DENTALTECHNOLOGY

SECTION EDITOR

DANIEL

H. GEHL

A modification
Richard Bauman, D.D.S.,*
U. S. Army DENTAC,

of the altered cast technique

and James DeBoer, D. D.S. **
Cola.

Ft. Carson,

he stability of a distal-extension removable partial denture may be enhanced by the use of an altered cast impression technique. This technique permits the clinician to precisely establish the extent of denture base coverage and develop an accurate relationship between that portion of the prosthesis which contacts the teeth and that portion which covers the edentulous ridge. One disadvantage of the altered cast procedure is the difficult laboratory phase, which involves sectioning the master cast, attaching the framework to the dentulous portion of the cast, and keeping the framework in position while new stone is poured in the edentulous parts. Another disadvantage is that occlusal records cannot normally be made at the same visit at which the altered cast impression is made. The modified technique described in this article is designed to accomplish the objectives of cast correction while eliminating these disadvantages.

Fig, 1. Altered

cast impression

tray and occlusion rim.

TECHNIQUE
1. Attach an acrylic resin tray to the framework of the partial denture in the edentulous area, and add a wax occlusion rim to the tray (Fig. 1). 2. Functionally border mold the tray using green stick modeling compound (Fig. 2). 3. Make a corrective wash impression of the edentulous ridge. Elastic impression materials or fluid wax may be used according to the preferences of the dentist (Fig. 3). Care must be taken to ensure that all occlusal rests are firmly seated while the corrective impression is being made. 4. Reduce the occlusion rim which is attached to the resin tray after the impression material has set so

Fig. 2. Border

molded

tray.

The opinions contained herein are those of the authors and are not to he construed as official or as reflecting the views of the U.S. Army. *Chief, Smith Dental Clinic. **R&dent, Removable Prosthodontics, Walter Reed Army Medical Center, Washington, D.C.

that the rim is short of contact with the opposing teeth. 5. Add green stick modeling compound to the rim and make a centric jaw relation record (Fig. 4). 6. Thoroughly chill the occlusal record and replace the prosthesis in the mouth (Fig. 5). 7. Select a tray and make an irreversible hydrocol-

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FEBRUARY

1982

VOLUME

47

NUMBER

ALTERED

CAST TECHNIQUE

Fig. 3. Corrective wash imuression.

Fig. 4. Making interocclusal

centric jaw relation record.

Fig.

6.

Completed two-stage impression

loid impression over the prosthesis and remaining teeth (Fig. 6). Placement of the dentists fingers at the border of the edentulous ridge provides sufficient support to ensure that the two phases of the impression will not separate when the tray is withdrawn. 8. Pour a completely new master cast into the combined impression. After the stone has set, remove the metal tray and irreversible hydrocolloid impression material. Care must be taken to avoid damaging the jaw relation record which is embedded in the irreversible hydrocolloid impression. 9. Mount the new master cast on the articulator by means of the interocclusal record. Arrange the teeth and process the denture base.

rect extension of the denture base, control the relationship of tooth and tissue-bearing areas of the prosthesis, and make centric jaw relation records in a single clinical visit.

REFERENCE
1. Academy practices 1977. of Denture Prosthetics: in prosthodontics. J Principles, PROSTHE~ concepts. and DEWT 37203,

Rcprinl

requests tot

~.RICHARD

BAGMAN U. S. Am DENTAC FT. CARSON, CO 80913

SUMMARY
The modification of the altered cast tehnique as described permits the dentist to determine the cor-

THE JOURNAL

OF PROSTHETIC

DENTISTRY

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