Abstract To treat a patient with anterior crossbite, the clinician should first assess if it is a genuine class III or a pseudo‐class III malocclusion. Cephalometric analysis is important; however, registering a patient's centric relation (CR) is simple, quick, and costless and can play a decisive role in a differential diagnosis for this type of patient profile. This clinical report depicts a patient clinically diagnosed as class III. After mandible manipulation in CR, it was noted that the patient in question was a pseudo‐class III. The treatment was based on the pseudo‐class III diagnosis. Therefore, the patient was rehabilitated by occlusal adjustments and conventional and implant‐supported prostheses and without the need for invasive orthognathic surgery.
50£The success of the edentulous patients' treatment also involves understanding the importance of the neutral zone in prosthetic dentistry.Professor Joseph J. Massad, together with his colleagues, has sought to provide us with the methods and techniques in which the neutral zone must be incorporated.The book entitled "Application of the Neutral Zone in Prosthodontics" contains 11 chapters and an index.The main objective of the book is to describe the current procedures in fabricating prostheses that include the neutral zone: implant-supported overdentures, fixed complete dentures and complete dentures.The authors exemplify the evaluation of edentulous patients, starting with the interview, facial analysis, prosthetic factors, oral characteristics, and then moving on to conditioning the abused tissues and stabilizing the existing prosthesis, seeking re-establishing the orthopedic mandibular position.There is an innovative, personal technique useful for each type of clinical prosthesis that simplifies fingerprinting, and reduces the number of clinical procedures.After the production of the definitive models, it continues with the laboratory procedures, the production of record bases, occlusal rims and the mounting of a central bearing device (designed by Massad) indicated in the preparation of the clinical phase of recording the centric relation.After adjusting the wax occlusal rim in alignment with the facial shape, mount the maxillary cast in the articulator to the transverse horizontal axis and then record the centric relation with the jaw recorder device.A separate chapter covers the recording of the physiological neutral zone for edentulous patients with an impression compound, and for a dentate patient with vinyl polysiloxane (VPS)impression material.Then there follows the selection and arrangement of the anterior teeth, maxillary and mandibular, and then the posterior, mandibular and maxillary teeth, depending on neutral zone registration.There follows the evaluation of wax trial dentures, firstly extra-oral evaluation, the teeth arrangement on the articulator, and then the intra-oral evaluation, esthetics, phonetics, OVD, CR position, and realization of external impressions through appropriate movements to physiologically mold the labial and buccal polished surfaces for one arch at a time.The treatment is completed by a series of procedures necessary for definitive dentures integration.In the last chapter the book shows a detailed presentation of the use of CAD / CAM technology to record and fabricate neutral zone dentures.The book is a valuable guide for students, general dentistry residents, prosthodontics, and practitioners who want to understand the neutral zone as a guarantee of the success of a prosthetic treatment.
Purpose This study measured the effects of commercial resin type on maxillary complete dentures with monoplane teeth by periodically comparing the occlusal vertical dimension of the polymerized dentures with the baseline, wax trial denture fiducial measurements. Materials and Methods Commercially available compression‐molded, injection‐molded, and fluid poly(methyl methacrylate) resins, as well as one compression‐molded methyl acrylate ester copolymer, were evaluated. Ten dentures were fabricated from each resin using monoplane teeth. The occlusal vertical dimension at the articulator pin was measured at the wax denture stage for each specimen, and changes in occlusal vertical dimension for each denture were evaluated at a simulated laboratory remount, and at 0, 3, 6, 24, and 48 hours after a simulated clinical remount. Repeated measures analysis of variance (α= 0.05) and post hoc one‐way factorial analysis of variance and Scheffe's F‐Tests for each resin group were performed using ranks of raw data. Results Changes in the maxillary denture mean occlusal vertical dimensions were recognized throughout the evaluation periods compared with the wax‐denture baseline, and time was a significant influence on displacement ( p = .0001 ). Only the compression‐molded poly(methyl methacrylate) dentures exhibited a mean laboratory remount occlusal vertical dimension that was significantly greater than the mean wax denture measurement, and all resin systems exhibited occlusal error that was significantly less than the laboratory remount measurements at 48 hours. At 48 hours, all resin groups exhibited mean occlusal vertical dimension changes that were less than 1 mm compared with the wax denture. Only compression‐molded poly(methyl methacrylate) dentures exhibited a mean 48‐hour clinical remount measurement that was statistically similar to the mean wax denture occlusal vertical dimension. Conclusions Individual maxillary dentures from all resin types and at all intervals exhibited dimensional change. At the last evaluation period, the compression‐molded poly(methyl methacrylate) showed no change in mean occlusal vertical dimension from baseline, whereas remaining groups exhibited occlusal vertical dimensions significantly less than baseline.
This chapter discusses the final clinical step in the denture-fabrication process. This is a critical step, which helps to confirm the accuracy of all the previous clinical steps. Esthetics, phonetics, CR, OVD, and PPS are assessed and, afterwards, external impressions are made.
The neutral zone is an area of equilibrium in the mouth where the outward forces applied by the tongue are neutralized by the inward forces applied by the lips and the cheek. This chapter discusses the procedure for registering the neutral zone, which consists of two steps. The first step is performed during the maxillo-mandibular jaw relation records appointment and the second step is performed during the wax try-in appointment.
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