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 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

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