Is lower RPD necessary to oppose complete upper?

[k00laid]

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Hi everyone, I am need of some help and advice.

I have a patient that is getting a complete upper denture. In the lower, he is a KC II missing #28-32. However, he does not have a lot of money and isn't really interested in getting a lower partial. He's more interested in just getting the complete upper, esp since he still has his lower anterior teeth there in the smile zone.

I am trying to look for articles discussing the importance (or unimportance) in having a lower partial opposing a complete maxillary denture. I'm having trouble searching for these articles though!!

Can you guys please give your opinion on whether or not he needs or should get this lower RPD? And if you have better luck in searching for articles, also send me some links to them? I would appreciate it so much, thanks!

 

[Mackchops]

Does he have any posteriors on the other side? Is the lower occlusal plane pretty flat?

Look up articles on "shortened dental arch" and "combination syndrome".

 

[k00laid]

He has up to the first molar on the other side. Do you have any comments on how his teeth/bone/TMJ will be affected if he were to not get a lower partial and just get the complete upper?

As for combination syndrome... does this only occur when a person has complete upper and distal extension RPDs? Or does it also occur with a person who has complete upper and no RPD on the bottom, but does have edentulous distal extension? I was also under the impression before that combination syndrome occurs in people with bilateral distal extension, but perhaps it applies to unilateral extension as well?

Thanks!!

 

[Mackchops]

Awesome questions. Combination syndrome is when someone has natural lower anterior teeth and a max denture - as the natural teeth bang into the denture it causes resorption of the premaxilla. This happens with or without a lower partial - but is made worse as soon as the partial loses occlusal contact and the patient starts chewing with his front teeth. Your patient has posterior occlusion on one side so this isn't really a worry for him.

I can't think of any teeth/bone/TMJ problems that he'll have by avoiding a lower partial as long as the max denture is in great balance - I made one like this and it was surprisingly harder to fine tune the occlusion even though there was less occlusion to worry about! Good luck.