Improvised Neutral Zone Technique in a Completely Edentulous Patient with an Atrophic Mandibular Ridge and Neuromuscular Incoordination: A Clinical Tip

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.