We encounter many patients who complain of odontalgia in the daily dental treatment. However, it is sometimes difficult to find the origin of the pain, since the pain sensation located in pulpal or periodontal tissues may be caused by not only pulpal or periodontal diseases but other origins (e. g., jaw bone disease, paranasal sinus disease, oral mucosal disease, neural disease, psychologic disease or systemic disease). These diseases relate to odontalgia, and vice versa. Further more, pulpal or periodontal pain is not well localized. Our clinical study on related pain has shown that 1) localization in posterior teeth is poor compared to that in anterior teeth for both pulpal and periodontal sensation, 2) mis-localization generally occurs in teeth proximal to the stimulated teeth, 3) pulpal sensation is sometimes mis-localized to a tooth in the contralateral jaw.
Diagnosis of odontalgia has been clinically undertaken by three approaches, i. e., interview, clinical findings and radiographic findings. It should be noted that a careful interview promotes a correct diagnosis. Our data, in this respect, have shown that more than eighty% of odontalgia can be diagnosed by interview alone.
Recent neuroscience study has shown that antidromical stimulation of the sensory nerve evokes vasodilatation and extravasation at the site of innervations, in short, pain promotes neurogenic inflammation. Particularly in the pulpal and periodontal tissues, severe vasodilatation is induced because of their low compliance system, and the induced vasodilatation evokes secondary pain in these enclosed tissues.
Consequently, determining the origin of odontalgia and immediate treatment of the pain should be most important.

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Purpose: Microfocus computed tomography (micro. CT) using cone-beam scan is becoming widely used for various studies of oral structures. However, this machine has not been used to evaluate the effective parameters for two-dimensional (2D) or three-dimen-sional (3D) images. This study evaluated the effective parameters of micro-CT for 2D or 3D images of oral hard tissue structures.
Subject and method:
1) Study of 2D images
We evaluated the CT value of 5 human teeth (upper first molars) to determine suitable CT value examined according to several X-ray parameters using CRT on a work station. CT information from the specimens was obtained using a micro-CT (Toscaner-31300μ, Toshiba ITC), under the conditions of tube voltage of 75kV, tube current of 120μA, 100∼1600 views, the number of times of addition, 512×512 pixel matrix, and 0.2 slice thickness.
2) Study of reconstruction images
We made 3D-reconstruction images from the micro-CT data. Three-dimensional reconstruction was performed using 2D images processed by the volume-rendering method using 3D-reconstruction soffware (TRI/3D BON, RATOC system engineering). Then, we evaluate the 3D tooth images. In the assessment of images, three dental radiologists evaluated several 3D tooth images using 3D-reconstruction images. Each image was scored on a five-level scale by Scheffé one-pair comparison method as follows: 5: much easier to evaluate, 4: easier to evaluate, 3: equivalent, 2: harder to evaluate, 1: much harder to evaluate. In scoring, each of the three dental radiologists made an individual assessment, and when differences among individual scores occurred, the score was ultimately assigned by consensus among the three individuals. Statistical analysis of the scores assigned by the three dental radiologists as described above was carried out using Stat View-J 5.0 (Abacus Concepts, Inc, USA) statistical software and Tukey-Kramer multiplecomparlson testlng.
Result & conclusion: The optimal CT value for evaluating the human tooth by micro-CT is 600 on 2D images. On 3D images, the optimal value is 600 for tooth and 400 for the mandible (p<0.01). Micro-CT of the tooth is useful for evaluation of dent-maxillo facial structures such as the tooth and mandible.

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Purpose: The purpose of this study was to evaluate the clinical effect of Cepharanthin^® against leucopenia by external radiotherapy for head and neck cancer.
Materials and methods: Between September 2002 and June 2004, 18 patients (14 males and 4 females) with head and neck cancer were treated with external radiotherapy and given Cepharanthin^® at the same time. The median age of this group was 69 years old, ranging from 27 to 91 years old. The total dose of external radiotherapy for these patients was 48-70 Gy (median; 52 Gy). We combined chemotherapy in 4 patients. All patients were given 6mg per day peroral Cepharanthin^® during external radiotherapy, and total medication of Cepharanthin^® was 150-378mg (median; 252mg). Between April 1990 and March 1993, 21 patients (13 males and 8 females) with head and neck cancer were treated with external radiotherapy and not given Cepharanthin^® at the same time. The median age of this group was 65 years old, ranging from 44 to 82 years old. The total dose of external radiotherapy for these patients was 30-70 Gy (median; 50 Gy). Five patients underwent combined chemotherapy. We examined the blood 4 times before, during and after external radiotherapy. We evaluated the maintenance rate in the blood of white blood cell, platelet, lymphocyte, and neutrophils.
Results: For the group without Cepharanthin^®, the average maintenance rate of white blood cells at the first half of radiotherapy, the second half of radiotherapy, and one month after radiotherapy were 86.0%, 76.0% and 84.2%, respectively. For the group with Cepharanthin^®, these values were 104.9%, 93.5% and 101.6, respectively. There was the significant difference between two groups in the second half of external radiotherapy (P<0.05).
Conclusion: It was possible to prevent leucopenia by administering Cepharanthin^® during external radiotherapy for head and neck cancer.

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