technique— Centric Relation Existing correct intercuspation (CRO) used to stabilize dentures

14. 14 Denture Preparations 1.Large undercuts relieved 2.Hard resin surfaces relieved 1.5 to 2 mm 3.Tissue conditioner removed or relieved” 4.Escape” holes drilled, particularly in maxillary base; this will also assist easy removal of palatal portion during laboratory rebase 5.Denture periphery shortened to create flat border Impression Procedure Border molding achieved with preferred material (i.e., low-fusing compound) Border molding retained from polymerized tissue-conditioning material Posterior palatal seal achieved with low-fusing compound Border molding achieved by choosing impression material that is soft and yet viscous enough to support and register peripheral detail (one of the polyether impression materials Prolonging the Useful Life of Complete Dentures: The Relining Procedure George A. Zarb , Rhonda F. Jacob

15. 15 FUNCTIONAL TECHNIQUE

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17. 17 Disadvantages- the materials often have produced a chemical burn on the mucosa (2) the result often was porous and subsequently developed a bad odor (3) color stability was poor (4) if the denture was not positioned correctly, the material could not be removed easily to start again. CHAIRSIDE TECHNIQUE acrylic or other plastic material that could be added to the denture and allowed to set in the mouth to produce an instant chairside reline/rebase

18. 18 RELINING AND REBASING KENNETH D. RUDD, ROBERT M. MORROW, R. NEAL EDWARDS, and AMBROCIO V. ESPINOZA LABORATORY TECHNIQUES ARTICULATOR METHOD

19. 19 RELINING AND REBASING KENNETH D. RUDD, ROBERT M. MORROW, R. NEAL EDWARDS, and AMBROCIO V. ESPINOZA

20. 20 RELINING AND REBASING KENNETH D. RUDD, ROBERT M. MORROW, R. NEAL EDWARDS, and AMBROCIO V. ESPINOZA

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26. 26 JIG METHOD

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31. 31 I.Based on curing : -Self cure- eg ., soften,viscogel -Heat cure- eg ., supersoft,molloplast B, Lucisoft , Flexor, Permaflex -Light cure resins- eg ., clearfitLC (polyisoprene based material classification

32. 32 II . Based on composition - Silicone elastomers -Soft acrylic compounds - Pthalate ester free compounds- eg .,di-n butyl sebacate,Benzyl benzoate,acetyl tributyl citrate,tri -n-butyl phosphate -Polyolefin liners -Fluoride containing liners(fluoroalkyl methacrylate)- eg. , maxfit

33. 33 III. Based on durability - Temporary/Short term liners- eg. , soft comfort -Definitive/long term liners IV. Based on consistency - Hard denture liners- eg ., Ufigel hard C -Soft denture liners- eg .,Silastic 390 -Soft denture liners are further classified as silicone based and resin based Auto cured and heat cured

34. 34 V. Based on the availability -Home reliners -Tissue conditioners VI. Based on water sorption property -Hydrophilic- eg ., kooliner (polymethyl/ethyl methacrylate polymer) -Hydrophobic- eg .,Elite soft(silicone polymer)

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36. 36 Powder Polymer beads- polymethylmethacrylate Initiator- benzoyl peroxide Liquid Monomer – methylmethacrylate Plasticizer – Di-n- butylphtalate Chemical activator- tertiary amine HARD RELINE MATERIALS

37. 37 Complete denture prosthodontic treatment and problem solving Yasemin k ozkan

38. 38 Natural Rubber Natural rubbers have been used as soft lining materials since the 1860s DISADVANTAGES quick absorbance of intraoral liquids difficulty in preparation low quality of connection to base material,

39. 39 Available in powder liquid form Polymer is methyl or ethyl-methacrylate They are divided into two groups, based on their preparation methods: 1. Acrylic-based soft lining materials that polymerize in room temperature 2. Acrylic-based soft lining materials that polymerize with heat SOFT ACRYLICS Composition polyethyl methacrylate in powder n-butyl methacrylate liquid amine activator.

40. 40 Silicone Elastomers The most widely used soft lining materials are silicone-based materials. No need to add plasticizing agent Material retain its rubbery consistency for longer period Silicone-Based Soft Lining Materials that Polymerize in Room Temperature Silicone-Based Soft Lining Materials that Polymerize with Heat

41. 41 Olefinic Soft Lining Materials having good elastic properties these require a special apparatus for lining need an adhesive. Water absorption is minimal since the lining material can be stained by nutrients, a coating agent must be used. E.G. Molteno (Molten) (indirect method)

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44. 44 TISSUE CONDITIONERS -Short term denture liners are also called tissue conditioners -Intraorally these materials are used one week to 15 days at most Complete denture prosthodontic treatment and problem solving Yasemin k ozkan

45. 45 Composition Complete denture prosthodontic treatment and problem solving Yasemin k ozkan

46. 46 Gelation reaction: When the powder and liquid are mixed, polymer is dissolved by plasticizer. This reaction is responsible for chain entanglement and thus formation of gel. Reaction- 15-20 min

47. 47 Uses Their main use is to treat chronic soreness due to dentures. Adjunct uses conditioning the tissues during fabrication of new complete dentures Temporary obturator Stabilize surgical splints or stents

48. 48 IN TEMPORARY OBTURATORS

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53. 53 Conclusion- Soft liners have important place in dental prosthesis but requires improved strength, improves adhesion , inhibit fungal growth Greatest virtue of tissue conditioners is versitality and ease to use

54. 54 References- Complete denture prosthodontic treatment and problem solving Yasemin k ozkan Essentials of complete denture prosthodontics, Sheldon winkler 3 rd edition Phillips science of dental materials 12 th ed Applied dental materials john f MC cabe 9 th ed

55. 55 THANKYOU