Japanese Journal of Oral and Maxillofacial Surgery
Online ISSN : 2186-1579
Print ISSN : 0021-5163
ISSN-L : 0021-5163
Volume 30, Issue 6
Displaying 1-20 of 20 articles from this issue
  • Investigation by a dynamic paratography
    Masayo KASUYA, Kiyotaka HIRAIWA, Kanji OHUCHI, Motohiro OHKOSHI, Toshi ...
    1984 Volume 30 Issue 6 Pages 747-757
    Published: June 20, 1984
    Released on J-STAGE: July 25, 2011
    JOURNAL FREE ACCESS
    An articulation after operation in a case of hemiglossectomy
    -Investigation by a dynamic paratography-
    The authors examined articulation after operation in a hemiglossectomy case and reconstitution by a skin flap with dynamic paratography and clarity of pronounciation.
    Results
    1) The clarity of pronounciation in this case was assumed to be due to three causes. First was considered that the grafted skin flap was upper convex and the reconstituted tongue had a same height as the remaining tongue. Second, that the remaining muscle in tongue could elevate the reconstituted tongue. Third that the remaining tongue had a freely movable tip of 1.5 cm, so that the reconstituted tongue could elevate that tip of the reconstitued tonge.
    2) In this case, disordered articulation was found in r, t, fi, tri, ni, kin, no.
    3) In a line, (sa) was mistaken as (a) and (m) as (sa).
    4)(i) line had a tendency to listed as most abnormal articulation, and (o), (u), (a) and (e) line as more abnormal articulation.
    5) In this case, the time to articulate a plosive of a consonant was somewhat longer after the operation and the plosive of a consonant had a tendency to become a friction.
    6) The grafted skin flap not only covered the wound but also had an important complementary function that elevated the intraoral pressure and form the route of the expiratory outflow in the articulation. This case demonstrated that the form of the grafted skin flap in the reconstituted tongue had an important function in articulation.
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  • Motohiro OHKOSHI, Tohru OKA
    1984 Volume 30 Issue 6 Pages 758-762
    Published: June 20, 1984
    Released on J-STAGE: July 25, 2011
    JOURNAL FREE ACCESS
    The use of computed tomography (CT) in the temporomandibular joint (TMJ) is discussed. The CT scan is useful in diagnosing TMJ disfunction. This article reviews the value of CT in the normal findings of TMJ.
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  • Motohiro OHKOSHI, Tohru OKA
    1984 Volume 30 Issue 6 Pages 763-767
    Published: June 20, 1984
    Released on J-STAGE: July 25, 2011
    JOURNAL FREE ACCESS
    The usefulness of CT scan in the diagnosis of TMJ diseases. Report II: Case reports.
    In the previous report, we had reveiwed CT (computer tomography) pictures of normal temporomandibular joint (TMJ).
    In this paper, readings for CT images of TMJ lesions will be discussed.
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  • Ken-ichi NOTANI, Nobuo INOUE, Tetsuro YAMASHITA, Yasunori TOTSUKA, Kin ...
    1984 Volume 30 Issue 6 Pages 768-778
    Published: June 20, 1984
    Released on J-STAGE: July 25, 2011
    JOURNAL FREE ACCESS
    The combined treatment of surgery and irradiation have been established for maxillary cancer patients by our department since 1974.
    The 51 patients (38 males and 13 females), whose age average was 54.9 years. They were treated by this method from Jan. 1974 to Jan. 1982. They were classified as 33 cases (64.7%) of stage III and 18 cases (35.3%) of stage IV. There were no patients of stages I or II. According to Nomura's classification, type P (tumor invasion posteriorly), type A (anteriorly), type AS (anterio-superiorly) were 25 (49%), 17 (33%) and 9 (17%) cases respectively.
    It is generally accepted that survival rates of type P were worst of the three types.
    The pathological analysis and classification were as follows; there were 46 cases (90%) of squamous cell carcinoma and 2 cases (3.9%) of mucoepidermoid carcinoma and anaplastic carcinoma and a case (2.0%) of malignant fibrous histiocytoma.
    Our initial treatment employed irradiation of 5040-5250 rad of 50Co/16 fractions, using a 45° wedge filter.
    Our routine irradiation exposure to the patients were ordinarily 4 or 5 occasions before the operation.
    The operation procedure was that a window was made as wide as possible intraorally by resecting the anterior wall of maxilla sinus and then the performance will be invaded to the alveolar process and to the palatal bone ocasionally. This procedure will make the easier way for the following procedure. The exposed tumor was completely removed during the operation. So-called necrotomy was carried out and irradiation begun anew in 3 or 4 days following. This necrotomy procedure was continued daily, and this the most important part of our combined treatment method.
    5-FU ointment was applied to the possible tumor region which may be left over from the surgical procedure. We didn't employ arterial infusion of anticancer drug. The results were as follows; the survival rates of 3 and 5 years were 64.6% and 61.8% respectively. The correlation between survival rates and stages showed that survival rates of 3 and 5 years in stage III were 74.8% and 70.2% respectively and that those of 3 and 5 years were both 48.2% in stage IV. The more stage progresses, the worse survival rates. As far as the survival rates of 3 years and the types of direction of tumor invasion were concerned, type A, type AS and type P showed 82.4%, 77.0% and 49.1% respectively.
    These results indicated that the control of progressive maxillary cancer, in particular those invading posteriorly, would not be treated sufficiently even with our combined treatment method.
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  • Yoshinao FUJIWARA
    1984 Volume 30 Issue 6 Pages 779-797
    Published: June 20, 1984
    Released on J-STAGE: July 25, 2011
    JOURNAL FREE ACCESS
    This study was performed to grasping the sensitivities of radiation and a chemotherapeutic agent, Pepleomycin (PEP), on oral squamous cell carcinoma objectively by examining the relationship between clinical effects (tumor regression rates) and time-lapse changes in the nuclear DNA content and nuclear area of cancer cells during treatment.
    A total of 26 cases of oral squamous cell carcinoma were studied. The nuclear DNA content and nuclear area were simultaneously measured by Vickers M 86 scanning microdensitometer after Feulgen staining.
    The results were as follows:
    1. With referring the nuclear DNA content of lymphocytes as control to be 2.0 C, the average values for each of the cases came within the range of 2.4-5.4 C before treatment. The frequency of the cells over 4.0 C was 7-74%. The average nuclear area was 46-120 p2. There was positive correlation between the nuclear DNA content and nuclear area. But the correlation ratio varied depending on cases.
    2. In cases which showed remarkable effects (4 cases) and moderate effects (7 cases), the variances of the nuclear DNA content and nuclear area and the frequency of cells in those which showed twice the modal C value, i. e. the cells at the G2M phases, increased in early stages of treatment. Furthermore, these cases presented polyploidization in the DNA histogram and diffusion in the scattergram. In cases which showed slight effects, these changes tended to delay (6 cases). In cases which exhibited no effects, changes were poor or almost unobserved. These changes almost invariably preceded the appearance of clinical effects.
    3. In cases where modal C value was 4.0 C region or obscure, which were categorized as mode III type, which showed the poly-peak type in the histogram, and which showed high correlation between the nuclear DNA content and nuclear area (the IV type in the scattergram) before treatment, a little change was noted in the DNA histogram after treatment. Many of these cases exhibited no effects clinically. Furthermore, it was found that cells characterized by hyper 2.0 C and small nuclear area were predominant among the remaining cancer cells.
    From these findings, it is conceivable that the changes in the nuclear DNA content and nuclear area in the course of treatment are related to the G2 block effect of radiation and PEP, reflecting some aspect of cell kinetics. Therefore, these analysis seem to have an important significance in the objective evaluation of therapeutic effects.
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  • Masaharu MITSUGI
    1984 Volume 30 Issue 6 Pages 798-817
    Published: June 20, 1984
    Released on J-STAGE: July 25, 2011
    JOURNAL FREE ACCESS
    The aim of this study was to characterize the nuclear atypia of cells for oral cancer in order to establish its new diagnostic criterion from a data analysis point of views, 171 exfoliative normal oral epithelium cells (BEN) from nine cases and 290 exfoliative squamous cell carcinoma cells (MAL) from 15 cases were sampled and examined. After Feulgen staining the nuclear DNA were measured by an autoscanning microphotometer connected to a computer. Multivariate statistical analysis was applied to these measurements. The analysis consisted of 1) analyzing the nuclear atypia of MAL from its varied aspects, 2) detecting MAL by using the linear discriminant analysis, and 3) establishing diagnostic criterion of the cases rather than the cells. The atypia scores of the cells were treated in each case and the malignancy score (MGD: the degree of deviation from the barycenter of the normal cases) was calculated and predicted based upon the mean score of one case and the score of the cell with the severest atypia of this case.
    This method was applied to 24 new cases and the diagnostic results were evaluated 2/3 of the normal cases and 1/2 of the cases of mild dysplasia were evaluated benign, whereas 1/2 of the cases of severe dysplasia and carcinoma in situ and 17/17 of invasive carcinoma were evaluated malignant. Satistical study was attempted on the relationship between the diagnostic results obtained by the present method and the following; 1) level of histological differentiation and 2) clinical course. When MGD values of squamous cell carcinoma cases were compared with the calssification of Broders, Broders I group showed a tendency of having a lower value than those of groups II, I, and IV. As for the clinical course of invasive carcinoma cases, a comparison was made of the MGD values of the surviving satisfactory group showing neither recurrence nor metastasis during the follow-up period of more than two years and of those of the unsatisfactory group which died of tumor. The results of this comparison showed that the MGD values of the unsatisfactory group had a tendti to have a higher value than that of the satisfactory group. This approach of cytoanalysis was useful for the diagnosis and the prognostic estimation of oral cancer.
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  • Kyoko KUMAGAE, Tadamitsu KAMEYAMA, Masato FUTAMI, Takaki KIMURA, Fujio ...
    1984 Volume 30 Issue 6 Pages 818-822
    Published: June 20, 1984
    Released on J-STAGE: July 25, 2011
    JOURNAL FREE ACCESS
    An air-turbine handpiece was used to section an impacted mandibular third molar in an extraction procedure.
    While the handpiece was being used, a sudden swelling of regions of the patient's a submandibular and neck was noticed. After stopping the operation, the patient was admitted to a hospital for observation.
    Chest radiographs showed air in the mediastinal space.
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  • Etsuhide YAMAMOTO, Gen-iku KOHAMA, Shin-ya DENSHO, Yoshio KOMATSU, Haj ...
    1984 Volume 30 Issue 6 Pages 823-831
    Published: June 20, 1984
    Released on J-STAGE: July 25, 2011
    JOURNAL FREE ACCESS
    Characteristics of cervical metastasis after excision of only primary lesion in cancer of the tongue were investigated from clinical and histological findings. Metastasis after treatment was found in 5 out of 16 cases which showed no local recurrence more than one year after excision of only primary lesion. Four of these five cases were clinically small in size (T1:4, T2:1) and endophytic in growth pattern. On the other hand, they were histologically of a tendency of low grade differentiation and high grade nuclear-atypia. The most interesting finding was that these cases all showed diffuse invasion in the tumor-host borderline. These cases were classified into three of grade 4 C and two of grade 4 D in the mode of tumor invasion by modified Jacobsson's criteria (Yamamoto & Kohama, 1982). Duration from the time of primary tumor excision to that of palpation of cervical metastasis was 6-20 months. Size of metastatic tumor ranged from 20 to 80 mm in diameter. Number of metastatic nodes was 1 in three cases, 3 and 7 in one case each. Location of nodes were level 1 and 2 in level of involvement proposed by the UICC. The control of these metastases was not so easy and resulted in bad survival rate (tumor-free survival: 2/5, 40%). Therefore for these cases strict follow up at least for one year and in some situations, prophylactic neck dissection would be recommended.
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  • Haruhiko SAKAMOTO, Akihito ASAKURA, Noriko OTOZURA, Tatsuo KASAKURA, T ...
    1984 Volume 30 Issue 6 Pages 832-837
    Published: June 20, 1984
    Released on J-STAGE: July 25, 2011
    JOURNAL FREE ACCESS
    The patient came to our hospital with a chief complaint of trismus due to glass chips embedded in the face from hitting the car winshield during a traffic accident.
    The patient was a 29-year-old man, who came to our department of oral surgery for posttraumatic trismus 23 days after a traffic accident. Open mouth range was 18 mm and dyskinesia of the right mandibular process was observed. Roentogenographic diagnosis revealed non-permeable images involking glass chips in the anterior, posterior and temporal cavities of the right mandibular process. Because of the trismus, general anesthesia was transnasally performed by inducing the tube with a soft fiberscope. Skin incision was carrier out from the right anterior auricular region by means of the buccal cicatrix, and glass chips in the external, internal, anterior and temporal cavities of the right mandibular process were observed and isolated. Simultaneously, seeing that there was cicatricial contraction of the tanporal muscles, the mandibular process was resected, resulting in an open mouth range of 40 mm. Ten days after operation salivary fistula was formed, which, however, disappeared by compression. Facial paralysis led to the start of functional training from the 18th postoperative day, and 3 months postoperatively the nerve paralysis showed improvement.
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  • Kouji FUJIWARA, Kunio IKEMURA
    1984 Volume 30 Issue 6 Pages 838-841
    Published: June 20, 1984
    Released on J-STAGE: July 25, 2011
    JOURNAL FREE ACCESS
    A 58-year-old woman with adenoid cystic carcinoma of the sublingual gland was reported. Adenoid cystic carcinoma is relatively rare in the sublingual gland. Our case was considered to be sublingual gland origin from surgical and histological findings. This patient was treated with surgical resection and postoperative radiation (5040 rad). She remains disease free during the postoperative period of 11 months.
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  • Shinobu IZUMI, Takayoshi YAMAMURO, Kohzo WATANABE, Jiro NAKAO, Kenzo T ...
    1984 Volume 30 Issue 6 Pages 842-846
    Published: June 20, 1984
    Released on J-STAGE: July 25, 2011
    JOURNAL FREE ACCESS
    A case of reconstruction with deltopectoral flap and labioplasty performed against buccal cancer is reported. Histopathologically, the tumor was a squamous cell carcinoma which infiltrated into the region just before muscularis mucosae. Radiotherapy and chemotherapy were performed prior to epauxesiectomy including buccal skin. Deltopectoral flap was used as double layers, folded at the apex of flap, and deepithelization was performed at the folded site for preventing oro-extra fistula. The flp tip was sutured at the mandibular side and the deepithelized area was sutured at the maxillary side. Four weeks later, the flap was cut off with fevorable prognosis. Howeve, because of doubled flap, trismus occurred and the dental prothesis failed to prepare. Labioplashy with normal lingual mucosal flap and commissuroplasty with double Z plasty (May's method) were thus performed for improving trismus. In consequence, a preparation of dental prothesis become possible.
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  • Takeshi HONDA, Ryo NAKASHIMA, Ichiro MASUI, Katsuma KOMOTO
    1984 Volume 30 Issue 6 Pages 847-855
    Published: June 20, 1984
    Released on J-STAGE: September 13, 2011
    JOURNAL FREE ACCESS
    A case of mandibular prognathism with slight open bite is reported in this paper. The patient, a 21-year-old girl, was referred for the correction of mandibular prognathism. Intra-oral examination revealed an anterior cross bite with overjet at -1 mm and slight open bite. Cephalometric analysis was made and the patient was ultimately diagnosed as skeletal class III malocculusion. Since single operative method seemed difficult to provide a successful outcome, a combinational surgical correction consisted of sagittal splitting osteotomy according to Obwegeser-Dal Pont's method of the right mandibular ramus and stepostectomy using modified Dingman's method in the left side of the mandibular body was performed. In consequence, a sufficient result was obtained with favorable prognosis.
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  • Itsuki KATO, Tokio OSAKI, Keinosuke NAKAO, Akihiko OHNO, Yukinobu TOMI ...
    1984 Volume 30 Issue 6 Pages 856-860
    Published: June 20, 1984
    Released on J-STAGE: July 25, 2011
    JOURNAL FREE ACCESS
    This paper described a case of aneurysmal bone cyst, one of extremely rare nonodontogenic diseases occurring in the jaws. An asymptomatic cystic lesion developed in the lower jaw was noted accidentally in a 14-year-old boy by routine dental X-ray examination and the patient was referred to our clinic for further detailed examination. Although slight bony expansion was palpated on the buccal side of the right premolar region, the overlying mucosa did not show any pathologic changes with healthy teeth in the corresponding region. No swelling of lymph node was observed in the affected region. Panoramic roentogenography revealed a monocystic radiolucent shadow at 543 apex portion, suggesting a presence of bone trabeculae. The margin of the shadow was clear as a whole except for slightly unclear proximal medial portion. A puncture using 20 G needle was performed from 4 apex portion which required intensive compression. Fresh red blood could be aspirated without any resistance. Aneurysmal bone cyst was strongly suggested by clinical and roentographic findings in addition to the result of puncture test.
    A surgical treatment was performed considering the possibilities of recurrence, massive hemorrhage, deformity of the jaw and abnormal occlusion. After intermaxillary fixation, a serial resection of mandible was carried out extraorally including the lesion. After the affected site was completely removed by curettage, the resected bone was returned to the original site and sutured. Clips obtained from the iliac bone was sampled and grafted in the bone defect site. The operation was completed without any abnormal occlusion or deformity of the jaw. No epithelial lying was observed in the tissue removed by operation, and the histopathological finding confirmed the clinical diagnosis.
    Except for sensory paralysis noted in the right submental region, there was no other anomalies. A case of aneurysmal bone cyst was reported in this paper, emphasizing the importance of puncture examination in the clinical diagnosis as well as the surgical procedure for avoiding abnormal occlusion and deformity of the jaws.
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  • Kazuhide KATO, Kenzo TAMAI
    1984 Volume 30 Issue 6 Pages 861-864
    Published: June 20, 1984
    Released on J-STAGE: July 25, 2011
    JOURNAL FREE ACCESS
    Pleomorphic adenomas are the most common salivary gland tumors. They may develop in any anatomic site in which salivary glands are located, including ectopic locations. Paradoxically, the upper lip is the one location where very few mixed tumors develop, even though salivary glands are present in abundance. This report described on a case of pleomorphic adenoma of the upper lip.
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  • Seiji KITAYAMA, Hiroshi HACHIYA, Toshihiko KAWAI, Hajime ODA, Tohru NA ...
    1984 Volume 30 Issue 6 Pages 865-871
    Published: June 20, 1984
    Released on J-STAGE: July 25, 2011
    JOURNAL FREE ACCESS
    It is considered that the flow of lymph and its metastasis may occur along the mental region when an inferior labial tumor infiltrates into the white labial portion. For treating this kind of tumor, Martin's method employing the resection of the mental region through vertical incision from the vermillion border down to the lower margin of the mandible is suitable. This method increases the degree of radical treatment for tumors on one hand, but makes difficult to reconstruct the lower lip because of enhanced buccal tone on the other hand.
    We now apply a modified Martin's method by adding incision on the lower margin of the mandible in the case of resection of inferior labial tumor and/or regional lymph vessel. For the reconstruction of inferior labial defect site, extensive cheek advancement flaps are used according to Fries's myoplastic method and our modifications mentioned above.
    The method has been applied in three patients with satisfactory results both esthetically and functionally as of 6 months after operation.
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  • Yoshikazu HAYATSU, Masato SAWAMOTO, SUSUMU OKITA, Hiroshi ODAKE, Toshi ...
    1984 Volume 30 Issue 6 Pages 872-878
    Published: June 20, 1984
    Released on J-STAGE: July 25, 2011
    JOURNAL FREE ACCESS
    The authors have done a clinico-statistical observation of maxillofacial fractures.
    The subjects were 68 patients who visited the Department of Oral and Maxillofacial Surgery, Toyama Medical and Pharmaceutical University Hospital, during a period of four years.
    The result were as follows:
    Of the 68 patients, 45.6% were aged 10-29 years, with a peak incidence of fractures occurring in the 10-19 year age group. Males constituted 82.4% of all the patients in the present study.
    Trauma due to road accidents caused the injuries in 41.2% of all the patients.
    The most common fracture was of the mandible (55 cases), followed by fracture of the midface (10 cases) and combined mandible and midface fractures (3 cases).
    Fifty-two cases were treated by close reduction (76.5%), while sixteen cases were treated by open technique extraorally or intraorally.
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  • Michio SAITOH, Takahide KOMORI, Nagahisa FUJIMURA, Toaki ONO, Shoji EN ...
    1984 Volume 30 Issue 6 Pages 879-883
    Published: June 20, 1984
    Released on J-STAGE: September 13, 2011
    JOURNAL FREE ACCESS
    The granular cell tumor is a circumscribed nodular lesion arising from the dermis or subdermal or submucosal tissue. Histlogically, the tumor is abenign lesion and it contains characteristic granules within the cytoplasm. Although the lesion occurs in various parts of the body, the oral cavity, paticularly the tongue, appears to be the most common location. Usually it occurs singly, but multiple lesion can be seen occasionally
    On March 17, 1980, a 38-year-old woman came to our clinic, complaining of a nodule in the tongue. The lesion had been presented for about 4 months and had not caused any pain and discomfort.
    She had received a resection of fibroma in the left breast in 1976.
    Family history was negative and she was in appearently good health.
    Clinical examination of the oral cavity revealed the presence of 2 nodules. One was flat, about 10×8×2 mm in diameter, located slightly left of the midline of dorsum of the tongue. The covering epithelium appeared granulous and slightly red in color. Palpation revealed that the nodule was clear in border, pedunculated and hard with elasticity.
    On the right lateral border of the tongue, the other was palpated with hard-elastic nodule. It was rhombic, flat and yellow in color about 10×5 mm in diameter and has slightly diffused swelling. It has indistinct border and adhered to muscle layer.
    On April 25, the nodule on the left side of the dorsum of the tongue was excised with the surrounding tissue under local anesthesia and the lesion on the right lateral border of the tongue was excised on May. 20. To this date, we can not find tendency of recurrence. Histopathologically, the tumor showed marked proliferation of granutlar cells. Neoplastic cells proliferated in the subepithelial layer and partially extended to muscular layer.
    In the covering epithelium pseudoepitheliomatous hyperplasia was remarkable. Cytoplasmic granules stained with PAS reaction were not decolored by diastase. From the examination of the specimen stained with Bodian method, definte axon was occasionally found in the cytoplasm. Electron microscopically, groups of granular cells were surrounded by basal lamina. Numerous cytoplasmic granules were supported by a limiting membrane and had the lysosome-like structure. Myofibrils were not found in the cytoplasm. The pathological diagnosis of the two nodules was granular cell tumor. The tumor cells were suspected to be a neurogenic orign.
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  • Takahide KOMORI, Michio SAITO, Toshiaki IWASA, Toaki ONO, Shoji ENOMOT ...
    1984 Volume 30 Issue 6 Pages 884-890
    Published: June 20, 1984
    Released on J-STAGE: July 25, 2011
    JOURNAL FREE ACCESS
    A pigmented nevus is defined as a hamartornatous proliferation of the melaninproducing cells (nevus cells). It is usually rare on the oral mucosa, especially the junctional type. In this report we presented the junctional typed nevus on the palate and its treatment using the laser vaporization.
    The patient was a 77-year-old man. About two years ago he was pointed out the pigmentation on the left hard palate by a dentist. But as the lesion was a symptomatic, he had received no cure. At the beginning of Oct. 1981 when he had the dental treatment, the increased pigmentation was pointed out again and he was referred to our university clinic by the same dentist. He had been diagnosed as having hypertension and chronic bronchitis five years before and had the operations for gastric ulcer three times. In the clinical examination of the oral cavity, a black, irregularly shaped, pigmentation approximately 20×8 mm was observed on the hard palate. The lesion was smooth and flat and not elevated. It had no ulcer or bleeding. The tomography of the maxilla showed no invasive destruction of the bone.
    Aa biopsy revealed histopathologic changes indicating a junctional typed nevus, we performed CO2 laser vaporization using Surgical laser system 400, a product of Coherent, on Jan. 19, 1982. It was done under the focused beam, continuous wave and the range of 10-15 w output. At follow-up two years postoperatively, the patient was free of symptoms.
    By light microscopic findings there observed many nevus cells containing melanin pigment in the basal and parabasal layers of the epithelium, but not in the deep area of dermis. By electron microscopic findings nevus cells contained melanin granules of various sizes. Tonofilaments were not observed in the cells, and no desmosomes around the cells.
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  • Norifumi NAKAMURA, Yasuharu TAKENOSHITA, Yoshinori HIGUCHI, Toshio NAG ...
    1984 Volume 30 Issue 6 Pages 891-896
    Published: June 20, 1984
    Released on J-STAGE: July 25, 2011
    JOURNAL FREE ACCESS
    Many patients with temporomandibular joint dysfunctions can be seen, however, lesions with organic changes in the condyle which involve chiefly benign tumor and hyperplasia, are relatively unusual. Particularly eosinophilic granuloma of the mandibular condyle is very rare. Clinical diagnosis of the lesions in the mandibular condyle is difficult, as radiography of symptomatic areas is the only effective technique.
    In the present case, radiographically poorly demarcated bone defect appeared to involve the entire condyle. Computed tomographic radiography and scintigraphic examination revealed that the lesion was localized in the condyle. At that stage, a defined diagnosis was not made, but the following tentative opinions were ventured: osteomyelitis, eosinophilic granuloma, giant cell granuloma, Ewing's tumor and osteosarcoma. Biopsy under local anesthesia was performed. As eosinophilic granuloma was mostly suspected on histological examination of an immediate frozen-section, the lesion was curetted as much as possible.
    Excision or irradiation are the mainstream of therapy. In the present case, conservative surgical removal was effective. Postoperatively, the temporomandibular joint dysfunction disappeared and the course was favorable.
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  • Masami FUJINO, Tetsuo NAGAI, Takuma MIURA
    1984 Volume 30 Issue 6 Pages 897-903
    Published: June 20, 1984
    Released on J-STAGE: July 25, 2011
    JOURNAL FREE ACCESS
    We describe a unique case of 12-years-old girl who was referred to this clinic because of gingival hypertrophy, loosened teeth, and painful leg.
    A panoramic dental radiograph of the patient revealed a number of abnormal features including cancellous bone destruction with diffuse cloudiness especially noticeable in the premolar and molar regions, loss of alveolar crestal bone, disappearance or thinning of lamina dura of the premolar and molars, disappearance of the mandibular nerve canals, thickening of periodontal membrane space, and enlargement of the both mental foramina.
    After examinations of the peripheral blood and the bone marrow, the case was diagnosed to be B-cell acute lymphocytic leukemia.
    Although antileukemic chemotherapy was undertaken at the pediatrics, she died on the 66th hospital day because of interstitial pneumonia.
    Thus, we suggest that panoramic radiography of the jaws could provide an important clue for diagnosis of some kind of leukemia.
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