Prosthodontics & Occlusion · patient case question
With only teeth 22 to 27 remaining opposed by a maxillary complete denture, what finding would you expect in the maxilla?
Patient case: A denture that will not stay put
demo: 71-year-old male
chief: His upper denture drops when he speaks and food collects under it. He also has a sore lump at the front.
history: He has worn the same maxillary complete denture for fourteen years and has never had it relined. Only the mandibular anterior teeth from 22 to 27 remain.
meds: None relevant.
findings: The maxillary anterior ridge is displaceable and mobile on palpation while the posterior ridge is firm. A folded, fibrous ridge of tissue lies in the labial sulcus adjacent to the denture flange. The mandibular anterior teeth show generalised wear.
Show answer and explanation
Correct answer: C. An anterior flabby ridge with localised bone loss
- A. Combination syndrome tends to produce an increase in interarch space anteriorly as bone resorbs, not a loss of it.
- B. Resorption in this syndrome is characteristically localised to the anterior maxilla, which is precisely what makes the pattern recognisable.
- C. Correct. This is combination syndrome. Natural mandibular anterior teeth concentrate occlusal load on the anterior maxilla, so the bone there resorbs and is replaced by displaceable fibrous tissue, while the posterior maxilla is relatively spared. The rest of the syndrome includes tuberosity overgrowth, papillary hyperplasia of the palate, extrusion of the mandibular anterior teeth and loss of posterior mandibular bone.
- D. The pattern is reversed. Posterior maxillary bone is relatively preserved because the anterior teeth carry the load.
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