A 49-year-old woman with mitral and tricuspid mechanical valve prostheses developed marked weight gain with increasing abdominal girth and facial plethora 4 weeks after anticoagulation was temporarily interrupted for abdominal surgery. Transthoracic and transesophageal echocardiography documented severe tricuspid stenosis and regurgitation. The two discs of the tricuspid prosthesis were immobilized, half open and half closed. The prosthesis was replaced and the patient did well.
Abstract:Prosthodontic rehabilitation of a patient with compromised edentulous ridges in a conventional manner is a difficult task. Modifications in the treatment procedures should be considered to fulfil the patient's functional and esthetic desires. This article reviews the various compromised situations commonly encountered in a routine clinical practice and the possible management of each of them.
This article reviews the various anatomical facts significant for preoperative planning of implant procedures in the mandible and the maxilla. This planning includes the precise evaluation of distinct anatomical factors, such as the position of the mandibular canal, the maxillary sinus, the width of the cortical plates, the existing bone density , appropriate implant selection and planning the most appropriate implant position in the existing clinical condition.
To achieve a successful prosthesis it is important to achieve harmony between the maxillomandibular relationship and anatomy of patient. This relationship is not simple opening or closing, but a complex relationship which exists in 3 dimensions. Variations may occur in any direction – vertical, anteroposterior, or mediolateral. Thus, it is essential to record this relationship with the least possible error to obtain a successful prosthesis. However when relating the maxillary and mandibular dental casts, the ultimate accuracy depends on accuracy and dimensional stability of the material and the technique used to record the maxillomandibular relationship.
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