Combined Prosthesis with Extracoronal Castable Precision Attachments

Satisfactory restoration in a patient with a partially edentulous situation can be challenging especially when unilateral or bilateral posterior segment of teeth is missing. Successful restoration can be done with various conventional and contemporary treatment options. One such treatment modality is attachment-retained cast partial dentures. This paper describes a case report of a patient with maxillary bilateral distal extension edentulous span restored with a cast partial denture having an extracoronal castable precision attachment (RHEIN 83 OT CAP attachments system). 1. Introduction Esthetically and functionally successful prosthetic rehabilitation requires careful attention and meticulous treatment planning. Rehabilitation of partially edentulous arch can be challenging when it is a distal extention situation classified under Kennedy’s class I and class II situations [1]. In such a condition, a fixed partial denture cannot be fabricated because of missing distal abutment. Implant-supported prosthesis can be planned, but it is sometimes not feasible due to insufficient amount of bone and economic reason. So, in such situation an acrylic partial denture or a cast partial denture is largely preferred. Cast partial dentures are made retentive by the use of retainers and precision attachment components [2]. Precision attachments could be extracoronal and intracoronal. Attachment-retained cast partial dentures facilitate both esthetic and functional replacement of missing teeth. Studies have shown a survival rate of 83.35% for 5 years, of 67.3% up to 15 years, and of 50% when extrapolated to 20 years [3, 4]. This paper describes a case report of a patient with maxillary bilateral distal extension Kennedy’s class I condition which is prosthetically restored by a cast partial denture retained using a extracoronal castable precision attachment (RHEIN 83 OT CAP attachments system). 2. Case Report A 50-year-old male reported with missing maxillary molar teeth bilaterally. He gave a history of unsatisfactory acrylic partial denture wearing. On intraoral examination, it was noted that the patient had missing maxillary I, II, and III molars bilaterally (Kennedy’s class I) and completely edentulous mandibular arch. The remaining teeth in maxillary arch were periodontally stable (Figure 1). Figure 1: Maxillary arch showing Kennedy’s class 1 situation. After complete clinical and radiographic examination, a prosthetic treatment plan was set up. Combined prosthesis with extracoronal precision attachment was planned for maxillary bilateral distal extension arch and