DENTALTECHNOLOGY

SECTION EDITOR
DANIEL H. GEHL

A modification of the altered cast technique

Richard Bauman, D.D.S.,* and James DeBoer, D. D.S. **
U. S. Army DENTAC, Ft. Carson, Cola.

T he stability of a distal-extension
partial denture may be enhanced by the use of an
removable

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 sec-
tioning 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 Fig, 1. Altered cast impression tray and occlusion rim.
article is designed to accomplish the objectives of
cast correction while eliminating these disadvan-
tages.

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 Fig. 2. Border molded tray.
the resin tray after the impression material has set so
that the rim is short of contact with the opposing
teeth.
The opinions contained herein are those of the authors and are not 5. Add green stick modeling compound to the rim
to he construed as official or as reflecting the views of the U.S.
and make a centric jaw relation record (Fig. 4).
Army.
*Chief, Smith Dental Clinic. 6. Thoroughly chill the occlusal record and
**R&dent, Removable Prosthodontics, Walter Reed Army Med- replace the prosthesis in the mouth (Fig. 5).
ical Center, Washington, D.C. 7. Select a tray and make an irreversible hydrocol-

212 FEBRUARY 1982 VOLUME 47 NUMBER 2

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 rect extension of the denture base, control the
teeth (Fig. 6). Placement of the dentist’s fingers at relationship of tooth and tissue-bearing areas of the
the border of the edentulous ridge provides sufficient prosthesis, and make centric jaw relation records in a
support to ensure that the two phases of the impres- single clinical visit.
sion will not separate when the tray is withdrawn.
8. Pour a completely new master cast into the REFERENCE
combined impression. After the stone has set, remove
1. Academy of Denture Prosthetics: Principles, concepts. and
the metal tray and irreversible hydrocolloid impres- practices in prosthodontics. J PROSTHE~ DEWT 37203,
sion material. Care must be taken to avoid damaging 1977.
the jaw relation record which is embedded in the
Rcprinl requeststot
irreversible hydrocolloid impression. ~.RICHARD BAGMAN
9. Mount the new master cast on the articulator U. S. Am DENTAC
by means of the interocclusal record. Arrange the FT. CARSON, CO 80913
teeth and process the denture base.

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

THE JOURNAL OF PROSTHETIC DENTISTRY 213