Revista de Odontologia da UNESP
https://revodontolunesp.com.br/journal/rou/article/doi/10.1590/1807-2577.1041
Revista de Odontologia da UNESP
Original Article

Signs of Combination Syndrome and removable partial denture wearing

Sinais da Síndrome da Combinação e o uso de prótese parcial removível

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

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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.

Keywords

Denture, partial, removable, denture, complete, bone resorption

Resumo

Introdução: A Síndrome da Combinação (SC) é uma condição patológica associada aos pacientes usuários de prótese total maxilar e prótese parcial removível (PPR) mandibular. Objetivo: Observar e mensurar a prevalência dos sinais da Síndrome da Combinação encontrados em pacientes usuários de prótese total maxilar na presença ou ausência de PPR mandibular (Classe I de Kennedy); e averiguar uma possível associação entre a utilização de PPR e a prevalência dos sinais clínicos da síndrome. Material e método: A amostra foi composta por 62 pacientes atendidos no Departamento de Odontologia da Universidade Federal do Rio Grande do Norte (UFRN). O exame clínico intrabucal foi realizado para a verificação da presença ou ausência dos sinais clínicos específicos da Síndrome da Combinação, descrita por Kelly (1972): reabsorção óssea na região anterior da maxila, aumento das tuberosidades, hiperplasia papilar palatina, extrusão dos dentes naturais inferiores anteriores e reabsorção óssea posterior mandibular (variáveis dependentes). Para determinação da associação entre as variáveis dependentes e independentes (uso de PPR inferior e tempo de edentulismo superior), foi utilizado o teste qui-quadrado com significância de 95%. Resultado: A característica mais frequente foi a presença de reabsorção mandibular (93,5%). Quanto à associação entre o uso de PPR inferior e as características da Síndrome da Combinação, só houve diferença estatisticamente significativa entre portadores e não portadores de PPR com relação à extrusão dos dentes inferiores anteriores (p = 0,045). Conclusão: Dentro das limitações deste estudo, verificou-se que os sinais clínicos da Síndrome da Combinação foram bastante prevalentes, e não foi observada associação entre o uso de PPR e as características da Síndrome.

Palavras-chave

Prótese parcial removível, prótese total, reabsorção óssea.

References

 


1. The glossary of prosthodontic terms. J Prosthet Dent. 2005 July; 94(1): 10-92. http://dx.doi.org/10.1016/j.prosdent.2005.03.013. PMid:16080238

2. Kelly E. Changes caused by a mandibular removable partial denture opposing a maxillary complete denture. 1972. J Prosthet Dent. 2003 Sept; 90(3): 213-9. http://dx.doi.org/10.1016/S0022-3913(03)00240-3. PMid:14503534

3. Saunders TR, Gillis RE Jr, Desjardins RP. The maxillary complete denture opposing the mandibular bilateral distal-extension partial denture: treatment considerations. J Prosthet Dent. 1979 Feb; 41(2): 124-8. http://dx.doi.org/10.1016/0022-3913(79)90292-0. PMid:366110

4. Salvador MCG, do Valle AL, Ribeiro MCM, Pereira JR. Assessment of the prevalence index on signs of combination syndrome in patients treated at Bauru School of Dentistry, University of Sao Paulo. J Appl Oral Sci. 2007 Feb; 15(1): 9-13. http://dx.doi.org/10.1590/S1678-77572007000100003. PMid:19089092

5. Kelsey CC. Alveolar bone resorption under complete dentures. J Prosthet Dent. 1971 Feb; 25(2): 152-61. http://dx.doi.org/10.1016/0022- 3913(71)90101-6. PMid:4924826

6. Tolstunov L. Combination syndrome: classification and case report. J Oral Implantol. 2007; 33(3): 139-51. http://dx.doi.org/10.1563/1548- 1336(2007)33[139:CSCACR]2.0.CO;2. PMid:17674680

7. Shen K, Gongloff RK. Prevalence of the ‘combination syndrome’ among denture patients. J Prosthet Dent. 1989 Dec; 62(6): 642-4. http:// dx.doi.org/10.1016/0022-3913(89)90582-9. PMid:2585321

8. MacEntee MI, Glick N, Stolar E. Age, gender, dentures and oral mucosal disorders. Oral Dis. 1998 Mar; 4(1): 32-6. http://dx.doi. org/10.1111/j.1601-0825.1998.tb00252.x. PMid:9655042

9. Xie Q, Ainamo A, Tilvis R. Association of residual ridge resorption with systemic factors in home-living elderly subjects. Acta Odontol Scand. 1997 Oct; 55(5): 299-305. http://dx.doi.org/10.3109/00016359709114968. PMid:9370028

10. Coelho CM, Sousa YT, Daré AM. Denture-related oral mucosal lesions in a Brazilian school of dentistry. J Oral Rehabil. 2004 Feb; 31(2): 135-9. http://dx.doi.org/10.1111/j.1365-2842.2004.01115.x. PMid:15009597

11. Canger EM, Celenk P, Kayipmaz S. Denture-related hyperplasia: a clinical study of a Turkish population group. Braz Dent J. 2009; 20(3): 243-8. http://dx.doi.org/10.1590/S0103-64402009000300013. PMid:19784472

12. Jo’ zefowicz W. The influence of wearing dentures on residual ridges: a comparative study. J Prosthet Dent. 1970 Aug; 24(2): 137-44. http:// dx.doi.org/10.1016/0022-3913(70)90136-8. PMid:5271099

13. Campbell RL. A comparative study of the resorption of the alveolar ridges in denture-wearers and non-denture-wearers. J Am Dent Assoc. 1960 Feb; 60: 143-53. PMid:13807301.

14. Tolstunov L. Management of biomechanical complication of implant-supported restoration of a patient with combination syndrome: a case report. J Oral Maxillofac Surg. 2009 Jan; 67(1): 178-88. http://dx.doi.org/10.1016/j.joms.2008.09.013. PMid:19070766

15- Cunha LDAP, Rocha EP, Pellizzer EP. Prevalência da Síndrome de Kelly em usuários de prótese parcial removível. RGO – Rev Gaúcha Odontol. 2007 Out-Dez; 55(4):325-8.

16. Cunha LD, Pellizzer EP, Verri FR, Falcón-Antenucci RM, Goiato MC. Influence of ridge inclination and implant localization on the association of mandibular Kennedy class I removable partial denture. J Craniofac Surg. 2011 May; 22(3): 871-5. http://dx.doi.org/10.1097/ SCS.0b013e31820f7d6a. PMid:21558932

17. Palmqvist S, Carlsson GE, wall B. The combination syndrome: a literature review. J Prosthet Dent. 2003 Sept; 90(3): 270-5. http://dx.doi. org/10.1016/S0022-3913(03)00471-2. PMid:12942061

18. Tolstunov L. Combination syndrome symptomatology and treatment. Compend Contin Educ Dent. 2011 Apr; 32(3): 62-6. PMid:21560744.

 

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