This presentation discussing use of tissue conditioner and soft liner in the field of prosthetic dentistry

1. Reza Talebian
ALS, DDS, CCRD

2. Contact with the author:
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Reza Talebian ALS, DDS, CCRD
Cosmetic & Reconstructive Dentist at Dental Private Practice
wWw.QueenDent.cO.uK.
email: wWw.QueenDent.cO.uK @gmail.com

3. 
Definition
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Applications
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Composition
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How to use
Reza Talebian ALS, DDS, CCRD.

4. Background Art 
It has been known that when a denture is used for 
extended periods of time, the shape of the oral cavity
gradually varies due to dissolution of alveolar bone that
is forming alveolar ridge into the oral tissue. In such a
case, fitness becomes poor between the denture base and
the oral mucosa, and the denture loses stability. If the
poorly fit denture is continuously used, non-uniform
pressure is exerted on the mucosa that comes in contact
with the denture. Therefore, an ulcer or an inflammation
occurs in the mucosa, and a pain is triggered by the force
of occlusion. Therefore, in case such an unfitness has
occurred, it becomes necessary to recover the fitness of
the denture to the mucosa by preparing a new denture or
by relining the denture that is in use.
Reza Talebian ALS, DDS, CCRD.

5. However, the oral mucosa of a patient who is 
suffering from a serious ulcer or inflammation
is in a very unstable state. Therefore, a
favorable fitness must be maintained between
the denture base and the mucosa prior to
preparing a new denture or relining the
denture until the oral mucosa (tissue) recovers
to a relatively healthy condition. The tissue
conditioner for dental use is used for such a
case. Namely, the tissue conditioner for dental
use is a therapeutic material used for relining
the denture that is now in use until the form
and color tone of the mucosa under the denture
base are recovered to a normal state.
Reza Talebian ALS, DDS, CCRD.

6. Reza Talebian ALS, DDS, CCRD.

7. Reza Talebian ALS, DDS, CCRD.

8. The tissue conditioner is a soft high-molecular
material which is applied to the surface of the
denture base that comes in contact with the
mucosa to release the distortion and indentation
of mucosa under the denture base and that varies
its state following the displacement of the
mucosa. The tissue conditioner is used in the
form of a paste formed by mulling a powder and
a liquid material together
Reza Talebian ALS, DDS, CCRD.

9. the tissue conditioner is relined onto the surface of the
denture base that fits poorly in order to recover the
fitness between the denture and the oral mucosa to
wait for the gradual diminishing of ulcer and
inflammation of the oral mucosa while relieving the
pain. As the ulcer and inflammation of oral mucosa
gradually diminish, the state of the oral mucosa
recovers with the passage of time to resume the
original state. Here, the tissue conditioner must
undergo the plastic deformation to meet a change in
the state of the oral mucosa. This is because, if the
tissue conditioner does not undergo the deformation
that is described above, the fitness is lost as the state of
the oral mucosa recovers creating a factor that causes a
pain again.

Reza Talebian ALS, DDS, CCRD.

10. the soft relining material is a material that is used when the oral 
mucosa is in a healthy condition. When the ulcer or inflammation
is occurring in the oral mucosa, the tissue conditioner is used until
the ulcer or inflammation extinguishes, i.e., to wait for the
extinction of the ulcer or inflammation. After the ulcer and
inflammation have extinguished and the oral mucosa has resumed
the healthy condition, the soft relining material is used. Therefore,
when neither the ulcer nor the inflammation is occurring, the soft
relining material is readily used without using the tissue
conditioner. That is, the tissue conditioner is applied to the
denture base as a temporary relining material for a period of
several days to several weeks until the ulcer or the inflammation
extinguishes, whereas the soft relining material is used as a
relining material for repairing the denture base when the oral
mucosa is in a healthy condition to exhibit its function for at least
six months. Therefore, the characteristics of the two are obviously
different.
Reza Talebian ALS, DDS, CCRD.

11. the soft relining material acts as a cushion or shock
absorber between the hard plastic base of a denture
and the gums. What used for the repaired denture
base is a soft material which, however, is slightly harder
than the tissue conditioner and does not exhibit such a
large plastic deformation as that of the tissue
conditioner. Besides, the soft relining material is used
for a period of time longer than the tissue conditioner
and, therefore, has mechanical properties such as tensile
strength and the like which are very higher than those
of the tissue conditioner.
Reza Talebian ALS, DDS, CCRD.

12. Composition
Powder and liquid parts mixtured together so as to be used as a
paste
the powdery material (a) is a non-crosslinked (meth)acrylic 
polymer powder having a glass transition temperature in a
range of 0 to 60° C 
the liquid material (b) is a liquid polymer having a mass 
average molecular weight in a range of 1,000 to 10,000 and
containing not more than 10 mass % of oligomers having
molecular weights of not more than 500.
many of the tissue conditioners now used are those 
comprising a (meth)acrylic polymer powder and a liquid
material of various plasticizers as chief components .The
plasticizers are the components necessary for exhibiting
softness and plasticity.
Reza Talebian ALS, DDS, CCRD.

13. If the plasticizer elutes out, the paste of the tissue
conditioner loses viscoelasticity with the
passage of time and is cured. The elution
occurs in a relatively short period of time of
about several days and becomes a serious
problem for the tissue conditioner which is
used for a period of time shorter than the soft
relining material and for which more softness
is required than the soft relining material.
Therefore, the tissue conditioner had to be
renewed every after several days.
Reza Talebian ALS, DDS, CCRD.

14. 
The conditioning procedure should be repeated until the
supporting tissues display an undistorted and healthy appearance.

Many dentists find that intervals of 4 to 7 days between changes of
the conditioning material are clinically acceptable.
Improvement in irritated and distorted tissue is usually noted
within a few visits, and in some patients a dramatic improvement
will be seen.

Usually 3 to 4 changes of the TCM are required.
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If positive results are not seen within 3-4 weeks, one should suspect
more serious health problems and request a consultation physician.
Reza Talebian ALS, DDS, CCRD.

15. 2.
1. DENTURE SURFACE BEFORE RELINING
ADJUST MISFITTING AREAS WITH A
CARBIDE
BUR, CLEAN AND DRY. CREATE SUFFICIENT
SPACE SO GC TISSUE CONDITIONER CAN
BE
APPLIED AT A MINIMUM THICKNESS OF 1
MM IN ORDER TO MAINTAIN THE
ELASTICITY
Reza Talebian ALS, DDS, CCRD.

16. 3. The coating agent can be used as
a bonding agent to improve the
bond strength and to avoid possible
delamination. Apply the coating agent
with a brush only on the areas where a
stronger bond is needed. In this case, GC
Tissue Conditioner cannot be peeled off
by hand.
MIXING
MIX POWDER AND LIQUID FOR 30-60
SECONDS
UNTIL THE MIXTURE REACHES A CREAMY
CONSISTENCY.
APPLICATION
Reza Talebian ALS, DDS, CCRD.

17. APPLICATION
APPLY THE MIXTURE EVENLY TO THE FITTING
SURFACES OF THE PREPARED DENTURE.
TO AVOID STICKING OF THE MATERIAL,
LUBRICATE FINGERTIPS OR INSTRUMENTS WITH
WATER. DO NOT USE LOTION OR PETROLEUM
JELLY.
B.PREVENT EXCESS FROM FLOWING INTO THE
THROAT.
SEAT THE DENTURE IN THE MOUTH. ASK
THE PATIENT TO GENTLY OCCLUDE IN THE
CENTRIC OCCLUSION AND MOVE THE LIPS
AND
MANDIBLES TO MUSCLE TRIM.
Reza Talebian ALS, DDS, CCRD.

18. AFTER KEEPING THE DENTURE FOR ABOUT 5
MINUTES IN THIS POSITION, REMOVE AND
INSPECT FOR EXCESS AND DEFICIENCIES.
REMOVE ANY EXCESS USING A SHARP
INSTRUMENT.
Reza Talebian ALS, DDS, CCRD.

19. FINISHING
WASH AWAY SALIVA FROM THE RELINED
DENTURE
UNDER RUNNING WATER. DRY WITH AN AIR
SYRINGE.
APPLY THE COATING AGENT TO THE RELINED
SURFACES OF THE DENTURE. DRY THE COATING
AGENT THOROUGHLY WITH AN AIR SYRINGE OR
LEAVE IT UNDISTURBED FOR 4-5 MINUTES.
10. FINISHED DENTURE
Reza Talebian ALS, DDS, CCRD.

20. Maximum benefit maybe obtained by:
1). Eliminating deflective or interfering occlusal contacts
of old dentures ( by remounting in a articulator if
necessary)
2). Extending denture base to proper form to enhance
support, retention, and stability
Reza Talebian ALS, DDS, CCRD.

21. 3) Relieving the tissue side of denture base
sufficiently (2 mm) to provide space for even
thickness and distribution of conditioning
material;
4) Applying the material in amounts sufficient to
provide support and a cushioning effect;
5) Following the manufactures directions for
manipulation and placement of the
conditioning material.
Reza Talebian ALS, DDS, CCRD.

22. FINISH