Prosthetic rehabilitation of patient with combination syndrome: A case report

Combination syndrome (CS) is a dental condition that is commonly seen in patients with a completely edentulous maxilla and partially edentulous mandible with preserved anterior teeth. This syndrome consists of severe anterior maxillary resorption combined with hypertrophic and atrophic changes in different quadrants of maxilla and mandible hence it is one of the most challenging dental management in the oral rehabilitation cases. Several potential problems may arise such as bone loss from the anterior region of the maxillary jaw, maxillary flabby ridge formation and overeruption of unopposed mandibular anterior teeth. The success of the prosthetic rehabilitation in such patients depends on the achievement of stability, retention and proper support for the prosthesis to interfere with the combination syndrome mechanism and associated major causative factors like; the great magnitude of forces, the unsuitability of the denture foundation and particularly the unfavourable occlusal contact produced by the remaining natural teeth. In addition to that, the proper use of the prostheses in the masticatory process is also a crucial factor. This case report illustrates the management of a patient who presented with a completely edentulous maxillary arch opposing a completely dentate mandibular arch with a metal reinforced maxillary complete denture.