Combination syndrome: treatment with dental implants.

Private Practice, Trail, British Columbia, Canada.
Implant Dentistry (Impact Factor: 1.11). 02/2003; 12(4):300-5. DOI: 10.1097/01.ID.0000094033.62974.BB
Source: PubMed

ABSTRACT Occlusal plane problems are often not evaluated adequately. They can be left untreated or improperly treated. This article reviews one such problem known as Combination Syndrome. The treatment method described involves using a fixed mandibular prosthesis over implants that have been placed immediately after dental extractions.

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    ABSTRACT: To assess the success and marginal bone loss, after 1 year of loading, of implants placed in anatomic buttresses of atrophic maxillae to rehabilitate patients with combination syndrome. A case series retrospective study of 22 patients with combination syndrome who were treated with implants in anatomic buttresses in the atrophic maxilla was performed. The inclusion criteria were Classes IV and V Cawood and Howell maxillary atrophy, rehabilitation with implants placed in anatomic buttresses, the presence of anterior remnant teeth in the mandible, and a minimum follow-up of 12 months after implant loading. The criteria of Buser et al were used to evaluate implant success, and marginal bone loss was measured on periapical radiographs. Statistical analysis was performed to relate implant success and marginal bone loss to gender, degree of maxillary atrophy, implant technique, and prosthesis type. A total of 18 patients fulfilled the inclusion criteria. A total of 117 implants were placed; 32 were placed with the conventional technique in the alveolar ridges with enough height and width, 35 were positioned palatally, 30 were tilted in the frontomaxillary buttress, 10 were placed in the pterygomaxillary area, 6 were placed in the nasopalatine canal, and 4 were zygomatic implants. The follow-up ranged from 1 to 7 years after implant loading. Of the 117 implants, 7 failed, for an implant success rate of 94%. The mean marginal bone loss was 0.63 mm. A statistically significant relation was found between bone loss and implant placement technique and the level of maxillary atrophy, being greater in tilted implants and in Class V Cawood and Howell maxillary atrophy. Implants in anatomic buttresses allow rehabilitation of atrophic maxillae in patients with combination syndrome. The implant success rate was high, and a mean marginal bone loss of 0.63 mm was recorded.
    Journal of oral and maxillofacial surgery: official journal of the American Association of Oral and Maxillofacial Surgeons 05/2012; 70(5):e322-30. DOI:10.1016/j.joms.2012.01.012 · 1.58 Impact Factor
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    ABSTRACT: The purpose of this systematic review is to evaluate the use of implant-tooth-borne removable partial dentures in prosthetic rehabilitation of Kennedy Class I partially edentulous arches. A comprehensive search was performed in MEDLINE, EMBASE, Cochrane Oral Health Group's Trials Register, Cochrane Central Register of Controlled Trials, UK National Research Register, Australian New Zealand Clinical Trials Registry (ANZCTR), conference proceedings and abstracts up to 25 August 2009. Searching the reference list of the selected articles and hand searching of several journals were also performed. A total of nine studies were included. Of these, two were randomized, three were retrospective and four were case reports. All but two had a low reporting quality (level IV on a four-level hierarchy of evidence). Nevertheless, the improvement in function, aesthetics and stability has been demonstrated in all studies with minimal prosthetic care. Within the limitations of this study, implant-assisted/supported removable partial denture may provide a simple, economical and less invasive treatment modality. The predictability of such approach in the management of bilateral distal-extension situation is, however, still questionable. A higher quality of published studies namely with a focus on long-term randomized clinical trials are needed.
    Journal of Oral Rehabilitation 03/2010; 37(3):225-34. DOI:10.1111/j.1365-2842.2009.02044.x · 1.93 Impact Factor
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    ABSTRACT: Background/purpose: Destructive changes in maxillary edentulous patients with different mandibular occlusal schemes were first described many years ago. However, little is known about the causative factors for "combination syndrome". The aim of the present study was to determine the prevalence and distribution of symptoms associated with combination syndrome among maxillary edentulous patients with different mandibular occlusal schemes. Materials and methods: This study examined the clinical and prosthetic status of 100 maxillary edentulous patients with four different mandibular occlusal schemes to evaluate the prevalence of and oral risk factors for combination syndrome. Data were analyzed using logistic regression analysis. Results: Only nine patients were found to have all five symptoms of combination syndrome. All of these patients used dentures. Eight of them had Kennedy class I and one had Kennedy class II mandibular occlusal schemes. Conclusion: Development of symptoms associated with combination syndrome, especially mandibular posterior alveolar bone loss, cannot be prevented by the use of removable partial dentures. Copyright
    Journal of dental sciences 12/2014; 9(4). DOI:10.1016/j.jds.2012.04.004 · 0.47 Impact Factor


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