A Modified Indirect Method For
Fabricating Silicone Soft-lined
Complete Dentures
M. Oki, T. Suzuki, & H. Takahashi:JPD:July 23, 2016
PRESENTED BY:
Dr. K. Akhil Sai Reddy
1ST YEAR POST GRADUATE
DEPARTMENT OF 2
PROSTHODONTICS AND CROWN
& BRIDGE
CONTENTS
• INTRODUCTION
• COMPOSITION
• CLASSIFICATION
• DIRECT METHOD
• INDIRECT METHOD
• DISCUSSION
• SUMMARY
• CRITICAL APPRAISAL
• REFERENCES
INTRODUCTION
Patients with mandibular edentulous and highly resorbed sharp
ridges with a thin mucosal membrane under the denture area
frequently experience chronic pain or discomfort.
The application of a soft lining material is beneficial because of
cushioning effect.
Soft denture liners provide better masticatory function than
conventional hard-based denture materials , and the use of long-
term silicone liners significantly improves mastication
parameters, including masticatory performance, chewing strokes,
chewing time and maximum occlusal force.
CLASSIFICATION
Based on duration of use
• Short term liners : Up to 1 month
• Intermediate liners : 1-6 months
• Long term liners : 1 year or longer
Based on composition:
• Heat-polymerised acrylic resin
• auto polymerized acrylic resin
• heat polymerised silicone,
• auto polymerized silicone
• Treatment liners (tissue conditioners).
Available Materials:
• Silicone type
• Acrylic type materials
COMPOSITION
Acrylic resin soft liners Silicone rubber materials
Powder : acrylic polymers and Composed of polymers of
copolymers. dimethyl siloxane.
benzoyl peroxide- initiator crosslinking agent: alkyl-silane
Liquid : methyl methacrylate Catalyst: an organometal salt or
monomer and a plasticizer. benzoyl peroxide
plasticizer : di-n-butyl phthalate E.g.: molloplast b, flexibase.
Indications for Soft liners
1. Congenital or acquired oral and maxillofacial
defects requiring prosthetic restorations.
2. Residual ridges with minimal overlying soft tissue.
3. Chronic soreness of the oral tissues related to the wearing
of dentures.
4. Poorly contoured ridges in which surgical intervention is
contraindicated.
5. Sharp ridges produced by resorption of the denture
supporting structure.
6. Dentures with soft liners have also been used successfully
by patients who have received radiation therapy.
Metal reinforced silicone-lined dentures. Morrow RM, Reiner PR, Feldmann EE, Rudd KD: JPD
1968 Mar;19(3):219- 8
29.
Soft denture lining materials may be applied using either
• Direct technique and
• Indirect technique.
• With the direct method, the location and thickness of the
denture base can be difficulty to control , and the resulting
material is often porous.
• Moreover, the lining material is easily debonded from the
peripheral area of the denture in an apparent peeling
process.
8
DIRECT TECHNIQUE
Trim the denture 2mm to create enough space Tissue surface of denture is cleaned with
For soft lining material application. Alcohol to remove debris.
Adhesive is applied to tissue surfaces for catalyst and base are mixed until
adherences of soft lining material. Homogenous mixture is achieved.
application of soft lining material
into the tissue surface of the denture.
Denture is placed in the mouth Remove the excess materials with
the scalpel.
abrasive and polishing drills are used to finish
and polish the dentures
Indirect method
A new indirect method for placing denture soft lining
materials in which the thickness and location are controlled
by using a photoactivated spacer.
In this method , the silicone denture soft lining material is
polymerized simultaneously with the heat polymerized
denture base materials , resulting in long term durability.
12
TECHNIQUE
1.After the trial placement of wax denture , complete the form of
the polished surfaces of the waxed denture.
2.Select the location and thickness of soft denture lining material
and fabricate a spacer according to the design by using
photoactivated polymer base plate (physio-spacer ;Nissin).
Activate the spacer for 5 minutes by using photoactivating
machine and trim it until optimum margins are achieved.
3.Prepare the gypsum mold for heat polymerized
acrylic resin in the conventional manner
4. After dewaxing and add a coat of separating medium
on the mold surfaces.
14
5.Attach the spacer to the lower 6.Mix and place the
half of the flask with acrylic resin dough of the
cyanoacrylate adhesive. hard base denture
material in the upper half
of the flask.
15
7.Insert a sheet of separating plastic film(polyethylene film)
between the upper and lower halves of the flasks and close
them by pressing the flasks.
16
8.After pressing, open the flasks and trim the
excess flash resin at the denture border until the
mold is filled and no flash is formed.
17
9.Remove the spacer from 10.Denture soft lining
the lower half of the flask ; material(sofre liner tough
and heat-polymerized super-soft; tokuyama)
material surface coated placed on the top of heat
with adhesive primer polymerized material.
18
11.Press and clamp the halves of the flasks and
process the denture base material and soft lining
material simultaneously for 8 hours at 75 C
following conventional procedure.
19
12.After cooling open the
flasks, de flask the denture,
and polish the surface of the
denture following
conventional procedures
13. Finally deliver of soft
lined denture
DISCUSSION
22
• Using the indirect method described , the location
and thickness of the denture soft lining material can be
controlled, and covering the margin of the denture
border area with the lining material can be avoided.
• Several lining designs have been previously described,
including the soft liner covering the entire mucosa and a
liner covering the attached mucosa but not extending to
the border area of the denture.
• Kawano et al
evaluated the influence of the lining designs on the
cushioning effect and showed that a silicone denture
liner that covers the entire mucosa was the most effective
design. Soft lining materials should cover the entire
supporting bone ridge.
• Different methods have been described to allow the
spacer material to withstand deformation during flask
pressing, including the use of photoactivated denture
base materials, baseplate wax, and thermoplastics
Guptal et al,
used a 2mm thick silicone putty as a spacer applied to a
mandibular denture.
In this method, an accurate thickeness was some what difficult to
determine and maintain over the entire surface as well as to trim
the spacer to the desired shape.
Hayakawa et al ,
used a1.4mm paraffin wax sheet as a spacer, and the wax was
added where sharp alveolar ridges are present.
The cushioning effect of silicone-based soft materials
is longer than that of acrylic-based materials,
silicone-based resilient materials are more suitable for
this method.
Limitation of this technique
It cannot be used for patients with a thin denture
base because of the occurrence of fractures or for
patients with an inadequate lingual flange because
of the occurrence of chronic pain during
mastication.
26
conclusion
Soft denture liners were used in patients with highly resorbed
ridges and thin mucosa under denture bearing areas, thereby
improving their masticatory function.
This article describes an indirect method of applying denture soft
lining material by using a photo-activated spacer.
• Using this technique, the thickness and location of the soft lining
material are reliably controlled, and it is easy to make dentures
with soft lining materials on the intaglio and hard-resin base.
• No obvious complications were associated with this method, and
masticatory function improved without any damage to the soft
lining material.
27
References
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