RESULTS OF 15 YEARS OF COLLABORATION BETWEEN THE DEPARTMENTS OF OPHTHALMOLOGY AND STOMATOLOGY IN ONCOLOGICAL SURGERY OF THE ORBIT: A DIAGNOSTIC AND THERAPEUTIC APPROACH.

AIM: To report an overview of the most frequent tumors of the orbit, suggest diagnostic approach and possible solution according to experience with own cohort of patients. MATERIAL AND METHODS: From patients files from the Department of Ophthalmology and Department of Stomatology, First Medical Faculty, Charles University, and General Faculty Hospital in Prague, Czech Republic, there were selected patients, who underwent the surgery due to the suspicion of malignant development in the orbit during the period 2005 - 2019. From the surgical records we found information about 497 cases. At the Department of Stomatology, there were 282 surgeries under general anesthesia performed, and at the Department of Ophthalmology, there were 215 surgeries, mostly under local anesthesia performed. RESULTS: The number of surgeries in men and women was equal; patients of all ages were present. The median of patients age operated on at the Department of Stomatology was 53 years, and at the Department of Ophthalmology 63 years. The most common primary benign tumor was the cavernous hemangioma (9 %), the most common non-tumorous expansion was the dermoid cyst (7 %); the most common malignant tumor was the lymphoma (17,5 %). The last mentioned tumor was the most common diagnosis in the whole cohort as well. CONCLUSION: Our cohort of patients is comparable with large cohorts published in the literature concerning age and gender distributions. Differences in frequencies of some lesions may be explained by that our cohort includes patients after the surgery only. The malignant lymphoma is the most common diagnosis indicated to surgical procedure, mostly biopsy. Comparing the two cohorts from our departments 20 years apart, the malignant lymphoma remains the most common indication for surgery, but the incidence of adenomas and adenocarcinomas of the lacrimal gland decreased. It is not the goal of this paper to evaluate all possible orbital affections. Suggested surgical approaches are just recommendations according to years of experience; however, in some situations, to choose an individual surgical approach is necessary.

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.

Nasal prosthesis supported with self-tapping implants with bioactive surface--a case report.

Nasal prosthesis using dental implants and magnetic abutments is a method of choice in replacement of missing hard and soft facial tissues. Nose form, coloration, and texture must be as indiscernible from the surrounding natural tissues as possible. Rehabilitation efforts can be successful only when patients can appear in public without fear of attracting unwanted attention. This case report evaluates on a step-by-step basis the materials and methods including implants insertion.

Denture reconstruction of the edentulous upper jaw in cleft palate using implants--clinical report.

OBJECTIVE: Early prosthodontic therapy (usually at around 18 years of age) often leads to early loss of teeth and in extreme cases to complete loss of dentition at between 40 and 50 years of age. PATIENTS: This report describes the clinical features of two middle-aged cleft patients. Edentulous maxilla with cleft defect was treated with 6 implants supported by fixed appliance. RESULTS: Treatment of the whole dental arch on the basis of implants is currently frequently used as it provides a possibility of thorough functional and aesthetic therapy to a patient. The biomechanics of the reconstruction enables individual adjustment of the shape of the dental arch. CONCLUSIONS: The problem in cleft patients involves other diameter relations in the dental arch caused by the defect alone or also by affecting the growth of the maxillary segment by surgery. A potentially removable framework is therefore the main method of choice because the position of the implants must be prosthetically modified.