Integrating functional muscular dynamics into complete denture rehabilitation of a severely atrophic mandible using the neutral zone technique: A case report

Rehabilitation of completely edentulous patients with severely resorbed mandibular ridges remains one of the most challenging aspects of complete denture prosthodontics because advanced residual ridge resorption compromises denture retention, stability, support, and masticatory efficiency. Conventional complete denture techniques often fail to provide satisfactory functional outcomes in such cases due to the absence of an adequate denture-bearing foundation. The neutral zone technique is a physiologic approach that records the zone of equilibrium created by the balanced action of the tongue, lips, and cheeks, thereby facilitating the fabrication of a prosthesis that is harmonized with the surrounding musculature. This case report describes the prosthodontic rehabilitation of a 70-year-old completely edentulous patient presenting with a severely resorbed mandibular ridge and significant difficulty in mastication. The neutral zone was utilized to guide functional tooth arrangement and contouring of the polished surfaces, ensuring that the prosthesis was in harmony with the surrounding oral musculature. The neutral zone-guided mandibular denture demonstrated improved stability during functional movements, enhanced retention, and greater patient comfort compared with expectations from conventional denture construction in severely resorbed ridges. The patient reported satisfactory masticatory function and adaptation to the prosthesis. Within the limitations of a single clinical case, the neutral zone impression technique appears to be a predictable and effective treatment modality for managing severely resorbed mandibular ridges by integrating prosthesis design with functional muscular dynamics, thereby improving overall denture performance and patient satisfaction.