Free-end saddles are liable to be displaced under occlusal pressure. This is as a result of the displaceability of the mucosa. The altered cast technique is employed to try and prevent this by making an impression of the mucosa under controlled pressure. The metal framework was constructed on a cast produced by a mucostatic impression material. Base plates were then constructed in self-cured acrylics on the framework in the saddle areas, and these are close fitting. Border molding was carried out; impression was made with zinc oxide eugenol impression paste.In the laboratory, the free-end saddle areas on the master cast are sectioned off. The denture is then positioned on the model and the new saddle areas are poured. The resulting model represents the free-end saddle areas under conditions, which mimic functional load. Denture construction then continues as normal. The distribution of loading of the free-end saddles is improved and denture is more stable.

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The National Health and Nutrition Examination Survey for 1999-2002 recorded that 21% of children and 23% of adults had untreated dental caries in the permanent dentition. Ten percent of adults had untreated root caries. Though considerable literature exists on rampant caries in children, because of the lack of strict diagnostic criteria, there is little published data on the incidence and prevalence of adult rampant dental caries. Diagnosis requires assessment of caries activity, oral dryness, dietary risks and medical risks. Management of this condition requires a disease control phase involving Caries risk assessment and evaluation, with reassessment throughout the program. Restoration of all cavitated lesions and use of fluoride releasing materials followed by preventive and therapeutic control strategies, including diet modification. This is followed by extensive multidisciplinary corrective phase involving endodontic, periodontal and prosthetic rehabilitation. The maintenance phase involves preventive and therapeutic agents employed from several different fronts simultaneously, tailored to the source of the caries risk. This case report highlights the importance of proper diagnosis, treatment planning and comprehensive multidisciplinary approach to achieve the function, esthetics and to regain self confidence of the patient in a rare case of adult rampant dental caries.

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