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Publications (3)0.71 Total impact

  • Hina Zafar Raja · Muhammad Nasir Saleem
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    ABSTRACT: Construction of a maxillectomy obturator for any surgical defect requires optimum retention, stability and obturation of defect. In the following case a closed hollow bulb obturator was constructed while utilizing surveying and neutral zone impression technique. After insertion, soft liner was applied to record functional impression of the surgical defect. The obturator was resurfaced with heat cure acrylic to improve the outcome. Patient was able to masticate adequately and speak comprehensively. Patient's resonance, speech, retention and stability were markedly improved. Follow-up was done weekly in first month, fortnightly for the next 2 months then after every 3 months. In succeeding years it will be once every year.
    No preview · Article · May 2011 · Journal of the College of Physicians and Surgeons--Pakistan: JCPSP
  • Hina Zafar Raja · Muhammad Nasir Saleem
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    ABSTRACT: To estimate the amount of shift in position of the neutral zone and the centre of alveolar ridge crest in different edentulous periods. Observational study. The study was carried out on edentulous patients reporting in Prosthodontics Department of Lahore Medical and Dental College, Lahore, from August 2006 to December 2008. Patients with edentulous period for at least 6 months exhibiting normal range of maximal mouth opening (40-50 mm) and normal temporomandibular joint movements were included and allocated into two groups, according to period of edentulism. Patient with any intra oral soft tissue or bony pathology and reduced intermaxillary space were excluded. The neutral zone was clinically recorded for all patients with impression compound. The shift between neutral zone and ridge crest in different edentulous periods was analyzed radio graphically and compared statistically. In longer edentulous period (> 2 years), neutral zone was lingually shifted by an average of 1.06 mm in anterior, premolar and molar regions. Neutral zone may be lingually shifted in relation to alveolar ridge crest in patients with prolonged edentulous period. This may help in arranging the teeth according to the clinical situation.
    No preview · Article · Jun 2010 · Journal of the College of Physicians and Surgeons--Pakistan: JCPSP
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    Hina Z Raja · M Nasir Saleem
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    ABSTRACT: The objectives of this study were to compare the arrangement of teeth according to the bone sup-port concept with the neutral zone concept, Evaluate the influence of two arrangement schemes on denture success. A total of 128 patients were equally allocated into two groups, according to period of edentulism. All groups were provided neutral zone and conventional dentures. Post insertion assessment of conventional and neutral zone dentures was compared. Both denture techniques showed satisfactory assessment results in shorter edentulous period. In longer edentulous period, neutral zone dentures showed better assessment results. Arrangement of teeth with neutral zone may improve denture success in patients with prolonged edentulous periods. INTRODUCTION The objectives of any prosthodontic service are to restore the patient to normal function, contour, es-thetics, speech and health 1 . Optimum denture stabi-lity is difficult to achieve in conventional complete dentures. This problem is more magnified with-in mandibular dentures. The design of prostheses to replace lost teeth and resorbed ridges is largely de-termined by the position and amount of morpho-logical change in the denture bearing area of the jaws 2 . These changes dictate artificial tooth posi-tions in complete denture patients. The arrangement of teeth must be physiolo-gically and esthetically acceptable. Dislodging for-ces, discrepancies in residual ridge, maxillo-man-dibular relationships, residual ridge relationships, functional and para-functional mandibular move-ments, esthetic requirements and preferences of pa-tients are factors governing appropriate tooth arran-gements 3 . According to stomatognathic system, natural teeth erupt into the mouth under the influence of muscular environment evolved over the centuries. After the loss of natural teeth, it is difficult to ascertain the exact position due to varying pattern of alveolar bone resorption in different segments. The concept of "teeth over the residual ridge" is based on the mechanical principle of ensuring sta-bility by directing the forces at right angle to sup-porting tissues. Mandibular posterior teeth are pla-ced with their central fissures coinciding with a line joining the cuspid tip and the middle of retro molar pad 4 . Bucco-lingually narrow teeth when placed clo-ser to ridge offer additional lever balance 5 . Crests of the residual ridge may be used as a biometric guide. Unfortunately the crests do not remain in same antero-posterior and medio-lateral position. Pietro-koviski and Massler 6 demonstrated that, viewed from the occlusal aspect, the crest of the residual alveolar ridge shifts lingually in maxilla and buc-cally in mandible. Both arches are resorbed in verti-cal and horizontal direction. The alveolar ridge crest changes its location in a bucco-lingual direction after resorption 7 . The probable cause of this resorp-tion pattern may be eruptive pathway of teeth, deve-lopment pattern of alveolar processes or muscular or myodynamic forces. So arrangement of artificial teeth strictly over the crest of residual ridge may ac-centuate facial deformity, provoke phonetic prob-lems and affect deglutition 8 . Neutral zone may be defined as the space where during function the forces of the lips and cheeks pressing inwards neutralize the forces of the tongue pressing outwards. The neutral zone concept imp-lies acquired muscle control especially by tongue, lips, and cheeks towards denture stability. Advo-cates of neutral zone agree that lack of favorable le-verage is observed when teeth are positioned direc-tly over the ridge 9 . As in this case teeth are not posi-tioned in harmony with the surrounding muscula-ture. By employing neutral zone concept, the dislod-ging muscle energy can easily become a retentive and stabilizing force 9 . Beresin and Schisser 10 have suggested that den-ture teeth should be arranged in the neutral zone. After loss of teeth, a potential denture space or void exists within oral cavity. It is bounded by maxilla and soft palate above, by mandible and floor of mo-uth below, by tongue medially or internally and by muscles and tissue of lips and cheeks laterally or externally 10 . Within the denture space, neutral zone lies.
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13 Citations
0.71 Total Impact Points

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