Signs of Combination Syndrome and removable partial denture wearing

Camila Maria Bastos Machado De Resende,José Werbeson Nogueira De Queiroz,Kássia De Carvalho Dias,Michel Platini Pereira Do Rego,Jaiane Augusta Medeiros Ribeiro,Adriana Da Fonte Porto Carreiro,Gustavo Augusto Seabra Barbosa,Ângelo Giuseppe Roncalli Da Costa Oliveira

doi:10.1590/1807-2577.1041

Abstract

Introduction: Combination Syndrome (CS) is a pathological condition observed in maxillary complete denture (CD) and mandibular removable partial denture (RPD) wearers. Purpose: The aim of this study was to observe and measure the prevalence of CS signs in treatment-seeking wearers of maxillary CD associated or not with RPD (mandibular Kennedy Class I). The association between RPD wearing and the number of CS clinical signs was also evaluated. Material and method: The sample included 62 patients seen at the Department of Dentistry, Federal University of Rio Grande do Norte (UFRN). A clinical oral examination was conducted to assess the presence of specific clinical signs of CS as described by Kelly (1972): bone resorption in the maxillary anterior region, tuberosity overgrowth, palatal papillary hyperplasia, extrusion of mandibular anterior teeth and bone resorption in the mandibular posterior region. The chi-square test at the 95% level of significance was used to test the association between dependent and independent variables. Result: Mandibular resorption was the most frequent complication (93.5%). There was a statistically significant difference between RPD wearers and non-wearers with regard to extrusion of mandibular anterior teeth (p = 0.045). Conclusion: Within the limitations of the present study, a high prevalence of CS clinical signs was observed, but no association between RPD wearing and syndrome characteristics was found.

Highlights

Combination Syndrome (CS) is a pathological condition observed in maxillary complete denture (CD) and mandibular removable partial denture (RPD) wearers
Prevention of degenerative changes caused by complete dentures occluding with bilateral distal-extension removable partial dentures is possible through an appropriate treatment plan and with periodic review of the RPDs and remaining teeth
The sample was selected from patients with a completely edentulous maxilla wearing maxillary complete dentures (CD) and with a bilateral partially edentulous mandible (Kennedy Class I), wearing or not wearing a mandibular removable partial denture (RPD), who were seeking treatment at the University of Rio Grande do Norte (UFRN) Prosthodontics Clinic between April and June 2011

Summary

Introduction

Combination Syndrome (CS) is a pathological condition observed in maxillary complete denture (CD) and mandibular removable partial denture (RPD) wearers. Kelly,[2] in 1972, introduced the term Combination Syndrome when analyzing six patients wearing a maxillary complete denture occluding with a distal-extension removable partial denture (Kennedy Class I RPD). The characteristic features of this syndrome include: loss of bone from the anterior portion of the maxillary ridge, overgrowth of the tuberosities, papillary hyperplasia of the mucosa of the hard palate, extrusion of mandibular anterior teeth, and loss of alveolar bone and ridge height beneath the removable partial denture bases. Prevention of degenerative changes caused by complete dentures occluding with bilateral distal-extension removable partial dentures is possible through an appropriate treatment plan and with periodic review of the RPDs and remaining teeth. Treatment alternatives such as preservation of posterior teeth to support mandibular RPDs and use of overlay-type complete dentures provide more adequate occlusal stability and should be considered as treatment options[2]

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