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RESILIENT LINERS

INTRODUCTION
During normal function in dentulous subjects, the vertical and lateral
forces are directed or transmitted mainly to the periodontium, whereas in
edentulous condition with complete dentures, the mucous membrane in
denture bearing area is forced to accept these loads. These forces tend to
compress or distort the mucosa to varying degree according to location,
thickness and histology of mucosa. These forces vary in magnitude before
being transmitted to bone. Thus denture bearing mucosa is forced to serve the
same purpose as the periodontal ligament that provides support for natural
teeth.
Accordingly it would be desirable to have a denture base that is
compressive on the tissue side but rigid or hard on the occlusal side and
shock absorbing as well as selectively resilient compatible with resiliency of
the tissues, able to recover to its original shape when deforming forces are
removed.
This quest led to the development and use of resilient liners in
complete denture treatment that would efficiently increase the thickness of
the oral tissues by serving as an analogue of the mucosa and periosteum with
its relatively low elastic modulus.
TERMINOLOGY
1. Plasticity : The quality that does not allow a structure or material to
return to its original form on removal of an eternal force.
1
!. Elasticity : The quality that allows a structure or material to return to its
original form on removal of an eternal force.
". Elastic limit : The greatest stress to which a material may be subjected
and still be capable of returning to its original dimensions when such
forces are released.
#. Modulus of Elasticity (E) : The term modulus of elasticity describes the
relative stiffness or rigidity of a material which is measured by the slope
of the elastic region of the stress$strain diagram.
%. Resilience : &an be defined as the amount of energy absorbed by a
structure when it is stressed to its proportional limit.
'. Viscoelasticity : After removal of an applied load if the recovery takes
place slowly or if a degree of permanent deformation remains, the
material is said to be viscoelastic.
(. Flexibility : The quality of a material being fleible.
Resilient Denture Liner*
A soft )resilient* lining material may be defined as a soft elastic and
resilient material forming all or part of the fit )impression* surface of a
denture.
)A+,-.ADA ,pecification +o. (%*
/ 0udah ,., et al 1 ,oft lining materials in prosthetic dentistry 1 A review. -nt.
2. 3rosthodont., 1445, " 1 #(($#6".
!
Tissue Conditioner
Wilson and Associates (!""#
$
defined a tissue conditioner as a soft
material which is applied temporarily to the fitting )basal* surface of a
denture to distribute the load equally, thus permitting mucosal tissues to
return to their normal contours.
Starc%e and Associates (!&'#
$
defined the tissue conditioner as a soft,
resilient, temporary reliner which acts by reducing and evenly distributing
stress on the mucosa of the basal seat.
+ Razek, MK1 Assessment of tissue conditioning materials for functional
impressions. 2. 3rosthet. Dent., 14(47 #! 1 "('$"65.
(ISTORICAL )AC*GROUND
The earliest soft lining material recorded )soft rubber* was used by
Twitchell in 16'4.
89elum: a soft natural rubber was used in 14#5 with vulcanite in
conjunction with obturators and as a soft lining for mandibular complete
dentures. This material had high water absorption, and it became foul and ill
fitting over a period of time.
-n 14#%, ;atthews used poly)vinyl chloride* powder with a liquid di$
n$butyl phthalate plastici<er in the form of a paste as a facial prosthetic
material and as a soft liner for patients with chronic mucosal tenderness.
=ammie and ,torer described the use of poly)vinyl chloride*
plastici<ed with di$butyl$phthalate and found it to be an unsatisfactory
material because it hardened in a short period of time )'$1! months* due to
"
the plastici<er leaching out. Dioctyl phthalate was a better choice for a
plastici<er to keep the liner soft.
-n the late 14#5>s +elson used butyl phthalate butyl glycollate as a
plastici<er for vinyl chloracetate to improve adhesion between the lining and
the poly)methyl methacrylate* denture base. =ammie and ,torer reported this
material to have high water absorption, hardening and cracking. They also
described a ?erman product, plastupalate, which was a polymer of "% parts
of methyl methacrylate to '% parts of butylester acrylic acid. @owever, it has
drawbacks like low bond strength and low resistance to abrasion.
,oftdent soft lining material, a hydrophilic gel based on glycol
methacrylate ester chemistry, was developed by Ahichterle and =im in 14'1.
Due to its high solubility it was not used much.
,ilicone rubber materials based on poly )dimethyl siloane* have been
used as soft liners since 14%6. =ater materials that could be processed with
poly)methyl methacrylate* at room temperature became available.
#
RE+IEW O, LITERATURE
Denture soft lining materials act as a cushion between the hard denture
base and the tissues to reduce the masticatory forces transmitted by
prosthesis to the underlying tissues.
Bor the first time Tylman, ,.D. )14#"* reported the clinical use of soft
or resilient lining for dentures.
;athews )14#%* reported the use of plastici<ed poly$vinyl$chloride as
a soft liner for a specific clinical situation.
According to =ammie and ,torer )14%6*, resilient liner could be useful
in the complete lower denture where the patients shows a senile atrophy, in
developing maimal retention where the ridges have bilateral undercuts in
the mouth, where a hard median palatal raphe is associated with a poor
retentive potentiality and in obturators for acquired and congenital defects of
palate. This soft material according to them will be tolerated even by the
traumati<ed tissue particularly where radiotherapy has been done. They
attributed the loss of resiliency of denture soft liners to leaching of
plastici<ers when in contact with water.
?on<ale<, 2.C., and =aney, A.D. )14''* studied some of the
properties of the resilient material which can be used in denture prosthesis to
prevent chronic soreness and found that the temporary resilient plastics can
be used for a relatively short time which can prevent chronic soreness from
dentures and permanent resilient plastics could be used for longer periods of
time for patients with ridge atrophy and they also found that the other
properties of the permanent fleible plastics were found to be important in
%
their selection such as colour stability, ease of finishing and polishing high
abrasive resistance and strength.
=aney A.D. )14(5* stated that a variable thickness of resilient liner
would help to equali<e the pressure over the edentulous ridge especially over
the prominent bony spicules subjected to a greater amount of applied force.
3arker ,. and Craden ; )146!* stated that soft lining materials were
classified broadly into two types, namely silicone elastomers and soft
acrylics, while the soft acrylics had ecellent adhesion to poly )methyl
methacrylate*, they had poor elastic properties and hardened due to the
leaching out of plastici<er whereas the silicone soft liners had ecellent
elastic properties but adhesion to poly)methyl methacrylate* was poor and
they deteriorated in the oral environment and also supported the growth of
&andida albicans. They also described two techniques to formulate soft
acrylics without easily leachable plastici<ers.
Crown D. )1466* stated that if a resilient soft lining was present, a
considerable amount of energy could be absorbed in its deformation, thus
less had to be absorbed by the tissues of the patient. @e also described the
glass transition temperature, a property related to the resilience of polymers.
Also a number of different types of resilient liners and their properties were
described and concluded that the desirable properties of the materials were
far from perfect.
;ack 3.2. )1464* described the indications and applications as well as
the disadvantages and contraindications of soft lining materials. @e
concluded that the success or failure of a soft lining material is dependent not
only upon the physical properties of the material but also the function of the
material as well as the tissues which come in contact with the material.
'
;ack 3.2. )1464* described five group of materials that had been
made available in detail vi<. the natural rubbers, vinyl co$polymers,
hydrophilic polymers and the silicone and acrylic based soft lining materials.
@e concluded that an ideal soft liner was still not available.
0udah ,., @arrison A. and @uggett D., )1445* reviewed the soft lining
materials including their historical development, clinical indications,
desirable properties and limitatons of those currently available. They
concluded that further research and development was necessary to achieve a
material with optimum properties.
Craden ;., Aright 3.,. and 3arker ,. )144%* reviewed soft lining
materials and also the laboratory testing and clinical studies of these
materials. They concluded that some success can be achieved by using heat
polymeri<ed silicone rubber materials. Though no complete satisfactory soft
lining material was available.
2agger D.&. and @arrison A )144(* have updated on the use of
permanent soft lining materials with their indications, limitations and
maintenance. They have critici<ed on the view that soft liners are frequently
used in conjunction with chronic pain under a lower denture. Ahereas it
would be more appropriate to find the cause and eliminate it.
MATERIALS A+AILA)LE AND T(EIR COM-OSITION
En the basis of their chemical structure soft lining materials can be
broadly divided into the following groups1
1. +atural rubbers.
!. 9inyl co$polymers.
(
". @ydrophilic polymers.
#. ,ilicone based compounds.
%. Acrylic based compounds.
!" #atu$al $ubbe$s :
,oft natural rubber was used as a soft denture liner as early as 16'4.
Fnfortunately, all natural or Gvelum> rubbers rapidly take up saliva and hence
become unaesthetic and foul after a short time in the mouth. There is not at
present any commercially available soft lining material based on a natural
rubber product.
%" Vinyl co&'olyme$s:
9inyl co$polymers )e.g., &orvic, -mperial &hemical -ndustries,
Australia* were the first synthetic materials that could be considered to show
any degree of clinical success. -n the oral cavity poly vinyl chloride )39&*
proved to be a relatively brittle substance and polyvinyl acetate )39A* over$
pliable. Although these materials were unsatisfactory, a copolymer of the two
was developed with dioctyl phthalate as the plastici<er and <inc oide )5.%H*
and calcium sterate )%H* were added to improve the flow characteristics of
the unset material. ?elation could only occur in heated dry moulds.
?radual loss of plastici<er resulted in hardening of the material. This
material though was not popular amongst dental profession.
Appearing slightly later than these first synthetic materials was a
resilient soft denture material based upon the urethane molecule. This
product consisted of a triple chemical grouping1 A polyfunctional hydroy
compound, a poly functional isocyanate and a catalyst. The resultant material
6
had good initial fleibility and edge strength, but unfortunately had high
water absorption, thus deteriorating. This material also did not gain any
acceptance either.
(" )yd$o'*ilic 'olyme$s:
@ydrophilic polymeric materials would seem at first to provide the
ideal soft denture lining material $ hard enough to trim and adjust at room
temperature yet demonstrating a clinical compliance at "(I& that could
render the material suitable for the purposes of tissue conditioning or as a
longer term soft lining product. The perceived young>s modulus for one such
commercially available substance )@ydrocryl, @ydron Dental 3roducts -nc.,
+ew Jork, F,A* varies from !555 ;3a when dry to !.5 ;3a when wet.
The main disadvantage was their water absorption by as much as !5H.
The base polymer is hydroy$ethyl$methacrylate with ethylene glycol
dimethacrylate as a cross linking agent. Due to their high water absorption,
these materials are not in use now a days.
+" ,ilicone based com'ounds:
These materials could be either heat cured or autopolymeri<ed.
The silicone rubber materials are basically composed of polymers of
dimethyl siloane K a viscous liquid that can be cross linked to give good
elastic properties. The cross linking agent is normally an alkyl$
silane, and the reaction is usually cataly<ed by an organometal salt or
ben<oyl peroide.
;olloplast$C, a heat$polymeri<ed silicone rubber is supplied as a one$
paste system activated by heat )boiling water for ! hours*, an adhesive )J$
4
methacryloy propyl trimethoysilane, a silicone polymer in a solvent* is
supplied to aid bonding to the denture base. The silicone autopolymer
Bleibase is supplied as a paste and a liquid system. The liquid or the catalyst
is a miture of dibutyl tin dilaurate and ethyl polysilicate. Aright states that
because silicone rubbers have no natural adhesion to poly )methyl
methacrylate*, an adhesive compound of a silicone polymer in a volatile
solvent must be used.
?ettleman et al have recently based an interesting soft lining material
on a bulk elastomeric polymer poly )fluoroalkoy* phospha<ine. Cy milling
in a suitable monomer, and both methyl and n$butyl methacrylate have been
reported, together with a suitable initiator, a promising material has been
achieved. The incorporation of the methacrylate of course confers good
adhesion to the denture and most physical properties fall within the middle
range of established acrylic and silicone rubber soft lining materials. The
material is marketed under the trade name 8+ovus:. This material has a
drawback of having high water absorption.
8Bleor: a poly dimethyl siloane perfluoralkanol dimetacrylate is a
fluoro silicone material recently developed. -t has low water absorption.
-" c$ylic based com'ounds:
Coth the heat$processed and autopolymeri<ing acrylic resin soft lining
materials consists of powder and liquid components. The powder is believed
to contain acrylic polymers and copolymers and the liquid is methyl
methacrylate monomer and a plastici<er. The purpose of the plastici<er,
usually di$n$butyl phthalate, is to reduce the transition of the polymer from
liquid to solid below mouth temperature. Thus at mouth temperature, the
material is semi liquid and therefore soft, this reduces the modulus of
15
elasticity of the soft material to a satisfactory level. The chemical
composition of the acrylic resin soft linings is similar to that of the acrylic
resin denture base material, thus no adhesive is required to form a bond.
E.-ERIMENTAL SYSTEMS
i" #atu$al Rubbe$. PMM /$aft 0o'olyme$ ,ystem:
A material was evaluated comprising a natural rubber.poly)methyl
methacrylate*, graft copolymer, cured at 155I& by a sulphur.<inc dimethyl
dithiocarbamate system. Adhesion was achieved with a toluene solution of
the graft polymer, applied to the 3;;A denture.
This gave ecellent results mechanically and showed greatest promise
clinically. Fnfortunately, it had to be abandoned because of the potential
dangers of mucosal reaction to the dithiocarbamate.
ii" Po1de$ed Elastome$ ,oft c$ylic ,ystems:
The concept that initiated this work was to retain the advantages of
soft acrylic systems, but to avoid the need for plastici<ers.
Llastomers in powder form are manufactured by cryogenic grinding,
or from =ate7 many use talc or other silicates as a separating agent and are
to be avoided because they result in very high water uptake.
3owdered elastomers will form easily handleable doughs, with the
right choice of monomer and the cured products have acceptable strength and
adhesion to 3;;A.
iii" Fluo$o'olyme$s:
11
Decent work reported from 2apan suggests the use of visible light
cured soft resins prepared by combining fluoroalkyl methacrylate monomers
with a vinylidene fluoride.heafluoropropylene co$polymer, or a vinylidene
fluoride.tetrafkuoroethylene . heafluoropropylene copolymer. They are
reported to be more wettable than silicones to have low solubility and low
residual monomer. ,ofter resins could be prepared by using lower molecule
weight fluoropolymers. ,uch materials have been reported before, but they
have not become widely available. There is one heat cured material of similar
chemistry currently on the market )Murepeet*.
DESIRA)LE -RO-ERTIES O, A RESILIENT LINER
Bor maimum efficacy, soft lining materials should display the
following properties1
1. They should be easily processed using conventional laboratory
equipment.
!. They should ehibit minimal dimensional change during processing and
such change should be the same as that of the denture base materials.
". Aater absorption should be minimal. Cates and ,mith comment that a
large water absorption may lead to swelling and stresses at the denture
base interface, tending to increase distortion and reduce bonding. -deally,
the total water absorption should be close that of the acrylic resin denture
base polymers, reported at !.!H. The effects of prolonged immersion in
water have been discussed by Craden and &auston. -f swelling occurs, the
bacteria and nutrient material in the mouth will find their way between
the lining and the denture base, and the area becomes unhygienic.
1!
#. The materials should have minimal solubility in saliva. -deally the
plastici<er )used in some materials* should not leach out with time,
however, if leaching does occur, it should be minimal.
%. They should retain their resilience. The degree of resilience will depend
on the chemical composition of the material and the thickness of the soft
lining. ,everal authors suggest that a thickness of ! to " mm is most
appropriate.
'. They should bond sufficiently well to poly )methyl methacrylate* to avoid
separation during use. -f the strength of the bond between the two
materials is weak, separation takes place during use and such locali<ed
areas of separation rapidly become unhygienic because of the difficulty of
cleaning.
(. Adequate tear resistance is of practical importance to resist rupture during
normal use. This is because the propagation of a crack or small tear at the
periphery of the soft lining could lead to failure and detachment of the
material.
6. They should be easily cleaned and not affected by food, drink or tobacco.
-t is also important that the resilience and surface teture of the lining be
unaffected by freely available denture cleaners of all types.
4. They should be non toic, odourless and tasteless to encourage long term
wear of the denture by the patient.
15. They should be aesthetically acceptable and their colour should match
that of the denture base material.
1"
11. They should be easy to finish and polish. Adequate finishing and
polishing of most of the resilient materials is quite difficult. The use of
high speed sand paper disks, free<ing the material, or the use of heated
instruments has been suggested. The molding of the resilient plastic in the
laboratory procedures is critical so that when cured it will need the least
amount of finishing.
LIMITATIONS IN USE O, RESILIENT LINERS
The use of soft lining material on the fit )impression* surface of the
denture is limited by a number of factors. These include1
1#
!" Reduction of t*e dentu$e base st$en2t*:
The replacement of part of the denture base with a soft and easily
deformable material will have an obvious effect on the fleibility and
strength of the denture as a composite structure. Ahen inter$ridge distance is
limited and the denture base thickness is minimal, the placement of a soft
lining will further reduce the overall strength of the denture and inevitable
increase the tendency of the denture base to fracture.
%" 3oss of softness and $esilience:
,ome of the soft linings are not stable in an aqueous environment such
as the oral cavity. This is true of those materials using a plastici<er to
increase softness and resilience, since the plastici<er will leach out and cause
the lining to harden, limiting its usefulness. Thermal effects from the
ingestion of hot and cold food and drinks may also have a deleterious effects.
(" 0olonization by 0andida albicans:
-t has been suggested that the porosity of soft linings allows water
absorption and the diffusion of nutrient material, which can easily become
coloni<ed by &andidal organisms.
+" 4ifficulty in kee'in2 soft linin2s clean usin2 no$mal dentu$e
cleanin2 met*ods:
The use of conventional denture cleansers may cause bleaching, and
the surface may become bubbled if an oygenating cleaner is used. -ngested
materials also present a problem. Cell has reported discolouration from
various drinks, and tobacco staining has been reported by ;akila and @onka
1%
and Cascom. The poor oral hygiene of most dentures with soft linings has
generally been blamed on the difficulty in cleaning.
-" 4imensional instability:
,ome soft linings lose their plastici<er with time, and most of them
absorb water, these factors may cause dimensional chagnes.
5" Failu$e of ad*esion:
A common finding is failure of adhesion between the silicone soft
linings and the denture base resulting in Gpeeling off> of the soft lining. A
poor laboratory procedure may be the cause, although rough handling at an
unsupported junction is a common culprit.
6" 4ifficulties in finis*in2 and 'olis*in2:
,oft lining materials are difficult to trim, finish and polish. -f
ecessive force is used, they may overheat or tear, leading to poor surface
finish.
The longevity of the soft liner though depends on correct processing
procedures and proper home care.
INDICATIONS ,OR USE ,OR RESILIENT LINERS
!" 7*in, non&$esilient mucosal co8e$a2e
The provision of a resilient liner beneath a rigid denture base can
improve both masticatory efficiency and oral comfort for patients presenting
with a reduced thickness or lessened resilience of the oral mucoperiosteum.
1'
%" Poo$ $id2e mo$'*olo2y 1*e$e t*e mental ne$8e is at t*e c$est of t*e
$id2e
-n some individuals, the gradual resorption of bone can lead to the
mental nerve lying on the surface of the alveolar ridge. The nerve can be
trapped between the denture and the tissue causing pain. -nclusion of
appropriate relief on the master cast together with a soft lining may help to
reduce the pressure on the nerve.
(" Pe$sistent dentu$e so$e mout*
-t may be due to occlusal problems, underlying bony irregularities,
reduced keratini<ation of the epithelium with increasing age, and atrophic
changes in postmenopausal women. -f these have been eliminated but
discomfort persists, soft lining materials may be used to line the fit
)impression* surface of the denture. To be effective, a permanent soft lining
should be about ! to "mm thick. The lining acts to absorb part of the force of
occlusion, releasing the stored energy as elastic recoil. -t therefore increases a
patients ability to use a denture comfortably and may lead to relief of the
symptoms of chronic soreness.
+" c9ui$ed o$ con2enital o$al defects
=ammie and ,torer suggested that soft lining material could be used
for the cleft palate patient, or an acquired oral defect related to trauma, to
improve retention of the denture by engaging undercuts. ,oft lining materials
are also used for obturators after maillofacial surgery.
1(
-" :e$ostomia
A soft lining may be indicated in those with a reduced saliva flow,
possibly as a result of degenerative changes in the salivary glands,
radiotherapy or drug therapy. Adequate saliva is benefit to the denture wearer
both for lubrication and to aid retention and its absence can result in loose
denture since the forces of adhesion, cohesion and negative atmospheric
pressure are lacking.
@owever, the use of silicone resilient liners which lack wettability
may result in trauma to the mucosa due to friction if the denture is loose and
is dragged across the tissues. &andidal coloni<ation of permanent resilient
linings is a common feature in the edentulous patient with a dry mouth.
5" 7*e need to '$omote mucosal *ealin2
After implant surgery or with immediate dentures the dentures can be
lined with resilient liners. The soft lining material assists in producing an
even distribution of functonal load over the entire denture bearing area,
avoiding local concentration of stress and to a limited degree reducing the
overall load falling onto the denture bearing area.
6" ;n cases of bilate$al unde$cuts
=ammie and ,torer suggested that soft lining material may be
indicated in the treatment of areas of bilateral undercuts, where placing a
rigid acrylic resin denture is difficult and there is a problem of retention. -ts
use in this situation allows the denture to be placed over the prominence and
since the soft material is elastic, it will spring back into close contact with the
undercut area. +ot only does this prevent air entrapment under the denture
16
from reducing the retention, but the retention will be increased as the
material will need to be deformed to remove the denture.
<" ;$$e2ula$ foundation
-n the presence of a maillary torus, mandibular tori, prominent
mylohyoid ridges or in irregular bony foundations, soft lining may be
indicated because there is usually an associated very thin mucosa covering
these bony projections. @owever, the use of soft lining material in the
maillary arch is limited by the subsequent increase in thickness of the
denture.
=" ,in2le dentu$e o''osin2 natu$al teet*
-n patients who have single denture either maillary or mandibular
opposing natural teeth or patients who are bruers, the soft lining material
acts to absorb part of the force of occlusion, releasing the stored energy as
elastic recoil.
!>"Mandibula$ distal extension base 'a$tial dentu$es
Ahitsitt et al state that soft lining material may be useful for
improving retention in mandibular distal etension base partial dentures
where there is retromylohyoid undercut and the presence of teeth limits the
available paths of placement, resulting in an absence of valuable retentive
and stabili<ing areas of the denture etensions. To overcome this problem,
acrylic resin material in undercut region of the retromylohyoid fossa is
replaced with soft lining material.
MAINTENANCE O, -ERMANENT SO,T LINING MATERIALS
14
Denture cleanliness is essential to prevent malodour, poor esthetics
and the accumulation of plaque and calculus with its deleterious effects on
the oral mucosa. 3ermanent soft linings can be coloni<ed by &andida
albicans and if not cleaned thoroughly can become stained and harbour
odours.
&are must be taken in choosing an appropriate method of denture
hygiene as inappropriate cleaning regimes can have deleterious effects
causing hardening or bleaching of the soft lining.
Bor both silicone and acrylic resin soft lining materials, similar
cleaning procedures are recommended. -n brief, the denture should be rinsed
after every meal and debris removed by brushing with a soft brush, liquid
soap and cold water. The denture should be soaked in an alkaline
hypochlorite solution for !5 minutes in the evening. The denture should be
rinsed thoroughly with cold water overnight. The other main types of denture
cleanser available for purchase over the counter can have mild effects on soft
linings such as loss color from immersion in acidic cleansers.
@eavy smoking, fruit juices, tea, coffee, and wine cause discolouration
and staining of the denture. Adjustment of the soft lining to ease pressure
points caused by errors in the fit surface is best achieved by using the
bur.trimmer provided with the resilient liner.
(OME RELINERS
Ever the counter reliners or home reliners though not available in
-ndia, but available in the west cause more harm than good. This is because
the customer believes the material can be used indefinitely, understanding
only that new applications or changes must be made periodically. Cecause
!5
the customer has had no professional training and very likely, inadequate
professional instruction in regard to his dentures and their maintenance, he is
not epected to know of the changes occurring in his oral tissues.
@ome reliner materials either induce or, certainly, perpetuate
pathologic changes in the oral tissues. The affected tissues are the mucosa of
the denture bearing areas and the supporting alveolar bone. Lach additional
application of the home reliner requires more material. This indicates bone
resorption which creates more space between the tissue surface of the denture
and the residual alveolar ridge.
Ahen the home reliner material is applied to the denture and the
denture is placed in the mouth, there is noticeable immediately an increase in
the vertical dimension of occlusion with a concomitant decrease in the
interocclusal distance. Aith insufficient interocclusal distance, the soft
tissues are traumati<ed and resorption and deformation of the underlying
bone occurs.
Bor these reasons the dental profession must be more emphatic in its
instructions to denture patients. 3atients must be instructed to return to the
dentist for adjustments or corrections instead of using home reliner materials
applied by an untrained individual.
,ome specific controls regarding the sale of home reliner materials to
the general public should be instituted by the appropriate federal agency.
CONCLUSION
The search for the ideal soft lining material for use beneath a
removable dental prosthesis has resulted in the eperimental and commercial
!1
eploitation of many different substances. Ef the multitude of preparations
advocated, none to date perfectly meets the eacting requirements for the
ideal soft denture lining material, although careful use of heat polymeri<ed
silicone rubber materials have achieved some success.
Despite the considerable concern over the physical behaviour of this
group of dental materials, their dimensional instability and their poor
longevity, they hold an important place in the treatment of edentulous or
partially edentulous patient.
-t is hoped that the present resurgence of interest in the soft denture
lining materials will lead to the early formulation of a material that is simple
to form, stable in function and closely similar in visco elastic properties to
the load$bearing mucoperiosteal tissue of the mouth.
Also it is hoped that more dentists use this invaluable material in their
day$to$day practice, for the comfort of the patient.
!!
)I)LIOGRA-(Y
1. Craden ;., Aright 3.,. and 3arker ,. 1 ,oft lining materials K A review.
Lur. 2. 3rostodont. Dest. Dent., 144%7 " 1 1'"$1(#.
!. Crown D. 1 Desilient soft liners and tissue conditioners. Cr. Dent. 2.,
14667 1'#1 "%($"'5.
". ?on<ale< 2.C. and =aney A.D. 1 Desilient materials for denture
prosthesis. 2. 3rosthet. Dent., 14''7 1' 1 #"6$###.
#. 2agger D.&. and @arrison A. 1 &omplete dentures K The soft option. Cr.
Dent. 2., 144(7 16! 1 "1"$"1(.
%. =ammie ?.A. ,torer D. 1 A preliminary report on resilient denture
plastics. 2. 3rosthet. Dent., 14%67 6 1 #11$#!#.
'. =aney A.D. 1 3rocessed resilient denture liners. Dent. &lin. +orth. Amer.,
14(57 1#7 %"1$%%1.
(. =ekha M. 1 &omparative evaluation of physical properties and effect of
water sorption of three different resilient liners currently available in
-ndia K An in vitro study, 144' 1 Dissertation submitted to Marnatak
Fniversity in partial fulfillment of the requirements for the degree of
;aster of Dental ,urgery in 3rosthodontics )+ot published*.
6. ;ack 3.2. 1 Denture soft lining materials 1 &linical indications. Aust.
Dent. 2., 14647 "#1 #%#$#%6.
4. ;ack 3.2. 1Denture soft linings 1 ;aterials available. Aust. Dent. 2., 14647
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15. ;eans &.D. 1 The home reliner materials 1 The significance of the
problem. 2. 3rosthet. Dent., 14'#7 1# 1 156'$1545.
11. 3arker ,. and Craden ;. 1 +ew soft lining materials. 2. Dent., 146!7 15 1
1#4$1%".
1!. 0udah ,., @arrison A. and @uggett D.1 ,oft lining materials in prosthetic
dentistry 1 A review. -nt. 2. 3rosthodont., 14457 " 1 #(($#6".
1". Da<ek ;MA 1 Assessment of tissue conditioning materials for functional
impressions. 2. 3rosthet. Dent., 14(47 #! 1 "('$"65.
1#. 9on Braunhofer 2.A. and ,ichina A.2.1 &haracteri<ation of the physical
properties of resilient denture liners. -nt. 2. 3rosthodont., 144#7 ( 1 1!5$
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CONTENTS
-ntroduction
Terminology
@istorical Cackground
Deview of =iterature
;aterials and &omposition
Desirable 3roperties
=imitations
-ndications
;aintenance
@omeliners
&onclusion
Cibliography
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