Dental Journal of Iwate Medical University

While citing references, we discuss the surgical methods and results of arthroscopic surgery of the temporomandibular joint at our department. Our subjects were 51 patients with 71 affected joints. These included 9 men with 10 affected joints, and 42 women with 61 affected joints. The average age of the male patients was 31.6 years (range ; 17-47 years), while that of the female patients was 34.3 years (range ; 17-74 years). Preoperatively the average mouth opening was 28.3 ± 6.6mm, and that improved significantly to 39.8±5.0mm postoperative (p<0.01). The VAS for temporomandibular pain and impaired daily living activity was 4.9±2.6 and 5.1±2.7 preoperative respectively, One month postoperative it was 1.5±1.5 (p<0.01) and 1.0±1.6 (p<0.05), respectively and three months postoperative was approximately one tenth of what it had been preoperatively. Of the 51 patients, there were 36 "significantly improved" cases (70.6%), 10 "improved" cases (19.6%), and 5 "mildly improved" cases (9.8%), and as a result, the efficacy rate was 90.2%.

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We analyzed trace elements in 100 normal oral mucosae by Particle Induced X-ray Emission (PIXE) method. We studied 48 males and 52 females, 11 to 77 years of age with a mean age of 31.6 years. The submajor elements Na, P, S, Cl, K and Ca were detected in all samples, and Mg was detected in 97% of the samples. Twelve trace elements, Si, V, Cr, Mn, Fe, Co, Ni, Cu, Zn, Se, Mo and Sn, were detected in the oral mucosae. Of these trace elements, Si, Cr, Mn, Fe, Ni, Cu, Zn and Se were detected in greater than 80% of the samples. We detected six ultratrace elements Ge, As, Br, Rb, Pd and Cd. Of these ultratrace elements, Br and Rb were detected in greater than 90% of the samples. Fourteen contaminated elements were detected in the oral mucosae. Al and Pb were detected in all samples, although contaminated elements do not normally exist in human body. There were significantly higher mean concentration values of Se and Pb in the males than in the females. There were significantly different concentration values of S and Cr, according to age groups.

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The pumping lavage system(PLS), a lavage technique for the upper joint cavity, cleans inside the upper joint cavity by repeated pressurized injection and aspiration of physiological saline through a single puncture. With existing PLS methods, the surgeon uses a syringe to inject physiological saline into the upper joint cavity based on tactile sensations at the fingertips, and as a result, pressure inside the upper joint cavity could potentially build up. In addition to this risk, the lavage procedures themselves are complicated. We have been obtaining favorable results using a pressurized bag with PLS to directly inject physiological saline from a transfusion bottle. When a pressurized bag is used with PLS, physiologcal saline can be injected at a specific pressure, thus partially simplifying the lavage procedure and improving the safety aspect. The efficacy of PLS using a pressurized bag was 81.3%.

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Bone graft in clinical dentistry prevails in periodontal patients who have three wall infrabony defect around the tooth because of its pathological morphology. In this case report, bone graft on the labial bone surface of the lower incisors (mandibular symphysis) was applied as an auxiliary procedure at the same time of orthognathic surgery to a patient who had fenestrations and circumscribed holes without gingival recession and skeletal Class III malocclusion. The initial lateral cephalometric radiograph revealed a narrow and high symphysis, with an incisor position straight above the thin bone. During the pre-surgical orthodontic treatment, the incisors had been derotated and moved in the minimal labiolingual direction. Some fenestrations and circumscribed holes were found during orthognathic surgery. Through the bone allograft, the labial bone surface of the lower incisors (mandibular symphysis) with fenestrations and circumscribed holes were covered with the patient's cancellous bone. Consequently, a series of the lateral cephalometric radiographs revealed that the grafted bone was kept for four years and ten months after surgery with stable occlusion and no rotational relapse on the lower incisors where it is usually easy to relapse clinically.

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