DENTURE LINING MATERIALS
Lining material (LM); Is a material forming all or part of the fit (tissue)
surface of the denture. It usually acts as a cushion between the hard denture
base and the tissue, reducing the masticatory forces that are transmitted by
the prosthesis to the underlining tissues.
Classified generally into two types:
Relining
Rebasing
Ideal Properties
[Link] of manipulation and processing.
2. Good dimensional stability.
3. Low water absorption and low solubility.
4. Permanent resiliency.
5. Sufficient adhesion to denture base to avoid separation during use.
6. Tear resistant.
7. Easy and unaffected cleaning.
8. Biocompatibility.
9. Oderlessness and tastelessness, good esthetic and color stability
10. Easy to repair and adequate shelf life.
Classification
LM can be classified according to their chemical composition:
1. Acrylic-based lining material
2. Silicone-based lining material
3. Polyphosphazine fluoroelastomers
LM can be classified according to their use:
1. Tissue conditioning materials.
2. Denture rebasing.
3. Denture reline materials.
LM can be classified according to their period of use:
1. temporary
2. intermediate
3. permanent
LM can be classified according to softness:
Soft lining
Hard lining
INDICATIONS
Reline Indications:
1. Poor retention.
2. Poor stability.
3. Food under denture.
4. Abused mucosa (use conditioning material).
5. Improving border extension (depth and /or width).
6. Should have correct jaw relations
Rebasing Indications:
1) Porous or artifact of the denture base.
2) Loss of retention & stability.
3) Should have correct jaw relations
Relining/ General Considerations:
1. Optimal tissue health.
2. Reasonable CR/CO.
3. Adequate vertical dimension.
4. Adequate peripheral extensions.
5. Relining cannot be used when:
a. No free way space.
b. Lack of balanced occlusion and articulation.
c. Incorrect contour for the peripheral boundary.
Patient and denture pre-requisites for relining:
1. Tissues must be in normal healthy state.
2. There must be reasonable centric occlusion in harmony with centric
relation.
3. There must be at least correctable rest vertical dimension and
occluding vertical dimension.
4. Absence of speech defects.
Relining techniques: Mainly:
I. Direct method “temporary” (chair-side relining material):
II. Indirect method/ Conventional “Permanent” (processed relining
material), which is subdivided to :
1. Static impression.
2. Functional impression.
Direct method (chair-side relining material): Make by…. cold cure Or
conditioning materials.
Indications:
1. Where no longer than 6 weeks is required.
2. Around over-denture abutments.
With drawer points:
1. As it deteriorates in oral environment, so it can’t be used for long term.
2. The material is difficult in adhering to denture base.
3. Color stability is of short duration.
4. If denture is not properly positioned, correction is difficult.
5. Tissue irritation may be caused by lysis of the local monomer, or burn
mucosa during polymerization.
6. Exhibits more dimensional changes.
Hard Relining: Cold & hot cured acrylic included by this relining
classification.
Aims: Provides even contact between the denture and its supporting
tissues, thereby improving retentive forces and support. “Stability and
retention”
Resilient soft linings: Silicon lining or conditioning materials are
used as resilient liners.
Aims: To absorb the impact energy of the masticatory forces and
distributes it more evenly over the supporting tissues. “Treatment”
Indications of the soft lining:
a. It is most effective when used over corticated bony elevations.
b. Use to improve retention by engaging undercuts.
Disadvantages of soft lining:
1. Tend to peel off the hard acrylic denture base (acrylic material adhere
better).
2. Difficult to adjust (acrylic materials more easily altered).
3. Porous, tending to absorb fluids (with resultant swelling and bad odor)
due to harbor bacteria and fungi.
4. Need more thickness to be effective this may be weaken the denture,
especially the lower denture.
5. Some patients can become habituated to such linings and cannot be
satisfy with hard tissue surface.
6. Rub the oral mucosa since they deform under masticatory pressure.
Chemical composition
1. Acrylic based SLM: They consist of powder (polymer), and liquid (a
mixture of a polymerizable acrylic monomer and a plasticizer).
Two types of acrylic-based SLM are available; cold cured and heat cured
liners.
2. Silicon based SLM: They are similar in composition to the silicone
impression material.
They are basically polydimethylsiloxane which is a viscous liquid that is
cross-linked to give a rubber with good elastic properties.
Two types of silicone-based SLM are available; cold-cured liners (e.g. GC
reline which is supplied as two pastes), and heat cured liners (e.g.
Molloplast-B liner which is supplied as a one paste system).
3. Polyphosphazine Fluoroelastomer: Have recently become available for
use as denture SLM.
They are supplied in sheet form and are manipulated in a similar manner
to the heat cured products.
Manipulation of SLM
A thickness of 2-3 mm of SLM is required for adequate cushioning.
The cold cured products are temporary SLM less than 1 month or
intermediate liner (1-6 months).
They are used in place of tissue conditioner in cases where it is not
practical to replace tissue conditioner every 2-3 days.
These materials harden within a period of a few weeks or a few months.
Therefore, they require a regular replacement. These materials can be
readily applied to an existing denture by the dentist, in a chairside
[Link] heat cured products are permanent SLM (1 year or longer).
They remain soft for longer time than intermediate SLM.
TISSUE CONDITIONERS
Tissue conditioners (TC) are soft denture liners which may be applied to
the fitting surface of a denture. They are used to provide a temporary
cushion which prevents masticatory loads from being transferring to the
underlying hard and soft tissues.
These materials should flow after loading in order to;
1. To allow for soft tissues changes once "trauma" has been removed.
2. To capture the shape of the supporting tissues in function.
INDICATIONS
1. Chronic residual ridge soreness.
2. Sharp and knife edge residual ridge.
3. Extensive bony prominence or projections (when surgery is
contraindicated).
4. Maxillofacial prosthesis; as obturator and mouth guards.
5. Nerve soreness like superficial mental nerve soreness.
6. Reduced tolerance to denture like in patients with nutritional
deficiencies, and psychological disturbance.
7. Reduced salivary flow.
8. Retention problems.
Chemical composition
Tissue conditioner are supplied as powder and liquid:
-Powder:Polyethylmethacrylate.
- Liquid: solvent (ethyl alcohol) and plasticizer (butylphthalyl
butylglycolate).
Manipulation of Tissue conditioner
Tissue conditioner are used in chairside technique according to following
steps;
1. The freshly material is applied to the fitting surface of the denture.
2. The denture is then seated in the patient's mouth whilst the tissue
conditioner is still in a semi fluid state.
3. The denture and the patient's soft tissues should be inspected after 2-3
days to ascertain the successfulness of the procedure.
Note: the tissue conditioner should be replaced every 2-3 days.
