Comparison of different final impression techniques for. 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 the construction of lower complete dentures. Schiesser, ddsb temple university school of dentistry, philadelphia, pa t he neutral zone approach to complete denture. 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. Introduction complete dentures are primarily mechanical devices,but since they function in the oral cavity, they must be fashioned. Aug 15, 2017 understanding the importance of the neutral zone is key to successful prosthodontic treatment. Dental implants placed with neutral zone technique stabilize the denture fabricated over atrophic mandibular ridge. The neutral zone technique revisited ayesha razzaque. It is the most effective method for the management. May, 2000 this technique is well documented and has been referred to as the neutral zone technique or anthropoidal pouch technique. Pdf neutral zone in complete dentures international. Schiesser, dds classic article j prosthet dent 2006. The technique aims to construct a denture that is shaped by muscle function and is in harmony with the surrounding oral structures.
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. Illustrates every technique described with more than 300 color photos covers all phases of complete denture therapy presents a stepbystep assessment and examination protocol. Neutral zone approach to denture fabrication for a severe. Concept of neutral zone dental seminars slideshare. Technique for the location of neutral zone a number of variations of the basic technique have been reported in the literature. Neutral zone, atrophic mandible, impression technique, stability. 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. 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.
Overcoming the unstable mandibular complete denture. The buccal contours of both neutral zones coincided at the median line. Prostheses which set teeth outside this zone risk problems such as discomfort, cheek or. 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 not new, but is one that is valuable yet not practiced. This paper has described an impression technique for the management of a denturebearing area that contains flabby tissues.
However, it had been stated that the neutral zone has not been given enough importance in the literature 4. Incorrect tooth placement and arbitrary shaping of the polished surfaces may have an adverse effect on the success of the prosthesis. 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. Application of the neutral zone in prosthodontics in. The mandibular rim is made from modeling plastic impression compound on a record base formed by the patient into the neutral zone. Schiesser, ddsb temple university school of dentistry, philadelphia, pa t he neutralzone approach to complete denture. Classic article the neutral zone in complete dentures victor e.
Utilization of various means of retention brings better compliance in mandibular defect patients provided with obturators. Improvised neutral zone technique in a completely edentulous patient with an atrophic mandibular ridge and neuromuscular incoordination. Aug 07, 2014 technique for the location of neutral zone a number of variations of the basic technique have been reported in the literature. Fabrication of complete dentures using the neutral zone technique is neither recent nor original. Various materials are used in recording neutral zone, which have their own advantages and disadvantages. In one patient sectional tray was used for impression while in one patient artificial teeth were arranged by neutral zone technique. One of the methods used to solve this problem is the neutral zone 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. However, with all these techniques of neutral zone approach, the usual sequence of complete denture construction is somewhat reversed. However on the basis of over all results neutral zone seemed to have slightdenture1620lective pressure impression technique fig. Stabilizing mandibular complete dentures using the neutral zone impression technique.
It is most effective for dentures where there is a highly atrophic ridge and a history of denture instability. Saxena aged 65 years presented to the department of prosthodontics with completely edentulous and severely resorbed mandibular ridge. Understanding the importance of the neutral zone is key to successful prosthodontic treatment. Soon after making primary impression, the impression was poured in plaster of paris and primary.
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 and technique journal of orofacial research, januarymarch 2012. Impression technique definition of impression technique. Pdf improvised neutral zone technique in a completely. The neutral zone technique is an alternative technique for the. Building the edentulous impressiona layering technique using multiple viscosities of impression material. Thus this article describes impression technique utilizing the neutral zone concept and monoplane occlusion to improve the stability of mandibular denture in. Salvation of a severely resorbed mandibular ridge with a. It is most effective for dentures where there is a highly atrophic ridge and a history of. Pdf stabilizing mandibular complete dentures using the. 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. The purpose of this study was to compare the retention of complete dentures made by using different impression techniques like conventional, admixed, all green, and functional techniques.
A simplified approach for recording neutral zone springerlink. A simplified approach for recording neutral zone europe. 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 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. Mar 12, 2005 the neutral zone technique is an alternative approach for the construction of lower complete dentures. The consistency of the compound should be similar to that used when making a primary impression. Joseph massad and his colleagues present methods and techniques for constructing predictable complete, implantsupported, and implantretained prostheses. The aim of this case report is to describe the technique to fabricate a mandibular complete denture in muscular balance, as muscular. The neutral zone is an important concept in prosthodontics, because prosthetic teeth generally must conform to the horizontal position determined by the neutral zone. The dentures will also have other advantages such as reduced food lodgement, good esthetics due to facial support, proper positioning of the posterior teeth. The impression was inverted onto graph paper, and the contour was outlined with a lead pencil. 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. The history of complete denture impression procedures has been influenced largely by the development of impression materials from which new techniques and ideas arose. A case report is presented in which the use of this. 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. Prostheses which set teeth outside this zone risk problems such as discomfort, cheek or tongue biting, and instability of the denture.
In application of the neutral zone in prosthodontics, dr. A water bath, preheated to the adequate temperature, is. A technique for obtaining maxillomandibular registration for complete denture patients is presented. This is particularly true for patients with reduced mandibular residual ridges, yielding flat or concave foundations. It is made by placing an appropriate material in a stock or custom dental impression tray which is.
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. During the past few decades, many articles which have incorporated or related to what we have named the neutral zone technique have been published. The neutral zone technique is an alternative approach for these cases. Impression technique definition of impression technique by. Neutral zone concept for severely resorbed ridges a. The aim of this case report is to describe the technique to fabricate a mandibular complete denture in muscular balance, as.
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. One impression was made for each subject, for each technique. 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. 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. 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. Denture space neutral zone impression different postures of patient during the moulding of neutral zone.
Concept of neutral zone dental seminars 11,278 views. The neutral zone technique is an alternative approach for the construction of complete dentures with such kind of challenges. The maxillary rim is formed with the use of conventional techniques. The neutral zone in complete dentures dentures human tooth. 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. This article discusses the use of polyether impression material which is simpler and more practical. Rehabilitation of a marginal mandibulectomy patient using. However, there may be certain medical, surgic al economic conditions when it is not possible to provide implants. Relating this to complete denture impression technique, we have been provided with a set of philosophies no pressure, minimal pressure. Neutral zone technique is long being used for the management of severely resorbed mandibular ridges.
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. Application of the neutral zone in prosthodontics offers a stepbystep guide to successfully designing and placing complete and implantretained dentures using neutral zone concepts. 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. We prefer to use the term denture form impression technique.
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 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. Morphologic comparison of two neutral zone impression. Using the neutral zone to obtain maxillomandibular. 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. Denture fabricated over severely resorbed mandibular ridge by neutral zone impression technique will. Plaster index around the neutral zone impression an example of the neutral zone from the a lateral and b posterior view base plate with selfcure acrylic pillars and with a vertical fin denture space neutral zone impression. Enhancement of stability for mandibular complete denture. In such complex cases the neutral zone impression technique is the only option. A number of different neutral zone impression methods have been suggested. Code of practice is dangerous and everchanging in todays world.
This technique is well documented and has been referred to as the neutral zone technique or anthropoidal pouch technique. If done correctly, the neutral zone can increase the stability and retention to a great extent. Impression techniques for the resorbed mandibular arch. The neutral zone is the area where the displacing forces of the lips cheeks and tongue are in balance. Neutral zone approach for rehabilitation of severely atrophic ridge. Building the edentulous impression a layering technique using multiple viscosities of impression material.