Prosthodontic Management of Combination Syndrome Using Digital Scanning and Direct Metal Laser Sintering Crowns: A Novel Approach

Combination syndrome presents unique challenges in prosthetic rehabilitation due to severe maxillary ridge resorption, supra-eruption of mandibular anterior teeth, and occlusal imbalances. This case report describes the management of a 76-year-old male patient with an edentulous maxilla and partially edentulous mandible, rehabilitated using a conventional maxillary complete denture and a mandibular removable partial denture since the patient declined implant-based treatment due to financial and surgical constraints. A mucostatic impression technique was used to avoid displacing hyperplastic tissues, ensuring optimal denture adaptation. To enhance durability and occlusal stability, direct metal laser sintering (DMLS) crowns were incorporated into the denture design to help minimize attrition and maintain occlusal harmony. The prosthesis was modified to evenly distribute the occlusal forces to prevent further ridge resorption and improve functional efficiency. The patient reported significant improvement in mastication, speech, and aesthetics, with no complications observed at the 12-month follow-up. The present case report highlights the importance of biomechanical considerations in managing combination syndrome. It also demonstrates that a well-planned, non-implant-based prosthetic approach can offer a stable, functional, and cost-effective solution for patients with financial or surgical limitations.