3.2.

3 PoIished surface
The polished surface of the prosthesis stretches from the borders of the base to the
synthetic teeth (Scott and Hunter 2008). This surface contains the form of the plate as
fine as the buccal and lingual surfaces of the acrylic in touch with the tongue, lips and
cheeks (Basker and Davenport 2002). Because of this, these pieces of dentures must
be formed in a suitable way to permit the function of the muscles to accord with the
prosthesis form.
Regions of the polished surface form might affect dissimilar actions, for instance, the
palatal vault of the upper prosthesis regarding speech (Scott and Hunter 2008).
The expression "neutral zone is an area between the tongue on one side and the
cheeks and the lips on the other where the muscular displacing forces playing on a
denture are the least. This is also known as the zone of minimal conflict (Basker and
Davenport 2002) and is usually used to illustrate the positioning of the synthetic teeth in
a place in which stability is obtained. This can often be accomplished by the clinician
and technician following the mentioned outlines. Nevertheless, in some stages, it might
be required to register an impression of the zone to permit maximum arrangement of
the synthetic teeth and the accurate forming of the polished surfaces (Gahan and
Walmsley 2005). This can be obtained by fabricating a solid denture base with occlusal
stops placed at the accurate vertical dimension. A tissue conditioner is an appropriate
material to register a functional impression that will show the dimension of the neutral
zone. The denture teeth are now formed and placed to accord with this, and the
polished surfaces are also formed so that they rest within this described zone. The
resulting teeth might well be very thin; however, as they are sited in a maximum location
for stability, the patient might be able to manage the prosthesis throughout function
more efficiently (Scott and Hunter 2008).

Uncommonly, instability of the maxillary denture is due to the coronoid process touching
an enormously thick buccal flange throughout opening. Suffering on opening is a
common symptom, but might be covered by a destabilizing intervention which can be
the main complaint (Lamb, 1993). The muscles of the cheeks, lips and tongue, along
with being of basic significance in the retention of dentures, are also able to cause
instability to the dentures. Displacement will happen if the polished surfaces have an
adverse slope (see Figure 3.2) and also if the prosthesis intervenes with the normal
position and functional action of the surrounding musculature. For instance, distal
movement of a lower prosthesis might be created too far labially. The teeth must
therefore be sited distant enough lingually to avoid this displacement, but not so far
away as to permit excessive tongue pressure (Basker and Davenport 2002).
Figure 3.2 Pressure from the bolus on the posterior part of the lower occlusal table,
which overlies a sloping part of the ridge, causes the lower denture to slide forwards (
Basker and Davenport 2002).


Irom rosthet|c 1reatment of the Ldentu|ous at|ent Iourth Ld|t|on

Act|ng through the po||shed surface
1he muscles of Lhe llps cheeks and Longue ln addlLlon Lo belng of fundamenLal lmporLance
ln Lhe reLenLlon of denLures are also capable of causlng denLure lnsLablllLy ulsplacemenL
wlll occur as menLloned earller lf Lhe pollshed surfaces have an unfavourable
slope (llg 43b) and also lf Lhe denLure lnLerferes wlLh Lhe hablLual posLure and
funcLlonal acLlvlLy of Lhe surroundlng musculaLure lor example dlsLal movemenL of a
lower denLure may be produced by Lhe lower llp lf Lhe anLerlor LeeLh are placed Loo far
lablally (llg 414) 1he LeeLh should Lherefore be placed [usL far enough llngually Lo prevenL
Lhls dlsplacemenL buL noL so far as Lo allow excesslve Longue pressure Lo develop
lL ls noL uncommon Lo see lower denLures LhaL are unsLable because Lhe posLerlor LeeLh
have been placed Loo far llngually under such condlLlons of resLrlcLed Longue space
movemenL of Lhe Longue durlng funcLlon wlll Lend Lo llfL Lhe denLure 1here ls an area
beLween Lhe Longue on one slde and Lhe cheeks and llps on Lhe oLher where Lhe muscular
dlsplaclng forces acLlng on a denLure are leasL 1hls area ls known as Lhe oeottol zooe or
zooe of mlolmol coofl lct oslLlonlng a prosLhesls wlLhln Lhls zone ls mosL lmporLanL for
Lhe lower denLure as Lhe physlcal reLenLlve forces are normally small and can do llLLle Lo
reslsL muscular dlsplacemenL
osLexLracLlon changes may lead Lo a gradual shlfLlng of Lhe neuLral zone lor example
lL ls common for posLerlor LeeLh Lo be exLracLed some conslderable Llme before
Lhe anLerlor LeeLh lf a parLlal denLure ls noL fl LLed Lhe Longue spreads laLerally lnLo Lhe
edenLulous space 1hls ln effecL moves Lhe neuLral zone laLerally as well as reduclng
lLs buccollngual dlmenslon so LhaL Lhere ls a reduced space ln whlch Lo place a denLure
1hls space mlghL be reesLabllshed aL leasL ln parL when a new compleLe denLure ls fl LLed
Powever Lhe modlfl caLlon ln Longue posLure and behavlour requlred Lo achleve Lhls
lncreases Lhe demand on Lhe paLlenL's ablllLy Lo adapL Some paLlenLs may fl nd lL dlffl culL
or even lmposslble Lo meeL Lhls challenge and so Lhe denLure could fall
Changes ln Lhe neuLral zone also occur beLween Lhe lower llp and Lhe Longue as a resulL
of posLexLracLlon changes affecLlng Lhe menLalls muscle 8esorpLlon of Lhe alveolar
bone leads Lo Lhe superlor fl bres of Lhe orlgln of Lhe menLalls muscle lylng on Lop of
Lhe resldual rldge and a llngual mlgraLlon of Lhe neuLral zone CerLalnly ln Lhese clrcumsLances
lL ls no longer posslble Lo poslLlon Lhe arLlfl clal LeeLh where once Lhe naLural ones
were slLuaLed
A furLher dlsLurbance of muscle balance can arlse as a consequence of lncorrecL Longue
posLure lf Lhe Longue Lakes up a 'defenslve posLure' Lowards Lhe back of Lhe mouLh a
lower denLure of whaLever deslgn wlll be unsLable lL ls necessary Lo explaln maLLers Lo
Lhe paLlenL and Lraln Lhe Longue Lo Louch Lhe llngual surfaces of Lhe lower lnclsors ln order
Lo resLore Lhe llngual balanclng force and Lhus sLablllLy (Llkeman 1997)


lrom omp|ete Denture rosthet|cs 3rd ed Ne|| Na|rn
1he LeeLh should be placed ln such a poslLlon LhaL Lhe forces from Lhe Longue are equallzed by Lhe
forces from Lhe llps and cheeks Lhey are Lhen sald Lo be ln Lhe neuLral zone 1he lower occlusal Lable
should be aL such a helghL LhaL Lhe Longue can easlly place Lhe food upon lL and also help hold Lhe
denLure down when Lhe mouLh ls open wlde and Lhe lower llp ls Lendlng Lo dlsplace Lhe denLure
posLerlorly
1he muscular forces wlll have lnfluenced Lhe poslLlons lnLo whlch Lhe naLural LeeLh erupLed and so Lhe
placlng of Lhe LeeLh ln Lhe neuLral zone ls accompllshed lf Lhey are placed ln Lhe approxlmaLe poslLlons
of Lhelr naLural predecessors A gulde Lo Lhls can be obLalned by conslderlng Lhe paLLern of bone
resorpLlon when Lhe LeeLh are losL
ln Lhe upper [aw resorpLlon occurs ln Lhe lablal and buccal areas and so Lhe resldual rldge ls Lo Lhe
palaLal slde of Lhe poslLlon occupled by Lhe naLural LeeLh 1hus Lhe arLlflclal LeeLh should be placed
lablally and buccally of Lhe resldual rldge lf Lhey are Lo be ln Lhe neuLral zone
ln Lhe lower [aw bone loss occurs on Lhe lablal slde ln Lhe anLerlor reglon equally on buccal and llngual
sldes ln Lhe premolar reglon and llngually ln Lhe molar reglon 1hus Lhe resldual rldge ls more llngual ln
Lhe anLerlor reglon abouL Lhe same ln Lhe premolar reglon and buccal ln Lhe posLerlor reglon
So Lhe arLlflclal LeeLh should be placed lablally of Lhe rldge anLerlorly over Lhe rldge ln Lhe premolar
reglon and sllghLly llngually ln Lhe molar reglon lf Lhe laLLer wlll glve a llngual overhang narrow LeeLh
should be used 1he naLural LeeLh poslLlons also lnfluence Lhe paLLern of movemenLs lnvolved ln speech
and lf Lhey are radlcally alLered speech musL be affecLed (llgures 132133)
When Lrylng ln Lhe wax denLures lnlLlally Lhe opporLunlLy ls Laken Lo yeL agaln check Lhe [aw
relaLlonshlps When you are saLlsfled LhaL Lhese are correcL Lhe poslLlon of Lhe LeeLh can Lhen be
checked and ad[usLed When Lhe wax denLures are saLlsfacLory a proLruded [aw relaLlonshlp ls recorded
whlch wlll be used Lo ad[usL Lhe condylar Lracks of Lhe arLlculaLor 1he arLlculaLor can be used Lo seL up
Lhe LeeLh Lo balance eccenLrlc occluslons