To comprehend the morphology of the mandibular head (MH), area and S/L ratio of the MH, each were measured for size and shape on the Xeroradiography at the submentovertical projection. Further evaluation was performed from the measurement of the ratio of the major axis of MH to the minor axis, and the adjacent interior angle at each intersection which was made by the center line and the outline of the MH (Each central angle was 22. 5°).
The comparison between the results of the patients so-called TMJ arthrosis and those of normal volunteers was mentioned below.
1) The average MH area of the patients was 118. 37 mm², and was smaller than that of normal volunteers (120. 88 mm²), especially in the patients with pain and sound at TMJ (96. 87 mm²).
2) The difference of MH area between left side and right side was not significant in either the patients or normal volunteers. In the patients who had both sound and pain, there was a tendency for symptoms to be found at the smaller side.
3) The average of S/L ratio in the patients with sound was 2. 40, and was significantly higher than the average in the patients with pain (2. 34).
4) The ratio of the major axis of the MH to the minor axis (0. 41) was significantly higher in the patients with sound (p<0. 05).
5) The average of the interior angle at the internal part of MH (93.30°) was significantly higher in the patients with sound (p<0. 05).
Those results suggest that the morphology of MH was related with the occurrence of sound at TMJ, and MH was approaching a round and small shape in the patients with sound.

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We had demonstrated in the former investigation that the effectiveness of imidazole radiosensitizer that is misonidazole, dinitroimidazole ethanol and 5-methoxy carbonyl-2-methyl sulfinyl-1-methyl imidazole for Ehrlich solid carcinoma transplanted into nude and conventional mice.
In this study, we report the effectiveness of imidazole radiosensitizer for oral malignant tumor.
Methods and evaluation: Battelle Columbus Laboratories Protocol. Tumor: KB cell=human mouth floor-tongue poorly differentiated epidermoid carcinoma.
Tumors were transplanted to subcutaneous of the right thigh of each mouse.
Subjects: Male nude CD-1 (ICR) mice (10 weeks age, 20-25 body weight).
Radiosensitizer: misonidazole (MISO), dinitroimidazole ethanol (DNIE) and 5-methoxy carbonyl-2-methyl sulfinyl-1-methyl imidazole (KIH-3).
Radiation: ⁶⁰Co 15 Gy local radiation. These radiosensitizers were administrated into the abdomen of the mice prior to 30 minutes of local irradiation.
Results: On KB cell of nude ICR mice, tumor reduction effect was evaluated on MISO 20 mg+⁶⁰Co 15 Gy group, but tumor recurred after 4 days, therefore the sensitization effect was not evaluated.
Radiosensitization effect was evaluated DNIE 10 mg +⁶⁰Co 15 Gy group. There is no effect in KIH-3 40 mg +⁶⁰Co 15 Gy group.

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We measured serum sialic acid in oral cancer patients by enzymatic method.
The mean serum level of sialic acid in the patients was significantly higher than that in normal volunteers, and the level was proportional to the stage of cancer. In most patients, serum levels of sialic acid returned to normal postoperatively. However, in patients with recurrence or metastasis, the levels rose gradually after surgery.
Serum levels of sialic acid were well correlated with those of aracid glycoprotein and ar macroglobulin. In addition, we found that O₂^- production of neutrophils was inhibited by sialic acid.
From these results, the measurement of serum sialic acid in oral cancer seems to be useful to estimate of progress, recurrence and metastasis. It is also suggested that sialic acid has deep connection with neutrophil's function.

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It has been reported in recent years that vitamin B compounds have an immunoregulatory effect. We evaluated the effects of a preparation containing vitamin B1, B6 and B12 and noted the lowered immunlogical functions could be improved by the concomitant administration of vitamin B compounds for chemotherapy, earlier as Part 1 of the study. In the present study, 4 cases were added for re-evaluation and the differences in the time of its continued administration were also examined.
Nine patients with oral cancer who had undergone the chemotherapy (CDDP, PEP and MMC) and radiotherapy were treated for two different durations of the daily administration of vitamin B compounds, i.e. a relatively short term of 1-2 weeks and a long term of 3-10 weeks in parallel with the chemotherapy and radiotherapy and in the other except for these therapies.
As the criterion of cell-mediated immunity, the PHA lymphocytes transformation and the rate of T-cells and B-cells were determined. Serum immunoglobulins (IgG, IgA and IgM) and IAP were also determined.
Both the PHA lymphocytes transformation and the levels of serum immunoglobulins were lowered after the chemotherapy and radiotherapy, but a tendency of improvement was observed in both groups having the long-term and the short-term administration of the vitamin B compounds. The degree of the improvement indicated no difference between the two groups under the long-term and the short-term administrations. Thus, the administration of vitamin B compounds in both the long-term and the short-term groups was confirmed to be able to suppress the tendency for decrease of humoral and cell-mediated immunity, which suggested the possible applicability of this preparation as the immunomodulator.

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Squamous cell carcinoma related antigen TA-4 (SCC-Ag) was examined by radio immunoassay in 33 patients with oral and maxillofacial lesions.
In nine of 10 patients with untreated malignant tumors, there were detected high positive levels of antigen. The average data of them showed 2.97 ± 1.09 ng/ml.
After treatment, 12 patients who had no recurrences or metastasis showed relatively low positive levels, such as the average of 2.31 ± 0.83 ng/ml. However, in benign tumors, cysts and other diseases with the exception of malignant tumors, there were detected lower than standard levels (2.0 ng/ml) or TA-4.
TA-4 (SCC-Ag) appears useful for diagnosing and monitoring to learn the recurrence of metastasis of patients with oral and maxillofacial malignant tumors.

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Effects of mefenamic acid ingested onto the wound healing process were evaluated in terms of both blood flow in the wounded area and histopathologic changes in mice. On the experimental day 1, an incision was made in to the skin and closed with nylon thread. One group of mice received mefenamic acid at a dose of 100 mg/kg p.o. and the rest, receiving surgical treatment alone, served as the control. Blood flow was measured with a laser doppler flow meter (LDF). The results are as follows:
1. In the control, when the skin was incised and closed with nylon thread, blood flow in the wounded area was increased from experimental days 1 to 10.
2. In animals receiving mefenamic acid, blood flow was also increased for 10 days after the surgical treatment, but all of the increments were significantly smaller than the corresponding values in the control. On experimental day 1, blood flow in the experimental group was 37.1±5.2% smaller than that in the control. The rate of difference increased to 41.3±9.4% on experimental day 4, and then began to diminish on experimental day 5. It decreased to 8.4±3.0% on experimental day 10 (P<0.01).
3. Histopathologic study showed that injured tissues were repaired to the normal in the control, but the reparative process was lengthened in mice receiving mefenamic acid.
Changes in blood flow, as measured with the laser doppler flow meter, were consistent with the histopathologic findings. Both aspects of wound healing thus indicate that mefenamic acid, at the dose of 100 mg/kg, delayed wound healing in skin incision in mice.
When possible delay in postoperative wound healing is taken into account, conventional extraction of the stitches on the postoperative day 7 should be reconsidered in those patients treated with non-steroidal anti inflammatory agents.

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Serum IAP levels were examined in 24 patients with oral cancer and 31 patients with benign oral disease (tumor and cystic lesion) as a control, in the Second Department of Oral Surgery, Kyushu Dental College Hospital, during the period from 1982 to 1984. The following results were obtained:
1) Serum IAP levels in patients with oral cancer were 566.9±100.9 μg/ml and 66. 7% of these were in a level over 500 μg/ml. In squamous cell carcinoma, serum IAP levels were 595. 7±101. 5 μg/ml and 72. 7% of these were in a level over 500 μg/ml. Therefore, serum IAP levels in patients with oral cancer were higher with statistical significance (p<0. 01) than those in the controls.
2) Serum IAP levels increased gradually in accordance with the progress of the oral cancer.
3) Serum IAP levels in good prognosis cases were 406.4 ±92. 8 μg/ml and in poor prognosis cases were 808. 9±230. 9 μg/ml (p<0. 01). In good prognosis cases, it was observed in patients with the reduction of high IAP level. On the other hand, serum IAP levels in poor prognosiscases showed a tendency to increase gradually.
4) In these investigations, it was suggested that the determination of serum IAP is useful in evaluating the progress of oral cancer, the effects of treatment and prognosis in oral cancer patients.

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There are some reports concerning to the use of computed tomography in dentomaxillofacial surgery.
In general, it is mentioned that CT examination is beneficial in displaying fine images of the temporomandibular structures, not easily shown clearly by conventional radiography.
In this paper, the authors report the results of the morphological observation of the temporomandibular joint and lateral pterygoid muscle with some discussion by comparison with other reports of anatomy and mento-vertex standard radiography.

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It has been accepted that parasympathetic innervation of submandibular gland is chorda tympani. This experiment is to study the influence of secretion and histopathologic change after section and suture of the chorda tympani.
A total of 33 adult mongrel dogs were used in the study. The animals were divided into the nerve section group and the nerve suture group. The chorda tympani of 12 dogs were cutted at 1cm from the submandibular gland. It was the nerve section group. Then after sectioning of the chorda tympani, the nerves of 21 dogs were sutured immediately with 10-0 mono-filament nylon sutures. This was the nerve suture group. The functional and morphological studies were carried out at various time intervals after the surgery.
The following results were obtained:
1. In the nerve section group, the gland weight was decreased to about 50% of the control group at the 8th week after the surgery. In the nerve suture group, the gland weight was decreased to about 40% of the control group at the 8th week. But at the 12th week, the gland increased its weight, and recovered to almost normal gland weight at 24th week.
2. The secretion of the submandibular gland, in the nerve section group, decreased gradually after the operation, and at the 8th week, no secretion was observed. On the other hand, the nerve suture group, the secretion started to recover at 12th week, and at the 24th week, about 80% of secretion of the control group was observed.
3. Histopathological finding showed that cells of the submandibular gland started to atrophy after the surgery, and at the 24th week after the sectioning, most of the cells were atrophied. However in the nerve suture group, the recovery of the cells were observed in all cases, and these recovered to the normal morphology at the 24th week.

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Many authors have reported the evidence of the involvement of the temporomandibular joint in chronic rheumatoid arthritis. There were shown various degrees of destruction and changes in the temporomandibular region upon by roentogenological examination. However, it was very rare that the jaw function was disturbed as severely as in ankylosis.
In this report, a case, the clinical experiences for which are described was treated by intermaxillary traction for the correction of the anterior condylar displacement associated with occlusal deviation and fibrous ankylosis of the right temporomandibular joint. As a result, occlusal disability was corrected with the subluxation of the lower anterior teeth. In the follow-up period of three and half years after initial treatment, she showed no severe limitation of the mouth opening and disability in taking food by herself with maintainance of jaw function and acceptable occlusion.

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Actinomycosis is a chronic inflammatory disease caused by an infection of Actinomyces israeli. Although lesions are commonly observed in the cervicofacial region, few cases in the salivary gland, especially in the submandibular gland, have been reported previously.
Moreover, highly developed antibiotics tend to mask the characteristic symptoms and make it difficult to distinguish this disease from other massive diseases of the submandibular region.
Two rare cases of actinomycosis observed in the submandibular gland region were experienced.
Case 1: 53-year-old male patient. The lesion had granulomatous tumor in contact with the submandibular gland. The clinical diagnosis was lymphadenitis or malignant tumor of the submandibular region.
Case 2: 43-year-old female patient. The lesion was isolated in the submandibular gland. Theclinical diagnosis was malignant tumor or chronic sialadenitis of the submandibular gland.
In both cases, the final diagnosis as “actinomycosis” was made pathohistologically after the surgical excision. ABPC had been administered postoperatively and no sign of recurrence have observed as yet.
Although long-term administration of proper antibiotics such as PC groups is the treatment of choice, surgical excision combined with antibiotics is considered to be more effective for the localized actinomycosis.

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Normal salivary glands and 5 cases of adenoid cystic carcinomas were examined by immunohistochemical staining with the antibodies to S-100 protein, neuron-specific enolasc (NSE), glial fibrillary acidic protein (GFAP), carcinoembryonic antigen (CEA), and immunoglobulin A (IgA) to speculate the differentiation of the tumor cells of adenoid cystic carcinoma. The myoepithelial cells of normal salivary glands were stained positively by the antibodies to S-100 protein and NSE. In adenoid cystic carcinomas, tumor cells of tubular areas were intensely stained and those of cribriform areas showed positive reaction to the anti-S-100 protein antibody. A little reaction was identified at the solid areas. These findings suggested that most of S-100 protein positive tumor cells might show a functional differentiation from the myoepithelial cells. NSE showed similar localization as S-100 protein, and the latter showed more intensive and extensive reactions than the former. No distribution of GFAP was shown in the normal salivary glands and adenoid cystic carcinomas. CEA was observed in the luminal surface of normal salivary glands, while IgA in the duct epithelial cells. Intraluminal contents of tubular areas were stained positively by the antibodies to CEA and IgA, which suggested intensive secretory activities at tubular areas in adenoid cystic carcinomas.

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A case of microstomia involved with a serious speech disturbance of a 19-year old female was reported. The patient visited Nagoya University Hospital on November 27 1982 complaining of a difficulty of mouth closing and speech disorders.
According to medical history, the patient contracted stomatitis at two years old and vestibular mucosa came to necrosis and lost. Vestibuloplasty has been carried out four times until now. From the initial examination, abundant scars were seen and vestibular sulcus of lower and upper lip were narrow. Selecting surgical method, we decided to carry out vestibuloplasty with fullthickness skin graft and free skin graft with the preserved subcutaneous vascular network to form the smooth movement of lips.
Under general anesthesia, scar tissue was removed and skin grafted. Eight days after the operation, all grafts were taken successfully. Deep vestibular sulcus was made, and then functional disturbance of lip was seldom observed.
We utilized the functions of articulation for an index in order to evaluate the postoperative restoration of lip function. The functions of articulation seemed to be a usefull index. At the 14 months examination following the surgery, there was no evidence of recurrence or other trouble.

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A case of venous hemangioma in submandibular region in a 6-year-old girl was presented. The patient complained of a painless, swelling in right submandibular region, which appeared suddenly. Her general condition was good, but we noticed a hen's egg-size swelling at right submandibular region, which was elastic hard and without redness, tenderness and fever. Plunging ranula was suspected from the initial clinical findings, and eosinophilic granuloma was considerable from eosinophilia (eosinophils reached 17 percent). CT scanning and ultrasound scanning showed a soft tissue mass with cystic area in submandibular region. Then we carried out aspiration biopsy and blood-like fluid was aspirated. Hemangioma was suspected. After RI-angiography and blood pool image, the tumor was surgically removed under general anesthesia and was diagnosed as venous hemangioma histopathologically.

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Diagnosis of a blow-out fracture of the orbital floor is relatively easy from clinical and roentogen findings but information from these findings are not adequate for the decision for surgical indication.
Until recently, computed tomography for the orbital region was generally performed only in axial plane. But the axial plane is parallel to the orbital structure, therefore it is difficult to visualize the orbital floor and inferior rectus muscle. On the other hand, coronal plane is cross-section to the orbital structure, and we can visualize the all orbital soft tissues including extraocular muscles.
We examined 3 cases diagnosed as a blow-out fracture of the orbital floor by conventional roentogen films and clinical findings. After axial CT was performed firstly, the coronal CT was scanned with 60 degrees to 70 degrees from OM line, setting the patient in the hanging head position.
Case 1 used coronal reformation of the axial CT data. Case 2 and case 3 used direct coronal scanning. By bi-plane CT we could diagnose whether inferior rectus muscle was entrapped or not, and confirm surgical indication.
Using of a cadaver, we studied the mechanism for limitation of eye movement. These studies revealed that it is rare that the inferior rectus muscle is entrapped directly by fractured segments at the orbital anterior floor. Because there is a lot of orbital fat-pad between the inferior rectus muscle and the orbital floor, and it may play an important role.
The limited mobility of the inferior rectus muscle may occur as a result of increased tension of the fibrous bands that attach to the muscle sheath from the prolapsed fat-pad, and contructure by scar formed secondarily.
Diagnosis of the location of a fracture in the orbital floor and cause of the limitation of eye movement must be done as early as possible and from this information we can confirm surgical indiction. We believe the bi-plane CT is one of the most useful methods for making a management plan of blow-out fractures of the orbital floor.

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Antitumor effect of UFT against human oral and maxillary cancers was examined clinically and biochemically. UFT therapy was carried out in 26 patients having primary or recurrent tumors in a daily dose of 300-600mg. The average period was 132.1 days and the average dose was 71.4g. UFT therapy was combined with operation and/or radiotherapy in 20 cases, and 6 cases were treated for adjuvant chemotherapy.
In preoperative administration, clinical response was observed in one case out of 5 evaluable cases (20%). When UFT therapy was combined with radiotherapy in five cases, tumors were diminished completely in every case. The survival rate of 24 cases was 76.5% in 30 months in those to whom UFT was administered for 4 weeks or more.
5-FU levels in the serum and the tumor tissues were examined in 4 cases. 5-FU levels in the tumor tissues were 0.081-0.166 mcg/g and these were reached 6-27 times of the serum one.
Side effects were observed in 8 cases (30.8%), mainly digestive symptom, bone marrow supression and liver disfunction. However, these were generally mild, only in 2 cases administration of UFT was stopped due to the side effects.
It is considered that UFT can be administered to oral cancer patients usefully and safely.

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The analysis is based on data obtained from 475 cases of oral and maxillofacial injuries treated at our hospital during the 11 years between April 1974 and March 1985.
Maxillofacial fracture is one of the most common cases in oral surgery. Statistically, almost 78 percent involved were males and a steady increase in the number of cases was observed every year.
The majority of patients were between the ages of 10 and 30 yers old, with a peak around 10 to 20 year age group. The etiology of injuries showed individual peculiarity to each age group. Further it was found to have some relation to the injury time.
The majority of patients were consulted within one week of injury. Fracture at mandibular angle and symphysis were the most noticed in this study.
Regarding combination fracture, mandibular with maxillary fracture were quite often observed in this study. Almost 47 percent of patients injured were in main city.

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The clinical application for a period of 3-years, from 1983 to 1985 involving 52 dental root implants, was carried out in the mandibular molar region and in which 1 to 3 of the teeth were lost. An implant consisted from Fe-Cr-Ni-Co alloy (similar to AMS-5376) coated with bioglass and was conical in shape with a round bottom. Implants were divided into 3 types, ranging in different lengths and diameters; small (S-type), moderate (M-type) and long (L-type). Using a diamond bur with pores for flowing water, in order to refrigerate the bone, a socket was drilled out for implantation with caution where the implant was tight.
The socket wound following implantation was immediately closed using a mucoperiosteal flap. The gingival mucosa located directly above the implant was resected 3 months later. A bonding between the implant and the surrounding bone was ascertained, then a post-core and an upper structure of the root implant was constructed and cemented. The results are as folows:
1) In the surrounding tissues, there were slight inflammatory reactions for 4 or 5 days after implantation and no physical obstruction due to implantation.
2) The implant must be very tight and secure in the socket in order to obtain a better bonding with bone and bioglass.
3) In the X-ray finding, an unclear border when bonding between bone and implant was ascertained, and a lineal radiolucency when it was not, were observed.
4) In acoustoelectric diagnosis, amplitude and cyclic waves, under the condition of wellfitting or bonding between bone and implant in the socket, were small and short, and to the contrary they were large and long.
5) In 17 of 23 cases (74%) of M-type implants, occlusion due to construction of the upper structure was recovered. On the other hand, the S-type and L.type implants were removed mostly because of no bonding.
Furthermore, the results of implantation will be advanced through improvement with instruments and skills. Therefore, it may be possible to employ the implant procedure in dental clinical situations.

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Dental treatment under local anesthesia was performed twenty-three times on 10 patients with hyperthyroidism.
Biophysical reactions before, during and after the treatment were studied.
1. Before undertaking dental treatment in patients with hyperthyroidism, it was important to determine the time of treatment from the changes in T₃ and T₄.
2. Confirmation of the presence or absence of complications secondary to hyperthyroidism was necessary.
3. Precaution against side-effect such as agranulocytosis due to an antithyroid drug was necessary.
4. Measurement of blood pressure and pulse was indispensable before the treatment.
5. Monitoring of blood pressure and heart rate was necessary during treatment.
6. As regards pots-treatment biophysical reactions, precaution is advised against possible systemic reactions that sometimes occur more severely rather than local reactions.

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The term “epulis” has been used as a clinical name for the benign circumscribed tumor originating in the gingiva. Recently, we experienced one case of relatively large epulis.
A 15-year-old girl, who complained of a mass in the molar region of the right mandible, was referred to our clinic.
Examination revealed a egg-sized pedunculated tumor in the lingual gingiva of the second molar of the right mandible. The mass was removed with a portion of the periosteum and the gingiva under local anesthesia. The histopathological diagnosis was epulis fibrosa. No evidence of recurrence has been observed until now.

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We made a clinical evaluation of fifty patients who underwent a surgical correction in the Second Department of Oral Surgery, Fukuoka Dental College during the past 9 years.
The results were as follows:
1. The number of patients showed a tendency to increase every year.
2. The ratio between males and females was 1: 5.3. The age ranged from 11.3 to 30.8 years with a mean age of 19.6 years.
4. All the patients were diagnosed as mandibular prognathism except one with only open bite.
5. As concerns operating methods, they were as follows: 27 cases by step ostectomy, 12 cases by Obwegeser-Dal Pont method and 5 cases by vertical ostectomy.
6. 20 cases with jaw deformities were done under pre or post-operative orthodontic treatment.
7. Bone resection in body ostectomy was mostly done on the first molars.
8. The extraction in body ostectomy was mostly done at both sides of premolar teeth.
9. On the condition and the number of extraction teeth, most of them had had dental prosthesis and conservation.
10. The average time of the operations was 3° 30' with a range from 2° 13' to 6°.
11. The average of bleeding was 209ml with a range from 31 to 626.
12. The average period of intermaxillary fixation was 51.4 days with a range from 25 to 68.
13. According to radiographic cephalometric investigation.
(1) A-B difference ranged from-13.5° to 5° with an average of-3.8°.
(2) According to Hanada's classification, they were classified as follows: 16 cases to group A, 7 cases to group B, 2 cases to group C, 9 cases to group D and 10 cases to group E.
(3) On dento-facial changes after surgical correction, L₁, Pog, and point B tended to move posteriorly on an average. U₁, Gonial angle, Mandibular plane angle hardly changed.
The change of overjet was more than that of overbite.
Difference by operating methods was little.

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Enucleation for ameloblastoma lesions frequently produce a recurrence. Radical resection, therefore, has become the most widely used from of therapy. Even after radical resection, however, the recurrence may be produced. This case is reported because the tumor recurred rarely at two sites after hemimandibulectomy; A-31-year old woman received hemimandibulectomy and immediate reconstruction of mandible with iliac bone in 1964. In 1980 and 1985, tumor recurrences were found at the molar region contacted with iliac bone with the size of tip of an index and temporal region with the size of 7×7×4cm, respectively. Both tumors were removed and at present the patient is tumor-free without complications.

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In regard to the correction of ankylosis of the TMJ, this paper describes a new technique by arthroplasty and the insertion of silicone coated cast vitallium glenoid fossa.
The purpose of this method is to obtain good fixation, good shock absorbing properties, and to prevent adhesion again, malocculusion and dead space. Offering extreamely good results and satisfaction expressed by the patient.

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Three patients reconstructed with free radial forearm flap following hemiglossectomy are presented. The postoperative complications were only paresthesia of the snuff box, and the function of the recipient sites were satisfactory in all cases.
This flap was proved to offer not only the thin and pliable skin for intraoral reconstruction, but also longer and larger vessels for vascular anastomosis. The versatility and advantages of the forearm flap are reviewed and discussed.

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Neurinoma may be found in all parts of the body, however, the occurrence in the oral region is relatively rare and reports of neurinoma of the lip are very few. In this report we discuss a case of neurinoma of the lower lip which we experienced clinically.
The subject is a 27-year-old male who had appeared at our hospital with the chief complaint of swelling of the lower lip. The clinical diagnosis was benign tumor of the lower lip. Resection of the tumor was performed under local anesthesia. The tumor was diagnosed histopathologically as neurinoma of Antoni A type partially with Antoni B type.
The patient has been in a good condition postoperatively and there is no evidence of recurrence.

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The results of this survery were as follows;
1. Of the 555 in-patients treated in our Department 351 were males and 204 were females, with a male/female ratio of 1.7: 1.
2. The mean age was 42.9 for females and 38.0 for males, with a total average of 40.1.
3. Of the 555 patients, 152 (28%) were treated for fractures, 90 (17%) for cysts and 83 (14%) for malignant tumors among others.
4. 55 patients received treatment at our Department in conjunction with; a) Third Department of Internal Medicine, 31 cases. b) Department of General Surgery, 9 cases. c) Department of orthopedics, 7 cases.

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Pemphigus vulgaris is a chronic autoimmune bullous disease with a severe prognosis which involves the epidermis and mucous membranes.
A 24-year-old woman was referred to our clinic for diagnosis and treatment of bullae and erosion of oral mucosa.
Intraoral examination revealed numerous extensive erytheraatous erosion on the palate, tongue, buccal mucosa, and labial mucosa.
Specimen for biopsy was obtained from lower lip mucosa.
Histopathological features showed suprabasal intraepithelial bulla formation with acantholysis typical of pemphigus vulgaris.
Direct immunofluorescent staining demonstrated intercellular substance deposition of IgG.
Ultrastructural investigation in oral pemphigus vulgaris showed loss of desmosomes, widened intercellular spaces and the tonofilaments accumulated around the nucleus.
The diagnosis of pemphigus vulgaris was established, and treatment with 40mg prednisone daily was instituted. With progressive improvement the dosage was tapered.
The skin and oral lesions remitted and a maintenance dose of 5mg of prednisone every other day and 25mg of gold sodium thiomalate once a week was instituted.

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A 15-year-o1d male with odontodysplasia was prescnted. The affected right upper central incisor was extracted and cut into two portions. Ground sections were made from the one half of the tooth and their microradiograms were taken with the soft X-ray. Decalcified sections were made from the other half of the tooth. Different two zones could be observed within the enamel layer. The outer hypoplastie enamel showed calcified globules, while the inner enamel showed normal structure. Dentin consisted of extensive interglobular region. The hypermineralized amorphous structure was observed in the coronal dentin.

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Elongation of the styloid process or ossification of the styloid ligament may produce variant symptoms: vague facial pain, throat discomfort, radiated otalgia, dysphagia and so forth.
Two cases of symptomatic elongated styloid process with discomfort of the pharyngeal area and the base of tongue and radiated otalgia are reported in this paper.
Case 1: A 41-year-old man with an ulcer of the base of tongue was referred to us by a dentist on July 25, 1984. He had discomfort of the base of tongue and neuralgic pain on the bilateral temporal area since late 1983. The ulcer was not seen but a hard mass could be palpated in the bilateral tonsillar fossa. Radiographs disclosed gross elongation of the right and left styloid processes.
Clinical diagnosis: Elongated styloid process.
On September 18, 1984, the patient underwent bilateral reduction of the styloid processes by trans-pharyngeal surgical procedure; 3.5 cm of the right process and 4.5 cm of the left one were removed. Histopathologically the two bone pieces showed normal osseous tissue with cortical bone of mature laminar bone.
Postoperatively the patient was free of all previous symptoms.
Case 2: A 31-year-old woman had pain and swelling of posterior region of right auricle, discomfort of pharyngeal area and vomiting since June, 1983. Her neurosurgeon diagnosed the swelling as atheroma with other symptoms resulting from inflammation. As her symptoms continued, she came to our office on July, 11, 1983. At the first visit, the swelling of posterior region of right auricle was not observed and radiographs disclosed abnormal elongation of the right styloid process. Clinical examination of the oral cavity showed reddned mucosa of the right tonsillar fossa. Intraoral palpation of the right tonsillar fossa disclosed a hard, bony cord.
Clinical diagnosis: Elongated styloid process.
We resected 4cm of the process on September 13, 1983. Three months after surgery the patient was free of pain and other previous symptoms.

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