The myelodysplastic syndrome (MDS) is characterized by pancytopenia, not only a decrease in the number of blood cells but also the morphological and functional abnormalities.
A 28-year-old female with this syndrome was referred to our clinic. We extracted the horizontally impacted left lower wisdom tooth after transfusion of platelet concentrates. The amount of transfusion was half compared with the previous extraction of the half erupted right lower wisdom tooth. Attelocollagen sponge soaked with platelet-rich plasma (PRP) was inserted into the site of extraction followed by the closure of the envelope flap.
Excellent healing process was obtained at the site of extraction of the left lower wisdom tooth in comparison with the previously extracted right wisdom tooth one month earlier. Radiopacity and soft tissue healing was clinically similar.
The therapeutic improvements achieved by using PRP with atelocollagen sponge has demonstrated the possibility of decreasing the amount of platelet infusion and avoidance and/or prevention of hemorrhagic complications. In consequence, this method has revealed its handiness, its safeness and above all the reduction in time requirement for wound healing as compared with a simple platelet transfusion.

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The number of dialysis patients due to diabetic nephropathy has been annually increasing. Malnutrition in the dialyzed patients is known as a significant risk factor in influencing the mortality rate.
A 67-year-old male suffering from diabetes mellitus undergoing hemodialysis and many other systemic involvements was referred to our clinic with masticatory dysfunction resulting from severe periodontitis. He was hospitalized and underwent teeth extraction with strict nutritional control. Management of infection, bleeding and cardiovascular conditions were performed. After extraction, the tooth sockets were packed with gelatin sponge and sutured. Prefabricated temporary denture was set and pressure was applied to the tooth sockets by biting. We had planned for an adequate postoperative control of energy, protein and fluid intake, so that an early improvement of the patient's diet pattern could be obtained.
The considerations applied for this dialyzed diabetic inpatient with various systemic involvements not only contributed in the improvement of the patient's quality of life but is also postulated to have favorable effects on the mortality of these patients.

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Good (Favorable) patient management can be carried out by (performed with) intravenous sedation during dental treatment of a patient with pathological laughing as a consequence of previous cerebral hemorrhage.
A female patient, 59 year-old, was scheduled to undergo extraction of an impacted wisdom tooth due to diagnosis of pericoronitis of the wisdom tooth. She had a past medical history of cerebral hemorrhage and suffered from pathological laughing as a consequence of the previous cerebral hemorrhage. During pathological laughing, regardless of the patient's intention, the patient has much difficulty in controlling it. In order to reduce the frequency of sudden seizures and seizures caused by mental strain, intravenous sedation using midazolam was selected for the dental treatment. The desired level of sedation was obtained by intravenous sedation using 4.5mg of midazolam. Although she had a sudden bout of laughter seizure immediately after administration of local anesthesia, the desired level of sedation was obtained by supplementation of (adding) 1.0mg of midazolam. Following treatment (extraction), she was diagnosed with chronic apical periodonititis of mandibular second molar and was scheduled to undergo (receive) a root canal. Expecting a complete disappearance or suppression of laughter seizure and with improved patient management, intravenous sedation using propofol was selected. The desired level of sedation was obtained by using the intravenous sedation using 50mg of propofol. Although recurrence of laughter seizure was encountered at the beginning of dental treatment, sedation was obtained with an additional administration of 10mg propofol. After that, the intravenous sedation was maintained at the rate of 4mg/lg/hr and the dental treatment was successfully completed.
Pathological laughing during dental treatment is dangerous because it may cause complications such as oral mucosa damage, accidental ingestion of tooth fragments, etc. Intravenous sedation has revealed (demonstrated) its usefulness in solving these intraoperative problems. (The intravenous sedation is useful to counter this problem.)

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Depending on the progressive stage of severity of muscular dystrophy, the patients may develop complications like open bite. But at present, there is no valid treatment method available. We treated a 14-year-old patient with open bite resulting primarily from progressive muscular dystrophy utilizing the intact healthy alveolar over denture method. Following treatment, sensuousness recovery and improvement of occlusion and masticatory function were attained and above all the patient was extremely satisfied with the results. This treatment method, intact healthy alveolar over denture method is worthy of mention for its effectiveness and low risk for the treatment of open bite for patients with progressive muscular dystrophy.

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We herein report a dental treatment for a patient with primary lateral sclerosis and hyperactive gagging reflex. A 73-year-old female was referred to our department with the chief complaints of pain and swelling of the gingiva in the left premolar region of the mandible and mobility of a maxillary bridge. She had been aware of dysbasia, dysarthria and dysphagia for approximately 25 years and was diagnosed as having primary lateral sclerosis. Since she was experiencing fear and anxiety for dental treatment and hyperactive gagging reflex, intravenous sedation with midazolam was performed for removal of the bridge and extraction of two teeth. The dental treatment was uneventful and the gagging reflex did not occur. In total, dental treatments were performed 7 times as planned. The administration of midazolam became unnecessary as dental treatment progressed. The hyperactive gagging reflex in this case was due to fear and anxiety about dental treatment, and not due to primary lateral sclerosis.
As for dental treatment of patients with primary lateral sclerosis, it is necessary to administer an adequate amount of midazolam and to prepare sufficient instruments for suction to prevent respiratory depression and aspiration.

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Recently serious odontogenic infections have decreased due to (because of) improved chemotherapy. However, it is difficult to control and manage the patient's medical status (condition) if the patient's defense mechanisms are compromised by such disorders as diabetes mellitus. In this paper, we herein report a case of neck and superior mediastinal abscesses complicated with diabetes mellitus, caused by periodontitis of the right lower second molar (second right lower molar).
A 57-year-old male was referred to our hospital complaining of swelling and pain in the submandibular region. The lesions were diagnosed as oral floor phlegmone. The computed tomography revealed that gas-producting lesions extended to the neck and mediastinal space. The patient was admitted for probable surgical incision and drainage, systemic antibiotic treatment and the control of diabetes mellitus.

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