A Distinct Parallel Attachment System for the Rehabilitation of Kennedy’s Class 2 Partially Edentulous Arch – A Case Report

Abstract

Among the numerous techniques of oral rehabilitation, precision attachments are considered as a good treatment option in removable (RPD) as well as fixed partial dentures (FPD). Precision attachments enhance patient’s self-confidence and selfimage as they help in facilitating aesthetic, functional and retentive replacement of teeth that are missing in the oral cavity. They can improve the aesthetics by eliminating the clasp assembly in cast partial dentures (CPD). This particular case report explains the treatment sequence and approach for the utilisation of attachments in a Kennedy Class 2 situation. A successful removable partial denture includes a precise diagnosis with meticulous treatment planning. However, re-establishment of partially edentulous arch is particularly challenging in distal extension situations classified as Kennedy’s class 1 or 2 conditions.1 In such clinical cases, where a fixed prosthesis cannot be fabricated, a prosthodontist often suggests an implant retained prosthesis that is not routinely possible because of the insufficient available bone width and height.2 Thus to ensure functional and aesthetic substitution of lost teeth, an attachment secured RPD can be considered as a good treatment option in such cases. Attachments are constructed in a ready to place form (pre-fabricated) known as precision attachments. Another one is semi precision attachment where the segments have to be constructed by dentists or dental technicians because it requires casting for incorporating into fixed unit of restoration.3 Hence precision attachments are considered as possible alternatives when patients demand for a fixed restoration in distal extension cases. Various extra coronal attachments are available and used in distal extension cases. Preci-Sagix is considered as an ideal extra coronal attachment for removable partial dentures and also in over denture cases. It is accessible in two sizes, 1.7 mm mini or 2.2 mm standard and is selected according to the permitted space. The male component is available in three varieties, a plastic castable pattern (any hard alloy), cast to no prax (only non-precious alloy) and a threaded male and base ring (2.2 mm size only).4 These attachments produce vertical, horizontal and rotational movements during its function which supports the prosthesis by transferring harmful forces from the abutments to the supporting structures by its passive movement, which helps in the rehabilitation of distal extension cases.5 This case report explains restoration of partially edentulous arch by incorporating a Preci Sagix attachment in mandibular cast partial denture retained by a six-unit FPD and a maxillary conventional cast partial denture.