 Increased life expectancy combined with improved

socialization has made people conscious about their

appearance and performance in the society.

 Although we make every effort to eliminate sources of

dissatisfaction in denture construction, it is impossible
to eliminate all possible sources.

 The dentures are worn for a longer time with

minimum rest to the denture -bearing tissues which
leads to irritation of the soft tissues, depriving it from
blood supply and also leading to resorption of the
supporting bony foundation.

 Soft tissues beneath the dentures suffer deformation.

1
 As a consequence, the dentures tend to loosen
demanding for the use of materials like tissue
conditioners and denture adhesives to improve
retention.

 Resilient liners which were used previously were

natural rubbers.

 In the year 1945,the first synthetic resin made of

plasticized poly vinyl resins were developed and the
silicone rubbers followed in 1958.

2
USES OF DENTURE RELINERS
 To improve fit of ill fitting dentures

 To prevent traumatic damage to the mucosa

 As
a cushion between denture bearing mucosa and
denture

 To retain over denture bar attachments

 To retain extra oral prosthesis

 To distribute occlusal forces

3
 To increase serviceable life of prosthesis

 To
replace the fitting surface of conventional hard
dentures

 To relieve mucosal pain under hard dentures

 Improves the rhythm of chewing strokes

 Compensates for the volumetric shrinkage of acrylic

resin

4
DESIRABLE PROPERTIES OF LINING
MATERIALS
 Long term viscoelastic behaviour which is stable

 Lowwater sorption Improved colour

stability

 Resistance to staining Tear resistance

 Good bond strength to denture base

 Dimensional stability Biocompatibility

 Resistance to fungal and bacterial growth

5
 Ease of processing Good shelf life

 High magnitude of energy dissipation

 Good
resiliency Low elastic
modulus

 Heatresistance Resistance to
radiation

 Low glass transition temperature

 Special rheological properties

6
INDICATIONS

 Thin atrophic mucosa underlying denture base

 Ridge atrophy or resorption

 Presence of deep anatomical undercuts

 Chronic bruxers or patients with bruxing tendencies

7
 Reduced tolerance level of the mucosa for occlusal
loads under denture

 Acquiredor congenital defects which require

obturation

 Presence of bony protruberances

 Retention of implant retained overdentures

8
CLASSIFICATION

I. Based on curing :

 Self cure- eg. soften, viscogel

 Heatcure-eg. supersoft, molloplast B, Lucisoft, Flexor,

Permaflex

 Lightcure resins-eg. clearfitLC (polyisoprene based

material)

9
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

10
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

Silicone based Auto cured and heat

cured
and resin based
11
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)

12
COMPOSITION

Cold cure acrylic based material :

 Powder Polyethyl methacrylate/copolymer,

Polymethyl methacrylate/copolymer, pthalyl butyl
glyconate, pigments, fillers.

 Liquid A mixture of ethyl alcohol, and

An aromatic ester (Dibutyl phthalate) - Plasticizer

13
Heat-cure liquid : In addition contains,
 Benzoyl peroxide - Initiator.

Home reliners :
 Powder
 Polyvinyl acetate, Ethyl alcohol
 Calcium carbonate - Increases elasticity
 Polypropylene glycol - Easy peeling of

conditioners
from dentures
 White bees wax - Plasticizer
 Alkyl methacrylate copolymer - Prevents adhesion
to
fingers.
14
Liquid :
 Acrylic Triacetyl citrate
Trismethoxyethoxyvinylsilane.
 Silica consists of 2 MDX (silastic MDX-4210) RTV
silicone -Fumed silica with high surface area
 Hexamethyldisilanazane - To repel
water.
 Polydimethylsiloxane
 3-methacryloxypropyl trimethoxysilane - Adhesive
 Silicic acid

Light cured material :

 Urethane acrylate oligomers
 Benzoyl peroxide
 Camphoroquinone .
15
GELATION REACTION

 Ethyl
alcohol is having a greater affinity for the
polymer. When the powder and liquid are mixed,
polymer is dissolved by plasticizer.

 This
reaction is responsible for chain entanglement
and thus the formation of gel.

 When tissue conditioners are in continuous contact

with liquids such as oral fluids, the plasticizer and
alcohol contents leach out.

16
LOSS OF RESILIENCY
 Asthe plasticizer and alcohol contents leach out, water or
saliva occupies these lacunae, and the material looses its
resiliency.

 Theabsorbed liquid acts like a plasticizer, lowering

mechanical property of the polymer network, thus lowering
the dynamic viscoelastic property.

 Highmolecular weight plasticizer leaches less compared to

low molecular weight plasticizers.

 Siliconematerials remain resilient for longer time because

they are devoid of plasticizers. In addition they have greater
cross linking and higher bonding capacity to the fillers.

17
PROPERTIES

18
19
20
21
HOW TO USE
 Inspectthe tissue surface of the denture.
Adjust misfitting areas with a carbide
bur, clean and dry. Create sufficient
space so that tissue Conditioner can be
applied at a minimum thickness of 1mm.

 Mixthe material to a smooth creamy

mix avoiding incorporation of air
bubbles.

 Applyon to the tissue surface of the

denture .
22
 Thepatient is asked to close in the
centric relation.

 Functional
border molding is
performed .

 Dentureis removed from the

mouth, the tissue surface of the
denture is examined and the
excess material is trimmed.

23
 Thepressure spots identified should be
selectively trimmed to attain a relief of
1.5mm and a new lining must be placed
to correct these errors.

 The patient must be instructed to soft

brush
the tissue surface of the denture, under
running water. To take a soft- diet and
should remove the dentures at night if
possible.

 Conditioner should be replaced by a

fresh mix every 3-4 days , till the abused
tissue has recovered completely.
24
CRITICAL ANALYSIS

25
Mechanical Properties of Tissue Conditioners,
Part 1: Theoretical considerations, behavioral
characteristics, and tensile properties.

• Coe-comfort is the toughest of the three, related to

ability to absorb energy without failure. It had a low
elastic modulus and exhibited better tissue conditioning
properties.

• Lynal achieved high elastic properties in the first hour

indicating suitability as a short acting functional
impression material.

McCarthy, J.A., Mechanical Properties of Tissue Conditioners, Part 1:

Theoretical considerations, behavioral characteristics, and tensile
properties. J prosthet Dent July 1978 VOL. 1O No. I; 89-97. 26
Effect of time lapse between mixing and loading
on the flow of tissue conditioning materials.

 Increase in delay between mixing and loading the

material resulted in less total flow of the material
after loading for all products.

Ward J.E., Effect of time lapse between mixing and loading on the flow of
tissue conditioning materials. J Prosthet Dent November 1978 VOL. 40 No.
5; 499-508. 27
DISCUSSION
 Tissue
conditioners have seen great change in
composition over the years.

 There is advancement in material science from hard

acrylic liners to the newer silicone based liners.

 Materials like anti - fungals were incorporated into the

liners for prevention of fungal growth in the moist oral
cavity.

 Thereis now a need to incorporate harmless herbal

extracts into the liners to prevent side effects and also to
overcome development of resistance to the commercially
available antifungal agents by the candidal species.
28
 Bonding of the conditioning materials to denture base
material is seen as a major problem in addition to staining
and biofilm development.

 Bonding is improved by surface modification Biofilm

development is tried to overcome by applying a sealer
onto the surface of conditioner.

 Hydrophobic tissue conditioners are also available.

 Whatever may be the type of tissue conditioners, there is

no doubt that it is a healing magician to the abused tissues
under the hard denture bases.

29
CONCLUSION

 Though a material of short term use, tissue

conditioning materials has a vast importance in the
field of Prosthodontics.

 Ittakes care of abused tissues well and recently many

research works have been carried out in order to
incorporate anti-fungals and also introduction of nano
particles into the denture base materials is under
study.

 Denture liner properties are exploited to maximum to

relieve symptoms of abused tissues.
30
 Propermaintenance of oral hygiene and incorporation of
methods to make the surface resistant to staining also
should be considered.

 Bonding is one of the major problems seen with tissue

conditioners and it is addressed by modifying the surface of
resin denture base by methods which improve mechanical
locking and also increase the surface area.

 Tissueconditioners have proven a very useful material in

terms of improving fit of old dentures and restoring tissues
to normal health.

31
CLASSIFICATION OF RESILIENT/
SOFT LINERS

1] Short-term soft liners[Tissue conditioners]

2] Long term soft liners.

Types of resilient liner:

1. Mouth cured soft liners

2. Processed soft liners

Mouth cured soft liners

Two types of materials are generally used.

Formulation-1
Powder: polyethyl [methacrylate ]and peroxide initiator.
Liquid: Aromatic esters, ethanol and tertiary amines.

Formulation-2
Powder: polyethyl[methacrylate] ,plasticizer such as ethyl
glycolate and peroxide initiator.
Liquid: methylmethacrylate and tertiary amines.
Processed soft liners
 Usedwith denture patients who experience chronic soreness with their
dentures because of heavy bruxism or poor health.

 Theyare processed in laboratory in a manner similar to processing of

denture base .

 Natural rubber
 Vinyl resin liners
 Acrylic resin liners
 Silicone rubber liners
Soft natural rubber.

 Velum rubber is probably the oldest type of soft liner

used .

 In service it becomes foul and ill fitting.

 Ithas high water absorption and does not adhere to the

acrylic resin denture bases.

 Presence of large porosities which make adjusting and

polishing difficult.

 Even newer formulations have not proved to be successful.

Vinyl resin

 Poly vinyl chloride requires large amount of

plasticizer to lower the gelling temperature and to
produce a soft material that can be packed into the
mold.

 In service the plasticizer leach out of the material and

the lining material hardens and fissures develop in it.
Acrylic resin liner

 Lessresilient.
 Loses plasticizer at a rapid rate.

 Reduced biocompatibility due to monomer content.

 Good durable bond to the denture.

 More resistant to candida growth.

 Acceptable tear strength.

 Betterabrasion resistance.
 Resonably resistant to damage by cleansers.
Silicone soft liners

 The
silicone resilient materials appear to be somewhat
more promising for use as soft resilient liners.

Heat activation Room temperature

vulcanization

 Highly resilient.

 Retains softness and elasticity.

 Low tear strength and abrasion resistance.

 More susceptible to fungal growth and denture cleansers.

 Low bond to the denture base.

 Eg-Silastic 390,Silastic 616,Molloplast-B

 Poly[fluoroalkoxy]phosphazine elastomeric system

is a new addition to the list.

 Developedby Gentleman this system contains

methylmethacralate which bonds well to the denture
base.

39
FACTORS CAUSING TISSUE
SORENESS

 Abnormal tissue responses may result either from

systemic disturbances or from local factors caused
by ill-fitting dentures.

 Often the cause is difficult to differentiate.

SYSTEMIC FACTORS
 Occlusal trauma is mainly due to errors in:

-Centric occlusion.
-Unilateral prematurity - vertical lifting and rocking of
the dentures as well as a lateral shifting to
accommodate.
-Vertical dimension.
-Position of the plane of occlusion.
-Pressure areas within the dentures.
GELATION TEMPERATURE
 Temperatureat which a sharp increase in the thermal
expansion coefficient occurs, indicating increased
molecular mobility.

REALEFF EFFECT (resiliency and like

effect)
 The mucosa is displaceable and compressible.
 This is due to its resilient nature, which Hanau has
described as “Realeff effect”.

43
FACTORS AFFECTING REALEFF

 A)Consistency of mucosa
 (a) Flabby ridge i.e., mobile or extremely resilient
alveolar ridge. Anterior part of maxilla with remaining
anterior teeth in mandible -Excessive load on residual
ridge,
-Unstable occlusal conditions and
-Prolonged denture wearing thus providing poor
support for
denture.

 (b) Hyperplasia of tissue: Generally caused by chronic

ill-fitting and overextended denture borders.
Dr. Reeta Jain , Dr Sonal Pamecha , Dr Gyan Chand Jain. Realeff – Relevance in
complete dentures. International Journal of Innovations in Engineering and
Technology (IJIET) Vol. 1 Issue 4 Dec 2012; 44-47. 44
 B)Excessbone loss during extractions- localized response to
traumatic extraction where large amount of bone is lost.

 C)
Person’s general health- influencing form and size of
supporting bone and associated mucosa.

 D)Elderly tissues take longer time for recovery from

moderate mechanical force as compared to younger
individuals.

 E)Smaller forces produce distinct compression-light loads for

long duration have more effect than heavy loads for short
duration. More deformity is seen in thicker tissues.

45
 F)Para functional habits - produce light loads for longer
duration as physiological practices produce heavier
loads for longer duration.

 G)Single complete dentures - mobile alveolar soft tissue

found in anterior part of maxilla as a result of wearing
upper complete denture as opposed to lower anterior
teeth.

 Thisresults in resorption of ridge and prominence of

anterior nasal spine leading to denture instability and
pain.

46
CARE AND MAINTENANCE
 The use of a soft brush in conjunction with a mild
detergent solution or non-abrasive dentifrice
is recommended to clean the material under
cold running water.

 Hard bristle brush since this will have a

tendency to tear the material away from the
denture base and from itself and also adversely
affect its contour.

 Moreover, most of the denture cleansers are

mildly acidic and are absorbed by the tissue
conditioner.

 Cause stomatitis and burns.

REFERENCES

 Dr. Julie George Alapatt, Dr. Neenu Mary Varghese, Dr.

Bennett Atlin Correya, Dr. Mohamed Saheer K. Tissue
Conditioners: A Review. IOSR Journal of Dental and Medical
Sciences (IOSR-JDMS) May. 2015: Volume 14, Issue 5 Ver.
I ;54-57.

 McCarthy, J.A., Mechanical Properties of Tissue

Conditioners, Part 1: Theoretical considerations, behavioral
characteristics, and tensile properties. J prosthet Dent July
1978 VOL. 1O No. I; 89-97.

 Ward J.E., Effect of time lapse between mixing and loading

on the flow of tissue conditioning materials. J Prosthet Dent
November 1978 VOL. 40 No. 5; 499-508.
48
 Grzegorz Chladek, Jarosław Żmudzki and Jacek Kasperski
Long-Term Soft Denture Lining Materials: Review. Materials
2014, 7 ; 5816- 5842.

 Shobha Rodrigues, Vidya Shenoy, Thilak Shetty. Resilient

Liners: A Review. J Indian Prosthodont Soc (July-Sept 2013)
13(3):155–164.

 Dr. Reeta Jain , Dr Sonal Pamecha , Dr Gyan Chand Jain.

Realeff – Relevance in complete dentures. International
Journal of Innovations in Engineering and Technology (IJIET)
Vol. 1 Issue 4 Dec 2012; 44-47.

49
THANK YOU

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