Combination Syndrome in Patients of an Ecuadorian University Dental Clinic: A Retrospective Study
DOI:
https://doi.org/10.29166/odontologia.vol27.n2.2025-e8290Keywords:
Partial Denture, Complete Denture, Bone ResorptionAbstract
Combination Syndrome is a condition affecting edentulous patients, significantly impacting their lifestyle. It is now understood that the full spectrum of characteristics initially described by Kelly is not always essential for the identification of syndrome.
Our main objective was to determine the prevalence of Combination Syndrome among patients who attended the dental clinics of a Dentistry School of an Ecuadorian university between 2017 and 2019. We also aimed to investigate its association with potential factors such as type of edentulism, age, and sex.
This observational, and retrospective study analyzed 651 panoramic radiographs; 404 belonged to women and 247 to men. Radiographic signs of the syndrome, including premaxilla bone resorption, maxillary tuberosity enlargement, and posterior mandibular bone resorption, were evaluated. The study sought to ascertain the prevalence of syndrome, providing statistical data to highlight the importance of care for these patients.
Our findings indicate that 8.35% of all patients seen during the study period presented with the syndrome. Among these, a relationship with mandibular Class I edentulism was demonstrated. According to the Tolstunov Classification, Class I modification I was found to be associated with age but not with sex. Regarding age, older adults constitute a high-risk group.
We concluded that Combination Syndrome is strongly associated with mandibular Class I edentulism. Age is a key contributing factor, with a notably high prevalence observed in older adult patients.
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References
Kelly E. Changes caused by a mandibular removable partial denture opposing a maxillary complete denture. J Prosthet Dent. 1 de febrero de 1972;27(2):140-50.
Samuel LL, Céspedes NL, Villalón MF. La pérdida dentaria. Sus causas y consecuencias. Rev Med Isla Juv [Internet]. 6 de noviembre de 2018 [citado 16 de octubre de 2023];19(2). Disponible en: https://remij.sld.cu/index.php/remij/article/view/212
Lopes de Aguiar MG, de Mello Fiallos AC, Rocha Valadas LA, Negreiros WA de. Síndrome da combinação: aspectos clínicos de importância para o odontólogo – uma revisão da literatura. Rev Faculdade Odontol Lins. 14 de diciembre de 2015;25(2):56-66.
Ramiro Guillén C, Guevara García C, Gómez Polo M, Celemín Viñuela A. ¿Qué tratamiento podemos elegir para rehabilitar pacientes con Síndrome de Combinación? Cient Dent Ed Impr. 2011;65-9.
Carlino P, Pettini F, Cantore S, Ballini A, Grassi FR, Pepe V. Surgical and Prosthetic Rehabilitation of Combination Syndrome. Case Rep Dent. 6 de enero de 2014;2014:e186213.
Dutt P, Srivastava V, Chand P, Pratap B, Jurel S. Analysis of Cases of Anterior Hyperfunction Syndrome: A Clinical Study. J Adv Med Dent Sci Res. 29 de mayo de 2018;6(6):12-4.
Saunders TR, Gillis RE, Desjardins RP. The maxillary complete denture opposing the mandibular bilateral distal-extension partial denture: treatment considerations. J Prosthet Dent. febrero de 1979;41(2):124-8.
Bentahar O, El Ghoulbzouri H, Benamar A. Syndrome de combinaison : symptomatologie, prévention et traitement. Actual Odonto-Stomatol. julio de 2017;(284):6.
Bagga R, Robb ND, Fenlon MR. An investigation into the prevalence of combination syndrome. J Dent. marzo de 2019;82:66-70.
Costa MM, Cardoso GM, Ferreira Júnior LH, Resende CD, Tavares LN, Rocha FS, et al. Síndrome da combinação: diagnóstico, prevenção e considerações sobre o tratamento. ROBRAC. 2016;59-64.
Valverde M. Perspectiva de tratamiento para el odontólogo general en el paciente con Síndrome de Combinación o Hiperfunción Anterior. Carta Odontológica [Internet]. 2019 [citado 18 de octubre de 2023];(1). Disponible en: https://www.sppdmf.pe/carta-odontologica-2019-1/
Resende CMBM de, Ribeiro JAM, Dias K de C, Carreiro A da FP, Rego MPP do, Queiroz JWN de, et al. Signs of Combination Syndrome and removable partial denture wearing. Rev Odontol UNESP. diciembre de 2014;43:390-5.
Tolstunov L. Combination syndrome: classification and case report. J Oral Implantol. 2007;33(3):139-51.
Farina J. Atrofia paraprotética de los maxilares I. Rev Ateneo Argent Odontol. 2013;29-33.
Blanco L, Capacho W, Picón J. Caracterización de los signos clínicos del Síndrome Combinado de Kelly en el hogar geriátrico de la ciudad de Bucaramanga. Ustasalud. 2016;15:7-12.
Sousa Leite Weitzel IS, Lima Lopes L, Muffato Itaborahy RC. Síndrome Da Combinação: Características Clínicas, Etiopatogenia, Diagnóstico, Tratamento E Prevenção - Revisão Literária. Gest E Políticas Públicas Em Odontol 2 Atena Ed [Internet]. 1 de enero de 2022 [citado 19 de octubre de 2023]; Disponible en: https://www.academia.edu/75831975/Gest%C3%A3o_e_pol%C3%ADticas_p%C3%BAblicas_em_odontologia_2_Atena_Editora_
Wical KE, Swoope CC. Studies of residual ridge resorption. Part I. Use of panoramic radiographs for evaluation and classification of mandibular resorption. J Prosthet Dent. 1 de julio de 1974;32(1):7-12.
Al-Jabrah OA, Al-Shumailan YR. Association of complete denture wearing with the rate of reduction of mandibular residual ridge using digital panoramic radiography. Int J Dent Res. 8 de febrero de 2014;2(1):20-5
Dóra M, Róbert S, Kristina V, Zsolt R, Gyula M, Márta R. A kombinációs szindróma gyakorisága a Pécsi Tudományegyetem Klinikai Központ Fogpótlástani Tanszékén a 2009 és 2014 között készült orthopantomogramok alapján [Incidence of combination syndrome based on the orthopantomograms made between 2009 és 2014 at the Department of Prosthodontics, University of Pécs, Hungary]. Fogorv Sz. 2016;109(1):23-7.
Kilicarslan MA, Akaltan F, Kasko Y, Kocabas Z. Clinical evaluation of maxillary edentulous patients to determine the prevalence and oral risk factors of combination syndrome. J Dent Sci. 1 de diciembre de 2014;9(4):394-9.
Korunoska-Stevkovska V, Guguvcevski L, Menceva Z, Gigovski N, Mijoska A, Nikolovska J, et al. Prosthodontic Rehabilitation of Patient with Anterior Hyper Function Syndrome. Open Access Maced J Med Sci. 15 de diciembre de 2017;5(7):1000-4.
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. febrero de 2007;15(1):9-13.
García Orellana BA, León Vintimilla MDL, Cornejo Córdova MA, Chamba Montaño VC. Prevalencia del Síndrome de Combinación y sus factores asociados en la Clínica de la Facultad de Odontología de la Universidad de Cuenca, periodo 2015-2016. Rev Médica Hosp José Carrasco Arteaga. 30 de marzo de 2020;12(1):25-9.
Vizcaíno K, Armas A, Prevalencia de edentulismo en adultos mayores en América Latina. Revisión de literatura. Rev Estomatológica Hered. octubre de 2022;32(4):420-7
Gordillo Castro DO. Estado Bucodental En Adultos Mayores De Un Centro Geriátrico De Azogues. Odontol Act Rev Científica. 17 de diciembre de 2019;4(Esp):45-8.
AlSheikh HA, AlZain S, Warsy A, AlMukaynizi F, AlThomali A. Mandibular residual ridge height in relation to age, gender and duration of edentulism in a Saudi population: A clinical and radiographic study. Saudi Dent J. abril de 2019;31(2):258-64.
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Copyright (c) 2025 Kimberly Yánez-Lema, Cecilia Molina-Jaramillo, Esteban Rodríguez, Valeria Suárez, Luis Ligña, Darwin Luna-Chonata
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