 hello everyone welcome back to another session in the industry and more today we have a small topic in prosthodontics that is combination syndrome so combination syndrome is nothing but on keeping a complete integer so we have a complete integer on upper arch and a distal extension case in lower arch that is only the natural teeth anterior teeth are remaining in lower arch so complete integer here a distal extension removal denger here so in such conditions the upper anterior ridge faces a problem because of the continuous pressure from the natural teeth in the lower anterior side so ultimately it will become a vicious cycle and a lot of changes happening over the oral cavity so this is known as combination syndrome so the combination of a complete integer and a partial denger okay so what happens in combination syndrome the first thing is loss of bone from the maxillary anterior adenzylus ridge then there is downgrowth of maxillary tuberosities okay so resorption happens in the anterior region the downgrowth of maxillary tuberosity then papillary hyperplasia of the tissues of the heart palate then extrusion of the lower anterior teeth so this lower anterior teeth will be extruded and loss of bone beneath the removal partial denger basis okay so there will be loss of bone under the removal partial denger basis so we can say that there are six changes happening one is the loss of vertical dimension then the occlusal plane discrepancy discrepancy on occlusal plane then we have anterior spatial resorption of the mandible then the development of apulose fissure atom which is a inflammatory change due to the chronic trauma of this denger borders on the oral tissues then poor adaptation of the processes for adaptation of the processes then there will be a lot of periodontal changes happening over the oral cavity and also the spatial resorption of mandible anterior resorption of mandible similarly there will be resorption of maxilla also so it is like a vicious cycle so those cycle changes happening natural teeth creating resorption of mandible sorry maxilla maxillary tuberosity downgrowth then the resorption of all the denger base the residual ridges then the spatial absorption of mandible then the loss of vertical dimension occlusal plane discrepancy the apulose fissure atom the poor adaptation periodontal changes and ultimately it becomes there is a loss of retention of all the renters with associated a lot of problems in the oral cavity so that is a combination syndrome when we keep a complete denger and partial denger in upper end lower lower arch with remaining natural teeth at the mandibular anterior region so it's a very small topic I hope you understood this simple one so I'll come up with a new topic in prosodontics thank you