This study included an immunohistochemical investigation of the local site of oral lichen planus with regard to the condition of appearance of immunoglobulins, C3 and fibrinogen, band-like infiltrate analyzed by monoclonal antibody, and Langerhans cells, which have recently been attracting attention as immunocompetent cells at the epidermis.
The subjects were 15 patients with oral lichen planus. Ig G, Ig M, Ig A, C3 and fibrinogen were determined by immunoperoxidase staining and immunofluorescence. Band-like infiltrate and Langerhans cells were studied using monoclonal antibodies, i. e., the Leu series and OKT 6, respectively. Observations by usual light microscopy and electron microscopy were also carried out. The results were as follows.
1. All cases were negative for immunoglobulins and C 3 in the marginal area of the epithelial tunica propria. 2. All cases were positive for fibrinogen in the marginal area of the epithelial tunica propria. Its staining pattern had a generally band-like appearance. On the whole, the band was broad and distinct at sites presenting a typical histological picture of marked cellular infiltration of the tunica propria, while it was narrow and rather obscure at sites of mild infiltration. In addition, the appearance of fibrinogen almost agreed with that of amorphous material in the basal membrane observed electron microscopically. 3. The bandlike infiltrate was mainly composed of T lymphocytes. Among their subsets, helper/inducer T lymphocytes tended to predominate over suppressor/cytotoxic T lymphocytes. 4. In the normal oral mucosa, Langerhans cells positive to OKT 6 monoclonal antibody wer found sporadically the prickle-cell layer directly above the epithelial basal layer. In contrast, in oral lichen planus, such cells were distributed profusely from the lower one-third of the prickle-cell layer to and into the band-like infiltrate, centering on the basal layer in the area of typical lesions.These cells were also relatively numerous in areas showing a lower degree ofinfiltration. 5. From these findings, involvement of the humoral immunity mechanism with immunoglobulins in this condition is inconceivable. It is suggested, however, that a mechanism of cell-mediated immunity against some mild and persistent antigenic stimulation in the epithelial basal area is involved.

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Neutrophils are thought to play an important role in the host defensive system against bacterial infections. Previously, we reported that peripheral blood neutrophil function was enhanced in acute bacterial infections and that elevated neutrophil activity returned to normal following recovery. In this study, peripheral blood neutrophil function of the patients with oral serious infections was investigated in order to elucidate the mechanism of its occurrence and persistence.
For this purpose, peripheral blood neutrophils were obtained from 7 patients with oral serious infections-namely, 3 patients with chronic osteomyelitis of the lower jaw, 2 patients with suspected actinomycosis of the jaw, one patient with radioosteomyelitis, and one patient with prolonged cellulitis of the mouth floor. Then, binding activity, chemotaxis, phagocytic and killing activity, and oxidative metabolic activity were estimated respectively. Killing activity was estimated by nitroblue tetrazolium reduction test and oxidative metabolic activity was measured by the production of luminol-dependent chemiluminescence.
Although slight enhanced phagocytosis was observed, other neutrophil activities were decreased in the patients with oral serious infections. Especially, the production of luminoldependent chemiluminescence was markedly reduced when compared with that of normal volunteers. These results suggest that reduced killing activity may result in persistent or severe infections.

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Freezing procedures applied extensively or to deep regions have become popular in recent years, and so their effect on nasal cartilage adjacent to the oral cavity and on articular cartilage should be considered. The author discusses the clinical application of freezing techniques, after examining rabbits whose auricular cartilage was frozen.
Macroscopic findings were that the edema was the greatest on 3 days, the frozen region was covered with scabs in 1 week, these scabs began to desquamate in 3 weeks, and the frozen region was finally epithelized in 6 weeks, with hypertrophied elastic hardness.
Histologically, the epithelium recovered in 4-6 weeks after freezing. The edema and infiltration of the inflammatory cells were decreasing at 4 weeks, but were still found in some cases in 14 weeks. The cartilage of frozen area was stained less than nonfrozen area 12 hours after freezing, and the perichondrium was swollne before absorption of the cartilage started in 2 weeks.
In the peripheral region, fibroblasts were occasionally found in 1 day. In 5 days the perichondrium was hypertrophied about 2 mm from where the epithelium had become necrotic for freezing. New growth of the cartilage was seen in this region in 1 week. Destruction of the old cartilage and growth of new cartilage continued thereafter, the frozen region almost replaced by new cartilage in 8-14 weeks. The new cartilage was thicker than the old, and was irregular in form.
Growth of new irregular cartilage and destruction of the old was still occuring even in 14 weeks, and this suggests that clinical freezing procedures should be applied carefully to tissues near cartilage.

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The rate of epithelialization on intraoral operative wounds was studied with special reference to the influence of blood supply disturbance on mucosa surrounding wound and of the nature of wound surface. A standardized wound was made on the rat hard palate and after various surgical treatments the epithelial extension from the wound edge was observed.
Results
1) Epithelial extension depended mainly on migration of the epithelial cell.
2) The disturbance of blood supply to the surrounding mucosa prolonged the lag period, then the extension started. This factor did not infleunce the rate of epithelialization thereafter.
3) In the groups in which the deep portion of the lamina propria was preserved on the wound surface, the rate of epithelialization was 0.19-0.21 mm/day. This value was similar to that reported previously about open skin wounds.
Saliva eased dehydration of the connective tissue surface of wounds but did not accelerate epithelialization.
4) In the groups in which the palatal bone was exposed to the wound surface, epithelialization was very slow because proliferation of the connective tissue was needed for the epithelial extension. But once the wound surface was covered with a new connective tissue, rate increased to half the level of the groups with the intact deep portion of the lamina propria preserved.
5) When the deep portion of the lamina propria, which was suffering from blood supply disturbance, was left on the wound surface, the rate of epithelialization was half the level of groups with the intact deep portion of the lamina propria preserved.
6) Edema and inflammation in the wound connective tissue decreased the rate of epithelialization.
7) From these findings, it can be stated that the nature of the wound surface is a very important factor which influences epithelialization of intraoral operative wounds. To increase the rate of epithelialization, it is effective to preserve the intact lamina propria in the wound and secondarily to accelerate proliferation of the granulation tissue. It is also effective to prevent inflammation of the connective tissue in the wound.

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The purpose of the present study was to elucidate the effect of mandibular fracture, one of causes of retardation of the postnatal mandibular development, on the growing condyle. Three groups (Groups A, B and C) of young rats, five weeks old, were used. In Group A, the mandible received no treatment. In Group B, the right mandible was sectioned with a dental fi ssure bur, and then the wound was merely closed. In Group C, the right mandible was also sectioned, but an aluminium foil was placed between the two fragments. The animals of the above three groups were killed 1, 2, 4, 6, and 8 weeks after treatment, and the mandibular condyles were examined radiographically and histopathologically.
1. Radiographic observations
(1) The mandibular condyles in Groups B and C were similar in size to those in Group A at 1 and 2 weeks. However, the mandibular condyles in both groups were smaller than those in Group A at 4, 6, and 8 weeks.
(2) In Group B, a clear radiolucent line was observed in the fracture site at 1 week. However, the line became indistinct with weeks. The fracture line was not clearly identified at 8 weeks. In Group C, the fracture line was clearly distinguished throughout the entire experimental period.
2. Histopathological observations
(1) In Group B, all zones (the zones of articulation, proliferation, differentiation, and hypertrophy) in the mandibular condyle were similar in structure to those in Group A at 1 week. However, the zones of proliferation, differentiation, and hypertrophy in the condyle were less cellular and thinner than in Group A at 2, 4, and 6 weeks. The above three zones in the condyle became similar in structure to those in Group A at 8 weeks.
(2) In Group C, all zones in the mandibular condyle were similar in structure to those in Group A at 1 week. However, the zones of proliferation, differentiation, and hypertrophy in the condyle were less cellular and thinner than those in Group A at 2, 4, 6, and 8 weeks.
(3) In Group B, the two fragments in the fracture site were connected with each other by fibrous and cartilagenous tissues throughout the entire experimental period. The connection of these fragments became tighter with weeeks.
(4) In Group C, because of insertion of an aluminium foil, the two fragments in the fracture site were not connected with each other throughout the entire experimental period.

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I carried out scanning electron microscope observations, of the rabbit, mongolian gerbil, dog, cat, and Japanese monkey joint discs, all having different occlusion organs respectively, in order to elucidate the functional significance of the temporomandibular joint disc. I investigated the three dimensional fiber architecture of the discs and obtained the following results.
1. The superior and inferior articular surfaces of all joint discs were covered with membranous structures organized from fine collagen fibrils of 0.1-0.2 μ in diameter.
2. Fold-like structures were observed in the superior and inferior articular surfaces of all the joint discs.
3. The fold-like structures reflected the fiber architecture inside the joint discs.
4. Differences in the fold-like structures were observed in the comparative study of the various animal species.
5. The fiber architecture of the matrix in the central portion of each joint disc was made up of fiber bundles running in an anteroposterior direction, but in the case of the dog and cat, these fiber bundles were of a wavy configuration.
6. The fiber architecture of the matrix in the mediolateral peripheral margins of each of the joint discs was mainly made up of fiber bundles running parallel to the peripheral margins. No clear differences could be established among the various animal species.
7. The fiber architecture of the anteroposterior peripheral matrix in all the joint discs was in common fiber bundles which ran parallel to the peripheral margins, interweaving with fi ber bundles running in an antero-posterior direction. However, the anterior peripheral matrix in the case of the cat was different.
8. Chondrocytes were noticed in the rabbit and mongolian gerbil, but the locations were different.
9. The joint disc of the monkey differed from the others by having an architecture that was resistant to multi-directional stress and to deformation.

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A 2 mm spot size focused beam from a continuous wave surgical carbon dioxide laser with diameter, integrated with an operating microscope was used to evaporate the normal dorsal surfaces of rabbit tongues under different conditions. The immediate effects of irradiation with carbon dioxide laser on the dorsal surface of the tongue were studied macroscopically and microscopically, and wound healing was examined microscopically, 1, 3, 5, 7, 14 and 21 days after he laser irradiation. The results were as follows.
1) The immediate change induced by a focused beam carbon dioxide laser was characterized by white coloration on the targetarea up to a laser emission of 1 Joul and by tissue defect formation when emission exceeded 2 Joul.
2) Tissue defect was characterized by a cone shape, and the floor of the defective was portion was slightly elevated at its center in some cases. The margin of the defective portion was slightly elevated over surrounding normal tissue.
3) The depth of tissue defect varied with output power and irradiation time. In the same output power, the depth of tissue defect was directly proportional to irradiation time.
4) Microscopic findings immediately after the laser irradiation varied with irradiation conditions. At 5 watts 0.1·0.2·0.5 second and 10 watts 0.1 second laser irradiations, tissue damage was only seen at the prickle-cell layer of the mucosal epithelium and the basal layer was not damaged. At 5 watts·1.0 second, 10 watts·O.2 second, 15 watts·O.1·0.2 second and 20 watts 0.1 second laser irradiations, tissue damage was seen beyond the basement membrane and in the submucosal layer, but the muscle layer was not damaged. At 10 watts 0.5·1.0 second, 15 watts·0.5·1.0 second and 20 watts·0.2·0.5·1.0 second laser irradiations, the muscle layer was damaged.
5) Wound healing differed according to the depth of tissue damage immediately after the laser irradiation mentioned above. Wound healing was fast and finished within 7 days after the laser irradiation in the group that tissue damage was limited only to the prickle-cell layer of the mucosal epithelium. In the group that tissue damage was seen beyond the basement membrane and in the submucosal layer, and did not extend to the muscle layer, wound healing finished within 14 days after laser irradiation, but in the group that tissue damage extended to the muscle layer, 21 days were necessary to complete wound healing.
From these results, it is speculated that the carbon dioxide laser will be effective to remove superficial lesions of the oral mucosa and of benefit to oral and maxillofacial surgery.

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The ameloblastic fibroma is known as a tumor of odontogenic origin characterized by proliferation of both epithelial and mesenchymal odontogenic tissues without the formation of hard tooth structures. The ameloblastic fibroma have been reported on only 29 occasions in the Japanese literature. An additional case of ameloblastic fibroma of the right mental region in a 16-year-old male is reported. The relevant features of ameloblastic fibroma were reviewed and discussed.

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A case of calcifying epithelioma arising from Regio parotideomasseterica in a 27-year-old man is presented.
Reports of calcifying epithelioma from oral surgeons are rare, and we could review only 9 cases in the literature in Japan.
As a parotid gland origin tumor was doubted clinically because of the location, we removed the tumor with Pars superficialis parotideus.

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A 58-year-old woman with an adenoid cystic carcinoma of the bilateral maxillary bone and paranasal sinus was reported. Adenoid cystic carcinoma is rare in the paranasal sinus membrane. Our case was considered to be paranasal sinus membrane origin from clinical prognosis and examination.
However, no histological evidence was obtained that can determine the site of tumor origin. The patient was treated with chemotherapy, surgical resection of maxilla and postoperative irradiation, and was free from local recurrence and distant metastasis 40 months after operation.

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A 58-year-old man complains of spontaneous and contact pain on the right inferior surface of the tongue. He did not agree to an operation, and regional arterial infusion and Ra-needle therapy were not performed by obstruction of the cannula and spontaneous falling off of needls. About eighty percent of the tumor mass decreased after one course of four-drug combination chemotherapy with vincristine, methotrexate, pepleomycin and mitomycin C, and he was released from pain.
There was a scar and small white lesion, and the tumor disappeared macroscopically after the second course administered with an interval of 2.5 weeks from the first course.
The patient has been asymptomatic without distance metastasis and recurrence for nine months. Carefull observation and immunotherapy are necessary in the future.

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We studied clinically 111 cases of tongue cancers from 1960 to 1978 at the Second Department of Oral and Maxillo-facial Surgery of Tokyo Medical and Dental University, and obtained the following conclusions:
1) Of 111 tongue cancer, 77 cases were male and 34 were female the average age was 53.3, the portions were mostly the side edge of the tongue, most frequent chief complaint was pain, and 94.6% was pathologically squamous cell carcinomas.
2) Cases treated by surgery were 40, treated by irradiation were 60, treated by surgery and irradiation were 10, And 49 cases of the 111 received chemotherapy.
3) The 5-year survival rates of high stage cases (Stage III and IV) wer lower than those of low stage ones (Stage I and II).(The 5-year survival rates; Stage I: 94.7%, Stage II: 69.1%, Stage III: 47.9%, Stage III:(Meta-) 60.2%, Stage III:(Meta+) 36.7%, and Total: 60.5%.)
4) The surgery group showed the highest 5-year survival rate (76.6%), followed by the irradiation group (53.3%), and the surgery and irradiation group (50.0%).
5) The Differences of 5-year survival rates between the group of cases receiving and those not receiving chemotherapy were not clearly detected.
6) Cases with metastasis of cervical lymph nodes treated by neck dissection surgery for the first treatment showed a markedly lower 5-year survival rate (30.8%) than those without lymph node metastasis (85.7%). Cases with metastasis of cervical lymph nodes treated by neck dissection surgery for the second treatment showed a lower 5-year survival rate (33.3%) than those without lymph node metastasis (50.0%).
7) Considering those facts, we can state the following: The prognosis of Stage 111 patients with metastasis of cervical lymph nodes were most unfavorable, and some Stage If patients might require more radical treatment.

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Ostopetrosis is characterized by a prominent radiologic feature of generalized skeletal sclerosis. The disease is divided into a severe malignant type which appears in infants or children and a benign type which usually appears in adults.
Osteomyelitis is a serious complication of osteopetrosis, occurring most frequently in the mandible. We present here a 35-year-old male patient with osteopetrosis associated with mandibular osteomyelitis which was caused by the extraction of an impacted wisdom tooth. The osteomyelitis was successfully treated by extensive surgical debridements and sequestrectomies.

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A case of postsurgical ocular complications, i. e. bilateral visual impairment after the open reduction of facial fractures is herein reported.
The patient was a thirty five year old male, who in an automobile accident was struck on the left facial area by the steering wheel on December 24, 1981. He was temporarily unconscious and bleeding from the mouth and nose. The left pupil was dilated and didn't react to direct or indirect light, thereby peripheral paralysis of the left oculomotorius was suspected. He was noted to have a remarkable malocclusion and was sent to the department of oral surgery.
When transfered to our hospital on December 28, 1981, the patient had swelling in the left facial area, a slight depression in the left malar portion and a left pen-orbital purpura. Despite marked subconjunctival hemorrhage no limitation of ocular movements and no diplopia were observed.
Visual acuity on the right was 1.5 (n. c.) and on the left 0.6 (n. c.). Upon funduscopy a slight degenerative change of the macula of the left eye was noted. Radiographically, mandibular, Le Fort 3 type, sagittal, and right clavicular fractures were revealed.
Open reduction surgery was performed under general anesthesia on January 6, 1982. Immediately after the operation the patient complained of severe headache and abdominal pain. Diplopia and lagophthalmus in the left eye appeared on the fourth postoperative day. Ocular examination revealed a bilateral reduction in visual acuity to 0.2 (n. c.), moderate midriasis in the left eye and decreased intraocular tension in each eye were also evident. Funduscopic examination showed a mild edema in the macular area of both eyes. Fluorescent fundus angiography disclosed moderate leakage and serous retinal detachment, consequently the diagnosis of Harada's disease was made.
Steroid hormone and a high osmotic agent were promptly administered. Visual acuity was restored to 1.0 and 0.7 respectively after 40 days of chemotherapy and diplopia disappeared. The intermaxillary fixation was removed on February 18. Although very slight lagophthalmus remained in the left eye, the patient was discharged on the 59 th hospital day.
Discussions about postsurgical ocular complications in the case of facial fractures followed. Because the eye is often covered with an eyepatch and swelling after trauma or surgery, early fi ndings of vision loss are easily overlooked, therefore surgeons should pay special attention to finding visual impairment.

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Three cases of large follicular dental cyst in the maxillary sinus region are reported. They are all females.
Case 1 aged 25 years had a hen's cgg-size cyst.
Case 2 aged 13 years had a child's fist-size cyst.
Case 3 aged 20 years had a hen's egg-size cyst.
Enucleation of the cyst combined with Caldwell-Luc procedure was performed in each case with successful postoperative course.

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Mesenchymal chondrosarcoma (MCS) was originally reported by Lichtenstein and Bernstein in 1959. A limited number of cases, however, has been reported to the present. Histological findings of several parts of this tumor are similar to those of the hemangiopericytoma (HP), reticulum cell sarcoma, and other small-cell tumors.
The present report demonstrates a 23-year-old female with MCS of the left maxillary region. The histological diagnosis was considered to be HP based on the findings of a small biopsied specimen. Partial maxillectomy was performed under general anesthesia. The histological findings of the various parts of the resected tumor, however, provided a diagnosis that the tumor was MCS with similar histological features of HP in some parts.
In this report, we have discussed the difference in clinical findings between MCS and HP.

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A new type of direct bonding bracket for teeth and intermaxillary fixation has been recently devised An additional hook designed bracket can be used for intermaxillary wiring, while a transverse wide slot on it's surface serves for the insertion of a 1.0 mm diameter wire whict is nsed for teeth fixation. By means of a 4-META adhesive resin, we tried to bond 359 brackets on tooth surfaces in 26 cases of fractured jaw, orthognathic surgery, etc. The frequency of breakage of bonding has been as low as 9 of 359 teeth (2.8%). The technique utilizing our new direct bonding bracket with 4-META adhesive resin has been found most effective and convenient in cases of fractured jaw and orthognathic surgery. Many of the disadvantages of conventional arch bars appear to be overcome with this new technique.

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The histogenesis of the lymphoepithelial (so-called branchial) cyst has been a matter of speculation and controversy for some time. The most popular hypotheses implicate the branchial apparatus, the thymic duct, and parotid salivary gland inculusions in lymph nodes.
Lymphoepithelial cysts occurring within the parotid gland are rare developmental anomalies.
A lymphoepithelial cyst within the parotid gland in a 52-year-old man is reported.
The patient had a six-month history of a gradually enlarging mass lesion anterior to his left ear. A parotid sialogram and computed tomographic examination revealed the presence of a mass lesion in the upper portion of the superficial lobe. The clinical diagnosis was benign parotid tumor. Under general anesthesia, excision was performed. Approximately 5 ml of yellowish fluid was removed and biochemical analysis revealed high activity of LDH and γ-GTP. Histologically, the cyst was lined with squamous epithelium or cuboid epithelium which was surrounded by lymphoid tissue with follicles.
There has been no recurrence of the lesion to date, 16 months after operation.

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An aggressive fibromatosis is a tumor-like fibrous lesion, and it resembles a welldifferenciated fibrosarcoma histologically. It is clinically aggressive to the surrounding tissues, but has no metastasizing ability. This report presents a rare case of an aggressive fibromatosis involving the inferior border of an infant mandible.
A three-year-old girl first visited the First Department of Oral Surgery, Tokyo Medical and Dental University, on April 26th, 1982. At that time, a firm 35×45mm mass was found in the right submandibular region.
The parents had found the painless mass in the left lower face of the patient November, 1981. At the first visit to our department, this mass showed cartilage-like hardness, and the demarcation of the mass was relatively definite but not tender. Submandibular lymph node was not palpable. Intraorally diffuse swelling was seen on the buccal site of the first and second deciduous molar region. Radiographically undermining bone defect was found at the lower border of the mandible beneath the second deciduous molar and the unerupted permanent first molar. By incisional biopsy the diagnosis of aggressive fibromatosis was made.
On May 24 th, 1982, segmental resection of the mandible including the surrounding tissues, masseter muscle and submandibular gland was carried out.
Examination of biopsy and surgical materials showed similar appearances. Tumor-like proliferation of fibrous tissues in the submandibular region invaded the cortex of the mandible and the periphery of the submandibular gland, but not into the bone marrow, the parenchyma inner portion of the submandibular gland, or the regional lymph node. Microscopic examination revealed cellular proliferation of elongated, spindle-shaped fibrocytes and fibroblasts with interlacing budles of collagen fibers. Cellular atypia was slight, and mitotic figure was little.
There was no evidence of recurrence or metastasis in the patient for 2 years and 5 months after the operation.

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Two cases of Lymphangiomatous macroglossia associated with severe open bite are presented, one is a 9-year-old girl and the other is a 6-year-old boy.
Examination of the lateral cephalograms indicated that both cases had similar craniofacial morphology.
In the skeletal pattern, high mandibular plane angle, large gonial angle, long anterior lower face height, long effective mandible length were observed; in the denture pattern, labial inclination of the upper and lower incisors were observed.
Surgical reduction of the tongue size was performed.

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Twelve cases of mandibular fracture were treated, applying monocortical osteosynthesis with Champy's miniature screwed plate by intraoral method. The operative technique was easy, and in the case of single fracture, the operation was possible under local anesthesia with minor tranquilizer application.
The advantages were as follows:
I. Intraoral approach to the mandibular fixation was possible due to the rational flexible miniaturized materials.
2. Reduction of the period of inter-maxillary fixation compared with conservative treatment.
In our experience, complications such as postoperative infection, wound debiscens, malunion, etc., were not found except in one case which had shattered bone fragments.
This method can be applied to various types of mandibular fractures, but it may be technically difficult in the case of premolar region or shatter fracture. It was considered that this method was effective for the treatment of mandibular fractures although there is a certain limitation to the application of the method.

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We report a case of adenomatoid odontogenic tumor, between the right maxillary lateral incisor and cuspid teeth in a 18-year-old girl.
On radiographic examination, the tumor was suspected of a globulo-maxillary cyst.
We further discuss the tumor's histogenesis and the nature of eosinophilic material at light microscopic level using various histochemical stainings.
Results were summarized as follows:
1) Duct-like and rosette-like structures were composed of columnar cells and spindle-shaped cells.
2) The nuclei of the columnar cells forming the duct-like structures were polarized away from the ducts.
3) Eosinophilic materials were often found in the above mentioned duct-like and rosettelike structures and solid cell masses in tumors.
4) The eosinophilic materials in the duct-like and rosette-like structures were positive for periodic acidschiff (PAS), alcian blue or toluidine blue staining, on the other hand the eosinophilic materials in the solid cell masses were negative for PAS.
5) Hematoxylinophilic materials in the solid cell masses were positive for PAS but negative for alcian blue.

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Neurilemmoma is a benign neoplasm believed to arise from the sheath of Schwann.
There are few cases of neurilemmoma in the fields of the oral and maxillofacial surgery. In 316 cases of non-odontogenic benign neoplasms recorded in the First Department of Oromaxillo- facial Surgery of Aichi-Gakuin University from 1975 to 1980, only 6 cases involved it.
We experienced an extremely rare case of neurilemmoma of the left mandibular body in a 5-year-old girl.
CT (computed tomography) numbers of the tumor were similar to neurilemmomas of greater nerves by CT examination.
The tumor was seen to arise from the molar branch of the inferior alveolar nerve at the midst of operative findings.
After excision of the tumor, cryosurgery (Zacarian C-21) was done immediately to the part of the defect of the mandibular body to prevent recurrence.
Paralysis of the inferior alveolar nerve was relieved 21 days after the operation.
Twenty one months after surgery, there has been no recurrence of the tumor and the prognosis is very good.

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Basal Cell Nevus Syndrome (BCNS) is primarily considered an autosomal dominant hereditary disease with the basal cell epithelioma, multiple jaw cysts and various skin and skeletal anomalies since Gorlin and Goltz reported the idea of this syndrome in 1960.
The cases reported as BCNS for the past two decades, however, showed several differences in symptoms from the original idea, such as a lack of skin lesion or jaw cyst.
The present study is intended to find a rationale of the diagnostic cues to BCNS by reviewing 60 cases reported in Japan involving 5 cases experienced by us.
The result indicates that BCNS could be diagnosed based on the condition of either skin lesion or multiple jaw cysts with one of the following symptoms: Evidence of a family history, bifid ribs, pits, lamellar calcification of the falx cerebri and other skeletal anomalies. It is considered that these criteria are pertinent to those reported by Rayner (1976) and Gundlach (1979).

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Ameloblastic fibro-odontoma, which is an odontogenic tumor similar to the ameloblastic fibroma, is associated with hard tissues, i.e., dentins or osteodentins, and enamels in the soft tissues. The condition is very rare, so that there have been only a few reports on it. The authors experienced two cases with this tumor: Case 1, a 5-year-old boy, had a tumor of the left maxilla; Case 2, a 9-year-old girl, had one in the right mandibular. The histopathological findings from Case 1 showed enamel formation and dentin formation with distinct trabecular structures in the ameloblastomatous tissues of part of the parenchyma of the tumor and sporadically showed differentiated tooth-germ-like structures along with an increase in relatively juvenile fibrous elements in the interstitial tissues. The histopathological findings from Case 2 showed proliferation of the juvenile connective tissues similar to the dental papillae, containing spindle cells of the interstitial tissue. In the connective tissues, proliferating lesions of the odontogenic epithelium that showed small and massive or restiform structures were observed. These were similar to those of the ameloblastic fibroma. In some of the lesions there were odontogenic hard tissues surrounded by irregular osteoid structures.
As treatment, the tumor, including the teeth in the tumor, was excised and extirpated together and the wound was closed in Case 1 and extirpation of the tumor and marsupialization were undertaken with preservation of the teeth in the tumor in Case 2. There is no recurrent tendency at present, and Case 2 particularly has shown eruption of the teeth in the dentition. In this study, these two cases are reported together with reference to the literature.

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A case of tuberculous lymphadenitis in the right submandibular and upper neck regions is presented. Patient Y.T., a 37 year-old female, with a chief complaint of swelling of the above regions was referred to our clinic.
On oral examination, the swelling of submandibular lymphnodes and gland was palpable, although no apparent dentigerous legions were observed. Roentogenographic findings including sialography indicated the presence of calcified bodies and chronic sialoadenitis in the submandibular region. Both PPD reaction and abnormal findings of chest X-ray were negative.
It was thus diagnosed clinically as chronic sialoadenitis and lymphadenitis. Under general anesthesia, extirpation of lymphnodes and gland was performed. Histopathologic examination showed typical tuberculous lesions with calcified bodies in the lymphnodes and chronic sialoadenitis.

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A case of cavernous hemangioma containing phlebolithiasis in the submandibular region in a 46-year-old Japanese woman was presented. The patient complained of a painless swelling in the sublingual to submandibular regions, which caused mild dysphagia and speech disorder. Plunging ranula with sialoliths were suspected from the initial clinical findings. However, a sialogram revealed that calcified materials were located free from the submandibular gland and its duct. A later CT angiogram showed a marked enhanced mass in the submandibular region. The tumor was surgically removed under general anesthesia and was diagnosed as cavernous hemangioma histopathologically.
We believed that sialography and CT angiography should always be performed for the differential diagnosis of diseases suspected of hemangioma.

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Malignant smooth-muscle tumors are common in the uterus and gastrointestinal tracts, but the occurrence of these neoplasms in the oral cavity is rare.
Oral leiomyosarcomas have been reported on only 30 occasions in the world literature. An additional case of leiomyosarcoma of the maxilla in a 42-year-old female is reported. The relevant features of leiomyosarcomas were reviewed and discussed.

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A case of amelanotic malignant melanoma occurring in the upper alveolus of a 58-year-old female is presented. The patients was first seen on September 22, 1983, with the chief complaint of the hemorrhagic lesion in the palatal side of the upper right molar. On oral examination, an ulcerous and nodular mass was found in the palatal and buccal sides of the molar. Initially, the tumor was diagnosed as anaplastic cancer from histopathologic findings of the biopsy material taken from the gingiva.
Thus, radiation therapy with a total of 3400 rad of ⁶⁰Co was carried out, resulting in no tumor regression. The ⁶⁷Ga scintigraphy demonstrated hot uptake of radioisotope in the primary lesion and right side of neck. Partial resection of the maxilla and radical neck dissection were performed under general anesthesia on November 11, 1983. The operation materials revealed the amelanotic malignant melanoma of the primary lesion and its lymph metastasis with a few melanin pigments in the tumor cells. Moreover, the diagnosis was confirmed by ultrastructural findings of the primary tumor.
Therefore, the patient was received the following combination chemotherapy as adjuvant therapy: The first regimen included 1 mg of Vincristine, 100 mg of ACNU and a total of 25 mg of Pepleomycin. On the secondary regimen, we exchanged Pepleomycin for DTIC. The combination of ACNU and DTIC appeared to cause delayed myelosuppression with moderate leukopenia and thrombocytopenia. Reversible hepatotoxicity by DTIC was seen 4 weeks after chemotherapy.
The patient was observed periodically and no evidence of recurrent or metastatic lesion was found one year after the operation.

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Angiomyoma is a solitary and benign tumor. The majority of angiomyoma occurs in subcutaneous tissue of the lower extremities and in middle aged females. This type of tumor in the oral region is less common.
The patient, a 43 year old male whose chief complaint was a painless mass in the right side of upper lip, visited our hospital. The tumor gradually developed in 6 years and then became an oval mass measuring about 20×15×10 mm. Histopathologically, the surgically extirpated tumor tisssue was encapsulated with connective tissue, and consisted of compressed and small vessels surrounded by proliferation of smooth muscle cells. Actin fibers were immunohistochemically found in the tumor cells. Electron microscopic examination confirmed that the tumor was smooth muscle cells in origin. The histopathological diagnosis was angiomyoma.

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