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Anterior Hyperfunction by Mandibular Anterior Teeth: A Narrative Review.

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Combination syndrome, also known as anterior hyperfunction syndrome, occurs when the maxilla is edentulous and the mandible has only anterior teeth. Management involves prostheses and addressing mandibular anterior teeth to restore occlusion.

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Area of Science:

  • Dental Science
  • Prosthodontics
  • Oral Rehabilitation

Background:

  • Combination syndrome, defined by Kelly in 1972, presents as an edentulous maxilla with a partially edentulous mandible retaining only anterior teeth.
  • Anterior hyperfunction syndrome, a synonym, was described in 1994, but 'anterior hyperfunction' lacks a clear definition.
  • This condition often involves loss of posterior occlusal support and reduced vertical dimension of occlusion.

Purpose of the Study:

  • To review the literature on anterior hyperfunction within the context of combination syndrome.
  • To discuss the etiology and clinical management strategies for anterior hyperfunction.
  • To clarify the definition and implications of anterior hyperfunction.

Main Methods:

  • A narrative review approach was employed.
  • An electronic bibliographic search was conducted.
  • Clinical cases were reviewed to supplement the literature search.

Main Results:

  • Combination syndrome with all five classic features is rarely observed.
  • Anterior hyperfunction is frequently associated with loss of posterior occlusal support and vertical dimension.
  • Implant-supported prostheses can potentially contribute to anterior hyperfunction.

Conclusions:

  • Management of anterior hyperfunction requires addressing the loss of posterior occlusal support and vertical dimension.
  • Conventional removable and implant-supported prostheses are key treatment modalities.
  • Interventions targeting mandibular anterior teeth are often necessary, and comprehensive management of remaining teeth and prostheses is crucial.