Describing The Use of Two Hybrid Prostheses in The Staged Surgical Repair of Aortic Dissection

Background-Reconstruction of the thoracoabdominal aorta after dissection (Stanford Type A with extension into descending aorta) has limited surgical options. Described here is a novel technique for the staged surgical repair of the thoracoabdominal aorta after reconstruction of the ascending aorta with aortic arch using a hybrid prosthesis. Case presentation- The thoracoabdominal aorta is accessed via a lateral thoracotomy. After a left-left bypass to perfuse the descending aorta, the proximal end of the prosthesis is anastomosed to the proximal aorta and distal end of the new prosthesis is then inserted into the true lumen of the descending aorta and the stent is deployed. Conclusion-Using this technique, operative time is reduced with accurate reconstructions of the anatomy.

Prosthetic Management of a Posterior Ridge Defect Case with Fixed Removable Type of Hybrid Prosthesis - A Case Report

The main aim of prosthetic dentistry is restoring the form, function, comfort and appearance of the patient by the placement of a prosthesis replacing the missing teeth and contiguous tissues.1 Various prosthetic options for partially edentulous patients include an interim removable partial denture (RPD) to a cast partial denture, a fixed dental prosthesis (FDP), and a more implant-retained prosthesis. However, FDP and implant-retained prosthesis are not always feasible, particularly in patients with excessive residual ridge resorption and jaw defects due to trauma and / or surgical ablation. In such a situation, a dentist may resort to another option of fixed-RPD prosthesis, to restore the defective hard and soft tissues to achieve natural aesthetics, phonetics, comfort, and better hygiene. This hybrid prosthesis fulfils the objectives of the rehabilitation such as support, stability, and retention characteristics similar to a fixed prosthesis and aesthetics and hygiene maintenance of a removable prosthesis.2,3,4,5 Any prosthesis designed or fabricated should be based on the prosthetic principles of support, stability, retention, and preservation of remaining structures.1 From the patient's perspective, retention is one of the important factors for its acceptability. These retentive options range from simple bar and clip attachments to more sophisticated spark erosion overdentures.6,7 Spark erosion prosthesis is technique sensitive, bulky, and requires expensive equipment.6,7 On the other hand, precision attachments provide better vertical support and stimulation to the underlying tissue through intermittent vertical massage.8 Treatment with a hybrid denture is an affordable choice to fulfil the patient's aesthetic demands along with providing a good prognosis for the prosthesis and preservation of the remaining dentition. This article presents two case reports of prosthodontic rehabilitation of a patient with mandibular defects using an attachment-retained fixed-removable hybrid prosthesis.

Pre-emptive BioGlue priming of the branched Evita Open NEO hybrid prosthesis: tackling excessive oozing

Excessive oozing after total arch replacement with the frozen elephant trunk technique through the fabric of the E-vita Open NEO raised concern about its early adaptation. The mechanism is speculated to be multifactorial. Our goal was to report our approach using pre-emptive BioGlue priming on the fabric against the oozing phenomenon.

Evaluation of Stresses on Implant, Bone, and Restorative Materials Caused by Different Opposing Arch Materials in Hybrid Prosthetic Restorations Using the All-on-4 Technique

The long-term success of dental implants is greatly influenced by the use of appropriate materials while applying the “All-on-4” concept in the edentulous jaw. This study aims to evaluate the stress distribution in the “All-on-4” prosthesis across different material combinations using three-dimensional finite element analysis (FEA) and to evaluate which opposing arch material has destructive effects on which prosthetic material while offering certain recommendations to clinicians accordingly. Acrylic and ceramic-based hybrid prosthesis have been modelled on a rehabilitated maxilla using the “All-on-4” protocol. Using different materials and different supports in the opposing arch (natural tooth, and implant/ceramic, and acrylic), a multi-vectorial load has been applied. To measure stresses in bone, maximum and minimum principal stress values were calculated, while Von Mises stress values were obtained for prosthetic materials. Within a single group, the use of an acrylic implant-supported prosthesis as an antagonist to a full arch implant-supported prosthesis yielded lower maximum (Pmax) and minimum (Pmin) principal stresses in cortical bone. Between different groups, maxillary prosthesis with polyetheretherketone as framework material showed the lowest stress values among other maxillary prostheses. The use of rigid materials with higher moduli of elasticity may transfer higher stresses to the peri implant bone. Thus, the use of more flexible materials such as acrylic and polyetheretherketone could result in lower stresses, especially upon atrophic bones.

Prosthodontic rehabilitation of residual mandibular defect with Fixed removable Hybrid prosthesis- A case report

Ameloblastoma is a rare, benign tumor of odontogenic epithelium that was recognized in 1827 by Cusack and renamed ameloblastoma in 1930 by Ivey and Churchill. Ameloblastomas can be found both in the maxilla and mandible with a greater predilection of about 80% in the mandible with the posterior ramus area being the most frequent site. While chemotherapy, radiation therapy, curettage and liquid nitrogen have been effective in some cases of ameloblastoma, surgical resection remains the most definitive treatment for this condition. Rehabilitation of residual mandibular defect post resection is a challenge due to long span compromised ridge condition and the absence of dentition. In such scenario, a fixed-removable prosthesis allows rapid return to excellent function by providing favorable biomechanical stress distribution along with restoration of esthetics, phonetics and ease of postoperative care and maintenance.This paper presents successful Prosthodontic rehabilitation of a patient with a large residual mandibular defect secondary to surgical resection for ameloblastoma using fixed-removable hybrid prosthesis.

Paving the way for E-vita open NEO hybrid prosthesis implantation for complex aortic arch disease in Asia-Pacific

We report first in man implantations of the newly designed Evita-open-NEO hybrid prosthesis (HP) for complex aortic arch disease from 3 different countries in Asia-Pacific including suggestions on how to proceed with optimized perioperative coagulation.