Abstract
The altered cast impression technique is commonly used for the mandibular distal extension partially edentulous arches. The technique is relatively simple and improves the residual ridge to dentition relationship of the prosthesis. Due to the displaceability of the mucosa, free end saddles get displaced under occlusal load. A 45-year-female patient reported to the Department Of Prosthodontics and Crown-Bridge, College of Dental Surgery, B.P. Koirala Institute of Health Sciences, Nepal with a chief complaint of missing bilateral lower posterior teeth. Clinical examination revealed missing teeth w.r.t 36, 37, 45, 46, and 47. The treatment plan was made to rehabilitate the patient with removable partial denture using functional impression along with the altered cast technique. The altered cast technique is the best alternative technique in the case of distal extension cases because better tissue adaptability, proper extension of a denture base, equal stress distribution, better support, and stability can be achieved. Finally, increased patient comfort and function are obtained.
Highlights
The primary objective of prosthesis should be the preservation of oral structure.[1]
Multiple treatment options are available for distal extension cases, which include removable partial dentures, clasp retained removable partial dentures and implant supported fixed prosthesis
Replacement of missing teeth by removable cast partial denture using altered cast impression technique was planned, because this technique allows the ridge to be recorded in functional form due to which, when prosthesis is seated, it simultaneously derives support from the tooth and the denture base
Summary
The primary objective of prosthesis should be the preservation of oral structure.[1]. Due to cost and time constraint, patient rejected implant supported fixed prosthesis and opted for cast removable partial denture. Replacement of missing teeth by removable cast partial denture using altered cast impression technique was planned, because this technique allows the ridge to be recorded in functional form due to which, when prosthesis is seated, it simultaneously derives support from the tooth and the denture base. Master casts were poured (Fig. 2C).The cast was placed on a surveyor for examination and design of the cast metal framework (Fig.2D). Border molding was carried out in the usual fashion for the desired extension with green stick compound and secondary impression was made with zinc oxide eugenol paste (Fig. 3B), the fit of the metal framework to the teeth and soft tissues was checked during border moulding and secondary impression.
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