Download as pdf or txt
Download as pdf or txt
You are on page 1of 8

Dental Materials Journal 2008; 27(3): 440-447

Original Paper

A Prospective Study on the Clinical Performance of Polysiloxane Soft


Liners: One-year Results

Mustafa Murat MUTLUAY1,2, Serra OGUZ3, Finn FLØYSTRAND1, Erik SAXEGAARD1, Arife DOGAN3, Bulent BEK4
and I. Eystein RUYTER2
1
Department of Prosthodontics, Faculty of Dentistry, University of Oslo
2
NIOM, Nordic Institute of Dental Materials, Haslum, Norway
3
Department of Prosthodontics, Faculty of Dentistry, Gazi University, Ankara, Turkey
4
Department of Prosthodontics, Faculty of Dentistry, Cumhuriyet University, Sivas, Turkey
Corresponding author,  M. Murat MUTLUAY;  E-mail:  mmutluay@gmail.com

Objective: The aim of the present study was to evaluate the clinical performance of four denture soft liners up to 12
months. Materials and methods: Thirty-three edentulous patients who experienced difficulties when using hard denture
bases because of changes in denture-supporting tissues were accepted for the study and randomly received Molloplast
B, GC Reline Soft, Silagum Comfort, or Mollosil Plus relines. Performance of the materials was evaluated using nine
criteria at 3, 6, and 12 months: physical integrity, surface detail, adhesion, color, odor, plaque accumulation, resilience,
hygiene, and mucosal condition. A four-point categorized scale (1=poor, 2=fair, 3=good, 4=excellent) was used.
Unscheduled maintenance events and the presence of fungal colonization were also recorded. Results: The percentage of
patients available at 3, 6, and 12 months were 91%, 91%, and 66%. Main reasons for dropouts and discontinuation were
fractured dentures and patient dissatisfaction. At 6 months, 96% of the performance scores were good or excellent and
the largest changes were observed for physical integrity, surface detail, color, and fungal colonization. Fungal colonization
was the most commonly observed problem and was the only reason of failure at 12 months. Conclusions: The clinical
performance of all soft liners was slightly impaired over the 12-month observation. Except for cases showing extensive
fungal colonization, the observed changes in clinical performance did not necessitate remaking of the dentures. Mollosil
Plus showed a performance comparable to that of Molloplast B, and the other materials had slightly lower performance
especially in terms of fungal colonization.

Key words: Polysiloxane, Removable denture, Fungal colonization

Received Sep 18, 2007: Accepted Dec 19, 2007

soft liners continue to be the main problems limiting


INTRODUCTION
their use9-11).
For patients who cannot tolerate a hard denture   In the last decade, soft liners have been
base, soft liners are an important adjunct treatment improved and new materials have become available12).
to help the patients adapt to their new dentures1). However, there are few published studies which
A recent report indicated that some 75% of effectively test the clinical performance of these
patients needed relining of the implant-supported liners and provide documentation about their
overdentures after an average of 7.8 months, and serviceability.
soft liners were often favored as an alternative to   The specific aim of this study was to assess the
conventional hard relining materials2). clinical performance of three recently introduced
  Use of soft lining materials was previously materials with relatively new formulations and
considered as a temporary measure3). However, application methods, and to compare their clinical
several authors have reported on a long service life performance with that of a well-studied, conventional
of soft liners, sometimes remaining on the denture material serving as a control.
for its full service life4-8).
  A soft liner’s assessment criteria as listed
MATERIALS  AND  METHODS
by many authors were, namely, resilience, tear
resistance, biocompatibility, lack of odor and taste, Soft liner materials
adhesive bond strength, color stability, and resistance The materials used in this study were, Molloplast
to abrasion9-11). Although some of the material types B, GC Reline Soft, Silagum Comfort, and Mollosil
were reported to maintain these qualities for a longer Plus (Table 1). All the four materials are based
time than the others, loss of bonding to denture base on polysiloxanes. They differ mainly in terms of
polymers and fungal colonization on and within the application technique, polymerization, and/or curing
DMJ 2008; 27(3): 440-447 441

cycle (Tables 1 and 2). Molloplast B is a heat- informed consent was obtained. The study protocol
cured, compression-molded material, and the other was reviewed and approved by the Human Ethics
soft liners are chairside relining materials which Committee at Gazi University’s Faculty of Medicine,
polymerize at room temperature. Ankara, Turkey.

Study population Treatment protocol


Subjects accepted for this study were edentulous During the first appointment, a detailed examination
male (15) and female (18) patients (median age for all form was filled out and the oral condition of the
patients was 65 years) who came to the prosthodon- patient was recorded.
tics clinic at Faculty of Dentistry, Gazi University in   Subjects were distributed according to a
Ankara, Turkey, with complaints relevant to clinical randomly generated treatment allocation to four soft
indications for a soft liner therapy. These problems liner groups and received the liners accordingly. For
arose from changes in the denture-bearing hard and the Molloplast B group (n=9), the tissue surface
soft tissues, i.e., alveolar resorption or poor quality of of the patient’s denture was ground to obtain the
the denture-bearing mucosa1). Patients who needed necessary space required. A thickness of 2-3 mm
local relief of pressure for wound healing following was aimed at, but because of anatomical variations
a surgical intervention or patients with other acute and variations among the different patients’ dentures,
problems were not included in this study, since such this was not always achieved. Consequently, the
indications usually require only short-term use of the dentures were border-molded and an impression
material limited to a few months. The distribution of was taken with a eugenol-free impression paste
the patients is given in Table 3. (Cavex Outline, Cavex, Holland). At the laboratory,
  Subjects were accepted for this study after their the recommended primer was applied as per the

Table 1 Materials used for the study


Brand names (Code) Manufacturer Processing method
Molloplast B (MLP) Detax GmbH, Ettlingen, Germany Heat-cure
Primo adhesive Detax GmbH, Ettlingen, Germany Recommended for Molloplast B. Apply and
let dry for 60-90 min.
GC Reline Soft (GCS) GC Co, Tokyo, Japan Autopolymerizing
GC Reline Primer R GC Co, Tokyo, Japan Recommended for GC Reline soft. Apply to
the surface and gently dry with air.
Silagum Comfort (SLC) DMG, Hamburg, Germany Autopolymerizing
Silagum Comfort Primer DMG, Hamburg, Germany Recommended for Silagum AM Comfort.
Apply and let solvent dry for 1 min.
Mollosil plus (MLS) Detax GmbH, Ettlingen, Germany Autopolymerizing
Mollosil plus Primer Detax GmbH, Ettlingen, Germany Recommended for Mollosil plus. Apply and
let solvent dry for one minute

Table 2 Chemical ingredients of the materials according to manufacturers’ information


Material Components Primer
MLP Condensation polysiloxane material, Mixture of methoxy and
PMMA, ethoxy silane derivatives
γ-methacryloyloxypropyltrimethoxysilane
GCS Silicon dioxide,
Ethyl acetate >90%
Vinyl dimethyl polysiloxane,
Hydrogen polysiloxane
SLC Vinyl polysiloxane, Hydrogen polysiloxane, Ethyl acetate, modified polyacrylate, additives
aerosil, additives
MLS Polydimethylsiloxane with functional Ethyl acetate 60-100%
groups, filler, pigments, platinum catalyst
PMMA=Poly (methyl methacrylate)
442 DMJ 2008; 27(3): 440-447

manufacturers’ recommendations and a standardized running water. They were thus instructed because
curing cycle was used for processing the Molloplast this was the most commonly used method which did
relines. The denture was then delivered to the not require the patients to purchase any additional
patient and necessary adjustments were made at material. The instructions were repeated during
chair-side. every recall for a continuous level of motivation.
  For chairside relining materials (n=8 for each
group), the dentures were ground on the tissue Data collection
contacting surface in order to obtain adequate space Patient demographics included gender, age, and
for the soft liner. This was done to a depth of 2 mm occupation (Table 3). Furthermore, patients’ health
as long as the denture thickness allowed. They were and medication usage, smoking history and their
coated with primer, relined with the soft liner, and oral hygiene practices were recorded. An intraoral
delivered to the patient at the same appointment examination was carried out, and the results were
according to the manufacturers’ instructions. entered in an examination form. A second form was
  Blinding in this study was not possible because filled out during the visits where the condition of the
the different relining materials had very distinct liner was subjectively evaluated according to the nine
color differences. The clinicians had no previous primary criteria (Table 4): physical integrity, surface
experience with the proprietary materials used; this detail, adhesion, color, odor, plaque accumulation,
would reduce any bias introduced by familiarity with resilience, hygiene, mucosal condition of the patient
one of the products. occasionally, and signs of fungal colonization5).
  Patients were instructed to clean the tissue Fungal colonization was recorded as P=present or
contacting surfaces of their dentures after every meal NP=not present; the other parameters were assigned
using liquid soap and a regular toothbrush under scores on a four-point categorized scale (Table 4).

Table 3 Data collected during the study


Demographics Gender distribution Male 15
Female 18
Age distribution (mean=65.5) 40-49 2
50-59 9
60-69 9
>70 13
History Smoking habits Smoking 3
Non-smoking 30
Medication usage Using at least one 14
medication regularly
Not on medication 19
Denture hygiene practices before Toothbrush and toothpaste 2
the study Toothbrush and soap 7
Soap only 19
Immersing into NaOCI 2
Cleaning tablets 3
Denture Upper 4
Lower 29

Table 4 Criteria used for the evaluation of the liners and the scoring system used to record the condition of the liner
Mucosal condition evaluation 1-4 rating
Liner conditon evaluation 1) Physical integrity: Tearing loss of material
2) Surface detail: Loss of surface texture, roughening
3) Adhesion: Failure of the bond 1-4 rating
4) Color: Comparison with fresh unused material (1=poor, 2=fair,
5) Odor: Presence of any distinctive odor 3=good, 4=excellent
6) Plaque accumulation: Surface coverage with plaque
7) Hygiene: Surface coverage with food particles
8) Resilience: Comparison with fresh unused material P-NP rating
9) Fungal colonization: Presence of colonization (P=present, NP=not present)
DMJ 2008; 27(3): 440-447 443

The worst site where the most obvious changes were


RESULTS
observed was also recorded where applicable.
  Patients were recalled at 3, 6, and 12 months Overall performance
for an evaluation of the liner, and unscheduled The recall rate at 3, 6, and 12 months were 91%,
maintenance events were also recorded. Dropouts 91%, and 66%. Table 5 lists the dropouts and dis-
from the study population were also categorized and continuers. The reason for discontinuing was severe
recorded at the time of the event either as patient not fractures which required remaking or rebasing of the
satisfied, patient lost to follow-up, adverse reaction, dentures. Five lower dentures (15%) had fractured
or fracture of denture. between baseline and 12 months.
  The main reason for dropout was patient dissat-
Statistical analysis isfaction with the denture. Only one adverse reaction
Collected data were analyzed using a SPSS statistical was recorded during the study: a female patient
package (version 14.0). The outcomes were changes using the MLS reported a burning sensation on the
in primary end-points and fungal colonization. A mucosa and generalized redness was observed.
comparison of the material performance over time   Among the followed relines, four were on
and among the material types was done by chi- upper dentures. Two of these patients were lost to
square and Wilcoxon signed rank tests. The 12- follow-up at 6 and 12 months. Therefore, a proper
month controls had too much lost data. Therefore, statistical analysis was not possible. Nonetheless,
the main statistical analysis was carried out on data no recognizable differences were observed between
obtained from the 3 and 6-months controls. upper and lower dentures in terms of material
performance.

Table 5 Dropouts and discontinued patients and reasons


3 months 6 months 12 months
MLP 0 0 2d,d
GCS 1 a
0 4b,b,d,d
SLC 0 0 1a
MLS 2a,c 0 1d
Superscript letters show the reasons for dropouts and discontinuers: a patient not satisfied, b lost to follow up, c adverse
reaction, and discontinued patients d severe fracture of denture requiring new prosthesis.

Table 6 Some of the parameters followed during the study. The values show the distribution of scores for every material
type at each recall
3 months 6 months 12 months
Excellent

Excellent

Excellent
Good

Good

Good
Poor

Poor

Poor
Fair

Fair

Fair

n n n
MLP 0 0 2 7 9 0 0 2 7 9 0 0 2 5 7
GCS 0 0 5 2 7 0 0 5 2 7 1 0 1 1 3
Physical integrity SLC 0 0 3 5 8 0 0 3 5 8 0 1 2 4 7
MLS 1 0 0 5 6 1 1 1 3 6 0 1 1 3 5

MLP 0 0 0 9 9 0 0 2 7 9 0 0 2 5 7
GCS 0 1 1 5 7 0 2 0 5 7 1 0 1 1 3
Surface detail SLC 1 0 1 6 8 1 0 4 3 8 1 0 3 3 7
MLS 0 0 1 5 6 0 1 2 3 6 0 1 1 3 5

MLP 0 0 0 9 9 0 0 2 7 9 0 0 2 5 7
GCS 0 1 1 5 7 0 2 0 5 7 0 1 1 1 3
Adhesion to denture base SLC 1 0 1 6 8 1 0 4 3 8 1 0 3 3 7
MLS 0 0 1 5 6 0 1 2 3 6 0 1 1 3 5

MLP 0 0 4 5 9 0 1 5 3 9 0 1 3 2 7
GCS 0 0 2 5 7 0 0 3 4 7 0 0 2 1 3
Color stability SLC 0 0 3 5 8 0 1 3 4 8 0 1 3 3 7
MLS 0 0 1 5 6 0 1 2 3 6 0 1 1 3 5
444 DMJ 2008; 27(3): 440-447

Performance outcomes areas were limited in size and did not require any
Physical integrity: Average physical integrity score maintenance (Fig. 1).
of the materials changed after 3 months (Table 6).   Surface detail: Scores given to visually assessed
The greatest decrease was with the GCS material changes in surface detail or deterioration in surface
where five of the seven dentures (71%) had problems texture, changed significantly after 3 and 6 months
related to physical integrity. This change was (p=0.008 for both). No significant differences were
significantly different from MLP which had changes found among the materials. The changes were
on only two dentures (22%) after 3 and 6 months often observed as roughening of the surface and
(p=0.049). No other significant differences were loss of shiny appearance ― which was first observed
observed among the materials. Of the 33 relined when the liner surface was cured against mucosa.
dentures, an average point of 3.5 was rated with Changes in surface detail were mostly observed in
the lowest score of 2 which was given to one denture the posterior area.
only, and for 13 dentures (39%) the score was still 4   Adhesion: Adhesion to denture base polymer was
after one year. The MLP material had more scores not significantly changed after 6 months compared
of 4 than the other materials. SLC also showed an to baseline, and no significant differences were
early decrease in physical integrity where three of found among the materials. 56% of the dentures
the samples had a decreased score after 3 months. still had the excellent score after 12 months, and
Failures were usually seen where the material was only three (9%) of the relines showed small failures
thin and not bonded to the denture base. These on the borders of the denture which did not require

Fig. 1 Clinical example of a MLP soft liner at 12 months’ Fig. 2 Clinical example of a GCS material at 12 months’
recall. Note the good condition of the liner in recall. Note the fungal colonization and problems
terms of physical integrity and surface detail as concerning physical integrity.
well as fungal colonization.

Table 7 Percentages of soft liners with fungal colonization and failures

3 months 6 months 12 months


(+) n (+) n (+) n
MLP 0 9 22 9 14 7
GCS 13 7 30 7 66 3
Fungal colonization SLC 13 8 75 8 83 7
MLS 0 6 0 6 20 5

MLP 0 9 0 9 14 7
GCS 0 7 0 7 33 3
Failure because of
SLC 0 8 0 8 56 7
fungal c.
MLS 0 6 0 6 20 5
DMJ 2008; 27(3): 440-447 445

repeating the relining procedure (Fig. 1). practice may thus be limited.
  Color change: Sixteen of the dentures (48%) were   The percentages of patients available for follow-
rated one or two points lower at 3 months. Scores up were 91%, 91%, and 66% for 3, 6, and 12 months
at 3 and 6 months were significantly different from respectively. At 12 months, three of the patients did
baseline (p=0.014). No significant differences were not want to continue and three of the dropouts were
found among the materials. Fading of the material patients that could not be reached. The dropout rate
was uncommon, and the main reason for color change appeared to be moderate, considering the relatively
was staining. The typical staining color was yellow- high age of the patients.
brown, and this was patient-dependent rather than a   Fatigue fracture of the denture base has
general finding. For three of the patients, an intense frequently been reported as the main reason for
color change was observed and the predominant discontinuing and this is ascribed to the decreased
color was brown. The average scores after 6 and 12 thickness of the denture5,14,15). In the present study,
months were 3.5 and 3.3 respectively. 15 percent of the dentures fractured within one year.
  Plaque accumulation and hygiene: The amount   Polysiloxanes are used in many biomaterial
of plaque found on the dentures, as well as hygiene, applications because of their stability and lack of
were assessed visually. The surfaces of all the toxicity. Although rarely reported and usually not
liners were partly covered with plaque, with very properly diagnosed, some adverse reactions to poly-
little variation among the patients. No significant siloxanes in different regions of the body have been
differences were found among the different materials reported15-17). One of the patients participating in our
(p>0.05). study showed a reaction to the polysiloxane soft liner
  Resilience: Resilience of the materials was MLS after 24 hours of contact, resembling a type 1
assessed by comparing the liner to an unused sample, allergy to this material or to some other materials
and any detectable change was recorded. After 12 used during the chairside relining procedure. This
months, none of the soft liners showed any change patient wanted to withdraw from the study, and her
that could be detected by the clinician. denture was relined with a conventional denture
  Condition of the mucosa: No indications of base polymer. A history of allergy was also recorded
change were observed after 3, 6, and 12 months, when this patient was first examined. Although no
except for one adverse reaction observed after 24 additional information was available for this patient,
hours. an allergic reaction was possible and this should be
  Colonization of the soft liner surface: Fungal kept in mind during treatments.
colonization of the soft liner surface was observed at   The term ‘physical integrity’ is related to the
3 months in two patients (6%). At 12 months, 36% general soundness and durability of the soft liner
of the dentures were affected with fungal colonization materials5). It may also reflect the durability of the
at different levels (Table 7, Fig. 2). For all the materials during cleaning procedures where brushing
time periods, SLC and GCS had a higher degree of or other means of cleaning subject the reline to
colonization than the others. At 12 months, seven various stresses. Failure is generally observed as
patients (21%) were recorded as failure because of tearing of the material and loss of parts of the reline
extensive colonization (Table 6). during clinical use. MLP showed slightly better
  The largest differences among the materials performance at 12 months than the other materials
were observed for the colonization scores. At 12 and significantly better than GCS. The clinical
months, only one of the dentures relined with MLS significance of this finding was questionable because
showed visually detectable colonization and MLP the physical integrity problems were small. Failures
had colonization on only two of the dentures. At 6 were observed where the thickness of the soft liner
months, MLS was significantly different from GCS was less than adequate or not properly bonded to the
(p=0.03) and SLC (p=0.02). denture base.
  A recent study by Oguz et al.18) published a
ranking of tensile strength and tear resistance of
DISCUSSION
MLP, GCS, and SLC. The results with and without
The survival of an oral restoration is affected thermocycling indicated that the tensile strength and
by operator-dependant factors, design factors, tear resistance results of MLP were not higher than
restoration material factors, intraoral location the others. The reason for performing better under
factors, and patient-related factors13). Operator clinical conditions might be the result of differences
factors are generally believed to be the most in the application procedure of the materials. The
important of these14). Our study was carried out in MLP material was cured in the laboratory using
a dental faculty environment by clinicians who are a conventional compression mold technique. As a
competent in the field of prosthodontics. Applicabil- result, it was possible to maintain an ideal thickness
ity of the clinical results to routine general dental and optimum physical conditions during curing.
446 DMJ 2008; 27(3): 440-447

The other materials (MLS, GCS, and SLC) might resilience remained optimal during the 12-month
have been negatively affected by less controllable period. These properties did not show any statistical
curing conditions during chairside application and changes compared to baseline and did not indicate
curing. The variable factors in terms of humidity, any failure related to material performance.
temperature, and pressure present during the   Fungal colonization of the soft liner surface
curing of these materials could have caused poor was frequently observed in this study. Colonization
crosslinking and varying material thicknesses. started at 3 months for GCS and SLC and at 6
  An intimate contact between a denture and months for MLP. Although the colonization of the
the supporting tissues is considered as one of the materials by oral fungi presents a problem regarding
key features of a successful removable denture. useful service life, no effects of such colonization on
Dentures must follow the contour and texture of the mucosal condition of the patients were observed.
the mucosa for both retention purpose and hygiene The lack of such a relation has been similarly
maintenance. The ability of a material to maintain reported in two published studies4,7). This lack of
this is important for long-term clinical success. The mucosal response to fungal colonization could be
materials used in our study showed changes in the explained by the fact that the patients chosen for
surface texture starting from the third month. This our study had no acute problems or no indications
type of degradation problem was frequently reported of denture stomatitis; they were generally healthy at
in previous publications4,5,8). MLP maintained the the beginning of the study22). Moreover, most of the
surface texture better than the other materials, dentures followed in our study were lower dentures,
which might be an indication of long-term success; and the inflammatory changes related to denture
however, this difference was not statistically stomatitis were reported to occur rarely under the
significant. This was comparable to a study where lower dentures23).
the dentures relined with MLP needed replacement   In the present study, fungal colonization was
after 4-9 years of clinical service5). Degradation of assessed by visual inspection of the dentures. For
the materials resulting in changes in surface detail colonized micro-organisms to be visible, they would
and roughening was mostly observed in the posterior have formed a plaque of significant size. Colonization
region, which was probably a result of forces of of the soft liner surface begins with the initial
mastication affecting this region. adhesion of the micro-organisms24). For forming
  Soft liners rely on good adhesion to the denture plaques or biofilms by cell division and agglutination,
base to function properly. Adhesion of polysiloxane surface roughness may be an important contributing
soft liners to denture base polymer has occasionally factor25-27). This was partly confirmed in our study,
been pronounced as the weak link19). In particular where visible colonization increased with changes
with the chairside polysiloxane soft liners, this has in surface detail (Tables 6 and 7). Changes in
been restated by many authors1,9,10,20,21). However, surface detail resulted in a very rough surface with
some studies also reported on long-term clinical many small cracks in the material, which thus
serviceability of the MLP material4,5,7,8). After one provided a larger surface area and a more protected
year of clinical service, the average score for the environment for colonization.
adhesion of soft liners to denture base polymer was   The number of failures recorded in this study
still 3.9 for the current study. This result strongly suggested that fungal colonization of the materials,
suggested that the adhesion obtained by these probably a result of roughened soft liner surface, was
systems was durable enough to withstand clinical use the main reason for replacement (Fig, 2). However,
for one year. Failure was observed only marginally, this was not a general finding and was probably
and no relines required replacement after 12 months related to the patient’s oral conditions, which in this
of use. This was also supported by a previous study case included diet, saliva secretion, saliva quality,
which reported only slight edge failure of adhesion and efficiency of the cleaning procedures.
for MLP4). No indications of adhesion failure were
reported for dropouts.
CONCLUSIONS
  The type of color change observed throughout
the study was staining of the materials rather than Within the confines of this clinical study, the
fading of the color. It did not affect the appearance following conclusions were drawn:
of the subject when using the denture. Three of 1. Among the chairside materials tested, MLS
the dentures showed heavy staining and these showed comparable performance to the
were related to smoking as expected. All the other compression-molded and heat-cured MLP,
dentures showed an acceptable resistance to staining followed by SLC and GCS. The easier/simpler
after one year. application procedure may thus render this
  Other evaluation criteria such as plaque material as an alternative.
retention, oral hygiene, condition of the mucosa, and 2. After one year of clinical service, adhesion
DMJ 2008; 27(3): 440-447 447

failure was observed only marginally and Am 2004; 48: 709-720.


no relines required replacement because of 12) McCabe JF. A polyvinylsiloxane denture soft lining
adhesion problem. material. J Dent 1998; 26: 521-526.
13) Nikawa H, Jin C, Hamada T, Makihira S, Kumagai
3. After one year, SLC and GCS showed fungal
H, Murata H. Interactions between thermal cycled
colonization sooner and more extensively than resilient denture lining materials, salivary and
the other materials. serum pellicles and Candida albicans in vitro. Part
4. Reducing fungal colonization on the surface II. Effects on fungal colonization. J Oral Rehabil
and improving mechanical strength may 2000; 27: 124-130.
further improve the clinical performance of 14) Jokstad A, Bayne S, Blunck U, Tyas M, Wilson N.
soft liners. Quality of dental restorations. FDI Commission
5. For all the investigated liners, the results were Project 2-955. Int Dent J 2001;51: 117-158.
15) Shim JS, Watts DC. An examination of the stress
good or excellent for majority of the patients
distribution in a soft-lined acrylic resin mandibular
after six months of clinical use.
complete denture by finite element analysis. Int J
6. For early detection of fungal colonisation, Prosthodont 2000; 13: 19-24.
every patient with a relined denture should be 16) Jordan DR, Nerad JA. An acute inflammatory
called back after three months of use. reaction to silicone stents. Ophthal Plast Reconstr
Surg 1987; 3: 147-150.
17) Davenport JC. An adverse reaction to a silicone
ACKNOWLEDGEMENTS rubber soft lining material. Report of a case. Br
The authors wish to express their gratitude to Dent J 1970; 128: 545-546.
18) Oguz S, Mutluay MM, Dogan OM, Bek B. Effect of
Professor Leiv Sandvik for statistical advice. We
thermocycling on tensile strength and tear resistance
also thank Professor Dag Ørstavik and Professor of four soft denture liners. Dent Mater J 2007; 26:
Timo Närhi for helpful discussions and valuable 296-302.
suggestions during the preparation of the manuscript. 19) Mutluay MM, Ruyter IE. Evaluation of bond
The materials were in part supplied by the strength of soft relining materials to denture base
manufacturers, and this was also much appreciated. polymers. Dent Mater 2007; 23: 1373-1381.
20) Kutay O, Bilgin T, Sakar O, Beyli M. Tensile bond
strength of a soft lining with acrylic denture base
REFERENCES resins. Eur J Prosthodont Restor Dent 1994; 2: 123-
126.
1) Mack PJ. Denture soft lining materials: clinical
21) McCabe JF, Carrick TE, Kamohara H. Adhesive
indications. Aust Dent J 1989; 34: 454-458.
bond strength and compliance for denture soft lining
2) Attard NJ, David LA, Zarb GA. Immediate loading
materials. Biomaterials 2002; 23: 1347-1352.
of implants with mandibular overdentures: One-
22) Okita N, Orstavik D, Orstavik J, Ostby K. In vivo
year clinical results of a prospective study. Int J
and in vitro studies on soft denture materials:
Prosthodont 2005;18: 463-470.
microbial adhesion and tests for antibacterial
3) Wright PS. Soft lining materials: their status and
activity. Dent Mater 1991; 7: 155-160.
prospects. J Dent 1976; 4: 247-256.
23) Wright PS, Clark P, Hardie JM. The prevalence and
4) Wright PS. The success and failure of denture
significance of yeasts in persons wearing complete
soft-lining materials in clinical use. J Dent 1984;
dentures with soft-lining materials. J Dent Res
12: 319-327.
1985; 64: 122-125.
5) Wright PS. Observations on long-term use of a
24) Radford DR, Challacombe SJ, Walter JD. Denture
soft-lining material for mandibular complete
plaque and adherence of Candida albicans to
dentures. J Prosthet Dent 1994; 72: 385-392.
denture-base materials in vivo and in vitro. Crit
6) Schmidt WF, Jr., Smith DE. A six-year retrospective
Rev Oral Biol Med 1999; 10: 99-116.
study of Molloplast-B-lined dentures. Part I: Patient
25) Quirynen M. The clinical meaning of the surface
response. J Prosthet Dent 1983; 50: 308-313.
roughness and the surface free energy of intra-oral
7) Schmidt WF, Jr., Smith DE. A six-year retrospective
hard substrata on the microbiology of the supra- and
study of Molloplast-B-lined dentures. Part II: Liner
subgingival plaque: results of in vitro and in vivo
serviceability. J Prosthet Dent 1983;50: 459-465.
experiments. J Dent 1994; 22: 13-16.
8) Jepson NJ, McCabe JF, Storer R. The clinical
26) Radford DR, Sweet SP, Challacombe SJ, Walter
serviceability of two permanent denture soft linings.
JD. Adherence of Candida albicans to denture-base
Br Dent J 1994; 177: 11-16.
materials with different surface finishes. J Dent
9) Braden M, Wright PS, Parker S. Soft lining
1998; 26: 577-583.
materials ― a review. Eur J Prosthodont Restor
27) Verran J, Maryan CJ. Retention of Candida
Dent 1995; 3: 163-174.
albicans on acrylic resin and silicone of different
10) Braden M. Polymeric Dental Materials, Springer-
surface topography. J Prosthet Dent 1997; 77: 535-
Verlag, Berlin, 1997, pp.125-137.
539.
11) Garcia LT, Jones JD. Soft liners. Dent Clin North

You might also like