1. Tissue Conditioner Dr.Najeeb Saad

2. Denture Patients • Patient with some teeth • Patient with no prosthesis • Patient with existing prosthesis • Abuse

3. Abuse • Continuous denture wear • Poor hygiene • Excessive denture movement • Poor denture fit • Parafunction

4. Denture Trauma Epulis

5. Inflammatory Papillary Hyperplasia

6. Abused Tissue • Remove • Address irritant • Oral Physiotherapy • Denture Hygiene • Anti-microbial agents

7. Abused Tissue • Tissue Conditioners • Soft Materials • Surgery

8. Tissue Conditioners • Soft Reline • Tempo • Visco-Gel • Coe-soft

9. Tissue Conditioners-Composition • Powder • Poly Ethyl Methylmethacrylate (PEM) • Pigments • Liquid • 10% Ethyl Alcohol • 90% Pthalate ester - Plasticizer

10. Tissue Conditioners-Plastizer • Types • Pthalate Esters • Di Butyl Pthalate • Butyl Phthalyl Butyl Glycolate • Problem • 3-6000 PPM leach from liner in 14 days • Allergic response

11. Tissue Conditioners-Chemistry • Gel formation not polymerization • Alcohol swells polymer beads permitting penetration of large plasticizer molecules which act as lubricant to increase distance between polymer chains of the PEM powder

12. Case • 65 Year old Woman • 13 Year old Dentures

16. Case

19. Trimming

20. Trimming

22. Tempo Kit • Powder • Liquid • Plastic cup • Steel Spatula

23. Mixing • Mix 45-60 seconds Wait

24. Doughy

26. Seating • Even Pressure by closing in CR/MI • Border Mould • Hold in light contact for 15 mins

28. Result • Even 2mm thick • No bare spots • Peripheral Roll • Maintain VDO

30. Excess

31. Deliver

32. Post-Delivery Instructions • No Heavy Pressure • Wrap in moist towel • No seating on liner • Clean carefully • Stain • 1 TSB bleach(Javex)/1 cup H2O • 20 minute soak, wash/rinse well • Loss of resiliency – 2 weeks

33. Problems • Taste • Peel • Allergy