The neutral zone impression revisited british dental journal. The management of a mandibular resorbed ridge with a neutral zone technique using an impression compound mixed with a green stick in the ratio of 3. 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. This article presents the application of neutral zone nz concept being incorporated in to impression making in an effort to achieve successful complete denture therapy. However, with all these techniques of neutral zone approach, the usual sequence of complete denture construction is somewhat reversed. Fabrication of complete dentures using the neutral zone technique is neither recent nor original. Overcoming the unstable mandibular complete denture. Salvation of a severely resorbed mandibular ridge with a. Understanding the importance of the neutral zone is key to successful prosthodontic treatment. Neutral zone concept for severely resorbed ridges a. Soon after making primary impression, the impression was poured in plaster of paris and primary. A case report is presented in which the use of this. The neutral zone technique is an alternative technique for the.
Neutral zone technique is long being used for the management of severely resorbed mandibular ridges. The neutral zone philosophy is based upon the concept that for each individual patient, there exists within the denture space a specific area where the function of the musculature will not unseat the denture and where forces generated by the tongue are neutralized by the forces generated by the lips. Aug 15, 2017 understanding the importance of the neutral zone is key to successful prosthodontic treatment. Introduction complete dentures are primarily mechanical devices, but since they function in the oral cavity, they must be fashioned so that they are in harmony with normal neuromuscular function. It is most effective for dentures where there is a highly atrophic ridge and a history of. Pdf improvised neutral zone technique in a completely. Comparison of different final impression techniques for. Enhancement of stability for mandibular complete denture.
Morphologic comparison of two neutral zone impression. If done correctly, the neutral zone can increase the stability and retention to a great extent. Rehabilitation of a marginal mandibulectomy patient using a. However, the neutral zone impression technique has various modifications, not only in terms of impression materials used or recording base designed, but also in terms of the functional movements performed and refinement to the initial record. Relating this to complete denture impression technique, we have been provided with a set of philosophies no pressure, minimal pressure. The neutral zone technique revisited ayesha razzaque. However, it had been stated that the neutral zone has not been given enough importance in the literature 4. The technique involves making an impression which is shaped by the patients oral musculature, and which defines the shape and contour of the patients neutral zone. Schiesser, dds classic article j prosthet dent 2006. Instead of impression compound, low fusing green sticky wax or the mixture of two 31,32 can be used to record the neutral zone depending on operators choice to modify the properties. This is particularly true for patients with reduced mandibular residual ridges, yielding flat or concave foundations.
Pdf stabilizing mandibular complete dentures using the. Neutral zone approach for rehabilitation of severely atrophic ridge. A hydrocolloid impression material alginate accutray, ivoclar was chosen as a material of choice the record bases were checked in the patients mouth for stability, while movements like swallowing and pursing of lips were made to be performed by the patient. Neutral zone impression technique the loose and unstable lower complete denture is one of the most common problems faced by denture patients. The neutral zone is the area where the displacing forces of the lips cheeks and tongue are in balance. Impression technique definition of impression technique by. Utilization of various means of retention brings better compliance in mandibular defect patients provided with obturators. Concept of neutral zone dental seminars slideshare.
A technique for obtaining maxillomandibular registration for complete denture patients is presented. Building the edentulous impression a layering technique using multiple viscosities of impression material. Though all of us realize the importance of neutral zone yet no one tries to use it for increasing the stability in complete denture prosthesis. This technique is well documented and has been referred to as the neutral zone technique or anthropoidal pouch technique. Joseph massad and his colleagues present methods and techniques for constructing predictable complete, implantsupported, and implantretained prostheses.
Mar 12, 2005 the neutral zone technique is an alternative approach for the construction of lower complete dentures. May, 2000 this technique is well documented and has been referred to as the neutral zone technique or anthropoidal pouch technique. Application of the neutral zone in prosthodontics offers a stepbystep guide to successfully designing and placing complete and implantretained dentures using neutral zone concepts. Aug 07, 2014 technique for the location of neutral zone a number of variations of the basic technique have been reported in the literature.
Prostheses which set teeth outside this zone risk problems such as discomfort, cheek or tongue biting, and instability of the denture. Neutral zone approach to denture fabrication for a severe. One impression was made for each subject, for each technique. Admix impression technique atrophic mandibular ridge definitive impression with admix of 3 parts by weight of red impression compound to 7 parts by weight of greenstick. This article describes a technique for improving the stability of mandibular complete dentures for patients who have a diminished mandibular neutral zone. Biometric denture space concept of neutral zone revisited. In this simple technique for making wash impression of highly displaceable maxillary anterior ridge with lowviscosity polyvinyl siloxane and zinc oxide eugenol, impression material is explained. A technique has been described in which the form of the polished surfaces is developed in nature pics pdf an impression paste at the tryin, and this form is. The neutral zone technique is an alternative approach for the construction of complete dentures with such kind of challenges. Various materials are used in recording neutral zone, which have their own advantages and disadvantages. It is most effective for dentures where there is a highly atrophic ridge and a history of denture instability. The aim of this case report is to describe the technique to fabricate a mandibular complete denture in muscular balance, as muscular. The technique aims to construct a denture that is shaped by muscle function and is in harmony with the surrounding oral structures.
The neutral zone is the area where the outward forces from the tongue are neutralized or nullified by the forces of the lips and cheeks acting inward during functional movements. The neutral zone technique is an alternative approach for the construction of lower complete dentures. The history of complete denture impression procedures has been influenced largely by the development of impression materials from which new techniques and ideas arose. The impression was inverted onto graph paper, and the contour was outlined with a lead pencil. Stabilizing mandibular complete dentures using the neutral zone impression technique. The neutral zone is an important concept in prosthodontics, because prosthetic teeth generally must conform to the horizontal position determined by the neutral zone. Classic article the neutral zone in complete dentures victor e. Illustrates every technique described with more than 300 color photos covers all phases of complete denture therapy presents a stepbystep assessment and examination protocol details the importance of accurate. Improvised neutral zone technique in a completely edentulous patient with an atrophic mandibular ridge and neuromuscular incoordination. A water bath, preheated to the adequate temperature, is.
Denture space neutral zone impression different postures of patient during the moulding of neutral zone. Impression technique definition of impression technique. Incorrect tooth placement and arbitrary shaping of the polished surfaces may have an adverse effect on the success of the prosthesis. Code of practice is dangerous and everchanging in todays world. Clinical visit 1 at the first visit primary impression of the maxillary and mandibular edentulous residual ridge were made with modelling plastic compound impression material. The neutral zone in complete dentures dentures human tooth. A dental impression is a negative imprint of hard teeth and soft tissues in the mouth from which a positive reproduction cast or model can be formed. Schiesser, ddsb temple university school of dentistry, philadelphia, pa t he neutral zone approach to complete denture. A simplified approach for recording neutral zone europe. It is made by placing an appropriate material in a stock or custom dental impression tray which is. Gahan and walmsley 2005 defined neutral zone as the area in the mouth where during function, the forces of the tongue pressing outwards are neutralised by the forces of the cheeks and lips pressing inwards. This case report describes the fabrication of a removable partial denture for a patient with marginal mandibulectomy and an anterior edentulous area using a modified neutral zone technique.
Building the edentulous impressiona layering technique using multiple viscosities of impression material. During the past few decades, many articles which have incorporated or related to what we have named the neutral zone technique have been published. Dec 09, 2010 neutral zone technique is long being used for the management of severely resorbed mandibular ridges. The neutral zone technique is an alternative approach for these cases.
The consistency of the compound should be similar to that used when making a primary impression. Prostheses which set teeth outside this zone risk problems such as discomfort, cheek or. The buccal contours of both neutral zones coincided at the median line. The dentures will also have other advantages such as reduced food lodgement, good esthetics due to facial support, proper positioning of the posterior teeth. It is the most effective method for the management. We prefer to use the term denture form impression technique. A denture shaped by neutral zone technique will ensure that the muscular forces are working more effectively in harmony and gives advantage of stabilizing potential of oral and perioral musculature 3,8. Using the neutral zone to obtain maxillomandibular. Technique for the location of neutral zone a number of variations of the basic technique have been reported in the literature. The aim of this case report is to describe the technique to fabricate a mandibular complete denture in muscular balance, as. The objective of this research was to study the accuracy of reproducibility of neutral zone by two commonly available dental materials, tissue conditioner and zinc oxide eugenol paste. Concept of neutral zone dental seminars 11,278 views.
Neutral zone, atrophic mandible, impression technique, stability. Saxena aged 65 years presented to the department of prosthodontics with completely edentulous and severely resorbed mandibular ridge. Importance of neutral zone as the area of the impression surface decreases due to alveolar ridge resorption, less influence it has on the denture retention and stability. The maxillary rim is formed with the use of conventional techniques. However on the basis of over all results neutral zone seemed to have slightdenture1620lective pressure impression technique fig. In such complex cases the neutral zone impression technique is the only option. Dental implants placed with neutral zone technique stabilize the denture fabricated over atrophic mandibular ridge. Rehabilitation of a marginal mandibulectomy patient using. Application of the neutral zone in prosthodontics in. Introduction complete dentures are primarily mechanical devices,but since they function in the oral cavity, they must be fashioned. A simplified approach for recording neutral zone springerlink. However, there may be certain medical, surgic al economic conditions when it is not possible to provide implants. Denture fabricated over severely resorbed mandibular ridge by neutral zone impression technique will. The mandibular rim is made from modeling plastic impression compound on a record base formed by the patient into the neutral zone.
This paper has described an impression technique for the management of a denturebearing area that contains flabby tissues. Illustrates every technique described with more than 300 color photos covers all phases of complete denture therapy presents a stepbystep assessment and examination protocol. The neutral zone technique is not new, but is one that is valuable yet not practiced. A number of different neutral zone impression methods have been suggested. Impression techniques for the resorbed mandibular arch. One of the methods used to solve this problem is the neutral zone technique. Schiesser, ddsb temple university school of dentistry, philadelphia, pa t he neutralzone approach to complete denture. Thus this article describes impression technique utilizing the neutral zone concept and monoplane occlusion to improve the stability of mandibular denture in. This article discusses the use of polyether impression material which is simpler and more practical. It is made by placing an appropriate material in a stock or custom dental impression tray which is designed to roughly fit over the dental arches. Opinion is divided as to whether the neutral zone impression to determine the labiolingual position of mandibular complete dentures requires the maxillary denture to remain insitu or not. In application of the neutral zone in prosthodontics, dr.
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