<![CDATA[Background: Delayed restoration in tooth loss can lead to tooth extrusion, bite collapse, and mastication difficulty, which reduce quality of life. Distal extension denture usage is challenging compared to bounded saddle dentures due to their comfort and denture longevity. Uprighting an impacted third molar can be a novel treatment option for transforming a free-end saddle into a bounded saddle. Purpose: The objective of this case report is to demonstrate reconstructive treatment of masticatory difficulty due to the prolonged loss of the first and second molars using orthodontic and prosthodontic approaches. Case: A 23-year-old female patient presented with complaints of protruding teeth and mastication difficulty on her left side. The patient was not recommended for odontectomy and implant. Incompetent lips with Class I skeletal patterns (ANB 3°), maxillary and mandibular incisor proclination (U1-NA, 35.87°; U1-NB, 49.07°), and lower lip protrusion were seen. Intraoral observations showed extrusion of #26 and #27, moderate lower arch crowding, fully impacted tooth #38, and missing teeth #36 and #37. Case Management: Facial profile improvement was achieved by extracting teeth #14, #24, and #44, and management of excessive space due to loss of teeth #36 and #37, followed by anterior retraction. Pre-prosthodontic preparation was managed by intrusion of teeth #26 and #27. A crown lengthening procedure was needed to expose the fully impacted #38, slight mesialization using temporary anchorage device was required due to distal movement limitation because of an external oblique mandible, and then uprighting of #38 was completed using copper nickel-titanium archwire sequences. Conclusion: The uprighting of the impacted third molar can be used as a novel strategy in transforming a distal extension denture into a bounded saddle denture that increases the patient's comfort and stability, and the longevity of the denture in a patient that was not recommended for odontectomy and implant.]]>
