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<p>Foreword ix</p> <p>Preface  xi</p> <p>About the Companion Website xiii</p> <p><b>1 Assessment of Edentulous Patients 1</b></p> <p>Introduction  1</p> <p>The Patient Interview 1</p> <p>Patient Interview: Age 2</p> <p>Patient Interview: Attitude 2</p> <p>Patient Interview: Expectations 2</p> <p>Patient Interview: Chief Complaint 3</p> <p>Patient Interview: General Health 3</p> <p>Patient Interview: Complete Denture Experience 3</p> <p>Patient Interview: Denture Remake Frequency 4</p> <p>Patient Interview: Patient Satisfaction 4</p> <p>Patient Interview: Photographs, Diagnostic Casts, and Radiographs 4</p> <p>The Facial Analysis  4</p> <p>Facial Analysis: Facial Tissue Tone  5</p> <p>Facial Analysis: Tooth and Denture Base Display  6</p> <p>Facial Analysis: Midlines 6</p> <p>Facial Analysis: Lip Mobility 7</p> <p>Facial Analysis: Lip Dimension  7</p> <p>Prosthetic Factors 8</p> <p>Prosthetic Factors: Vertical Dimensions 8</p> <p>Prosthetic Factors: Existing Dentures 8</p> <p>Prosthetic Factors: Skeletal Relationship 9</p> <p>Prosthetic Factors: Saliva 9</p> <p>Prosthetic Factors: Oral Tolerance 10</p> <p>Prosthetic Factors: Temporomandibular Joints 10</p> <p>Prosthetic Factors: Oral Cancer Review 10</p> <p>Oral Characteristics 11</p> <p>Oral Characteristics: Palatal Throat Form 11</p> <p>Oral Characteristics: Arch Size 11</p> <p>Oral Characteristics: Maxillary Ridge Height 11</p> <p>Oral Characteristics: The Palate 12</p> <p>Oral Characteristics: Maxillary Ridge Contour 13</p> <p>Oral Characteristics: The Maxillary Denture Foundation 13</p> <p>Oral Characteristics: Mandibular Ridge Height 14</p> <p>Oral Characteristics: Mandibular Ridge Contour 14</p> <p>Oral Characteristics: Mandibular Muscle Attachments 14</p> <p>Oral Characteristics: Mandibular Denture Foundation  15</p> <p>Oral Characteristics: Maxillary Tuberosity Curve 15</p> <p>Oral Characteristics: Vestibule 16</p> <p>Oral Characteristics: Frenula Attachments 16</p> <p>Oral Characteristics: Pterygomandibular Raphe 16</p> <p>Oral Characteristics: Denture Bearing Soft Tissues 16</p> <p>Oral Characteristics: Retromolar Pads 17</p> <p>Oral Characteristics: Maxillary Ridge Crest to Resting Lip Length (Esthetic Space) 17</p> <p>Oral Characteristics: Mandibular Ridge Crest to Resting Lip Length (Esthetic Space) 17</p> <p>Oral Characteristics: Maximal Oral Opening 17</p> <p>Oral Characteristics: Retromylohyoid Space 18</p> <p>Oral Characteristics: Tongue Size 19</p> <p>Oral Characteristics: Tongue Position 19</p> <p>Oral Characteristics: The Neutral Zone 20</p> <p>Summary  21</p> <p>References  21</p> <p><b>2 Orthopedic Resolution of Mandibular Posture 25</b></p> <p>Introduction 25</p> <p>Conditioning Abused Tissues and Stabilizing the Existing Prosthesis 26</p> <p>Materials Properties and Technique 26</p> <p>Technique 26</p> <p>Re?-establishing Orthopedic Mandibular Position 28</p> <p>Summary  33</p> <p>References  33</p> <p><b>3 Definitive Impressions 35 </b></p> <p>Preimpression Considerations 35</p> <p>Background  35</p> <p>Impression Fundamentals 35</p> <p>Impression Materials 36</p> <p>Edentulous Impression Trays 37</p> <p>Technique for Making Single Appointment Definitive Impressions for Conventional Complete Dentures 37</p> <p>Tray Selection and Tray Adaptation 37</p> <p>Fabrication of Tray Stops 38</p> <p>Border Molding the Impression Tray 39</p> <p>Final (Definitive) Impression  41</p> <p>Techniques for Making Single Appointment Definitive Impressions for Implant?-Assisted Complete Dentures and Immediate Dentures  43</p> <p>Attachment Selection 43</p> <p>Implant?-Retained Overdentures 43</p> <p>Tray Selection 43</p> <p>Impression Technique 44</p> <p>Implant?-Retained and Supported Overdentures 45</p> <p>Immediate Dentures 46</p> <p> Master Cast Production 47</p> <p>Summary  48</p> <p>References  48</p> <p><b>4 Fabricating Record Bases, Occlusal Rims, and Mounting a Central Bearing Device 51</b></p> <p>Introduction 51</p> <p>Fabrication of Record Base and Occlusal Rims 51</p> <p>Fabrication of Maxillary Wax Occlusal Rim 52</p> <p>Fabrication of Neutral Zone Mandibular Occlusal Rim 56</p> <p>Technique 56</p> <p>Jaw Recorder Device (Central Bearing Device) 59</p> <p>Jaw Recorder Device Assembly  59</p> <p>Mounting the Jaw Recorder Device on Record Bases 59</p> <p>Mounting of the Jaw Recorder for Implant Overdentures 61</p> <p>Mounting the Jaw Recorder Device on Partially Edentulous Arches 61</p> <p>Procedure 62</p> <p>Summary  62</p> <p>References  64</p> <p><b>5 Developing an Esthetic Blueprint  65</b></p> <p>Introduction 65</p> <p>Contouring and Shaping the Maxillary Occlusal Rim 65</p> <p>Summary  72</p> <p>References  72</p> <p><b>6 Registering the Maxillo?-Mandibular Jaw Relationship 75</b></p> <p>Introduction 75</p> <p>Facebow Recording  75</p> <p>Centric Relation Recording for the Edentulous Patient 76</p> <p>Centric Relation Recording for the Partially Dentate Patient 83</p> <p>Summary 86</p> <p>References  86</p> <p><b>7 Neutral?-Zone Registration  89</b></p> <p>Introduction 89</p> <p>Recording the Physiologic Neutral Zone for Edentulous Patients 89</p> <p>Technique 90</p> <p>Recording the Physiologic Neutral Zone for a Dentate Patient 94</p> <p>Technique 94</p> <p>Summary  96</p> <p>References  96</p> <p><b>8 Second Laboratory Procedure: Selection and Arrangement of Prosthetic Teeth 99</b></p> <p>Introduction 99</p> <p>Indexing the Esthetic Blueprint Record 99</p> <p>Indexing the Neutral Zone Record 100</p> <p>Selection of Anterior Teeth 101</p> <p>Maxillary Anterior Teeth Arrangement 102</p> <p>Mandibular Anterior Teeth Arrangement  103</p> <p>Selection of Posterior Teeth 105</p> <p>Mandibular Posterior Teeth Arrangement 106</p> <p>Maxillary Posterior Tooth Arrangement 108</p> <p>Tooth Selection and Arrangement for the Partially Edentulous Patient 109</p> <p>Summary  111</p> <p>References 111</p> <p><b>9 Trial Placement Appointment 113</b></p> <p>Trial Placement 113</p> <p>Evaluation of Esthetics  113</p> <p>Evaluation of Phonetics 114</p> <p>Evaluation of Occlusal Vertical Dimension (OVD)  116</p> <p>Evaluation of Centric Contact Position 116</p> <p>External Impressions 117</p> <p>Technique 118</p> <p>Summary  124</p> <p>References 125</p> <p><b>10 Denture Placement 127</b></p> <p>Introduction 127</p> <p>Placement of Immediate Dentures 127</p> <p>Placement Procedures 129</p> <p>Evaluation and Adjustment of Intaglio Surface 129</p> <p>Technique 129</p> <p>Evaluation and Adjustment of Denture Borders 131</p> <p>Evaluating the Cameo Surface 133</p> <p>Occlusal Evaluation and Correction 133</p> <p>Subtractive Correction Technique 135</p> <p>Additive Correction Technique 136</p> <p>Patient Education and Instructions 137</p> <p>Technique for Adhesive Application 138</p> <p>Technique for Adhesive Removal 138</p> <p>Home Care Instructions for Denture Patients 140</p> <p>Postplacement Problems with New Dentures 140</p> <p>Retention Problems 140</p> <p>Soreness 141</p> <p>Sore Throat 141</p> <p>Speech Problems 141</p> <p>Gagging 141</p> <p>Summary  142</p> <p>References 142</p> <p><b>11 Use of CAD/CAM Technology for Recording and Fabricating Neutral?-Zone Dentures  145</b></p> <p>Introduction 145</p> <p>Registering the Neutral Zone during Impression Making 145</p> <p>Technique 145</p> <p>Registering the Neutral Zone during Maxillo?-Mandibular Records 147</p> <p>Technique 147</p> <p>Registering the Neutral Zone during the Trial Placement 147</p> <p>Technique 147</p> <p>Summary  150</p> <p>References 151</p> <p>Index 153</p>

<p><b> The authors<br> Joseph J. Massad,</b> DDS, is Associate Professor in the Department of Prosthodontics at the University of Tennessee Health Center, School of Dentistry in Memphis, Tennessee, USA; Adjunct Associate Professor in the Department of Prosthodontics and Operative Dentistry at Tufts University School of Dental Medicine in Boston, Massachusetts, USA; Adjunct Associate Professor in the Department of Comprehensive Dentistry at the University of Texas Health Science Center, School of Dentistry in San Antonio, Texas, USA; Adjunct Associate Professor in the Department of Restorative Dentistry at Loma Linda University School of Dentistry, in Loma Linda, California, USA; Clinical Assistant Professor at the University of Oklahoma College of Dentistry in Oklahoma City, Oklahoma, USA; and Private Practice in Tulsa, Oklahoma, USA. <p><b> David R. Cagna,</b> DMD, MS, is a Professor in the Department of Prosthodontics, Associate Dean of Postgraduate Affairs & Director of Advanced Prosthodontics at the University of Tennessee Health Science Center, College of Dentistry, Memphis, Tennessee, USA; Diplomate & Director of the American Board of Prosthodontics; and Fellow of the American College of Prosthodontists. <p><b> Charles J. Goodacre,</b> DDS, MSD, is Distinguished Professor in the Department of Restorative Dentistry at Loma Linda University School of Dentistry in Loma Linda, California, USA; and Diplomate and Past-President of the American Board of Prosthodontics. <p><b> Russell A. Wicks,</b> DDS, MS, is Professor and Chairman in the Department of Prosthodontics at the University of Tennessee Health Science Center, College of Dentistry in Memphis, Tennessee, USA. <p><b> Swati A. Ahuja,</b> BDS, MDS, is Adjunct Assistant Professor in the Department of Prosthodontics at the University of Tennessee Health Science Center, College of Dentistry in Memphis, Tennessee, USA; and Prosthodontic Consultant at Lutheran Medical Center in New York City, New York, USA.

<p> Understanding the importance of the neutral zone is key to successful prosthodontic treatment. In <i>Application of the Neutral Zone in Prosthodontics,</i> Dr. Joseph Massad and his colleagues present methods and techniques for constructing predictable complete, implant-supported, and implant-retained prostheses. In addition to the incorporation of the neutral zone technique, the authors have included the inter-arch tracer and external surface impressions into the denture fabrication process. All the steps of denture fabrication, including patient examination, impression making, occlusal, esthetic, and neutral zone records, try-in, and placement, have been described in detail, including the laboratory procedures. <p> Successful denture therapy can be challenging for less experienced practitioners. As a consequence, many dentists opt to not offer complete dentures as part of their practices. This book addresses the most common problems with dentures and provides time-tested techniques for successful clinical outcomes. <ul> <li>Illustrates every technique described with more than 300 color photos</li> <li>Covers all phases of complete denture therapy</li> <li>Presents a step-by-step assessment and examination protocol</li> <li>Details the importance of accurate diagnosis and prognosis prior to committing to treatment</li> <li>Describes an alternative to traditional impressioning procedures that can be accomplished in a single appointment</li> <li>Includes access to a companion website with video clips and student handouts, with teaching PowerPoints available for instructors</li> </ul> <br> <p> An ideal guide for dental students and prosthodontic and advanced general dentistry residents, <i>Application of the Neutral Zone in Prosthodontics</i> also has much to offer experienced general practitioners and prosthodontists at every stage of their careers.

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