DENTAL TECHNOLOGY

SECTION EDITOR
DANIEL H. GEHL

A technique for the delivery of complete dentures

H. M. Landesman, D.D.S.,M.Ed.*
University of Southern California, School of Dentistry, Los Angeles, Calif.

1 his technique is based on the premise that

dentures with a soft, “movable” material on the
tissue and external surfaces will allow the patient to
adapt to them with less chance of soreness and
simultaneously permit the patient to mold the exter-
nal and internal surfaces of the denture. By the time
the material has hardened, the patient has likely
overcome the initial shock of a mandibular prosthe-
sis and is more likely to feel comfortable with the
final hard acrylic resin on the surfaces of the den-
tures.
The tissue conditioners used in dentistry are gen-
erally composed of a powder (ethyl methacrylate)
and a liquid (commonly butyl phthalyl butyl glyco-
late) with up to 30% ethanol. As the ethanol grad-
ually evaporates, the material becomes harder in the Fig. 1. .A11undercuts are relieved on the tissue side of the
mouth. The amount and duration of flow of the completed denture.
material is determined to a great extent by the
amount of ethanol remaining in the material. The
tissue conditioner is placed on the external and indicating paste is used to detect excessive pressure.
internal surfaces of the mandibular denture at the A centric jaw relation record is made to correct
time of placement of the dentures. occlusal discrepancies. The tissue conditioning mate-
The tissue conditioning material allows the rial is then applied to the mandibular denture.
patient to adapt to the new prosthesis with a
TECHNIQUE FOR APPLICATION OF THE
minimal amount of discomfort by providing a soft
TISSUE CONDITIONER
material in the undercuts and on the lingual flange.
It allows the patient to functionally border mold the 1. Relieve all undercuts and at least 1 to 2 mm of
denture and make an accurate impression of the acrylic resin lingual to the crest of the ridge on the
tissue surface and external surface of the mandibular tissue side of the denture with an acrylic bur. Do not
denture. It minimizes chairside adjustments. destroy any extensions (Fig. 1).
The disadvantage to the technique is that it 2. Mix two parts liquid with two and one-half
requires a reline or rebase procedure after the den- ‘parts powder of tissue conditioner* for 30 seconds.
tures are processed and delivered which is more Allow the material to sit for 3 minutes. (Note: These
costly to the patient. ,proportions are not according to the manufacturer’s
At the time of placement of the dentures, pressure- instructions.)
3. Lubricate the fingers with a suitable lubricant,
and roll the conditioning material into a ribbon
Presented at the Pacific Coast Society of Prosthodontists, Newport
approximately l/4to 3/ inch in diameter (Fig. 2).
Beach, Calif., and at the Academy of Denture Prosthetics,
Scottsdale, Ark.
*Associate Professor and Associate Chairman, Department of *Visco-Gel, AD International Limited (De Trey Divisiofi), Lon-
Restorative Dentistry. don, England.

348 MARCH 1980 VOLUME 43 NUMBER 3 CO22-3913/80/030348

+ 04$4X1.40/0
0 1980 Tbe C. V. Mosby Co.
TECHNIQUE FOR DELIVERY OF COMPLETE DENTURE

Fig. 2. Tissue conditioning material is rolled into a Fig. 5. Patient performs functional movements for 5 to
ribbon */4to 3A inch in diameter. 10 minutes.

Fig. 3. Tissue conditioning material is placed on the Fig. 6. Excess material is trimmed with a thin-bladed
border of the denture. scissors or a sharp scapel blade.

Fig. 7. Tissue conditioning material is placed on the

Fig. 4. Denture is seated in the mouth. polished surface of the denture where indicated.

THE JOURNAL OF PROSTHETIC DENTISTRY 349

Fig. 8. Tissue conditioning material is placed on the Fig. 11. Silicone material is used for flasking purposes.
tissue side of the denture.

Fig. 9. Patient has worn the denture lined with tissue Fig. 12. Finished denture.
conditioning material for ~4 hours.

4. Place the ribbon of material on the border of

the denture. The material can be placed on the
entire border of the denture or only on the lingual
flange as deemed necessary (Fig. 3).
5. Seat the denture in the mouth, and guide the
mandible into terminal hinge closure. Allow the
patient to perform functional movements for 5 to 10
minutes (Figs. 4 and 5).
6. Remove the denture; trim any excesses with
thin-bladed scissors or a sharp scapel blade
(Fig. 6).
7. Make a second mix of material using the same
liquid/powder ratio, and allow this mixture to sit for
2 minutes.
8. Place the mixed material on the polished sur-
face of the denture where indicated (Fig. 7).
Fig. 10. If the material is ddmaged after 7 to 14 days, L
zinc-oxide eugenol paste or an elastomeric material is 9. Insert the denture, and instruct the patient to
used as a final impression. make functional movements for 5 to 10 minutes.

350 MARCH 1980 VOLUME 43 NUMBER 3

TECHNIQUE FOR DELIVERY OF COMPLETE DENTURE

10. Remove the denture; trim any excess. 18. If severe undercuts are present on the external
11. Make a third mix of material by following the surface of the denture, use a silicone rubber materi-
manufacturer’s instructions; mix 1 measure of liquid al* to flask prior to processing (Fig. 11). The tech-
with 1 measure of powder for 30 seconds. nique has been described by Marcroft and asso-
12. Place the mixed material on the tissue side of ciates.’
the denture (Fig. 8). 19. After processing, remove the denture from the
13. Seat the denture in the mouth, and guide the flask. The external surface of the denture needs
patient into terminal hinge closure. Instruct the minimal polishing (Fig. 12).
patient to make functional movements for 5 to 10 20. Deliver the finished denture to the patient.
minutes.
14. Remove the denture; trim any excess. SUMMARY
15. Place the denture in the patient’s mouth, and This article describes a technique for the delivery
instruct the patient not to remove the denture for 24 of complete dentures which allows the patient to
hours. Tell the patient not to use a denture brush or adapt to a mandibular prosthesis and, at the same
any abrasive to clean the denture for the first 24 time, to functionally make a final refitted mandibu-
hours (Fig. 9). lar impression.
16. Examine the denture at the end of 24 hours
for pressure areas. At this time, the material can be *Silastic 388, Denture Release, Dow Corning Corp., Midland,
trimmed and polished with acrylic burs and wet Mich.

pumice. Do not attempt to polish the material for

REFERENCES
the first 24 hours.
17. The patient functions with the material in the 1. Marcroft, K. R., Tencate, R. L., and Hurst, W. W.: Use of a
layered silicone rubber mold technique for denture process-
denture for 7 to 14 days until total comfort is
ing. J PROSTHET DENT 11:657, 1961.
achieved. At that time, perform a laboratory reline
or rebase procedure. If the material needs to be Reprint requeststo:
DR. H. M. LANDESMAN
replaced, remove all the material on the tissue
UNIVERSITY OF SOUTHERN CALIFORNIA
surface of the denture with an acrylic bur (do not SCHOOL OF DENTISTRY
remove any of the extensions or any material on the 925 w. 34TH ST.
external surface), and make a final wash impression Los ANGELES, CALIF. 90007
with a zinc-oxide eugenol paste or an elastomeric
material (Fig. 10).

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THE IOURNAL OF PROSTHETIC DENTISTRY 351