Improving Tissue Support- Altered Cast Technique

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Cast partial denture made using altered cast technique creates an environment in which the teeth and the edentulous tissues support the denture bases as compatible as possible, resulting in a more stable cast partial denture. The tissues of the edentulous ridge in distal extension removable partial denture are liable to be displaced under occlusal pressure. This is a result of the displaceability of the mucosa. The difference between the resiliency of the residual ridge tissues and the teeth causes disparity of support, that causes the denture to rotate about its distal abutment, inducing heavy tortional stresses on the teeth and possible traumatisation of alveolar ridge. Studies have proved that better support and stability can be achieved in distal extension cases using functional impression along with altered cast technique. The following article is a case report of a distal extension cast partial denture using altered cast technique for better tissue adaptability and stress distribution. For recording Kennedy’s class I and II edentulous areas, optimum residual ridge coverage with a well fitting denture base is required. This reduces stresses, preserving the remaining supporting structures which can be achieved with the use of altered cast technique.

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The cast partial framework was used as a part of the custom tray for recording the functional impression. Spacer wax (DPI) was adapted on the saddle area of the framework and acrylic custom tray was made using Self cure acrylic resin material (DPI). The custom tray was checked in the patient’s mouth for correct extension. Border moulding was done using low fusing impression compound (green stick, DPI). Spacer wax was removed to provide space for the wash impression material. Tray was coated with a layer of adhesives so that the elastomeric impression material adheres to it. Wash impression made using polyether impression material (3M, ESPE). The master cast was sectioned into 3 pieces with the help of a hand saw and the distal edentulous area was removed. The wash impression made on the framework was placed on the sectioned master cast making sure that it seats completely in the rest seat areas.

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Several functional methods have been proposed for recording the edentulous area and the abutment teeth. An altered cast technique for fabricating cast partial denture was used in the above article. This impression technique helps in registering and co-relating tissues of different resiliency. This improves the stability and support of the denture, resulting in optimal load distribution. : An altered cast technique is a way better and faster as compared to other techniques. In this technique the cast partial framework is kept ready before the recording of functional impression. Because of the correct fit of the cast partial framework this technique helps in recording the hard and soft tissues in a better way. Thus, it can be routinely utilized for the recording of distal extension area.

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