4. Tissue Conditioning4. Tissue Conditioning

John Beumer III, DDS, MSJohn Beumer III, DDS, MSDivision of Advanced Prosthodontics, Division of Advanced Prosthodontics, Biomaterials and Hospital DentistryBiomaterials and Hospital Dentistry

UCLA School of DentistryUCLA School of Dentistry

This program of instruction is protected by copyright ©. No portion of This program of instruction is protected by copyright ©. No portion of this program of instruction may be reproduced, recorded or transferred this program of instruction may be reproduced, recorded or transferred by any means electronic, digital, photographic, mechanical etc., or by by any means electronic, digital, photographic, mechanical etc., or by any information storage or retrieval system, without prior permission.any information storage or retrieval system, without prior permission.

Tissue ConditioningTissue Conditioning

Inflamed oral mucosaInflamed oral mucosa

Healthy oral mucosaHealthy oral mucosa

At the first clinical appt. the patients existing dentures are At the first clinical appt. the patients existing dentures are evaluated for fit and occlusion. If they are found inadequate they evaluated for fit and occlusion. If they are found inadequate they can be adapted with temporary denture liners and the occlusion is can be adapted with temporary denture liners and the occlusion is reestablished using tooth colored cold cure acrylic.reestablished using tooth colored cold cure acrylic.

Soft tissue conditioning is necessary to improve the health of the Soft tissue conditioning is necessary to improve the health of the soft tissues prior to fabrication of new dentures.soft tissues prior to fabrication of new dentures.

The procedure is repeated every 2-3 weeks until the soft tissues The procedure is repeated every 2-3 weeks until the soft tissues appear healthyappear healthy.

Soft tissue conditionerSoft tissue conditioner

Tissue ConditioningTissue Conditioning

Indications:Indications:

a.a. DiscomfortDiscomfort

b.b. Abused tissuesAbused tissues

c.c. Lack of retentionLack of retention

d.d. Loss of vertical dimensionLoss of vertical dimension

Loss of vertical dimensionLoss of vertical dimension

Papillary hyperplasiaPapillary hyperplasia

Tissue ConditioningTissue Conditioning

Tissue Preparation:Tissue Preparation:Clinical examinationClinical examinationTissue treatment linerTissue treatment linerOral hygiene instructionsOral hygiene instructionsSurgical procedures as necessarySurgical procedures as necessaryLeave dentures out at nightLeave dentures out at nightRepeated applications of treatment liner Repeated applications of treatment liner

Epulis Fissuratum

CandidaCandida

Tissue ConditioningTissue Conditioning

Tissue Conditioning ProcedureTissue Conditioning Procedure

Check the flange extensions and shorten as necessaryCheck the flange extensions and shorten as necessaryResin may need to be removed from the bearing surfaceResin may need to be removed from the bearing surface

Tissue Conditioning ProcedureTissue Conditioning Procedure

Mix material to a smooth creamy consistency taking care to avoid incorporation of air bubbles into the mix.

Apply a smooth even layer of the material to the surface of the denture ..

Before inserting the denture, immerse it into the water bath for a few seconds.

Follow the manufacturer’s mixing instructions

Tissue ConditioningTissue Conditioning

ProcedureProcedure Have patient close into centric relationHave patient close into centric relation

Verify the Vertical Dimension of Occlusion Verify the Vertical Dimension of Occlusion (VDO)(VDO)

Check the midlineCheck the midline

Wait 10-15 minutes, remove and evaluate Wait 10-15 minutes, remove and evaluate the new linerthe new liner

Carefully trim the excess materialCarefully trim the excess material

Gross occlusal discrepancies should be corrected at this appointmentGross occlusal discrepancies should be corrected at this appointment

Restore VDO in patients with collapsed occlusion.Restore VDO in patients with collapsed occlusion.

In this patient this has been accomplished by applying tooth colored In this patient this has been accomplished by applying tooth colored acrylic resin to the occlusal surfaces and reestablishing centric acrylic resin to the occlusal surfaces and reestablishing centric relation and VDOrelation and VDO. .

Occlusal AdjustmentOcclusal Adjustment

Tissue ConditioningTissue Conditioning

Life span of the material:Life span of the material: 2-4 weeks depending upon oral 2-4 weeks depending upon oral

hygiene and oral florahygiene and oral flora instruct patient not to soak the instruct patient not to soak the

denture in polident or other denture denture in polident or other denture denture cleansersdenture cleansers

Note Note deteriorationdeterioration

Healthy TissuesHealthy Tissues

The patient is now ready to proceed with fabrication of new dentures.The patient is now ready to proceed with fabrication of new dentures.