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Improving the Retention of Resilient Liner Materials to Dentures

Tissue conditioning for the treatment of edentulous patients is a common procedure in the dental practice. As part of the comprehensive preparation of a patient receiving complete dentures, tissue conditioning aids in the recovery of the mucosa prior to making definitive impressions.1 A recovered mucosa improves the stability of record bases, making the process of denture fabrication more predictable when determining maxillomandibular relations and making centric relation records. It also increases the retention and stability of the prostheses. 

The clinical procedure for the reline of dentures with a resilient material is simple and quick. It can be performed chairside and provides the patient with immediate results. The success of this procedure, however, depends on the ability of the reline material to bond to the denture substrate. The most common difficulties that arise during the relining of removable prostheses are associated with the retention of the soft reline material around the borders of the denture. The current literature on resilient liners is focused on their chemical and physical properties.2,3 Several methods have been studied and described to chemically improve the bond strength of resilient liners to the denture base.4-6 Little attention has been paid to create a mechanical source of retention for resilient liners. The technique outlined herein has several advantages: 1) it provides mechanical retention of the denture liner to the denture base; 2) it allows for a definite finish line of the material, making it easier to finish and polish; and 3) if border extensions are required, it reinforces the new borders created with the resilient material.

 

Clinical Procedure

  1. Disinfect the prosthesis and remove organic and mineral deposits using an ultrasonic cleaner.
  2. If the borders of the denture are extended correctly, carve a 2-mm--deep groove using a No. 8 round bur 2 mm from the borders of the denture on the intaglio surface.  If the borders of the denture need to be extended or modified, carve a 2-mm--deep groove using the round bur alongside the borders on the polished surface (Figure 1).  It is essential to continue the groove into the palatal surface of the prosthesis (Figure 2).
  3. Roughen the entire surface to be covered with the reline material, removing any polished or glazed areas of acrylic.
  4. Apply any bonding or surface-activating chemical agent, following the manufacturer’s instructions of the resilient liner.  The authors have found that wetting the intaglio surface of the prosthesis with polymethylmethacrylate monomer increases porosity; therefore, it enhances mechanical retention (Figure 3).
  5. Mix the appropriate amount of monomer and polymer of the resilient liner according to the manufacturer’s instructions, and cover the entire surface to be lined (Figure 4).  Be sure to extend reline material into the retention groove (Figure 5).
  6. Introduce the prosthesis intraorally.  Instruct the patient to close to the desired occlusal vertical dimension in the centric occlusion position and perform border molding movements. Allow the material to polymerize intraorally for 10 to 15 minutes.
  7. Remove the denture from the patient’s mouth.  Trim any excess material, finish, and polish (Figure 6).  Insert the prosthesis, inspect for any errors in the occlusion, and perform adjustments.  Implement a patient remount procedure, if necessary.

 

Conclusion

The retention of resilient denture liners to the acrylic denture base is one of the most common difficulties encountered during the relining of dentures.  This article describes how this can be eased by the addition of a retention groove alongside the borders of the denture.  A retention groove also reinforces the reline when extending or modifying denture borders.

 

*†Private practice, Houston, TX.

‡Private practice, Dallas, TX

 

References

  1. Lytle, RB.  The management of abused oral tissues in complete denture construction. J Prosthet Dent 1957;7(1):27-42.
  2. Lammie GA, Storer R.  A preliminary report on resilient denture plastics.  J Prosthet Dent 1958;8(3):411-424.
  3. Garcia LT, Jones JD. Soft liners. Dent Clin North Am 2004;48(3):709-720.
  4. Minami H, Suzuki S, Ohashi H, et al.  Effect of surface treatment on the bonding of an autopolymerizing soft denture liner to a denture base resin. Int J Prosthodont 2004;17(3):297-301.
  5. Hong G, Murata H, Hamada T. Relationship between plasticizer content and tensile bond strength of soft denture liners to a denture base resin. Dent Mater J 2004;23(2):94-99.
  6. Leon BL, Del Bel Cury AA, Rodrigues Garcia RC.  Water sorption, solubility, and tensile bond strength of resilient denture lining materials polymerized by different methods after thermal cycling. J Prosthet Dent 2005;93(3):282-287. 
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