J Dent Rehabil Appl Sci.  2018 Sep;34(3):218-224. 10.14368/jdras.2018.34.3.218.

Neutral zone approach and external impression for rehabilitation of macroglossia: a case report

Affiliations
  • 1Department of Prosthodontics, School of Dentistry, Chonnam National University, Gwangju, Republic of Korea. mcnihil@chonnam.ac.kr

Abstract

Macroglossia is an obstacle in regard to general prosthodontic restoration. Not only is it difficult to obtain support and stability from dentures manufactured from normal protocol, obtaining efficacy from basic mastication is also difficult. In such cases, realizing harmony between the occlusion and surrounding muscle structures may be important with regard to manufacture of stable full dentures, and it is necessary to form the appropriate polished surface for this case. The neutral zone is defined as the potential area resulting from the neuromuscular function that results in equilibrium between the outward force exerted by the tongue and the inward force exerted by the lips and cheeks. The artificial teeth of the full denture lies in this area, and if the polished zone follows the anatomic form of the dynamic muscles, the movement of the muscles simply acts as an element of stabilizing the dentures improving the esthetics through facial support.

Keyword

macroglossia; neutral zone; external impression

MeSH Terms

Cheek
Dentures
Esthetics
Lip
Macroglossia*
Mastication
Muscles
Rehabilitation*
Tongue
Tooth, Artificial

Figure

  • Fig. 1 Initial panoramic radiograph.

  • Fig. 2 Initial intraoral photographs. (A) Frontal view, (B) Occlusal view of maxilla, (C) Occlusal view of mandible.

  • Fig. 3 Provisional denture. (A) Frontal view, (B) Occlusal view of maxilla, (C) Occlusal view of mandible.

  • Fig. 4 Final impression (A, B) and Master cast (C, D).

  • Fig. 5 Vertical dimension and centric recording (A), Mounting of master casts (B).

  • Fig. 6 Lower acrylic resin base with retentive loops (A), compound rim (B).

  • Fig. 7 Artificial tooth arrangement according to the silicone putty index (A, B).

  • Fig. 8 Wax denture (A, B), External impression on upper wax- denture using Coe-soft (C) and External impression on lower wax- denture using Coe-soft (D).

  • Fig. 9 Clinical remounding (A), Denfinitive denture delivery (B).

  • Fig. 10 Polished surface (A, B), tissue surface (C, D) of new denture.

  • Fig. 11 Comparison of Cross sectional view of new denture (black line) and provisional denture (brown line) at premolar area (A) and molar area (B) by 3Shape viewer®.


Reference

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