Combination Syndrome in Patients with Mandibular Implant Supported Overdenture and Conventional Maxillary Denture - A Systematic Review.

Objectives: Implant-supported mandibular dentures are increasingly preferred for edentulous mandibles due to their superior function, stability, and patient satisfaction. However, when opposed by a conventional maxillary complete denture (CD), it remains unclear whether this configuration contributes to Combination Syndrome. This systematic review investigates the presence and clinical features of Combination Syndrome in such cases.

Methods: A systematic search of Scopus, Ovid Medline, Web of Science, and Embase was conducted for studies published between 1994 and 2024. Of 133 initially identified articles, six met the inclusion criteria. These included four cohort studies, one cross-sectional study, and one randomised controlled trial, involving 141 participants.

Results: Common findings included anterior maxillary bone loss, loss of posterior occlusion, and reduced retention of the maxillary denture-often linked to excessive anterior contact. Some studies reported increased ridge resorption with implant-supported overdentures, while others found no significant differences compared to conventional dentures.

Conclusion: Due to the limited number and quality of available studies, no definitive conclusion can be drawn regarding the prevalence of Combination Syndrome in this prosthetic arrangement. Further well-designed clinical studies are needed to clarify its long-term implications.