• Journal of Dental Rehabilitation and Applied Science
• /
• v.17 no.2
• /
• pp.107-112
• /
• 2001

The prosthodontic treatment of severely resorbed edentulous patients has been one of the frustrating areas due to extensive loss of tissues. The integrated neuromuscular balance among tongue, lip, and cheek is compromised. The retention, stability, and support are the three major factors to influence the clinical outcome. Fish described a denture as having three surface, with each surface playing an independent and important role in the over all fit, stability, and comfort of the denture. He recommended that the polished surface should be a series of inclines so that pressure from muscular activity will retain dentures. Within the denture space there is an area that has been termed the neutral zone. The neutral zone is that area in the mouth where, during function, the forces of the tongue pressing outward are neutralized by the forces of the cheeks and lips pressing inward. According to Jacobson and Krol, neuromuscular control interacts to provide retention and the relationship of polished surface of denture base to the surrounding muscular structure of orofacial capsule facilitates the stability and retention. This neutral zone concept has been demonstrated with various modification by a number of authors. The theory used to develop the denture base contours is based on the belief that the muscle should functionally mold not only the border but the entire polished surface. Lott and Walsh reported the clinical success on complete mandibular dentures with application of neutral zone concept. A number of studies demonstrated that denture stability and retention are more dependent on correct position of the teeth and correct contour of external surfaces of the denture in a severely resorbed alveolar ridge. This article presents a prosthodontic approach to treatment of a edentulous patient using neutral zone technique to improve the retention and stability of the prosthesis.

• Journal of Dental Rehabilitation and Applied Science
• /
• v.17 no.2
• /
• pp.113-123
• /
• 2001

The success of complete denture prosthesis is to satisfy three basic requirements for the edentulous patient : maximum comfort, efficiency, and esthetic appearance. This can be achieved only if the dentures are both stable and retentive. When the residual alveolar ridge has resorbed significantly, stability and retention are more dependent on the correct position of the teeth and external surfaces of the denture. The stability and retention of the denture can be improved by locating the denture in the neutral zone and reproducing exact mandibular border movement for balanced occlusion. The neutral zone philosophy is based upon the concept that there exists a specific area where the musculature function will not unseat the denture in the mouth. In here, forces generated by the tongue are neutralized by the forces generated by the lips and cheeks. One of the simplest methods for recording border movements in three dimensions is to make stereographic record of condylar movement. Stereographs are made in the mouth during mandibular movement with intraoral clutches and central bearing point, and used in dictating the condylar movement on the articulator later by generating the condylar paths in doughy acrylic resin. Its procedure is simpler and more convenient than that of Pantograph. In this clinical report, we introduce the concept of neutral zone and stereograph in complete denture fabrication.

• Journal of the Korean Academy of Esthetic Dentistry
• /
• v.32 no.1
• /
• pp.8-15
• /
• 2023

In case with severely atrophied mandibular ridges, it may be difficult to achieve adequate retention and stability of dentures through the normal functional impression process of complete dentures. In these patients, an approach using the neutral zone raising technique may be an effective alternative. The neutral zone is defined as the area where the pressure of the tongue towards the outside of the mouth and the pressure of the cheek and lips towards the inside are balanced during the normal oral function of the muscular-nervous system. Complete dentures made through neutral zone impression not only improve retention and stability, but also provide adequate tongue space in the posterior teeth area. Additionally, food residues are reduced in the area around artificial teeth, and aesthetics are improved through appropriate facial support.

• The Journal of Korean Academy of Prosthodontics
• /
• v.54 no.4
• /
• pp.407-412
• /
• 2016

The neutral zone technique is an alternative approach for the construction of complete dentures on highly atrophic ridges with history of denture instability. This technique achieves two objectives. First, the teeth will not interfere with the normal muscle function, and second, the force exerted by the musculature against the denture is more favorable for stability and retention. In this case of a 78-years-old female patient with severely atrophic ridges who had been using unstable complete dentures, the neutral zone impression technique was used to increase the stability and the retention of dentures. The neutral zone for both arch was located with modeling compound. After the arrangement of artificial teeth within the neutral zone, the external impression was taken to determine the tissue surface. The final dentures showed enhanced stability and retention and the patient was satisfied with the new dentures with respect to functional and esthetic aspects.

• The Journal of Korean Academy of Prosthodontics
• /
• v.61 no.1
• /
• pp.18-25
• /
• 2023

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.

• Journal of Dental Rehabilitation and Applied Science
• /
• v.34 no.4
• /
• pp.324-330
• /
• 2018

In order to produce a stable denture for severe alveolar bone loss area, it is not only important that .0a suitable occlusion is established but also to consider compatibility with the surrounding muscle to form a suitable polished surfaces. Neutral zone is defined as a potential area where the neuromuscular system of the tongue, cheeks and lips is balanced can be determined through the neutral zone impression technique. And if artificial teeth are aligned within the neutral zone and the polished surface follows the anatomical form of the dynamic muscle, higher stability and retention of the denture may be obtained through coordination with the surrounding muscle tissue. This case is being reported since the concept of the neutral zone was applied to a patient with severely atrophic residual alveolar ridge and the result was clinically satisfactory in both function and aesthetics.

• Journal of Dental Rehabilitation and Applied Science
• /
• v.39 no.4
• /
• pp.214-221
• /
• 2023

In order to fabricate stable dentures in patients with severe resorption of residual ridges, various factors must be considered. One of them is the neutral zone, which is defined as the potential region in which the pressure of the tongue outward in the oral cavity and the pressure of the cheeks and lips directed inward from the outside of the oral cavity equalize during functioning. In patients with severe ridge resorption, if the teeth are usually arranged above the residual ridge, the teeth are located on the lingual side rather than the original position. Therefore, the functional space of the tongue is invaded, the tongue is positioned backward, and the sealing of the lingual border is broken, which acts as a factor reducing the maintenance of denture. In addition, it is also important for the stability of dentures to assume an interalveolar crest line connecting the maxillary and mandibular ridge crests, and to arrange the maxillary and mandibular artificial teeth to match the masticatory force to the interalveolar crest line. Therefore, good clinical results were obtained by fabricating dentures for the patient with poor alveolar residual ridge using neutral zone impression and ridge relationship analysis.

• The Journal of Korean Academy of Prosthodontics
• /
• v.28 no.1
• /
• pp.123-135
• /
• 1990

It would be of importance to determine the neutral Tone by a resultant axis of relation on relation to the mandible in understanding the biomechanics of the mandibular movement. In this study, the neutral zone at the habitual opening and closing mandibular movements is the shape of the paths described by a minimum moving point occured as an average center of the determined instantaneous centers of rotation. Twenty, aged $23{\sim}25$, male dental students without Temporomandibular disorders and with normal occlusion clinically were selected for the study. The habitual opening and closing mandibular movements were recorded by the Gnathorecouder and analyzed by the computer program of a planer rigid body model and the determined method of a minimum moving point. The results obtained from this study were as follows. 1. The minimum moving points were placed in the body of the mandible except two subjects. 2. The mean of maximum displacements of a minimum moving point was $0.62{\pm}0.08cm$ on X-axis and $0.73{\pm}0.16cm$ on y-axis. 3. The mean of maximum displacements of a minimum moving point was $3.39{\pm}0.62cm$ 4. The position and shape of the neutral zone were determined by the position, displacements, and moving distances of a minimum moving point.

• 대한치과보철학회:학술대회논문집
• /
• 2002.04a
• /
• pp.29-29
• /
• 2002

• Journal of the Korean Home Economics Association
• /
• v.30 no.2
• /
• pp.81-86
• /
• 1992

The purpose of this study was to investigate the psychophysical correponding to temperature and to establish the comfort zone of thermal environment for Korean in winter. An experimental investigation was carried out in climate chamber maintaining the air temperature at 20, 22, 24, 26℃ and subjects were 128 college-age Korean(64 males and 64 females) in good health. Data were analyzed by SPSS PC＋ packages. 'Neutral' on the thermal sensation ratings was most frequently indicated at 24℃ by subjects was 23.1℃ (male 24.0℃, female 22.7℃), therefore the comfort zone of thermal environment in winter was considered as 23∼24℃.