Altered cast technique for management of large maxillary defects

Abstract

Restoring defects of acquired causes in the maxilla presents an unique challenge to the prosthodontist due to the sheer size and anatomic nature of the defect itself. Since most of the maxillary defects are intraoral in nature, the prosthodontist should decide on the extent of the defect that can be restored. Recording, fabricating, inserting and removing the prosthesis is limited by mouth opening and undercuts present. The conventional techniques of impression making of large maxillofacial defects have inherent deficiencies as the visualization of the amount of extension that can be worn or inserted by the patient comfortably is difficult and also; due to limited mouth opening, custom fabricated trays can be quite difficult to insert. These difficulties can be circumvented by using altered cast technique. This article describes the technique of fabricating prosthesis for large maxillary defect using altered cast technique.