Suchergebnisse

"Dental practitioners, sometimes, are facing patient's requests to overtreatment care, which in many situations is completely unnecessary or even dangerous/ risky/ disproportionate to the patient's (oral) health state/condition. It can include procedures such as: teeth whitening, removal of amalgam fillings, closing diastema, veneers, dental extractions, root canal treatment, dental implants or fixed orthodontic appliances. It is known that dentistry practice belongs to two different and conflicting worlds, medical and business. In front of such situations, dentists should decide the right way of doing their job: being a medical doctor and treating patients or doing business and executing exactly what patients are asking for. Due to these facts, this presentation aims to: 1) identify the main issues related to this dilemma of dentists and 2) offer a better perspective on realizing dental esthetics treatments without jeopardize the oral health of the patient, but also the dentist's profession and professional integrity. "

Introduction. The primary tonsillar neoplasm is a common malignancy of the head and neck, alcohol and/or cigarette smoke and Human Papilloma Virus is the main etiological agent. This study offers a retrospective analysis of the tonsillar neoplasm cases in a tertiary medical center from Romania. Patients and methods. We present a 4-year (2015-2018) retrospective study on 72 patients diagnosed with tonsillar neoplasm in our clinic, previously untreated patients. The study was included only the patients diagnosed through histopathological evaluation with tonsillar neoplasm. We searched the cases in our clinic database, and we collected data about age, gender, symptoms on admission, findings of the objective physical examination, oro-pharyngoscopy, medical imaging examination results, histopathological results, stage of the disease, therapeutic management. Results. The group composition is: 75% men and 25% women, 62.5% of them are smokers. Dysphagia/swallowing discomfort was the most common symptom identified, and the non-keratinized squamous cell carcinoma was the most common histopathological form. Stage I tonsil carcinoma was diagnosed in 25% of the cases, stage II in 15.3%, while 47.2% of the cases had stage III or IV. None of the patients presented distant metastases. Lymphoma was diagnosed in 12.5% of the cases. We performed for all patients in stages I and II underwent total unilateral tonsillectomy. For the patients in stages III and IV, we performed surgery after radiotherapy-chemotherapy treatment or only radiotherapy-chemotherapy. Conclusions. In Romania, smoking is still the most important risk factor for tonsil cancer. The majority of patients have visited a doctor only when dysphagia and, above all, palpable cervical adenopathy, were present, and the tumor was in the advanced stage. In Romania, the ENT-oncology integrated medical services are few, in most cases patients are lost from otorhinolaryngological follow-up.