TISSUE CONDITIONERS

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

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.

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.

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

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.

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.

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.

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.

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.

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.

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.

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.

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.

References Bouchers 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