Japanese Journal of Oral and Maxillofacial Surgery
Online ISSN : 2186-1579
Print ISSN : 0021-5163
ISSN-L : 0021-5163
Volume 31 , Issue 9
Showing 1-22 articles out of 22 articles from the selected issue
  • Hitoshi KUNO
    1985 Volume 31 Issue 9 Pages 2049-2061
    Published: September 20, 1985
    Released: September 13, 2011
    JOURNALS FREE ACCESS
    This experiment was conducted to examine hemorrhagic acute anemia effects on wound healing, in particular the influence of serum transfusion. Rabbits weighing 900 to 1, 100g were the subjects. Open wounds of 1cm in diameter was produced on the back skin for examining reduction of the wounded area, mean duration of wound healing, histological findings and mitotic index.
    The subjects were divided into 3 groups: acute anemia group (Bleeding of 25ml/kg body weight), serum transfusion group (after the collection of blood, serum separated from blood was transfused), and non-bleeding control group.
    All groups showed a similar course of reduction in the wounded areas, but differed in period of rapid reduction in the wounded areas. In control and serum transfusion groups, the period was between the 7th day and 9th day, whereas it was between 8th to 10th day in acute anemia group.
    The mean durations of wound healing were for 10.75 days in control group, 10.95 days in serum transfusion group, and 12.10 days in acute anemia group.
    Histological findings revealed that wound healing was delayed 1 or 2 days in the acute anemia group when compared to control and serum transfusion groups. The mitotic index showed maximum on the 2nd day, gradually decreased from the 4th day and returned to normal range on the 10th day in control group. In the serum transfusion group, maximum level was obtained on the 4th day, gradually decreased from the 5th day, and returned to normal range on the 10th day. On the other hand, the acute anemia group maximum level was obtained on the 2nd day but the level was lower than that of control or serum transfusion groups, and decreased gradually from the 6th day but did not return to normal range on the 10th day.
    Hemorrhagic acute anemia induced delay of wound healing, which was markedly improved by treatment with serum transfusion.
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  • Hitoshi NAKAMURA
    1985 Volume 31 Issue 9 Pages 2062-2081
    Published: September 20, 1985
    Released: July 25, 2011
    JOURNALS FREE ACCESS
    It has been accepted that bone formation was accelerated by electric stimulation. The present experiments were reported to clarify the nature of the induced bones by electric stimulation from histological, crystallographical and elementally analytical standpoints, as well as clarify induced osteoid into muscle.
    Femoral bone marrow of male rats (Donryu) was employed. A cathode of electric stimulation wire was inserted in the bone marrow and the anode was placed around the bone. The control dummy wire was used in a similar manner. Periods of the experiment were 3, 5, 7, 9 and 14 days during constant stimulation of 15.5μA.
    Electrically stimulated bone marrow for 5 days was transplanted into the muscle, and specimens were examined on days 3, 5, 7, 14 and 21 after grafting. For histologic observations, H-E and Van Gieson, and fluorescence microscopy were done. The sections obtained from the same specimen were examined by X-ray diffraction and X-ray microanalyzer to detect crystallization and concentration of Ca, P, Mg.
    Histologic findings showed that bone formation including developing osteoprogeniter cells, osteoid and calcified bones were enhanced by electric stimulation, whereas crystallization and mineral concentration of induced bones had features similar to those of the control bones.
    On days 3 and 5 after grafting, new bone formation in the electric stimulation group was increased more than in the control group. On days 14 and 21, histologic pictures of bone formations of both groups were obtained and did not show so many prominent differences.
    In conclusion, the stimulating effects of bone induction and formation by constant electric stimulation existed in rats femur bone marrow.
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  • Hidenobu NABETANI
    1985 Volume 31 Issue 9 Pages 2082-2100
    Published: September 20, 1985
    Released: July 25, 2011
    JOURNALS FREE ACCESS
    It is necessary for oral surgeons treating maxillofacial lesion to comprehend the facial shape three-dimentionally.
    60 normal faces (30 males and 30 females) taken by moiré topography were analized quantitatively using a FACOM M 200 computer.
    Results
    1. The left side of the face was higher than the right in both male and female.
    The right-left difference of the upper portion of the face was greater than that of the inferior portion, however the difference of the lateral portion was greater than that of the mesial portion. The difference, which was about 4mm at most, should be regarded within normal limit at surgical treatment of the cheek region.
    2. The right-left difference of the female face was greater than that of the male.
    3. The right-left difference was a little over 1mm on the upper lip, so this length was regarded three-dimentionally within normal limit at surgical treatment of the lip region.
    4. The skin surface at the infraorbital region was a little rugged in both male and female, showing variable skin slope.
    5. The male nose was more protrudent than the female, but the male cheek was less protrudent than the female, showing a steep skin slope from the nose to the cheek in male.
    6. Conversely, the female nose was less protrudent than the male, but the female cheek was more protrudent than the male cheek, showing a gentle skin slope from the nose to the cheek in female.
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  • Yoshio TAKAHASHI
    1985 Volume 31 Issue 9 Pages 2101-2112
    Published: September 20, 1985
    Released: July 25, 2011
    JOURNALS FREE ACCESS
    This study investigates the electromyographic changes of mandibular prognathism indicated sagittal splitting of the mandibular ramus.
    1. After surgery, duration of the temporal muscle on the chewing side decreased significantly in gum chewing. Standard deviation of duration, interval and cycle time decreased significantly in gum chewing. That is, masticatory rhythm became more regular and tended to resemble that of the normal group. In gum or rice chewing, maximum amplitudes of the temporal and masseter muscle became higher on the chewing and the nonchewing side and tended to resemble that of the normal group.
    2. In the preoperation group, the muscle activity of the digastric muscle on the nonchewing side was greater than that on the chewing side. In the postoperation group, the difference of muscle activities between both side decreased significantly and tended to resemble that of the normal group.
    After orthognathic surgery, the coordination of muscle activities of the temporal, masseter and digastric muscles improved and almost became similar to that of the normal group.
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  • Hideo KUROKAWA, Minoru KAJIYAMA, Takanori YAMANO, Nobuto NOMURA, Takah ...
    1985 Volume 31 Issue 9 Pages 2113-2119
    Published: September 20, 1985
    Released: July 25, 2011
    JOURNALS FREE ACCESS
    CEA was examined in 49 patients with oral cancer and 39 with benign oral disease as a control, in the Second Department of Oral Surgery, Kyushu Dental College Hospital, during the period from 1980 to 1983.
    The following results were obtained:
    1) Serum CEA levels in patients with oral cancer were 2.73±1.73ng/ml and 32.7% were in level over 2.5ng/ml. In squamous cell carcinoma, serum CEA was 3.03±1.87ng/ml and 37.5% was in level over 2.5ng/ml.
    2) Immunological localization of CEA in cancerous tissues was 54.3% and in squamous cell carcinoma was 59.3%.
    3) Serum CEA levels of cancerous tissue CEA-positive were 4.44±1.82ng/ml and tissue CEA-negative were 1.90±0.56ng/ml (p<0.01).
    4) In these investigations, CEA is considered to be clinically more useful as tumor-marker in oral cancer patients.
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  • Kazufumi YAMAGUCHI
    1985 Volume 31 Issue 9 Pages 2120-2134
    Published: September 20, 1985
    Released: July 25, 2011
    JOURNALS FREE ACCESS
    A comparative study was made on the healing process and prognosis of 50 mandibular condylar fracture cases in the adult and young groups of patients by reviewing recent results of treatment given in our hospital. At the same time, by the use of puppies and adult dogs with experimentally induced fracture-dislocation in the jaw, histological observations were made on the healing process.
    The late results showed that in all the subjects in the younger age group the severity degree of fracture was O-I, indicating that they do not feel much inconvenience in their everyday life. By contrast, in the older age group, the severity increased with age.
    Cephalometric radiograph disclosed shortened mandibular ramus in one case of the younger age group. Clinical observations did not show any changes in the facial profile. Retrogression of the lower jaw was noted in one case of supra-inframandibular fracture-dislocation in the older age group.
    Radiographic examination of fractures showed that anatomically normal condyle was formed in patients of 10 years and below.
    In the patients of 20 years and over, morphological changes in the double-headed condyle of the mandible and the head of the lower jaw were evident. In the patients in their tens, it was found that healing was in an intermediate stage.
    Histological observations of the healing process revealed that puppy bone fragments were being unified into larger fragments after absorption and addition, and histologically normal condyle was formed six months later. In the adult dogs, deformity was observed in the condylar process because displaced bone fragments were fused with larger fragments by cartilaginous tissue.
    All the clinical cases were treated without making a surgical opening to the fracture site. In the convalesent stage, use of splints aimed at stability in occulsion and prevention of mandibular condylar deviation was most effective.
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  • Susumu TAKAKU
    1985 Volume 31 Issue 9 Pages 2135-2143
    Published: September 20, 1985
    Released: July 25, 2011
    JOURNALS FREE ACCESS
    Surgical treatment was performed in 12 cases of discopathy of the temporomandibular joint with displacement of the articular disc. Clinical and pathological studies on these cases gave the following results.
    1. Classification of the type of displacement of the articular disc showed 6 anterio-lateral type cases, 5 anterior type and 1 anterio-medial type.
    2. In 9 cases, the injury to the articular disc was serious and adhesion to the condylar head was also observed.
    3. In 2 cases, the articular disc had a horizontal rupture as well as a transverse rupture.
    4. Rupture of the organizing collagenous fibers of the articular disc was seen in all cases, including 3 cases in which no macroscopic injury to the articular disc was found.
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  • Takashi KITA, Nozomu FUKUDA, Miyo YOSHINARI, Jun SATO, Masaru NAGAYAMA
    1985 Volume 31 Issue 9 Pages 2144-2149
    Published: September 20, 1985
    Released: July 25, 2011
    JOURNALS FREE ACCESS
    A case of “false” median cleft of the upper lip is reported.
    The facial deformities include defects of prolabium, premaxilla and columella. Mental retardation was present, however the abnormalities of CT scanning and EEG and chromosome aberration were not detected.
    According to the clinical features, this case was considered to be the third type of Kundrat's classification of arhinencephaly.
    Operation was done by Gillies' fan flap method modified by the authors for the construction of median cleft lip. The postoperative course was good.
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  • Takeshi UCHIYAMA, Mayumi NANBA, Yoshitaka OZAKI, Masaharu OKANO, Takan ...
    1985 Volume 31 Issue 9 Pages 2150-2157
    Published: September 20, 1985
    Released: July 25, 2011
    JOURNALS FREE ACCESS
    We experienced a case of total resection of mandible for subacute suppurative osteomyelitis in a 25 year old man.
    As an extensive area of right mandible already was found to have been destroyed at first examination, resection of affected side was indicated.
    But, inflamation developed to the residual left side of the mandible and diffused bone destruction rapidly extended to the ramus of the mandible.
    About 1 year after hemimandibulectomy we had to completely resect the mandible.
    About 3 years after hemimandibulectomy we carried out secondary total reconstruction with iliac bone grafting and AO metal plate.
    Then 5 years after hemimandibulectomy we performed mandibular vestibuloplasty with inlay skin grafting which enabled the patient to accept a full denture.
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  • Katsuyuki TODAKA, Harumi MIZUKI, Tetsuo KAWAMURA, Rintaro MATSUSHIMA, ...
    1985 Volume 31 Issue 9 Pages 2158-2162
    Published: September 20, 1985
    Released: July 25, 2011
    JOURNALS FREE ACCESS
    We experienced a rare case of large epulis fibrosa osteoplastica. The patient was a 48-year-old male who had cerebral palsy. At the first examination, he had a pigeon egg sized, half round and elastic hard phyma in the 654 ulo-buccal transitional region. It was pedunculate and had a stalk with a diameter of 5 mm on the 65 buccal interdental papilla. X-ray films showed some trabeculer density in its center. Under local anesthesia, the phyma was initially incised at the stalk and removed for the purpose of getting a good visual field. Then the remaining stalk, its surrounding periodontal tissues and 5 tooth were removed en bloc surgically, expecting a good prognosis because.of his past history of cerebral palsy. The histopathological findings showed marked trabecular bone formation surrounded by proliferated fibrous connective tissues and was diagnosed as epulis fibrosa osteoplastica. One year and nine months after operation, no recurrence has been observed.
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  • Yasuo KINOSHITA, Toshiya NAKANO, Youji TOMIDA
    1985 Volume 31 Issue 9 Pages 2163-2168
    Published: September 20, 1985
    Released: July 25, 2011
    JOURNALS FREE ACCESS
    Lipomas are generally found on the limbs and trunk where adipose tissue is present; however, in the maxillofacial region lipomas are rare.
    Three cases of maxillofacial region lipomas which occured extensively from the right temple to the right cheek of a 75 year-old woman, in the left side of the tongue apex of a 54 year-old woman and in the right cheek of a 32 year-old man were reported.
    Thc first case was a giant tumor measuring 5×5×16cm and wcightcd 105g.
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  • Kenji KURASHINA, Mikito YAJIMA, Susumu TAKEDA, Tadashi YAMAZAKI, Toshi ...
    1985 Volume 31 Issue 9 Pages 2169-2178
    Published: September 20, 1985
    Released: July 25, 2011
    JOURNALS FREE ACCESS
    It is known that hydroxyapatite ceramics have a good biocompatibility and unite directly to the bone tissue. The authors reported it's promising properties as a bone substitute by animal experiments.
    In this paper, four cases are reported in which hydroxyapatite ceramics were used as an artificial bone. Three types of hydroxyapatite ceramics-dense, porous and particulate-were used for augmentation of deficient alveolar ridges and for implantation to partial bone defects. There has been no adverse reaction of hard and soft tissues such as surrounding bone resorption or inflammatory changes of soft tissues.
    However, it is considered necessary that long-term follow-up studies of these cases and further basic studies on degradability of hydroxyapatite ceramics and on cases to which respective shapes of ceramics can be suitably applied will be carried out in the future.
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  • Hidemi YOSHIMASU, Shigetoshi SHIODA, Kenji KASHIMA, Kenji HASHIMOTO, F ...
    1985 Volume 31 Issue 9 Pages 2179-2182
    Published: September 20, 1985
    Released: July 25, 2011
    JOURNALS FREE ACCESS
    A Preprimed bracket refers to a bracket whose base has been primed with an adhesive component. The bracket base is covered with a PMMA powder primer. When bonding, the base is dipped in 4-META/MMA-TBB resin monomer for two or three secondsand merely pressed into place on the etched tooth surface. A setting time of eight minutes is allowed before placement of maxillomandibular ligation or traction in the usual manner. Bracket removal may be accomplished by using a bracket removing plier. We tried to bond 212 brackets on tooth surfaces in 17 cases of fractured jaws, orthognathic surgery, etc. It was observed that during about 7 weeks of fixation, the frequency of breakage bonding was only 0.9%. Our preprimed bracket technique showed a lower frequency of breakage of bonding than did the brush-on technique. The technique utilizing our new direct bonding bracket offers many advantage: a) it is a relatively easy and painless procedure, b) it does not injure teeth or periodontal tissue, and c) in comparison with wire ligation in fixation of loosened and displaced teeth, the result of the new method seems to be much better.
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  • Manabu OKAMOTO, Satoru OZEKI, Takanori HIRAKAWA, Hiroko HARA, Hideo TA ...
    1985 Volume 31 Issue 9 Pages 2183-2188
    Published: September 20, 1985
    Released: July 25, 2011
    JOURNALS FREE ACCESS
    Among 41 primary patients with squamous cell carcinoma of the lower gum treated at our Department of Oral Surgery between 1961 and 1980, 21 patients received neck dissection because of possible cervical lymph node metastasis. In these patients, mode of the cervical lymph node metastasis was examined and the application of partial neck dissection was evaluated.
    Metastasis to the lymph nodes had histological confirmation in 11 patients. However the metastasis were all confined to the upper neck region (submental, submandibular and superior internal jugular nodes) but the contralateral submandibular lymph nodes were also involved in 3 cases. Primary lesions of these 3 cases were located in the anterior part of the lower gum.
    Partial neck dissection was performed on 12 patients and 6 had histologically positive lymph nodes. Two of them had recurrence in superior internal jugular region, although the primary lesions were under control. In these cases there were many large metastatic lymph nodes that firmly adhered to the surrounding tissuese. Subsequent secondary radical neck dissection was difficult.
    It was concluded from these findings that the radical neck dissection is be indicated for lower gum cancer when clinical signs of neck metastasis are noticed. When partial neck dissection is indicated for unavoidable reasons, it is necessary to thoroughly dissect the supraomohyoid region.
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  • Yujiro TSURU, Yasuo MIMATA, Keiji OMORI, Ichiro MASUI, Takeshi HONDA, ...
    1985 Volume 31 Issue 9 Pages 2189-2193
    Published: September 20, 1985
    Released: July 25, 2011
    JOURNALS FREE ACCESS
    We experienced two cases in which isolated bone fragments were found in the maxillary sinus.
    The first case was a 34-year-old man. Radiographic examination showed a radiopaque shadow that appeared to be calcic substance isolated in the left maxillary sinus. It was surgically enucleated with the antral mucous membrance. A histopathological examination revealed the calcic substance was an isolated bone fragment which consisted of a laminated bone tissue and an enclosed connective tissue that had become necrotic, in which there found neither an osteoblast nor osteoclast. Microscopically, the antral mucous membrane contacted to the bone fragment showed chronic inflammatory infiltrate which was a feature of chronic sinusitis.
    The second case, which was found in a 33-year-old woman, was clinically suspected of a benign tumor in right maxillary sinus by radiographic examination. The enucleated tissue was a bone fragment in a size of 25×15×5mm. Microscopically, there found bone cells, however, neither osteoblast nor osteoclast were found, which was the same as that described for the first case. The antral mucosa contacted to the bone fragment was edematous, and increased connective tissue consisting of collagen fiber was found in deep layers of the mucosa.
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  • Yoshinori HIGUCHI, Norifumi NAKAMURA, Hideo TASHIRO
    1985 Volume 31 Issue 9 Pages 2194-2200
    Published: September 20, 1985
    Released: July 25, 2011
    JOURNALS FREE ACCESS
    It is sometimes difficult to differentiate ameloblastoma from odontogenic cysts, especially from dentigerous cysts. In our department, we have experienced four cases of unicystic ameloblastomas which was first diagnosed as odontogenic cyst at the time of initial biopsy.
    Patients ages at first visit ranged from 14 to 40 years old. There was a predilection to occur at the molar-ramus region or premolar region of the left mandible and two cases were associated with impacted third molar.
    Histological findings of four cases at initial biopsy were thin and flat epithelium which had characteristics of squamous cells that ordinarily line odontogenic cyst. Two showed cytoplastic vacuolization and palisading of basal cells which might be a part of the manifestation of the ameloblastoma. Correct diagnosis of ameloblastoma was done during marsupialization in one case, at enucleation in two cases and recurrence after 16 years in one case.
    Causal relation between ameloblastoma and odontogenic cyst was unable to be determined.
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  • Hiroshi OKUI, Takenori ISHIKAWA, Masahisa NOMURA, Masaharu MITSUGI, Ma ...
    1985 Volume 31 Issue 9 Pages 2201-2212
    Published: September 20, 1985
    Released: July 25, 2011
    JOURNALS FREE ACCESS
    The secretory function in an acinic cell tumor arising in buccal minor salivary gland was examined ultrastructurally and cytochemically by means of tannic acid uranyl acetate (TAUA) method, periodic acid-methenamic silver (PA-MS) reaction, thiamine pyrophosphatase (TPPase) reaction and acid phosphatase (AcPase) reaction.
    The tumor was composed mainly of secretory cells which revealed morphological similarity to serous cells seen in normal parotid and submaxillary glands, and undifferentiated cells probably derived from the reserve cells of the intercalated duct. Secretory cells showed also histochemical resemblance, since it was proved by periodic acid-Schiff (PAS) reaction and alcian blue staining that they contained neutral glycoproteins in their cytoplasmas.
    Compared to normal serous cells, secretory cells neither formed definitive lumina, nor showed apico-basal polarity. The Golgi complexes remained well-developed in the secretory cells and displayed an ultrastructure similar to that of normal serous cells. Within the secretory cells, TA-UA strongly stained Golgi stacks, the periphery of condensing vacuoles, matured secretory granules and luminal cavity. PA-MS reaction showed a stainability similar to that of TA-UA method. TPPase activity was localized in the Golgi stacks. AcPase reaction was detected in the Golgi stacks, lysosomes and secretory granules. Acpase activity within the secretory granules varied from scant to rather intense.
    These data may sugest that the complex carbohydrates synthesized in the Golgi stacks directly reaches the condensing vacuoles. The pathway of intercellular transport of carbohydrates appeared to be quite similar to that of some excretory cell types. On the other hand, the increase of lysosomal enzyme within the secretory granules may be presumably one of the characteristic findings in this secreting tumor.
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  • Misao YAMAGUCHI, Makoto MURATA, Mikio OHASHI, Junichi SHINDO
    1985 Volume 31 Issue 9 Pages 2213-2217
    Published: September 20, 1985
    Released: July 25, 2011
    JOURNALS FREE ACCESS
    Pleomorphic adenoma frequently occurs in the parotid gland and palatine glands but is relatively rare in the submandibular gland.
    Recently, we experienced a case of pleomorphic adenoma of the right submandibular gland with a large cyst in the tumor center.
    The 55-year-old woman patient, was aware of a painless swelling of the right submandibular region for 5-years. She had not recieved any treatment but recently visited our department because of tumor expansion.
    This tumor was removed with submandibular gland.
    Microscopically, the parencyma of the tumor consisted of multipicated epitherial cells, partly like a tubular gland and metaplasia of squamous epithelium. The stroma had myxomatous structure and the cyst wall lacked epithelium. Histological diagnosis was pleomorphic adenoma.
    This lesion is about 60% of all salivary gland tumors but rarely occurs is in the submandibular gland. This tumor sometimes forms a cyst in a long progress, although there is no consensus of views about its forming process.
    Surgical excision that includes the submandibular gland is the best treatment. The patient must be carefully followed because of the tendency of recurrence.
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  • Atsushi NAKAMURA, Ken-ichi SAITO, Mayumi YOSHIDA, Yukihiro MICHIWAKI, ...
    1985 Volume 31 Issue 9 Pages 2218-2222
    Published: September 20, 1985
    Released: July 25, 2011
    JOURNALS FREE ACCESS
    A 37-year-old woman had a mass of sublingual area of the tongue visited us and had her tumor resected. Histopathological evaluation revealed it to be a neurinoma of type A in Antoni's distribution. In addition, an immunohistochemical study using the antibody of S-100 protein was carried out. The results suggested that the tumor originated from Schwann cells. The clinical and histopathological characteristics of neurinoma are discussed.
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  • Norio TAKAHASHI, Yasushi OHASHI, Masaki ABE, Makoto ONISHI, Ritsuo TAK ...
    1985 Volume 31 Issue 9 Pages 2223-2230
    Published: September 20, 1985
    Released: July 25, 2011
    JOURNALS FREE ACCESS
    Two cases of Basal Cell Nevus Syndrome are presented. One patient was a 64 year old female and another one was 12 year old boy with cleft lip and submucous cleft palate. Both cases had many features of this syndrome. Histopathological diagnosis of multiple jaw cysts is odontogenic keratocysts. Recurrence of cysts are not seen, but we think it necessary to have a long term follow up.
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  • Tsuyoshi KAWAI, Kunio AOKI, Kiyoshi KANAMORI, Hidenobu NABETANI, Shige ...
    1985 Volume 31 Issue 9 Pages 2231-2235
    Published: September 20, 1985
    Released: July 25, 2011
    JOURNALS FREE ACCESS
    We have used double Z plasty on the upper lip in 15 cases of postoperative deformity after primary bilateral cleft lip plasty, and concluded as follows:
    1. This method, compared with other operation methods, is very easy to design the contour of the Cupid's bow, and the operation carried out in a short time, resulting in easier and more accurate reconstruction of the Cupid's bow.
    2. It is possible to use this method with other procedures which improve the postoperative deformities after primary cleft operation.
    3. As the blood supply to the flaps is excellent, necrosis on the flap is not observed postoperatively.
    4. The contour of the Cupid's bow remains well after operation without relapse. Therefore, this method is very useful in such postoperative bilateral cleft cases that the line of the mucocutaneous ridge of the prolabium is arc from frontal view and the upper lip is not tight.
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  • Mikio ENDOH, Juntaro NISHIO, Tokuzo MATSUYA, Kazuo INOUE, Masakazu SUG ...
    1985 Volume 31 Issue 9 Pages 2236-2244
    Published: September 20, 1985
    Released: July 25, 2011
    JOURNALS FREE ACCESS
    The temporomandibular joint ankylosis often recurs for various reasons. In such cases, the bony adhesion at the temporomandibular joint advances more rigidly which may result in poor mobility of the mandible.
    Surgical trials in this kind of bony ankylosis of temporomandibular joint were made in two cases with the extensive bony excision from the middle portion of the mandible ramus up to the condylar head involving coronoid process and with the implantation of Al203 ceramic condylar prosthesis in place of the real joint.
    We had pretty good prognosis during 6 to 10 months observation following surgery without any complications. The surgical procedure for the implantation of ceramic prosthesis was described and some of the possible technical problems in approach to this surgery were also discussed.
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