J Korean Acad Prosthodont.  2023 Jan;61(1):18-25. 10.4047/jkap.2023.61.1.18.

Neutral zone approach for rehabilitation in a patient who underwent mandibulotomy: A case report

• Shin H
• Lee HY
• Kim JH

• KMID: 2539311
• DOI: http://doi.org/10.4047/jkap.2023.61.1.18

Abstract

We present the case of a 65-year-old man with maxillary and mandibular complete dentures prepared using neutral zone technique after undergoing mandibulotomy due to tonsil cancer 10 years ago. The patient had a short edentulous period; hence, there was minimal absorption of the alveolar ridge and no abnormality in the motor function of the tongue. However, the retromolar pad was located inside the hamular notch, and the posterior alveolar ridge was relatively turned inward. If the artificial teeth would have been aligned conventionally, the functional space of the tongue would have been invaded, which would have moved the tongue posteriorly thereby reducing the stability of the denture. Therefore, applying the concept of the neutral zone can be a good reference point in such cases. The neutral zone was registered using tissue conditioner, and tooth alignment was performed by making a silicone putty index. The biggest advantage of using neutral zone concept is denture stability. In this case, the neutral zone technique was applied to obtain the lingual alignment limit of the posterior teeth to avoid invasion of the tongue space by the left posterior part of the mandible. Particularly, in case of a patient in which denture stability is difficult to obtain due to absorption of the alveolar ridge, it is believed that better results can be obtained using neutral zone technique.

Keyword

Complete denture; Full edentulism; Neutral zone