Japanese Journal of Oral and Maxillofacial Surgery
Online ISSN : 2186-1579
Print ISSN : 0021-5163
ISSN-L : 0021-5163
Volume 33 , Issue 12
Showing 1-28 articles out of 28 articles from the selected issue
  • Mugio KATO, Kazuhiro KAKAMI, Kenji YOSHIDA, Ataka ITO, Akira ISHIHARA, ...
    1987 Volume 33 Issue 12 Pages 2347-2357
    Published: December 20, 1987
    Released: July 25, 2011
    JOURNALS FREE ACCESS
    Recently, low power density lasers have been used in dental and oral surgical treatments. We had an experience of using low power density He-Ne laser (Soft laser 632 by Mainfar Co.) on stellate ganglion. We evaluated the clinical effect of the low power density He-Ne laser irradiation by thermograph “TVS-4300 ME”.
    It seemed that the effect of relieving pain was result of laser irradiation.
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  • Kazuyuki MIYATA, Koshin IWAGAMI, Takeshi WADA, Masakazu HARADA, Kenji ...
    1987 Volume 33 Issue 12 Pages 2358-2365
    Published: December 20, 1987
    Released: July 25, 2011
    JOURNALS FREE ACCESS
    The effects of isoproterenol on the outgrowth from human salivary gland explants were studied in primary culture.
    Isoproterenol was added to the growth medium to produce a graded series of concentrations of 10-4, 10-5, 10-6 and 10-7g/ml.
    In the absence of isoproterenol, the cellular outgrowths from salivary gland were easily degenerated after 4-6 weeks of culture, and in most cases fibroblastic growth exceeded epithelial outgrowth.
    Isoproterenol did not increase the growth of salivary gland cells when used at doses of 10-4, 10-5 and 10-6g/ml.
    At 10-5g/ml, isoproterenol appeared to have the property of maintaining the sheet-like structure of cellular outgrowth.
    The inhibitory effect on fibroblastic growth was observed in doses of 10-4, 10-5 and 10-6g/ml.
    These results show that isoproterenol may act as a regulatory factor in the control of the proliferation and differentiation of human salivary gland cells.
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  • Eisuke FUJIMOTO, Masaru MIYATA, Hideaki SAKASHITA, Kiyomasa NAKAGAWA, ...
    1987 Volume 33 Issue 12 Pages 2366-2371
    Published: December 20, 1987
    Released: July 25, 2011
    JOURNALS FREE ACCESS
    Malignant lymphoma is a neoplasm arising from the lymph node and lymphoid tissues. This tumor occurs frequently in the head and neck, but it occurs rarely in the oral cavity. Usually the first symptom of this tumor is painless swelling. A 56-year old man was reffered to the clinic with the chief complaint of severe pain and ulcer formation on the upper jaw gingiva. The specimen from the gingiva indicated malignant lymphoma histologically. The patient received radiotherapy and combination chemotherapy with ACOP. Therapy was not so effective in this case. The patient was dead 6 months after onset. In this report, the clinical course is presented with some comments based on the existing literature.
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  • Arifumi MIKAMI, Atsushi ASHIMOTO, Akihito MICHITA, Takaaki OGAWA, Take ...
    1987 Volume 33 Issue 12 Pages 2372-2375
    Published: December 20, 1987
    Released: July 25, 2011
    JOURNALS FREE ACCESS
    The aneurysmal bone cyst was first described as a pathologic entity by Jaffe and Lichtenstein in 1942. This disease is known as a non-neoplastic bone lesion, forming a cystic cavity filled with nonendotheliallined space containig blood, but the etiology remains unknown. A 13-year-old boy was referred to our hospital for treatment of mandibular fracture caused by an accident. xray showed a fracture line at the mental region of the mandible and defined multilocular cyst-like radiolucency on the left side of the mandible.
    From CAG, no aneurysm was revealed, but capillaries were seen corresponding to the cyst-like shady region. Under general anesthesia, the left side of the mandible was exposed through an intraoral approach and curretted. The lesion was a multilocular cavity containing blood and coagulation.
    Histologically, the cavity was lined with a thin fibrous connective tissue stroma filled with numerous capillaries and blood. In some areas, new bone formation and hemorrhage were seen. The lesion was diagnosed as an aneurysmal bone cyst.
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  • Yasuhiro FUKUCHI, Masaaki GOTO, Takeshi KATSUKI, Wataru SOEJIMA, Hisat ...
    1987 Volume 33 Issue 12 Pages 2376-2384
    Published: December 20, 1987
    Released: July 25, 2011
    JOURNALS FREE ACCESS
    In conjunction with the increased applicability of laser beams to areas of medicine and dentistry observed in recent years, a variety of laser apparatus have been developed. Often a new type of apparatus is specifically designed for a given physical region or for a given variety of lesions. In oral surgery in particular, a great deal of attention is now given to the contact head-equipped Nd-YAG laser system. The reason is that the contact head type provides light-hemorrhage incisions and better manipulability as opposed to the non-contact head type, which is less suited for use in this field since the oral cavity has such movable parts as the tongue and the oral floor in addition to its high vascularity and moisture from saliva.
    For the present report, a Nd-YAG laser system was installed for treatment of the oral surgery out-patients at the Saga Medical School Hospital. The number of subjects who underwent surgery there between April and October, 1986 totalled 31: 19 cases of benign tumor, 6 cases of cyst, 2 cases of keratotic lesion, and 4 cases of miscellaneous lesion. The contact head Nd-YAG laser system exhibited a high capability of incision and easy manipulability. Furthermore, in all cases, we applied no suture or surgical packing to incised parts, but observed good post-operative healing.
    In conclusion, with the development of the contact type of head, the Nd-YAG laser system has become applicable to more regions of the oral cavity and proved to be a useful surgical technology in oral surgery.
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  • Harumi MIZUKI, Hiroshi SHIBATA, Masatsugu SHIMIZU
    1987 Volume 33 Issue 12 Pages 2385-2390
    Published: December 20, 1987
    Released: July 25, 2011
    JOURNALS FREE ACCESS
    There are two types of pyogenic osteomyelitis of the jaws. One is intramedullary osteomyelitis and the other is subperiosteal osteomyelitis.
    Subperiosteal osteomyelitis on the outer cortical bone of the mandibular ramus adjacent to the submasseteric space, usually results from pericoronitis. If a submasseteric abscess, which is formed by backward spreading of the pericoronitis, presents itself continuously, the outer cortical bone is involved and osteomyelitis results.
    We would like to present a case with subperiosteal osteomyelitis of the outer cortical bone of the ramus.
    The patient, a 43-year-old man, visited our clinic complaining of trismus and swelling of the left cheek on 17 th of March, 1985.
    Two months before his first visit to us, he had pain in the region of the left lower third molar, swelling of the left cheek and mouth-opening limitation.
    Although he received extraction of the left lower third molar tooth and administration of antibotics at a dental clinic, he did not improve.
    Then he visited an ENT and was advised to visit to our clinic.
    At the first examination by us, clinical findings revelaed diffuse swelling on the left cheek and the left molar gingiva, trismus and pus discharge. The X-rays showed bone distraction of the outer cortex of the ramus.
    We administered antibiotics intravanously and operated on the patient under general anesthesia. The curettage and sauserization was done intraorally. A drain was inserted and the wound was closed.
    After the operation, pus discharge, swelling and trismus disappeared and there has been no reccurence.
    Histopathological examination of the excised and curetted tissue showed formation of active or old granullation tissue and bone necrosis. Adjacent to them, there were chronic inflammatory cell infiltration, proliferation of fibrous tissue and new bone formation.
    Diagnosis of subperiosteal osteomyelitis adjacent to the submasseteric space was made from its clinical feature and histopathological findings. Its location and radiological findings are characteristic, so it can be said that this case is one of typical subperiosteal osteomyelitis adjacent to the submasseteric space.
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  • Yoshiaki KATADA, Makoto TSUCHIMOCHI, Joji KATO
    1987 Volume 33 Issue 12 Pages 2391-2407
    Published: December 20, 1987
    Released: July 25, 2011
    JOURNALS FREE ACCESS
    Ten patients with intensely invaded malignant tumors at the mandibles were studied with bone scintigraphy (Tc-99m MDP) and Ga-67 citrate scintigraphy. All patients were classified by type of accumulation of both radionuclide pharmaceuticals. In almost all patients with invaded malignant tumors, bone scintigraphy revealed decreasing uptake in the center of the lesion and increasing uptake in the peripheral region. Ga-67 citrate scintigram showed increasing concentrated accumulation which was smaller than the area of Tc-99m MDP uptake in almost all cases. These types of accumulation were compared with those of other oral and maxillo-facial diseases. The patterns of accumulation of both radionuclide pharmaceuticals in ameloblastoma (3 cases), radicular cyst (3 cases), bone fracture (2 cases), diffuse sclerosing osteomyelitis (2 cases), and one sagittal ramus osteotomy case were different from that of bone involvement of malignant tumor cases. From the types of accumulation, we may be able to differentiate the oral and maxillo-facial diseases to some extent. In addition, the intensity of accumulation of Tc-99 m MDP was measured by using bone to soft tissue ratio (4 hrB/St ratio). The mean 4 hrB/St ratio was higher in moth-eaten absorbed type than in permeated type of resorption in roentgenogram. However, we could not obtain a definitive conclusion because of too few cases. The mean 4 hrB/St ratio in the bone involvement by malignant tumor was higher than that in radicular cyst, and lower than that of diffuse sclerosing osteomyelitis. Unfortunately, we could not differentiate each disease of the involved malignant tumor, ameloblastoma, or bone fracture by only the 4 hrB/St ratio. The Tc-99m MDP accumulated beyond the region where the radiolucencies exist in roentgenograms. We consider that both scintigraphies have a great role in planning surgical treatment, especially in selecting osteotomy.
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  • Hirofumi MURASE, Hirohiko TAIRA, Tomoyoshi ASOH, Kanji KITAMURA, Tetsu ...
    1987 Volume 33 Issue 12 Pages 2408-2418
    Published: December 20, 1987
    Released: July 25, 2011
    JOURNALS FREE ACCESS
    The alveolar ridge forming operation on the edentulous case with the sub-periosteal tunnel process using hydroxyapatite (HAP) is a pre-prosthetic surgical treatment that can be adapted to the aged, is quite simple under local anesthesia, and has wide applications. HAP is also attracting clinical attention for its utility as a prosthetic and compensatory compound for osseus tissue, with excellent histoaffinity and osseus induction capability.
    In the alveolar ridge forming operation on the edentulous case with the sub-periosteal tunnel process using HAP, the mucous membrane of the canine region is incised longitudinally under local anesthesia. Centering about the alveolar crest and up to front of the retromolar region, heperiosteum is elevated blindly, and HAP is injected in this region with an injection cylinder and the shape of the alveolar ridge is fixed with a plate splint and circumferential wiring of the mandible with the alveolar ridge forming operation, X-ray measurements showed that the height increased about 1.4 times in the anterior region and about 1.8 times in the molar region. There was a remarkable alveolar ridge lifting by the operation, with the buccal shelf extensively flattened to a form that is advantageous to improvements in maintenance and stability of dentures and support of masticatory pressure. A 20% enlargement of the denture-bearing area was observed after the operation.
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  • Ryuichi KAJI, Shigeru UENO, Akira MATSUO, Moritaka SHIMA, Yutaka MIKAM ...
    1987 Volume 33 Issue 12 Pages 2419-2424
    Published: December 20, 1987
    Released: July 25, 2011
    JOURNALS FREE ACCESS
    Before radical operation of tongue cancer of the patient with idiopathic thrombocytopenic purpura (ITP), γ-globulin was given in high dose and satisfactory results were obtained.
    The patient was a 38-year-old man referred to us by his dentist with a complaint of the presence of induration in his tongue.
    Histopathological examination revealed the lesion as squamous cell carcinoma. Preoperative radiation of 30 Gy was given, but the tumor showed radiation resistance. Therefore, additionally 80mg/body of CDDP was administrated. As the result of the chemotherapy, the number of platelets decreased to 0.2×104/mm3 and spontaneous bleeding from gingiva and purpura appeared. Platelettransfusion was undertaken and the number of platelets increased to 24.9×104/mm3 at a peak period. The platelet count finally reached 5.0×104/mm3.
    As a diagnostic therapy, high dose γ-globulin was administrated intravenously to confirm the diagnosis of ITP and the number of platelets reached to 7.1×104/mm3. Radical operation including tracheostomy, hemiglossectomy and radical neck disection was performed. Reconstruction was subsequentry undertaken with PM-MC flap. Although total bleeding was 2, 767ml, control of the hemorrhage was not difficult. Postoperative bleeding from suction catheter was 1, 118ml.
    Postoperative course was uneventful and recurrence of the tumor was not observed.
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  • Kasuke NAKASHIMA, Yasuyuki UENO, Masamichi IDA, Hitoshi TANABE, Tatsuo ...
    1987 Volume 33 Issue 12 Pages 2425-2433
    Published: December 20, 1987
    Released: July 25, 2011
    JOURNALS FREE ACCESS
    The recent developments in anti-cancer chemotherapy have led to a gradual increase in successful treatment of head and neck cancer.
    Many anti-cancer chemotherapeutic methods have been used, but the direct effects of the various combination methods using CDDP appear particularly valuable at present.
    For this reason, over the past 4 years and 3 months, we have treated cancer patients using Neo-adjuvant chemotherapy, with the main treatmental agent of CDDP in conjunction with PEP, MMC, MTX and others. 9 chemotherapeutic regimens were used. Divided into the PP method, the PPM method, and the P-others method. The most commonly used regimen-PP-3, consisted of the continuous infusion or arterial perfusion method of CDDP and PEP, with dosages varied with each trial. A total of 42 patients with a mean age of 58.5 years were treated. The main tumor affected regions, (accounting for 76.1% of all cases) were the maxillary sinus, buccal mucous membrane, mandibular gingiva and tongue.
    Histologically, these tumors consisted of the following: 31 new cases and 6 recurrent cases of squamous cell carcinoma, one primary case and one recurrent case of adenoid cystic carcinoma, one case each of mucoepidermoid carcinoma, adeno carcinoma and one case undefined by histological diagnosis.
    The overall response rate exhibited was 57.1%. Broken down, this includes 70.9% of new cases of squamous cell carcinoma, 16.6% of recurrent cases, and 20.1% of the non-squamous cell carcinoma. The rate of response fell gradually according to tumor growth.
    A clear correlation was seen between histological differentiation and the effect of Neoadjuvant chemotherapy with well differentiated cases exhibiting a high rate of response in both new and recurrent cases.
    However, differences in the response rate were observed between the continuous infusion method and the arterial perfusion method. Of four cases treated by arterial perfusion, two showed complete response (CR), and two partial response (PR), the two CR cases both being of low differentiation.
    Various treatment methods were used in applying Neo-adjuvant chemotherapy to head and neck cancer. In terms of effect, and in consideration of side effects, we found the arterial perfusion method to be very useful.
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  • Kasuke NAKASHIMA, Masamichi IDA, Yoshikazu HAYATSU
    1987 Volume 33 Issue 12 Pages 2434-2437
    Published: December 20, 1987
    Released: July 25, 2011
    JOURNALS FREE ACCESS
    Varix is found throughout the body, it generally appears in the ramus inferior, semiferous, and oesophageal regions with age increase. The disease is characterized pathologically by the local dilation of the vessel wall to form a tumor.
    Literature concerning the occurence of varix in the head and neck regions is rare, and a search revealed no cases involving young men or women.
    In this report, we described the details of a case of varix occurring in the submental region of a young girl. The patient, an 11 year old girl, complained of repeated elastic soft swelling in the submental region and of spontaneous pain when swallowing.
    The tumor was located by palpation near the surface of the submental region. At first it was diagnosed from clinical findings to be a dermoid or epidermoid cyst or haemangioma. Although a scar would result, a skin incision was carried out and the tumor was removed under general anesthetic. The tumor was dark purplish red in color and had partially invaded the mylohyoid muscle.
    The specimen consisted of small vein, venules and capillaries suggesting haemangioma.
    However the endotherial cells of veins were well developed, and there was thrombosis like stagnation of erythrocytes and polymorphonuclear leukocytes in the venous lumens, indicating a diagnosis of varix.
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  • Komei SHIGEMURA, Kasuke NAKASIMA, Tatuo TSUJI, Fumihiko SHINOZAKI
    1987 Volume 33 Issue 12 Pages 2438-2441
    Published: December 20, 1987
    Released: July 25, 2011
    JOURNALS FREE ACCESS
    A case of angiokeratoma occuring in the right buccal mucousa is reported in this paper.
    A 17-year-old male visited our hospital with a chief complaint of tumor formation in the right buccal mucosa.
    The pathological diagnosis was solitary angiokeratoma.
    The tumor was resected and the remaining tissues were cautierlized by CO2 laser.
    Recurrence isn't observed at present (three months after).
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  • Kihachiro ABE, Hirohide NIKAIDOH, Chie TAKUMA, Masuichiro OKA, Yoshino ...
    1987 Volume 33 Issue 12 Pages 2442-2446
    Published: December 20, 1987
    Released: July 25, 2011
    JOURNALS FREE ACCESS
    A 10-year-old girl developed a central giant cell granuloma in her right maxilla. The lesion was noticed as a painless swelling. At the time of her first visit, a cystic lesion was diagnosed because of the radiographic appearance and of the blood like aspirated involvement. Marsupialization was intended but the solid involvement appeared, so biopsy was performed. After the histopathological diagnosis of central giant cell granuloma was made, the lesion was enucleated completely under general anaesthesia. Post operative course was good and no recurrent sign was seen almost 3 years after operation.
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  • Kenji YOSHIDA, Kazuhiro KAKAMI, Akira ISHIHARA, Michio KANEKO, Mugio K ...
    1987 Volume 33 Issue 12 Pages 2447-2458
    Published: December 20, 1987
    Released: July 25, 2011
    JOURNALS FREE ACCESS
    The Nd-YAG laser was at first used chiefly for coagulation of hemostasis effects. But the development of the contact type rod using a new ceramic (Al2O3), enabled cutting organ finely.
    We experienced using SLT contact laser DCL 50 apparatus in oral surgery by contact method, which can be used as high power or low power.
    Nd-YAG low power laser beam (120 mmW) was irradiated on the stellate ganglion of a normal adult male, and revealed hyperthermoregion over the face by a thermogram.
    We used high power Nd-YAG laser beams for the purposes of vaporization and cauterization of lichen planus and leucoplakia, excision of hemangioma and mucocele and extirpation of mucomembrane cancer in the gaumen region Postoperative symptoms were slight, compared with those by the non-contact method.
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  • Hiroshi CHIKUMARU, Shinjiro AOKI, Yoshimi ISHIKAWA, Seiichi HAYASHI, G ...
    1987 Volume 33 Issue 12 Pages 2459-2465
    Published: December 20, 1987
    Released: July 25, 2011
    JOURNALS FREE ACCESS
    This report presents the detailed description of a case of erectile cavernous hemangioma in the masseter muscle.
    A 15-year-old male patient was referred to our Department on February 28, 1986 with a chief complaint of a hemispherical swelling of the right masster region at masseter muscle contraction or physical exercise.
    Clinical examination revealed that the swelling appeared immediately following masseter muscle contraction and disappeared soon after the masseter muscle was relaxed. This swelling was elastically soft, 40×40mm in size and without spontaneous pain or tenderness. Skin surface had normal color, and no fluctuation was felt. Two milliliters of vessel blood was aspirated by puncture. The intraoral examination revealed no abnormal findings.
    An extended mass was found in masseter muscle with CT scanning and ultrasonic scanning.
    Under the diagnosis of erectile hemangioma, the sized about 40×20×15mm was removed surgically and diagnosed histologically as a cavernous hemangioma.
    The clinical symptom disappeared and there is no sign of recurrence.
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  • Ryuta KATAOKA, Kousuke OHNO, Takashi OKADA, Yasushi ARISAWA, Hiroshi Y ...
    1987 Volume 33 Issue 12 Pages 2466-2475
    Published: December 20, 1987
    Released: July 25, 2011
    JOURNALS FREE ACCESS
    Granular cell tumors are characterized by acidophillic granules in the cytoplasm. The histogenesis of this lesion is still a matter of controversy.
    Four cases of granular cell tumors, including one case of congenital epulis, are presented and investigated pathologically to determine the histogenesis. Histochemically, in all of these cases, intracytoplasmic granules were faintly positive in the PAS reaction, but negative in the Alcian-blue reaction, the Sudan III reaction, and the Kliiver-barrera and Bodian reaction. Immunohistochemically, two cases were positive and two cases were negative in the antisera against S-100 protein reaction. On ultrastructual evidence, the axon-like structure was found in one case, and a myelinic structure was found in all cases.
    According to these results, neurogenesis of granular cell tumors was suggested in three of the four cases.
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  • Kohji MOCHIZUKI, Tetsuji KAWAKAMI, Tadaaki KIRITA, Katsuhiro HORIUCHI, ...
    1987 Volume 33 Issue 12 Pages 2476-2481
    Published: December 20, 1987
    Released: July 25, 2011
    JOURNALS FREE ACCESS
    A case of squamous cell carcinoma (superficially extending cancer) of the soft palate was reported.
    Clinically the lesion appeared inflamed and uneven without induration. It was neither exophitic nor ulcerative. Histopathologically, the most part of the overlying epithelium proliferated showing carcinoma in situ, and in several spots normal epithelia or microinvasions were seen. The lesion was limited to the lamina propria, “extending superficially”.
    It was suggested that superficially extending carcinoma in this report might have arisen “multicentrically” through a process of “field cancerization”, which could be an important factor concerning the persistance or recurrence of squamous cell carcinoma in the oral region.
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  • Shun OHTA, Yoko KIDA, Toshio MOGI, Toshie OKADA
    1987 Volume 33 Issue 12 Pages 2482-2486
    Published: December 20, 1987
    Released: July 25, 2011
    JOURNALS FREE ACCESS
    A case of false ankylosis following bilateral condylar fractures of the mandible is presented. Patient was treated by resection of fractured condylar processes and immediate reconstruction with autogenous costal cartilage grafts for interposition. Vertical dimension of the ramus was maintained physically by cartilage grafts and satisfactory results without facial deformity or deviation of the mandible were obtained.
    It can be concluded that autogenous cartilage grafts for interposition will survive for enough time to prevent postoperative muscular contracture.
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  • Makoto ONISHI, Tokio OYAMA
    1987 Volume 33 Issue 12 Pages 2487-2495
    Published: December 20, 1987
    Released: July 25, 2011
    JOURNALS FREE ACCESS
    A clinicostatistical analysis of 9, 478 out patients in the Clinic of Dentistry and Oral Surgery, Nagaoka Red Cross Hospital during the past 6 years from January, 1981 to December, 1986 is presented. The patients consisted of 4, 518 males and 4, 960 females with a male to female ratio of 1:1.1. Eighteen percent of them were in the twenties, 15% in the thirties and 20% were over sixty. The number of patients visiting us each year increased from 1, 510 in 1983 to 1, 683 in 1986 with a mean of 1, 580. In terms of month, it was higher during the summer season from June to August than during the winter season from November to February. Fifty eight percent of patients were residents of Nagaoka City where our hospital is located and those from outside Niigata prefecture was less than 1%. In 1982, patients referred to our hospital from other dental and medical facilities constituted 59% of the total patients, but the rate fell to 41% in 1986, mainly due to the decrease of patients referred to us from dentists in general practice and in other hospitals. Forty eight percent of patients visited us for treatment of dental and periodontal diseases, which were followed, in order of frequency, by inflammation (17%), tooth loss and inadequate prosthetics (9%), traumas (7%), cysts (5%), diseases of the temporomandibular joint and the oral mucosa (5% each), malformations and jaw deformities (2%) and benign and malignant tumors (2%). Patients with diseases of the salivary glands and neurologic diseases were less than 1%. A tendency to gradual increase was noted in the number of patients with traumas, cysts, diseases of the temporomandibular joint and the oral mucosa, whereas those with dental and periodontal diseases and inflammation decreased every year.
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  • Nobuyuki MIZUKI, Noriaki AOKI, Shinjiro AOKI, Yoshimi ISHIKAWA, Susumu ...
    1987 Volume 33 Issue 12 Pages 2496-2503
    Published: December 20, 1987
    Released: July 25, 2011
    JOURNALS FREE ACCESS
    We consider that the purpose of the treatment of maxillofacial bone fractures is not only to correct the dysfunction but also to reduce the aesthetic disturbance as much as possible. From this reason, we used a subciliary incision technique to approach the fracture lines of the orbital floor and infraorbital rim in 7 cases. One Le Fort I, II type, 2 blowout fractures, and 4 zygomatic bone fractures involving the infraorbital rim were included in our 7 cases. We obtained aesthetically and functionally good results with this subciliary incision technique.
    Originally developed as a blepharoplasty type of incision, the subciliary incision was developed by Converse et al for the treatment of maxillofacial bone fractures. There are many types of surgical approach to the orbital floor, but we used preferably a step incision where each layer of tissue of the lower eyelid is divided at a different level so as to be able to prevent an ectropion caused by scar contracture. This technique provides an excellent exposure of the entire orbital floor and the lower part of the lateral and medial walls.
    Classifying grossly, there are 4 incision techniques (orbital rim incision, lower eyelid incision, subciliary incision, and conjunctival incision) for the exposure of the orbital floor, infraorbital rim, and zygoma from the lower eyelid. We should decide the most suitable technique for each case depending on the basis of the extent, the state, and the time of fractures. It is important to acquire a good knowledge of each of the 4 incision techniques in order to make this choice. Our subciliary incision technique with the step incision had several advantages over the other methods, namely, a wide operative field, nearly invisible scars, and absence of complications. Therefore, we consider that this technique is very useful for the treatment of maxillofacial bone fractures.
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  • Hitoshi SAOTOME, Kuniya FUJITA, Yoshiaki SHIGEMATSU, Kazuhiko SAITOH, ...
    1987 Volume 33 Issue 12 Pages 2504-2511
    Published: December 20, 1987
    Released: July 25, 2011
    JOURNALS FREE ACCESS
    Since the first reported case of multiple primary carcinomas (Billroth 1869), this interesting condition has become more prevalent from year to year.
    We report a case of multiple primary carcinoma involving the oral floor and the liver in a 62-year-old male. This case satisfied diagnostic criteria of both Billroth as well as Warren and Gates.
    In addition we reviewed the Japanese literature from 1934 to 1986 which included 323 cases of multiple primary carcinoma involving the head and neck regions.
    (1) The average age of patients was 60.4 years, cases occurred most frequently during the 7 th to 8 th decade.
    (2) The ratio of males to females was 2.4:1.
    (3) Synchronous (within 6 months) carcinomas occurred in 42% of cases and metachronous was found in 58% of cases.
    (4) In multiple primary carcinomas of head and neck, carcinomas involving multiple different maxillary lesions were most frequent.
    (5) In cases of primary carcinoma of the head and neck involving other regions, the stomach and esophagus were most frequent sites.
    (6) The most common histologic type of neoplasms were squamous cell carcinoma. Both first and second cancers frequently well identified.
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  • Yasuhisa MINENO, Takayuki YAMAUCHI, Kohji SATOH, Takeshi MURAI, Kinko ...
    1987 Volume 33 Issue 12 Pages 2512-2517
    Published: December 20, 1987
    Released: July 25, 2011
    JOURNALS FREE ACCESS
    Occlusal splint therapy and intra-articular injection therapy were administered to 30 patients (3 males and 27 females, average 35 years 10 months) with TMJ arthrosis in whom conservative therapy such as drug therapy and physiotherapy had been ineffective. The clinical efficacy of the two therapies was evaluated.
    1. Occlusal splint therapy was applied to 28 patients, and it consisted of relaxation splint in 14.3%, stabilization splint in 46.4%, resilient splint in 14.3%, pivoting splint in 7.1% and other splints in 17.9%, stabilization splint therapy was thus applied to the largest number of patients. The efficacy rate as a function of the kind of splint was 75.0% for relaxation splint, 61.5% for stabilization splint, 75.0% for resilient splint, 50.0% for pivoting splint and 60.0% for other types of splint. The overall efficacy rate was thus a high 64.3%.
    2. Intra-articular injection therapy was performed in a total of 7 patients, consisting of triamcinolone acetonide in 5 patients and glycosaminoglycan polysulphate in 2 patients. The effect lasted more than 2 weeks in out of 5 cases of triamcinolone acetonide and 2 out of 2 cases of glycosminoglycan polysulphate.
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  • Akira KITAMURA, Tsugio INOKUCHI
    1987 Volume 33 Issue 12 Pages 2518-2523
    Published: December 20, 1987
    Released: July 25, 2011
    JOURNALS FREE ACCESS
    The function of the jaw corrected by saggital mandibular osteotomy has been checked by mandibular kinesiograph (MKG). The data of the MKG taken one year after the operation was compared with the preoperative one. The mandibular movement at the preoperative stage showed various kinds of qualitative pattern compared with that of the postoperative data. The postoperative results indicated improvement in the mandibular movement and no subjective abnormal feature could be found. Thus, it seems that sagittal reposition of the mandible will improve mandibular function.
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  • Kazuyuki MIYATA, Nobuo MORITA, Takeshi WADA, Masakazu HARADA, Manabu Y ...
    1987 Volume 33 Issue 12 Pages 2524-2529
    Published: December 20, 1987
    Released: July 25, 2011
    JOURNALS FREE ACCESS
    Two cases of basal cell nevus syndrome are presented.
    Both cases were referred for evaluation of multiple radiolucent jaw lesions.
    In the case of a 16-year-old female, multiple jaw cysts, a broad nasal root, ocular hypertelorism, frotal and temporal bossing and prominent calcification of the falx cerebri were present.
    In the other case, a 26-year-old male, multiple jaw cysts, ocular hypertelorism, calcification of the falx cerebri, mild prognathism and bifid rib were present.
    Histopathological diagnosis of jaw cysts was odontogenic keratocyst.
    Both cysts were enucleated, the patients being followed up on an outpatietnt basis.
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  • Toshiyuki TERANO, Yoshinobu KUBO, Kenji KAKUDO, Harumi ARAKI, Harumi U ...
    1987 Volume 33 Issue 12 Pages 2530-2536
    Published: December 20, 1987
    Released: July 25, 2011
    JOURNALS FREE ACCESS
    A new technique for preoperative diagnosis and treatment planning has been developed. The dento-maxillofacial model which was composed of facial and dental models was designed for postsurgical prediction of the face and occlusion. A facial asymmetry case was presented to demonstrate the diagnostic capabilities of model surgery by using this model. The dento-maxillofacial model has greatly improved our ability to plan the treatment of gross facial asymmetry.
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  • Shinsuke YAMAMOTO, Kazuyoshi UEMURA, Munehiro CHIN, Seiji YOSHIDA, Ken ...
    1987 Volume 33 Issue 12 Pages 2537-2543
    Published: December 20, 1987
    Released: July 25, 2011
    JOURNALS FREE ACCESS
    104 cases of malar bone fracture have been treated in our department in the last five years. Type of fracture, term from injury to treatment, methods of treatment and complications were reviewed in each case. Treatment and prognosis of malar bone fracture were discussed based on these results and survey of the literature.
    It is conluded that closed reduction was effective for zygomatic arch fracture and body fracture without rotation. Satisfactory results were obtained by open reduction and fixation in rotation or complex fractures. Principally, open reduction was performed from infraorbital and lateral eyebrow region, and these are fixed with mini-plate and screw.
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  • Keisuke HORIUCHI, Toyohiko KAMIBAYASHI, Etsuo SHOHARA, Ikuhiro YOSHIDA ...
    1987 Volume 33 Issue 12 Pages 2544-2550
    Published: December 20, 1987
    Released: July 25, 2011
    JOURNALS FREE ACCESS
    The thyroid gland which appears in the floor of the pharyngeal gut between the tuberculum impar and the copula in the developmental stage goes downward to take a normal position in the neck. During this process, certain kinds of disorders occasionally bring congenital diseases which later make tumors in the lingual or cervical regions.
    Four cases of median cervical tumor derived from the thyroid gland were treated in our clinic. All the patients, 5-year, 8-year, and 4-year old boys and d 58-year old woman, visited our hospital because of painless swelling at the median cervical region. The tumors, the diameters of which were in the range of 15-28 mm, smooth surfaces and relatively clear margins, caused no symptomatic difficulties in breathing, speaking or swallowing. All tumors were excised under clinical diagnoses of thyroglossal cyst. Histopathological observations revealed that the first three cases were thyroglossal cysts, but the fourth case was ectopic thyroid. No complications have been seen after the operations in every case.
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  • Tatsumi HIROSAWA, Tomokazu MIYAMOTO, Shigeru HASHIMOTO, Hidetoshi WAKA ...
    1987 Volume 33 Issue 12 Pages 2551-2557
    Published: December 20, 1987
    Released: July 25, 2011
    JOURNALS FREE ACCESS
    The benign osteoblastoma is an uncommon benign bone tumor. The most frequently affected sites include the vertebral column and the long tubular bones, but rarely in the jaws.
    We experienced a case of large benign osteoblastoma in the maxillary of a 25-year-old female.
    On July 7, 1985, she was referred to our hospital because of a swelling of the left maxilla.
    Intraoral examination revealed a diffuse swelling of the buccal aspects of maxilla in the left maxillary premolar and molar regions.
    Roentgenographic examination revealed a radiopaque area in the left molar region, involving the anterior wall and floor of the maxillary sinus.
    In addition to the histologic exmination, we diagnosed benign osteoblastoma.
    The tumor was total excised under general anesthesia.
    The weight of the extracted tumor was 120g.
    The postoperative course was uneventful, with no evidence of recurrence after 11 months.
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