Rehabilitation of a marginal mandibulectomy patient using a modified neutral zone technique: a case report

Pekkan, Gürel; Hekimoğlu, Canan; Şahin, Nilay Ercan

doi:10.1590/s0103-64402007000100018

Cited by 15 publications

(21 citation statements)

References 6 publications

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“…• Severely atrophic mandibular ridge (Atwood's class V and VI resorption) • Prominent and highly attached mentalis muscle • Lateral spreading of tongue as a result of poor transition from dentulous to edentulous state 6 • Patients with atypical shape or consistency of oral and perioral structures, e.g., marginal or segmental mandibulectomy and partial glossectomy 7 • A surgical stent fabricated in Neutral zone helps placement of implants in optimal position for implantsupported overdentures, which enhances the overall outcome of treatment 8 • Patients with poor neuromuscular control, such as history of stroke, Parkinson's disease, and impaired motor innervation to oral and facial muscles as a result of brain surgery 9…”

Section: Indicationsmentioning

confidence: 99%

Neutral Zone: A Novel Technique for Management of Severely Resorbed Ridge.

Bagul¹,

Khandagale²

2017

IJPCDR

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The average life expectancy of the population has increased, with advances in all the branches of medicine. Thus, a greater number of geriatric patients seek dental services. But due to various conditions they end up in edentulism for longer duration in later stages, which leads to problems related to loose-fitting dentures. As retention of the denture is compromised due to poor denture base foundation, the role of stability becomes even more important, which is achieved by neutral zone. The complete denture must not only fit the edentulous ridge, but its concave mechanical surfaces should fit against the tongue, cheeks, and lips. This case report presents management of Atwood's class V and VI resorbed ridge with neutral zone and management of flabby ridge with window technique.

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Section: Indicationsmentioning

confidence: 99%

Neutral Zone: A Novel Technique for Management of Severely Resorbed Ridge.

Bagul¹,

Khandagale²

2017

IJPCDR

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“…Patient's photographs were taken in frontal views of each patient's face in the natural head position with a digital camera as a record for patients to be evaluated before prosthetic construction. Every partially resected mandible patient received conventional partial denture with neutral zone registration which then acted as pre surgical stent [6,9,15]. …”

Section: Pre-operative Analysismentioning

confidence: 99%

Effect of implant assisted partial overdenture with neutral zone concept in partially resected mandible restoration on facial contour and bone density

Mohamed

Amin

Sadakah

et al. 2014

Tanta Dental Journal

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This study was performed to evaluate the effect of implant assisted partial overdenture located in neutral zone for restoring partially resected mandible on facial contour and bone density. Material and methods: 10 patients their age range from 18 to 45 years were selected. Each patient had partially resected mandible with osseous bone graft. Patients received removable partial overdenture assisted by two implants with suitable length and diameter guided by CBCT scan using early loading protocol two months after implant insertion. That partial overdenture respected neutral zone registration. Patients were recalled after two months from transitional partial denture insertion, two months after implant insertion and two months after implant assisting removable partial overdenture for facial symmetry evaluation, and assessment of bone quality. The data were collected, tabulated and statistically analyzed using test (ANOVA) with repeated measures comparing different follow up periods for bone density, and paired t-test comparing facial symmetry before reconstruction versus after reconstruction and mirror images to healthy side. Results: Currently it was found that early loading protocol with two implants supported mandibular partial overdenture with neutral zone in reconstructed resected mandible produce implant success rates, and improve facial asymmetry.

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“…Se ha determinado que la reabsorción del reborde residual es mayor en el hueso mandibular, dejando menor cantidad de tejido para dar retención y soporte a las prótesis inferiores aumentando la dificultad en su confección. Debido a esto, las prótesis mandibulares suelen ser menos usadas por los pacientes por provocar dolor e inestabilidad (11,12) . Además, en una reabsorción de reborde residual avanzada, donde el vestíbulo se encuentra muy disminuido, se puede llegar hasta la zona de las inserciones musculares e inclusive quedar sobre el reborde residual, como sucede en la zona anterior con el músculo mentoniano, en cuyo caso la zona neutra sufre un desplazamiento en la zona anterior hacia lingual (13) .…”

Section: (Figura 1)unclassified

Reporte clínico: Registro piezográfico de la zona neutra, en un paciente con espasmos musculares involuntarios

Astorga

Vergara

2013

Rev. Clin. Periodoncia Implantol. Rehabil. Oral

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RESUMENToda función del sistema estomatognático involucra la acción sinérgica de la musculatura paraprotética, representada por estructuras complejas tales como lengua, labios, mejillas y piso de boca. Al rehabilitar a través de prótesis completas no siempre se considera la influencia de la dinámica muscular, y menos aún cuando alguna de estas estructuras presenten alguna patología, por ejemplo, el compromiso del nervio facial que genera espasmos musculares involuntarios. En tal situación, la ubicación de los dientes y la forma de las superficies pulidas pueden llegar a ser decisivos entre éxito o fracaso de la rehabilitación. Se sabe que los implantes oseointegrados proveen retención, soporte y estabilidad, sin embargo existen situaciones especiales en que no es posible acceder a este tipo de tratamiento, tanto por razones médico quirúrgicas o costos asociados. En este estudio se ha utilizado un registro Piezográfico de la Zona Neutra en un paciente con compromiso del nervio facial que genera espasmos musculares involuntarios del lado afectado, obteniéndose una rehabilitación protésica basada en la apropiada relación entre superficie protésica externa y tejidos circundantes, mejorando requisitos funcionales tales como retención y estabilidad. Se ha utilizado el sistema de tomografía computarizada Cone Beam, con el objetivo de evidenciar el registro piezográfico. Los resultados obtenidos con estas prótesis piezográficas demuestran ser superior en factores como comodidad y fonoarticulación pero inferior en eficiencia masticatoria comparada con la técnica convencional. ABSTRACTEvery function of the stomatognathic system involves the synergistic action of the musculature around the prosthesis, consisting of complex and individual structures such as tongue, lips, cheeks and mouth floor. When planning and making complete prostheses, the muscular dynamic is not always considered. This can generate instability of the device during function, the location of the artificial teeth is made arbitrarily on the top and middle parts of the flange, and the configuration of the polished areas is made according to mechanistic concepts. This factor takes more relevance in patients with severe atrophy of their residual flanges, where the prosthetic stability can be a decisive factor between the success or failure of the rehabilitation. It is known that the osseointegrated implants provide retention, support and stability. However, there are special situations in which it is not possible to access to this type of treatment, both for medical surgical reasons or associated costs. In this study, a Piezographyc record of the Neutral Zone was used in a patient with facial nerve involvement generating involuntary muscle spasms of the affected side. A prosthetic rehabilitation based on the appropriate relation between external prosthetic surface and surrounding tissues was obtained, improving functional requirements such as retention and stability. The computerized tomographic Cone Beam system was used, with the objective to show the piezo...

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Rehabilitation of a marginal mandibulectomy patient using a modified neutral zone technique: a case report

Cited by 15 publications

References 6 publications

Neutral Zone: A Novel Technique for Management of Severely Resorbed Ridge.

Neutral Zone: A Novel Technique for Management of Severely Resorbed Ridge.

Effect of implant assisted partial overdenture with neutral zone concept in partially resected mandible restoration on facial contour and bone density

Reporte clínico: Registro piezográfico de la zona neutra, en un paciente con espasmos musculares involuntarios

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