Resiliency and it’s effect on complete denture construction:

The masticatory mucosa, which consists of a surface epithelial layer and a deeper
connective tissue layer called the lamina propria, demonstrates significant
resistance to deformation under stress. Intercellular channels
(mucopolysaccharides), which provide deformability and load carrying, are present
in this layer and are used for communication with neighboring cells. The deeper
reticular layer and the papillary layer are the two sublayers of the compact fibrous
tissue known as lamina propria. The oral mucosa is rendered immobile with a tight
connection to the bone, resisting compression and shear in function because of the
presence of these fibrous attachments, termed as mucoperiosteum. The thickness of
the whole mucosa can vary greatly ,ranging from 0.30 mm on the connected buccal
mucosa in the canine mandible to 6.7 mm in the area of the maxillary tuberosity.

The oral mucosa, in addition to its structural functions, distributes masticatory

pressures and guards the underlying residual ridge from excessive loading. The
mucosa is a highly vascularized tissue that includes a significant amount of
interstitial fluid, and the mechanical cushioning effect is what gives it its protective
function. The interstitial fluid is pushed to the unloaded neighbouring tissues by
the pressure created by dentures. Collagen fibres are compelled to align along
mechanical stress lines by fluid movement, passively shielding the underlying bone
and connective tissue. The IFP increases with increased masticatory loads. Blood
flow will be decreased and may even momentarily stop whenever IFP surpasses
the vascular pressure, which could result in localised ischaemia. This process is
time-dependent and reaches a plateau after increasing with loading time. The size
and length of the loading affect the degree of ischaemia. The sustained obstruction
of blood flow also causes local anoxia and metabolite buildup, which eventually
destroy the supporting bone structures and are referred to as residual ridge
resorption.

Reaction of Tissue to loading is Initial Elastic Compression, Delayed elastic

compression, Instant elastic decompression and Delayed elastic recovery
Ideal mucosa should be:
Firmly attached to the periostium of the underlying bone of the residual ridge to
decrease mucosa and denture movement as much as possible and to withstand
pressure applied during different masticatory movements. Slightly displaceable to
allow the denture to be seated comfortably in place as the mucosa will adapt itself
to the fitting surface of the denture. Mucosa will also act as a cushion to the normal
stresses to mastication and prevent development of sore spots.
 

Difficulties associated with impression recording due to tissue resiliency:

For the maxilla: detection of the displaceability of the palate if hard palate shows
minimal displacement, then relief the crest and raphe to avoid rocking by selective
imp. Technique If the palate is recorded in displaced position they will tend to
rebound.
For the mandible: Shape of ridge is considered before imp. Making If ridge is
developed, it can be used to aid in support, however if it’s thin, sharp or spiny, full
of nutrient canals or flat, no masticatory forces should be applied, it should be
transferred to buccal shelf area. Retromolar pad must be covered not to provide
support but to complete the seal.
Factors influencing the tissue displacement are the forces exerted by the dentist,
flow of the matter, if the tray is confined or vented and the resiliency of the
mucosa.
With normal resilient tissues what should be considered during denture design and
recording impression, for proper peripheral Seal Borders of the denture should be
placed on the resilient tissues with slight displacement to provide seal and serve to
resist lateral, horizontal and torquing forces. The non-resilient tissues should be
relived to Provide comfort for pt in sensitive areas, compensate for dimensional
changes, compensate for ridge resorption, and Prevents instability and denture
fracture.
Impression techniques for resilient and mobile tissues:

Sectional impression technique or window technique. A primary Impression is

taken in alginate loaded in a stock tray. The Impression is then poured and a
special tray is constructed on the model. The special tray Is close fitting and has a
hole or "window" over the area corresponding to the flabby ridge.
An Impression is taken In Impression paste (mucodisplacive). Once this has set it
Is left in place and Impression plaster (or any light body Impression material -
Mucostatic) Is painted over the flabby ridge and allowed to set and removed as one
Impression. The Impression is removed as one, cast and the denture constructed on
the resulting model.
Selective impression technique. A primary Impression Is taken in a Mucostatic
Impression material. Then a spaced special tray for an Impression Compound
Impression Is then constructed on this model. The tray Is loaded with Compound
and an Impression taken of the model of the patient's mouth. This reduces the risk
of displacing the flabby ridge. The Impression Is removed Inspected and re-tried
In the mouth to Check that It Is stable. If any instability occurs then the Impression
should be reheated and re-taken. Lastly A wash Impression may be taken in
Impression paste to obtain maximum detail and retention and stability .

Difficulties associated with recording jaw relation due to tissue resiliency:

The jaw relation record should be recorded with minimal pressure to prevent
displacement and provide simultaneous and uniform contact without causing the
patient to clench.
Effect of resiliency on Jaw Relation
With Normal resilient tissue construction of a stable denture base, ensure even
pressure, and use of soft displaceable material is possible
With highly resilient tissues tracers and pantographs cannot be used as the forces
generated on the movable mucosa will not result in an accurate result.
Considerations when setting the denture teeth:
Due to tissue resiliency bilateral balance cannot be establish. The long centric
concept is recommended to compensate for tissue resiliency and limitation of
articulator.
Resiliency of tissues affects the accuracy of , articulating paper , central bearing
device and tracers due to shift of the dentures under forces of occlusion

Considerations when delivering the denture:

Correction of occlusal discrepancies require multiple remounting procedures using
either of:
 Remounting using un strained jaw relation record with a passive material
that necessitates minimal occluding force to record jaw relation so as not to
displace the mucosa , selective grinding is accomplished
 Remounting using strained jaw relation record with a resistant material
that necessitates the jaw to close with force that displace the supporting
tissues. Selective grinding is accomplished