Team approach in treatment of extensive maxillofacial defects - five case report serie.

Long-lasting functional and esthetic rehabilitation and good health-related quality of life of patients with maxillofacial defects is based on effective interdisciplinary cooperation especially of surgeons, dentists and technicians. Extensive defects occur after the first phase of the oncologic surgery and immediately after injuries. Subsequent plastic surgery is the initial step of functional reconstruction and creates a base for future fabrication of post-operative dentures and implant-born epitheses. Five clinical reports demonstrate complex rehabilitation of typical maxillofacial defects solved within the multidisciplinary cooperation. Four patients with oncological diagnoses and complex surgical treatment, resp. radio- and chemotherapy are reported with interim and long-term prosthetic solutions. One patient suffered from a congenital malformation. Titanium implants were inserted in defect bone margins using two-phase method. Healing time was at minimum three months and after this period superstructures were applied. Artificial eyes were made of both glass and acrylic materials. Retention of presented postoperative prostheses was reliable; patients were satisfied with the functional and esthetical results of the reconstruction. Prognosis of the rehabilitation depends on the histological stability of adjacent tissues, quality of osseointegration and durability of materials used (silicones, acrylates). Satisfactory health-related quality of life of these patients is based on the multidisciplinary healthcare.

Pentazocine abuse. Report of a case with pulmonary arterial cellulose granulomas and pulmonary hypertension.

We report a patient who developed pulmonary hypertension following repeated intravenous injection of dissolved pentazocine tablets. Through analysis of lung biopsy material, this was shown to be due to embolization of the cellulose filler in the tablet and the tissue reaction it produced. Administration of prednisone appeared to improve the patient's clinical state.