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Soft Liner in a Complete Denture: Report of Case
S o f t li n e r in a c o m p le t e d e n t u r e : r e p o r t o f c a s e
Stanton B. Davis, DMD, Fram ingham , Mass
Procedure For a num ber o f years an edentulous p a tie n t had experienced d is c o m fo rt and pain from u n s a tis fa cto ry dentures. There was need fo r a s o ft liner. A p p lic a tio n o f a liner, a s im p le procedure, relieved the p a tie n t’s d is c o m fo rt and allowed the denture to f i t s a tisfa cto rily.
A 4 5 -year-old m an who had a com plaint o f ten derness o f the edentulous m andibular alveolar ridge was referred to the dental clinic. F o r a num ber o f years this patient had been com pletely edentulous; his dentures had been unsatisfactory. T he patient was retired from m ilitary service about 20 years ago because o f disabling arthritis. H e had a history o f diabetes and long-term steroid therapy for the arthritis. Because of the patient’s m ental illness, it was difficult to keep him on regular m edication. Probably as a result o f his m aintenance steroid therapy, the patient has a history o f inability to respond to traum a. When his teeth were extracted, he suffered shock and had to rem ain hospitalized for several days. T he p atien t’s m andibular alveolar ridge was not com pletely prepared for a denture. H is d ia betes, bruxism , and bilateral areas of undercut on the lingual surface o f the alveolar ridge caused his dentures to fit poorly. Because o f his physical and m ental condition, corrective surgery would not have been feasible at this time. 1360
The use of a soft liner seem ed to be the best treatm ent m ethod; both com plete coverage and coverage o f only the affected areas w ere consid ered. Because m ost o f the p a tien t’s denture diffi culty was restricted to two large regions, the soft liner was used only on these. T his was an excep tion to the usual procedure o f com pletely covering the tissue surface o f the denture. M any instances of chronic ridge tenderness seem to be generalized rather than restricted to specific regions. (See illus tration.) The B arnhart1 technic for application of the soft liner was used. T he usual procedure for rebasing a com plete m andibular denture was followed. W hen the heat-cured acrylic resin was packed in the trial packings, a 2 mm thickness of wax shim was placed on the stone model cov ering the necessary regions of the alveolar ridge with soft liner. T he trial packing was com pleted and the flask was separated. The denture base m aterial to be covered with soft liner was then coated with D ow -C om ing prim er and allowed to dry. W hile the prim er was drying, the wax shim was removed and the model was rinsed with clean, boiling w ater; all traces o f wax were re moved. The regions o f the model th at w ould contact the soft liner were brushed with a 10% solution of mild detergent w ater and then air dried. A
Denture is placed In patient’s mouth (left); regions of soft liner are shown outlined with a marker after three months of successful use (right).
liquid foil substitute was applied to the rem ain ing surfaces o f the model that would contact the denture base m aterial. A generous layer o f Silastic 390 (soft liner developed by D ow -C om ing C orporation) was applied to the previously prim ed denture base surface, slightly overfilling the space created by the wax shim. T he flask was closed slowly and the clam p tightened. T he denture base m aterial was cured nine hours by placing the flask in a 165 F w ater bath. A fter the processing was com pleted, the flask was opened and the denture carefully rem oved. W ith sharp scissors, the flash was cu t away at the soft liner denture base ju n c ture. A sandpaper disk and a bristle brush with very wet pum ice under light pressure were used for necessary com pletion o f this junction. The finished denture was soaked in a m ild solution of sodium b icarbonate to neutralize a slight odor of acetic acid.
Summary T his case report indicates th at there is need for obtaining an adequate clinical history. T he p atient’s denture problem indicated need o f a soft liner; application of one proved successful. B ecause of a very sim ple dental procedure, the patient no longer suffers daily oral pain and dis com fort caused by dentures. T he p atien t’s n euro psychiatric condition also seems to have improved.
Doctor Davis is a Veterans Administration career resi dent in prosthodontics, and a post doctoral clinical fellow at Harvard School of Dental Medicine, Boston. His ad dress is 53 Claudette Circle, Framingham, Mass 01701. I. Robinson, J.E., and Barnhart, G.W. Silicone rubber soft denture material: technique and clinical applications. Dent Dig 70:362 Aug 1964.
D a v is: SO FT LIN ER IN A C O M PL E T E D E N T U R E ■ 1361
Stanton B. Davis, DMD, Fram ingham , Mass
Procedure For a num ber o f years an edentulous p a tie n t had experienced d is c o m fo rt and pain from u n s a tis fa cto ry dentures. There was need fo r a s o ft liner. A p p lic a tio n o f a liner, a s im p le procedure, relieved the p a tie n t’s d is c o m fo rt and allowed the denture to f i t s a tisfa cto rily.
A 4 5 -year-old m an who had a com plaint o f ten derness o f the edentulous m andibular alveolar ridge was referred to the dental clinic. F o r a num ber o f years this patient had been com pletely edentulous; his dentures had been unsatisfactory. T he patient was retired from m ilitary service about 20 years ago because o f disabling arthritis. H e had a history o f diabetes and long-term steroid therapy for the arthritis. Because of the patient’s m ental illness, it was difficult to keep him on regular m edication. Probably as a result o f his m aintenance steroid therapy, the patient has a history o f inability to respond to traum a. When his teeth were extracted, he suffered shock and had to rem ain hospitalized for several days. T he p atien t’s m andibular alveolar ridge was not com pletely prepared for a denture. H is d ia betes, bruxism , and bilateral areas of undercut on the lingual surface o f the alveolar ridge caused his dentures to fit poorly. Because o f his physical and m ental condition, corrective surgery would not have been feasible at this time. 1360
The use of a soft liner seem ed to be the best treatm ent m ethod; both com plete coverage and coverage o f only the affected areas w ere consid ered. Because m ost o f the p a tien t’s denture diffi culty was restricted to two large regions, the soft liner was used only on these. T his was an excep tion to the usual procedure o f com pletely covering the tissue surface o f the denture. M any instances of chronic ridge tenderness seem to be generalized rather than restricted to specific regions. (See illus tration.) The B arnhart1 technic for application of the soft liner was used. T he usual procedure for rebasing a com plete m andibular denture was followed. W hen the heat-cured acrylic resin was packed in the trial packings, a 2 mm thickness of wax shim was placed on the stone model cov ering the necessary regions of the alveolar ridge with soft liner. T he trial packing was com pleted and the flask was separated. The denture base m aterial to be covered with soft liner was then coated with D ow -C om ing prim er and allowed to dry. W hile the prim er was drying, the wax shim was removed and the model was rinsed with clean, boiling w ater; all traces o f wax were re moved. The regions o f the model th at w ould contact the soft liner were brushed with a 10% solution of mild detergent w ater and then air dried. A
Denture is placed In patient’s mouth (left); regions of soft liner are shown outlined with a marker after three months of successful use (right).
liquid foil substitute was applied to the rem ain ing surfaces o f the model that would contact the denture base m aterial. A generous layer o f Silastic 390 (soft liner developed by D ow -C om ing C orporation) was applied to the previously prim ed denture base surface, slightly overfilling the space created by the wax shim. T he flask was closed slowly and the clam p tightened. T he denture base m aterial was cured nine hours by placing the flask in a 165 F w ater bath. A fter the processing was com pleted, the flask was opened and the denture carefully rem oved. W ith sharp scissors, the flash was cu t away at the soft liner denture base ju n c ture. A sandpaper disk and a bristle brush with very wet pum ice under light pressure were used for necessary com pletion o f this junction. The finished denture was soaked in a m ild solution of sodium b icarbonate to neutralize a slight odor of acetic acid.
Summary T his case report indicates th at there is need for obtaining an adequate clinical history. T he p atient’s denture problem indicated need o f a soft liner; application of one proved successful. B ecause of a very sim ple dental procedure, the patient no longer suffers daily oral pain and dis com fort caused by dentures. T he p atien t’s n euro psychiatric condition also seems to have improved.
Doctor Davis is a Veterans Administration career resi dent in prosthodontics, and a post doctoral clinical fellow at Harvard School of Dental Medicine, Boston. His ad dress is 53 Claudette Circle, Framingham, Mass 01701. I. Robinson, J.E., and Barnhart, G.W. Silicone rubber soft denture material: technique and clinical applications. Dent Dig 70:362 Aug 1964.
D a v is: SO FT LIN ER IN A C O M PL E T E D E N T U R E ■ 1361