Experimental formation of mucous cyst was conducted by cutting off a duct of the minor sublingual gland at the floor of the mouth of Wistar rat, and the following results were obtained.
1. From around day 5 after duct cutting a hemispherical swelling appeared under the mucosa at the floor of the mouth, and it formed a translucent swelling, which resembles ranula in man, of such a size as to push the tongue upward by day 28.
2. At the initial period of the experiment mucous granulation was formed around the cut off-duct but this was gradually compressed by the extravasating mucous to the peripheries, and the cyst cavity was formed. After day 28 it presented a finding conforming to extravasation mucous cyst having the mature thin fiber cyst wall in man.
3. Hyperplasia and squamous metaplasia were observed in the epithelium of the duct at the cut off-region in almost all cases.
In a few cases the epithelium of the duct became thin, then this thinning progressed along the inside of the cavity and covered the whole cavity inside on day 56, and a finding of the cyst having an epithelial lining was shown.
4. The remnant on the mucosal side of the cut off-duct in the oral cavity showed a tendency toward earlier atrophy and disappearance due to compression accompanying the cyst formation.

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In order to do an epidemiological investigation of temporomandibular joint disorder, 612 students of a junior high school and a high school in Nagoya city were investigated by a questionnaire. The results were as follows:
1. Frequencies of complaints of temporomandibular joint sound were 12.1%. No significant difference was found in age and sex distributions.(P>0.1)
2. 3.7% of junior high school students and 7.9% of high school students complained of more than two complex symptoms (P<0.05), which were typical symptoms of TMJ arthrosis, TMJ sound, pain and limitation.
3. For the initial onset of disorder, 55.2% of the total samples indicated that the disorder was manifest in junior high school students. This result suggested the association between complaints of TMJ disorder and dental stage IVA (Hellman's classification).
4. The association between complaints of TMJ disorder and feeding, bruxism and chewing on one side were P<0.05 (in girls), P<0.001 (total), P<0.05 (in boys), respectively.
5. The results suggested that further extention of the sample is necessary to investigate the etiology of TMJ disorder.

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Squamous cell carcinoma (scc) is the most frequently type of oral cancer, but no reliable specific tumor markers of scc have been obtained. In this paper, the authors applied measurement of squamous cell carcinoma related antigen (scc antigen), a useful tumor marker of scc of the uterine cervix, to oral cancer patients and evaluated the clinical values of scc assay in diagnosis, follow-up and prognosis.
The subjects were 29 cases of oral cancer and 23 cases of benign oral disease. The oral cancer cases included 12 cases of tongue cancer, 5 of buccal cancer, 4 of gingival cancer, 2 of cancer of the oral floor, 2 of cancer of the maxillary sinus and 4 cases of other cancers. Twenty one of these cases (about 72%) were histologically scc.
Serum scc antigen levels were determined by the RIA KIT employing 125 I-labelled scc antigen as tracer. The cut off level was set as 2.3ng/ml.
The following results were obtained.
1) The subjects with oral cancer exhibited a higher scc antigen level than those of patients with non-bearing oral cancer or those of cases with benign oral diseases.
2) The positive rate of the subjects with oral cancer was relatively high and 44% were at a level over 2.3ng/ml. Particularly in scc, 60% were at a level over 2.3ng/ml. Among 16 subjects with non-bearing oral cancer, on the other hand, only one subject showed positive. All subjects with benign oral disease were within normal range.
3) As to the regions of oral cancer, tongue cancer and cancer of the oral floor showed relatively high scc antigen levels.
4) There was no relationship between stages and scc antigen levels.
5) Post-treatment scc antigen levels tended to decrease to within normal range in cases where the disease followed a good course, while they tended to increase in those that followed a poor course.
6) The measurement of scc antigen levels appears to be especially useful for diagnosis, follw-up and evaluating prognosis in oral squamous cell carcinoma.

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Using permanent magnets of 50 gauss (control), 800 guass and 2700 gauss, the influence of the actions of the magentic field on the peripheral circulatory kinetics of the hamster's buccal pouch was determined by the laser doppler flowmeter (LDF), and the following conclusions were made.
The magnets of 800 and 2700 gauss caused increases in blood flow 4-fold (p<0.01) and 17-fold ( <0.001) as much as the control, respectively.
The blood flow proved to increase immediately after applying the magnet and to be constant regardless of time. It also proved to decrease immediately after stopping the application.
These results are thought to have elucidated one of the effects of magnetism.

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A considerable number of histopathological studies concerning replanted human and animal teeth have been carried out. Mature replanted teeth have not shown pulpal repair, except on rare occasions, in contrast to immature teeth.
The purpose of the present investigation was to study whether the exposed pulp tissue, performed at the time of the operation, affects the tissue reactions of the pulp and periodontal membrane of replanted mature teeth.
The materials consisted of 288 single-rooted teeth (incisors and first premolars) from 36 adult dogs. 144 teeth were replanted after hard tissue removal of root apex and pulp tissue exposure (experimental group). 144 teeth were replanted without hard tissue removal and pulp tissue exposure (control group). The observation periods were 1, 7, 14, 30, 90 and 180 days. The teeth were radiographed before sacrifice, and then, they were longitudinally sectioned at 6 pm in a bucco-lingual direction. The sections were stained with hematoxylin and eosin and the elastica-Masson.
No difference was noted in the inflammatory reactions of the gingiva tissue between experimental group and control group, but a little more teeth discoloration was found in control group than in experimental group. In radiographic findings, 14 days after replantation, periodontal space was enlarged, but at 180 days it was almost normal in both groups.
In the histopathologic findings, experimental group initially had severe inflammatory reactions, but repair occured through ingrowth of connective tissue that had reached the median pulp after 180 days. Cells containing hard tissue were postoperatively formed on both root canal walls and pulp. In control group, pulp inflammatory reactions were mild, but repair did not occur much more than in experimental teeth. Pulp necrotic changes were shown in the control group. No difference was noted in periodontal membrane healing between both groups.

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Temporomandibular arthrosis has been reported in many fields: oral surgery, dental prosthetics, otolaryngology, radiology, psychosomatic medicine etc Roentgenographic examination plays an important role in the diagnosis of temporomandibular arthrosis. There have been studies on various types of roentgenograhy of the temporomandibular joint, but because its anatomical morphology is so complicated that it is difficult to obtain an adequate roentgenograph. Thus, no definite method of roentgenography has been clearly established. We developed a new method of roentgenography that takes advantage of the characteristics of orthopantomography, and analyzed our results statistically. The following results were obtained:
1) As conditions for roentgenography, the optimal tube voltage was 60-75 KVp, but this varied according to sex and age; the optimal tube current was 15mA.
2) The optimal position of the head in the anteroposterior position was 10 mm in front of the standard point, and that in the vertical position was the central part of the film.
3) The optimal position of the head was reached when the OM line was horizontal.
4) On the basis of the data obtained from these basic experiments, images from standard roentgenography were compared statistically with those from the modified method of Schuller in patients with temporomandibular arthrosis. There was a significant difference between the images (P<0.01).
These results demonstrated that this method of roentgenography may be useful in standardizing X-ray procedures, provides images of temporomandibular arthrosis of high reproductive quality, suggesting that this method may be adequate for more definitive diagnoses.

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The following experiments were performed to examine the effect of low-output CO₂ laser on wound healing process.
Two wounds, incised 2cm in length, were created on the back of rat. One of the wounds was sutured for control group, the other was closed by irradiation of low-output CO₂ laser.
Hydroxyproline contents were spectrophotometrically determined by Edwards' method, and water contents were estimated at the same time.
Histological findings were obtained after staining with hematoxylin and eosin.
The results were as follows.
On the first day after 200m W irradiation, degenerated layer of tissue and inflamatory response on the surface of wound were observed.
On the first day after suture, necrosis and inflamatory response were found.
Until 7 experimental days, hydroxyproline contents showed a higher level in irradiated group than in control group.
Water contents of two groups varied near the same way.
There were few differences in histological findings between irradiated group and control group.
In the incised wound, heat stimulation by laser irradiation promoted collagen synthesis and hastened healing.

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A case of recurrent tongue cancer associated with DIC (disseminated intravascular coagulation) under treatment of hypercalcemia of malignancy is reported.
A 38-year-old man was seen in December, 1984 with a 44×25×16 (mm) moderately differentiated epidermoid carcinoma (T3 Ni MO) on the right side of the tongue. As he refused the operation, interstitial radiotherapy to the primary lesion and chemotherapy were initialy carried out. Four months after the first medical examination, right radical neck dissection was carried out. When recurrent tumor was found in the right neck, it was treated by chemotherapy, hyperthermia, and radiation. Immediately after radiotherapy, elevation of the serum calcium associated with leukocytosis was noted. The highest serum calcium level was 19.7mg/dl and leukocyte was 23400/mm³. But serum levels of calcium elevating hormones (PTH-C, 1, 25 dihydroxyvitamin D₃, 25 hydroxyvitamin D₃) and plasma levels of ones (PTH-N, prostaglandin E₂) were both within normal range, Ga and Tc scintigram showed no radioisotope accumulation in bones.
Hypercalcemia was treated by calcitonin and hydration of normal saline solution. Under the treatment of hypercalcemia, abnormal bleeding from the injection spot was found and at the same time abnormalities of coagulation was noticed. From the laboratory findings, DIC could be diagnosed, and FOY (1g/day) and heparin (15000 U/day) were administered. But after about a month from onset of hypercalcemia the patient died of heart failure. In his autopsy a remarkable carcinomatous pericarditis was found, and the cause of his death was heart failure induced by it.

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Branchial cyst generally develops in the lateral cervical area, and it rarely develops in the oral cavity. In 1949 King et al. designated it as lymphoepithelial cyst from the pathohistological aspect. It is characterized by the presence of lymphatic tissue below the lining stratified squamous epithelium of the cyst.
This paper presents a case of lymphoepithelial cyst in the inferior surface of the tongue in a 40-year-old woman. The tumor appeared as a round mass about 7 mm in diameter in the left side slightly posteriorly from the caruncula sublingualis. The mass was light yellow and well defined. Clinically, it was diagnosed as lipoma and resected under local anesthesia. Histopathological findings revealed that the cyst was lined by stratified squamous epithelium. Subepithelially, the lymphatic tissue with germinal center was observed. From these findings, it was diagnosed histopathologically as lymphoepithelial cyst. Her postoperative course was uneventful, and she is without recurrence after 20 months.

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This study investigated the histological features of bone tissue in monostotic fibrous dysplasia.
The materials were obtained from four cases of fibrous dysplasia of the jaw. Two cases involved the lower jaw and two were maxillary. Tissue sections were prepared and observed by the following methods.
Thin, ground, undecalcified sections were viewed by U.V. light microscopy and contact micrography.
Sections stained by Cole's H-E were observed by light microscope.
The following results were obtained.
1) In two cases, the majority of lesions were composed of lamellated bone and in the other two cases, the majority of the lesions were composed of woven bone.
2) In the cases where lesions were composed of lamellated bone, osteoids and osteoblastic rimming were observed on the margin of the trabeculae.
3) In the cases where lesions were composed of woven bone, osteoids and osteoblastic rimming were found in one case only.
These findings suggested that bone maturation lack is not the only factor involved in monostotic fibrous dysplasia of the jaws.

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Extra-mammary Paget's disease associated with head and neck cancer is extremely rare. We had a ease of extra-mammary Paget's disease of the scrotum associated with the squamouse cell carcinoma of the right maxilloalveolar region.
The patient, a 82 year-old man, visited the Dentistry and Oral Surgery, Shinsenri Hospital with the chief complaint of swelling and spontaneous pain on the right maxilloalveolar region after radiation therapy against the right maxillary cancer. The biopsy of the region was histopathologically diagnosed as recurrent squamous cell carcinoma. He was treated by intra-arterial infusion chemotherapy.
Clinically, ulcer was found on the scrotum and was removed surgically. Histological examination revealed extra-mammary Paget's disease.
In this report, the clinical course is presented and the literature on extra-mammary Paget's disease associated with head and neck cancer was reviewed.

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Case reports was made on five cases of granular cell ameloblastoma. Age of the patients ranged from 17 to 53 years and mean age was 31. One case was in male and four were females. All cases occurred in the mandible. Four lesions involved the mandibular body or the ascending ramus and one involved the symphyseal region. Radiographic examination revealed unilocular appearance in four cases. Only one case indicated multilocular type. Histologically many of the granular cells were restrictively shown in the stellate reticulum of the epithelial nests. Granular cells were suspected to change from the stellate cells. The granules were ultrastructurally similar to the lysosomes. Although the granular cells indicated various stages of breakdown, in which the granules were released extracellularly, the nuclei retained normal pattern. These findings rejected the possibility of degenerative change of the cells.

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Underdevelopment of the maxilla is frequently seen in post-operative cleft lip and palate patients. This is considered mainly due to cleft lip and palate repair, or the retarded growth potential of the disease itself, but the cause still remains unexplained. Accordingly, cephalometric roentgenograms and oral casts of two unoperated adult cleft palate patients were analyzed.
Case 1. A male, aged 41, with unilateral (left side) cleft lip and palate, had a lip closure operation just after birth. Unfortunately, he had no further palate operation.
Oral findings; The right upper first incisor, left upper first incisor, left upper second incisor, and left upper canine were missing. Bridge work was found from the right upper second incisor to the left upper first premolar. Reversed relation of the jaws was not observed, but the right upper second incisor was significantly displaced towards the palate. A slightly narrow upper dental arch was found.
Cephalometric findings; A slightly concave type of skeletal pattern because of the undergrowth of the anterior part of maxilla was observed. The mandibule was located anteriorly and a slightly prognatia type of skeletal pattern was observed.
Oral cast findings; The maxillary dental arch width was a little less than average.
Case 2. A female, aged 22, with unilateral (right side) cleft lip and palate, had a lip closure operation at the age of 12.
Oral findings; The left and right upper second incisors were congenitally missing. The left and right upper first incisors were slightly inclined towards the palate, but the fore teeth relationship was normal.
Both the results of the cephalometric analysis and oral casts analysis were almost within normal limits.
This is the presentation of two cases. However, these findings suggest that early lip closure seems to be a factor restricting the development of the maxilla. But, the development of maxilla and especially the maxillary dental arch width were not affected in our cases compared with the case which had palatoplasty during infancy.

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Eosinophilic granuloma is an unknown etiological lesion, which is histopathologically characterized by diffuse eosinophilic and histiocytic infiltration in granulation tissues. Though this lesion may occur in the skull and soft tissue, involvement of the mucosa of maxillary sinus is extremely rare.
We have recently experienced one case of eosinophilic granuloma considered to have extended from alveolar bone of 6 to the mucosa of maxillary sinus in a 57 year-old man. Postoperative course was good and there was no recurrence seen after 5 months.

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Clinical statistics were conducted on 511 hospitalized cases of jaw fractures at the Department of Oral Surgery, Mie University Hospital during the 24-year period from 1960 to 1983.
Inpatients in this period totaled 2, 290 cases.
The incidence of fractures was 24.1% of all inpatients.
1) The number of patients with jaw fractures each year tended to increase from 1960 to 1970, but there was almost no change from around 1971 to 1983.
2) The male/female ratio was 4.5: 1, but the ratio in the past eight years narrowed the gap to 3.5: 1.
3) The seasonal variation in the incidence of fractures was not significant.
4) The most common causes of injury were traffic accidents in both males and females, especially female fractures were more by traffic accident than from any other cause.
5) Fracture of the incisive region was the most common.
6) The average fixation time for old fractures was slightly longer than that of fresh fractures but in the past eight years there was no difference between them, and it tended to be shorter.

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Necrotizing sialometaplasia is an inflammatory self-healing lesion emanating from the salivary gland. This lesion is easily confused with squamous cell carcinoma or mucoepidermoid carcinoma because clinical and histological appearances are similar. A twenty-threeyear-old female was referred to us complaining of swollen palate. The lesion was suspected to be salivary gland tumor. Histological examination revealed necrotizing sialometaplasia emanating from a minor salivary gland of the palate. Her lesion almost completely healed without treatment after 4 weeks.

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Patients with oral cancer often suffer from severe pain even when their general condition is good. Therefore medication is desirable to relieve pain without disturbing consciousness.
In this study, we tried a continuous subcutaneous infusion of ketamine to relieve pain in 5 patients with head and neck cancer in the terminal stage.
The results are as follows: it was markedly effective on 2 patients and relatively effective on 2 but not effective on 1 patient. No particular side effect was observed in any case and the patients kept clear consciousness during medication.
It is suggested that this method is effective on patients in the early stage.

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A 8-year-old girl developed a calcifying epithelioma in the right cheek. The lesion was noticed as a painless, well-defined and movable mass.
The 11×17×13 mm mass with overlying skin was excised under local anesthesia.
Histologically the mass consisted of proliferation of shadow cells and a few basophilic cells. Calcification was occasionally seen.
Infrared spectrum analysis of calcification revealed that main absorption peaks were given by protein and calcium phosphate.
The postoperative course is uneventful with no sign of relapse.

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Relationship between the mode of tumor invasion and the prognosis was investigated in 89 primary patients with squamous cell carcinoma of the tongue treated at our Department of Oral Surgery from 1965 to 1984.
The mode of invasion of these cases was histologically investigated using initial biopsy specimens and classified into 5 grades according to the criteria of Yamamoto et al (1982); three cases were Grade 1, 19 were Grade 2, 21 were Grade 3, 35 were Grade 4 C, and 11 cases were Grade 4 D. Most of the Grade 4 D cases showed endophtic growth pattern and belonged to stage III, IV. The histopathological findings in the cases of Grade 4 C and 4 D showed poorer keratinization and higher cellular pleomorphism than in the cases of Grade, 1-3, and the histological grading by WHO classification in the cases of 4 D were grade II and III.
Clinically, the mode of invasion was not correlated with local recurrence, although Grade 4 D showed higher incidence of regional lymph node metastasis (81.8%) compared with the cases of Grade 1+2 (22.7%), Grade 3 (38.1%), and Grade 4 C (48.6%). Moreover, in the cases of Grade 4 C and 4 D, multiple metastatic nodes were more frequently observed and the incidence of secondary metastasis was higher than in the cases of other Grades. Five-year survival rate was 48% in the case of Grade 4 D and 70% in the cases of other Grades. Three out of 6 cases of Grade 4 D died of neck lesion recurrence following radical neck dissection. But, 5 cases of Grade 4 D whose primary lesions were less than 25 mm in diameter showed good clinical course.

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The methods for reconstruction with a flap after resection of head and neck tumors have progressed since Bakamjian developed the D-P flap in 1965. During the intervening 21 years, such excellent flaps/organs as stalked muscle flaps, the free forearm flap, and the free jejunum flap have been devised.
However, the fast progress of surgical techniques has brought with it a concomitant increase in the difficulty of training clinicians to apply said techniques.
Therefore, we developed a spacer for use in performing microsurgical vascular anastomoses. We studied the difficulties involved in using it for patients undergoing oral reconstruction (with a forearm flap) in the treatment of oral cancer.
Oral reconstruction by means of angiostomy featurs a free flap that includes anastomosis of the nourishing vessels with the transplanted vessels. This method obviously favors a more successful oral reconstruction than methods that use the conventional D-P flap or various muscle flaps.
However, learning the operational technique presents a problem.
This spacer is designed specifically for microsurgical vascular anastomoses. It was developed in 1983 at the Department of Head and Neck Surgery of the Cancer Institute Hospital, the 5leading author of this article.
We introduced this spacer because it enhances the safety, simplicity, and reliability of microsurgical vascular anastomoses.

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Thermotherapy by 2450 MHz microwaves was performed on oral cancer patients and its effectiveness was analyzed and evaluated.
Subjects were 7 primary oral cancer patients (4 lower gum cancer, 2 buccal mucosa and 1 oral floor) and 5 recurrent cancer patients (3 with cheek lesion and 2 with neck lesion). Heat was generated by a microwave apparatus of 2450 MHz.
Seven cases which received intraoral thermotherapy on primary lesions were treated in combination with radiation and bleomycin. Thermotherapy was performed twice a week, up to 5-8 times in total, applyied immediately after the radiation therapy. Intraoral applicator was a flexible leakage-type coaxial applicator 2-4 mm in diameter and 40-90 mm in length. It was modified depending on each tumor size and shape. Tumor surface was heated to 42-45°C for 30-50 minutes and the heat distribution pattern of each modified applicator was checked using Phantom Model. Of the seven lesions, 6 (85.7%) showed complete regression (CR) and one showed partial regression (PR). Histological examination was made on five cases which received surgical tumor resection. Among them, one was grade III and the rest were grade IIb by Simosato's criteria. Tumor necrosis and mucosal reaction were seen at the heated site from the early stage of treatment and the thermotherapy was obviously effective.
Five recurrent cancer patients received extraoral thermotherapy without radiotherapy on the cheek or neck lesions using the non-contact type applicator. Tumor necrosis was limited to the surface area and the regression effect was minimum which might be due to the lack of combination therapy of radiation.
Thermotherapy seemed effective for the oral cancer when used in combination with radiation. However, more clinical experience is needed to evaluate the usefullness of this treatment.

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Eosinophilic granuloma of the soft tissue occurred solitarily or multiply, mostly found in the parotid, cheek and submandibular regions. A case of this disease in the cheek and submandibular regions of a 46-year-old male is reported. The relevant features of eosinophilic granuloma of the soft tissue were reviewed and discussed.

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Papillary cystadenoma is a relatively rare salivary gland tumor which has been reported sometimes in association with minor salivary glands.
Here, we report a case of papillary cystadenoma of minor salivary gland origin located in the floor of the mouth, in a 59-year-old woman. The patient complained of swelling of the floor of the mouth. During the course of the first medical examination, a circumscribed, elastic hard, movable, dark reddish oval mass was found in the floor of the mouth just by the lower right wisdom tooth, measuring 12×13mm.
Clinically an hemangioma was suspected. Under general anesthesia, the lesion was totally excised. Histologically, sections revealed a small and a large cystlike cavities lined with tall, eosinophilic granular epithelial cells disposed in papillary projections filling the lumen. Histopathologically it was diagnosed as a papillary cystadenoma.
There was no evidence of recurrence in the patient 7 months after the operation.

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