Prosthodontics & Occlusion · patient case question
Which is a contraindication for a complete mandibular denture?
Patient case: Contraindication to a complete mandibular denture
Scenario: Which finding would be a CONTRAINDICATION to constructing a complete lower denture? The options were all normal/acceptable findings except one, which referred to MAXILLARY rather than mandibular teeth.
Show answer and explanation
Correct answer: C. The presence of remaining natural maxillary anterior teeth opposing the denture
- A. Healthy keratinised mucosa is the ideal denture-bearing tissue.
- B. Adequate vestibular depth is favourable, allowing proper flange extension and a peripheral seal.
- C. Correct. A complete mandibular denture opposed by RETAINED NATURAL MAXILLARY ANTERIOR TEETH is the setup for COMBINATION (Kelly) SYNDROME. The natural anterior teeth generate heavy, concentrated anterior loading, producing resorption of the anterior maxilla, downgrowth of the maxillary tuberosities, papillary hyperplasia of the palate, and accelerated resorption of the posterior mandibular ridge.
- D. A well-formed residual ridge is a FAVOURABLE finding — it provides support, stability and retention.
Note: Kelly's combination syndrome classically arises with a complete MAXILLARY denture opposing natural mandibular anteriors with a distal-extension RPD. The principle is the same in either direction: opposing natural anterior teeth against a complete denture concentrates load anteriorly and drives resorption.
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