Enhancement of stability for mandibular complete denture prosthesis in atrophied ridge with neutral zone technique — A case report

Abstract

The Neutral Zone technique is not a new but a very valuable technique, it is an alternative approaches in constructing stable complete denture in case of a highly atrophic mandible. The main aim of the Neutral zone technique is to construct denture in muscle harmony, so that it does not get displaced during the actions of the muscles surrounding as the actions of swallowing, mastication, speech and so on. Key words—Neutral zone, Atrophic mandible. Introduction: The goal of dentistry is for patients to keep all their teeth throughout their lives in health and comfort. If the teeth are lost despite all efforts to save them, a restoration should be made in such a manner as to function efficiently and comfortably in harmony with the muscles of the stomatognathic system and the temporomandibular joints. With the increase in the life expectancy of the population, the numbers of complex complete denture cases also have been increasing. The treatment for these complex complete denture cases should be different from those of traditional complete dentures. In case of Atrophic mandible, Dental implants may provide stabilization of mandibular complete dentures, but in cases when it is not possible to provide implants on the grounds of medical risks, economic limitations or patients attitudes, an alternative technique should be thought. The Neutral Zone Technique is an alternative approach for these cases. The Neutral zone technique is not new, but is one that is valuable yet not practiced. The Neutral zone has been defined as the area in the mouth where during function, the forces of the tongue pressing outwards are neutralized by the forces of the cheek and lips pressing inwards. The aim of the Neutral zone is to construct a denture in muscle balance. If the denture is out of harmony with the neutral zone, it will result in instability, interference with function or some degree of discomfort. Thus neutral zone must be evaluated as an important factor before aligning the teeth in complete denture or partial denture. This is the zone where the natural dentition exists. As the mandible atrophies at a greater rate than the maxilla and has less residual ridge for retention and support, the lower denture commonly presents the most difficulties with pain and looseness being the most common complaints. The Neutral zone technique is most effective for patients who have had numerous unstable and nonretentive lower complete dentures. These patients usually have a highly atrophic mandible and there has been difficulty in positioning the teeth to produce a stable denture. The Neutral zone approach has been used for patients who have had a partial glossectomy, mandibular resections or motor nerve damage to the tongue– which have led to either atypical movement or an unfavorable denture bearing area. Background: Sir Wilfred Fish in 1931 first described the influence of the polished surface on retention and stability. He also described how dentures should be constructed in the ‘dead space’, which later became as the