Modified Combined Impression Technique for Cawood & Howell Class V/VI Mandibular Ridges: A Case Report

Abstract

Geriatric prosthodontic rehabilitation with compromised residual ridge has become challenging, the principal concern being rejuvenating and maintaining complex stomatognathic functional harmony with severe residual ridge resorption (RRR). Modification of contemporary treatment techniques should be considered to achieve a patient’s functional and esthetic requirements. Contemporary prosthodontics utilizing combination of Neutral zone technique (NZ) and all green impression (AGI) for the management of Cawood & Howell Class V/VI (severely resorbed) ridges are innovative techniques for the construction of removable prosthesis with a profound effect in denture stability and retention, particularly in mandible. NZ implies the principle of synergistic activity of Oro-muscular function in denture stability by arranging the prosthetic teeth within the neutral zone area, hence preventing their interfere with the oro-muscular function, while AGI aimed at achieving prosthesis retention through functional moulding and the viscosity of impression material helps disseminate the forces transmitted to the denture-bearing area reducing the potential for discomfort arise from the soft tissue folds over atrophic ridge. This case report attempts to present a combination of modified impression techniques utilizing all green impression techniques and neutral zone techniques in a 66-year-old patient for C&H Class V mandibular ridge. The goal of this technique is to provide optimal stability covering the maximum denture bearing area and selectively distributing the pressure and to produce a denture molded by oro-muscular function in harmony with its surrounding structures thereby enhancing stability and retention.