Improvised Neutral Zone Technique in a Completely Edentulous Patient with an Atrophic Mandibular Ridge and Neuromuscular Incoordination: A Clinical Tip
Identifieur interne : 007004 ( Ncbi/Merge ); précédent : 007003; suivant : 007005Improvised Neutral Zone Technique in a Completely Edentulous Patient with an Atrophic Mandibular Ridge and Neuromuscular Incoordination: A Clinical Tip
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- Cureus [ 2168-8184 ] ; ????.
Abstract
Resorption of mandibular ridges is a multifactorial and biomechanical disease that is chronic, progressive, irreversible, and cumulative leading to loss of sulcular depth, vertical dimension loss, and decreased lower facial height. Some common neurological, hormonal, and metabolic disorders affect the adaptability of dentures, and this can be diagnosed by a trained prosthodontist with proper history-taking and clinical examination.The denture becomes passive due to complex neuromuscular control and causes difficulties in impression-making, mastication, and swallowing, which in turn leads to loss of retention and stability in complete dentures. Hence, residual ridge resorption becomes a challenging scenario for a clinician during fabrication of complete dentures. The neutral zone concept plays a significant role in overcoming these challenges. 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. It is most effective for dentures where there is a highly atrophic ridge and history of denture instability. The technique aims to construct a denture that is shaped by muscle function and is in harmony with the surrounding oral structures. The technique is by no means new, but it is a valuable one. It is rarely used because of the extra clinical step involved and its complexity. Complete and partial denture failures are often related to non-compliance with neutral zone factors. Thus, the evaluation of the neutral zone is an important factor. Increased retention and stability with reduced chairside time are the salient features of this new approach to any clinically challenging situation in complete dentures.This clinical report describes a modification of the conventional neutral zone technique using improvised procedures to minimize chairside visits for a patient with an atrophic mandibular ridge and neuromuscular incoordination.
Url:
DOI: 10.7759/cureus.1189
PubMed: 28553567
PubMed Central: 5443647
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<front><journal-meta><journal-id journal-id-type="nlm-ta">Cureus</journal-id><journal-id journal-id-type="iso-abbrev">Cureus</journal-id><journal-id journal-id-type="issn">2168-8184</journal-id><journal-title-group><journal-title>Cureus</journal-title></journal-title-group><issn pub-type="epub">2168-8184</issn><publisher><publisher-name>Cureus</publisher-name><publisher-loc>Palo Alto (CA)</publisher-loc></publisher></journal-meta><article-meta><article-id pub-id-type="pmid">28553567</article-id><article-id pub-id-type="pmc">5443647</article-id><article-id pub-id-type="doi">10.7759/cureus.1189</article-id><article-categories><subj-group subj-group-type="heading"><subject>Other</subject></subj-group><subj-group><subject>Physical Medicine & Rehabilitation</subject></subj-group><subj-group><subject>Quality Improvement</subject></subj-group></article-categories><title-group><article-title>Improvised Neutral Zone Technique in a Completely Edentulous Patient with an Atrophic Mandibular Ridge and Neuromuscular
Incoordination: A Clinical Tip</article-title></title-group><contrib-group><contrib contrib-type="editor"><name><surname>Muacevic</surname><given-names>Alexander</given-names></name></contrib><contrib contrib-type="editor"><name><surname>Adler</surname><given-names>John R</given-names></name></contrib></contrib-group><contrib-group><contrib contrib-type="author" corresp="yes"><name><surname>Saravanakumar</surname><given-names>Prathibha</given-names></name><xref ref-type="aff" rid="aff-60915">1</xref></contrib><contrib contrib-type="author"><name><surname>Thirumalai Thangarajan</surname><given-names>Saravanan</given-names></name><xref ref-type="aff" rid="aff-60915">1</xref></contrib><contrib contrib-type="author"><name><surname>Mani</surname><given-names>Umamaheswari</given-names></name><xref ref-type="aff" rid="aff-60915">1</xref></contrib><contrib contrib-type="author"><name><surname>Kumar V</surname><given-names>Anand</given-names></name><xref ref-type="aff" rid="aff-60915">1</xref></contrib></contrib-group><aff id="aff-60915"><label>1</label> Department of Prosthodontics, Faculty of Dental Sciences, Sri Ramachandra University, Porur, Chennai, India</aff><author-notes><corresp id="cor1">Prathibha Saravanakumar <email>prathu_saran@yahoo.com</email></corresp></author-notes><pub-date date-type="pub" publication-format="electronic"><day>24</day><month>4</month><year>2017</year></pub-date><pub-date date-type="collection" publication-format="electronic"><month>4</month><year>2017</year></pub-date><volume>9</volume><issue>4</issue><elocation-id>e1189</elocation-id><history><date date-type="received"><day>5</day><month>4</month><year>2017</year></date><date date-type="accepted"><day>24</day><month>4</month><year>2017</year></date></history><permissions><copyright-statement>Copyright © 2017, Saravanakumar et al.</copyright-statement><copyright-year>2017</copyright-year><copyright-holder>Saravanakumar et al.</copyright-holder><license license-type="open-access" xlink:href="http://creativecommons.org/licenses/by/3.0/"><license-p>This is an open access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.</license-p></license></permissions><self-uri xlink:href="http://www.cureus.com/articles/6947-improvised--neutral-zone-technique-in-a-completely-edentulous-patient-with-an-atrophic-mandibular-ridge-and-neuromuscular--incoordination-a-clinical-tip">This article is available from http://www.cureus.com/articles/6947-improvised--neutral-zone-technique-in-a-completely-edentulous-patient-with-an-atrophic-mandibular-ridge-and-neuromuscular--incoordination-a-clinical-tip</self-uri><abstract><p>Resorption of mandibular ridges is a multifactorial and biomechanical disease that is chronic, progressive, irreversible, and cumulative leading to loss of sulcular depth, vertical dimension loss, and decreased lower facial height. Some common neurological, hormonal, and metabolic disorders affect the adaptability of dentures, and this can be diagnosed by a trained prosthodontist with proper history-taking and clinical examination.The denture becomes passive due to complex neuromuscular control and causes difficulties in impression-making, mastication, and swallowing, which in turn leads to loss of retention and stability in complete dentures. Hence, residual ridge resorption becomes a challenging scenario for a clinician during fabrication of complete dentures. The neutral zone concept plays a significant role in overcoming these challenges. 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. It is most effective for dentures where there is a highly atrophic ridge and history of denture instability. The technique aims to construct a denture that is shaped by muscle function and is in harmony with the surrounding oral structures. The technique is by no means new, but it is a valuable one. It is rarely used because of the extra clinical step involved and its complexity. Complete and partial denture failures are often related to non-compliance with neutral zone factors. Thus, the evaluation of the neutral zone is an important factor. Increased retention and stability with reduced chairside time are the salient features of this new approach to any clinically challenging situation in complete dentures.This clinical report describes a modification of the conventional neutral zone technique using improvised procedures to minimize chairside visits for a patient with an atrophic mandibular ridge and neuromuscular incoordination.</p></abstract><kwd-group kwd-group-type="author"><kwd>neutral zone</kwd><kwd>atrophic ridge</kwd><kwd>admix material</kwd><kwd>neuromuscular incoordination</kwd></kwd-group></article-meta><notes><p content-type="disclaimer">The content published in Cureus is the result of clinical experience and/or research by independent individuals or organizations. Cureus is not responsible for the scientific accuracy or reliability of data or conclusions published herein. All content published within Cureus is intended only for educational, research and reference purposes. Additionally, articles published within Cureus should not be deemed a suitable substitute for the advice of a qualified health care professional. Do not disregard or avoid professional medical advice due to content published within Cureus.</p></notes></front></pmc><affiliations><list></list><tree></tree></affiliations></record>Pour manipuler ce document sous Unix (Dilib)
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