Techniques Of Tissue Conditioning For Complete Denture Patient
1. Oral hygiene
– Plaque causes inflammation and edema
– Demonstrate how to brush all denture surfaces
– Have patient massage tissues with a soft tooth brush twice a day – morning/night; begin with 30 seconds and increase to 2 minutes.
2. Tissue Rest
Lytle (JPD, 7:27, 1957; JPD 9:539, 1959)
– Abused tissues were treated by removing dentures for periods of 48 – 72 hours
– Tissue inflammation disappeared, then recurred if faulty dentures were replaced
Kydd, Daly, Wheeler, (JPD 32:323,1974)
– When tissue was loaded, recovery was affected by age:
a. 10-30 years old: 90% had immediate recovery when load released.
b. 72-86 years old: 61% had recovery after 10 minutes; some took 4-1/2 hr.
– Clinical reports suggest regular finger massage/tooth brushing of mucosa with a warmed, soft brush may be useful to improve tissue health
3. Occlusal Correction
Lytle showed improper occlusion can cause to poor tissue health
**This is one of the most overlooked causes of tissue irritations**
Methods for correction:
1. Add to occlusal surfaces of acrylic teeth with acrylic resin, – improves vertical dimension, balances occlusion
2. Soft mouth guard over teeth – reversible procedure, inexpensive
3. Clinical remount and occlusal adjustment
4. Temporary Soft Liners
(Reference: Dent. Clin. N.A. 28(2): 239, 1984)
(Lynal, Viscogel, Coe-Comfort, Tru-Soft, Soft-Tone)
– Can improve comfort, retention, occlusal vertical dimension (minor changes), and extension of denture bases (minimal).
– Use manufacturers recommendation for mixing, usually 1:1.5-2.0 powder/liquid.
– Typical composition:
Powder – polyethyl methacrylate
Liquid – aromatic ester-ethanol
– These materials are soft and resilient and flow under pressure.
– Material becomes rigid after a week – plasticizer leeches out
– Change the soft liner as necessary (usually lasts no longer than 4-6 weeks)
The length of time required for tissue conditioning depends on the severity of irritation. A combination of treatment may be necessary.