Values for eleven orthodontological parameters were obtained in 42 cases of TMJ arthrosis in girls (T group; averageage: 15 years 11 months) who sought examination at the Department of Oral Surgery at the Attached Hospital of the Nagoya University School of Medicine, the Department of Oral Surgery at the Fujita-Gakuen Health University Hospital and at the Lion Foundation for Dental Health. The values were also obtained in 49 control females (N group; average age: 18 years 2 months). The parameters studied were: 1. Angle's classification, 2.Σ 5-5 (mesio-distal crown diameter)(A), 3.Σ 3-3 (mesio-distal crown diameter)(B), 4. Basal arch length, 5. Basal arch width, 6. Coronal arch length, 7. Coronal arch width, 8. Inter canine length, 9. Inter canine width, 10. B. A. L./A, B. A. W./A, C. A. L./A, C. A. W./A, I. C. L./A, I. C. W./A. 11. I. C. L./B, I. C. W./B etc. The values obtained were subjected to stochastic analysis (t-test) and the following results were obtained: 1. With respect to Angle's classification in the T group, 9.5% were found to have normal occlusion and 45.2% were found to be Angle II cases. In the N group, 30.6% had normal occlusion and 14.3% were Angle II cases. 2. Maxillary basal arch length in the T group was 19.826±2.9081mm, while mandibular basal arch length was 18.3667±4. 7735mm. In the N group, maxillary basal arch length was 23.2775±2.6377 mm, while mandibular basal arch length was 20.2877±4.1162 mm. Therefore smaller values were obtained in the T group. 3. With respect to occlusion status, abnormalities in the dental arch analysis were found to be frequent among normal occlusion, Angle I and Angle III cases in the T group. 4. Abnormalities in the dental arch analysis were not found in Angle II cases.

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Human peripheral lymphocytes were cultured with succinatc 1, 4-¹⁴C, which is a TCA cycle intermediated metabolic substance, in the stimulation with pokeweed mitogen (PWM). It was recognized that ¹⁴C was taken into the lymphocytes, utilized for cell metabolism and finally synthesized into immunoglobulins.
The lymphocytes were separated into T cell enriched and B cell enriched fractions by En-rosette formation method, and equal numbers of these fractionated cells were mixed for T+B fraction. Each fraction was cultured with 5μCi/m/ of succinatc 1, 4-¹⁴C for 1, 3, 5 or 7 days. PWM was added as mitogen. Immunobeases were used for detecting immunoglobulins.
The results were as follows:
1) 14C concentration in the unfractionated lymphocytes (UNF) kept at low level for 1-7 days when cultured without PWM. However stimulating with PWM increased tripled the level the first day, and then they decreased with day.
2) The intracellular ¹⁴C concentration cultured with PWM for 7 days was the following order of T, UNF < T+B, B fraction (p<0.05). These differences suggested the influence of B cell ratio against T cell.
3) ¹⁴C concentration in the macromolecular substances detected in the PWM-stimulated culture supernatant increased with time from the third day on (p<0.05). The maximum value of ¹⁴C in the macromolecular substances was 0.4% of that initially added.
4) Immunoglobulins (IgG, A and M) containing ¹⁴C were detected in the supernatant after 7 days culture with PWM. The maximum level of ¹⁴C was 5.6% of that detected in the macromolecular substances in the supernatant. The order of ¹⁴C content was B<UNF<T+B fraction (p<0.05).

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Mandibular dento-osseous segmental osteotomy in the molar region has been recently reported to improve the occlusal relationship. The repositioning of small dento-osseous segment, however, has been criticized by several investigators, because the maintenance of a good vascular supply to the segment is very difficult. Especially, revascularization and reinnervation to the dental pulp in the segment are the important points in this surgical procedure. Then we experimentally studied bone healing, vascular supply and pulpal changes after two different surgical procedures for repositioning dento-osseous segment in the mandibular molar region.
Twenty-two adult monkeys (Macaca fuscata) divided into 3 groups were used. In the A group (16 segments), three teeth segmental osteotomy was performed in the mandibular molar region. The horizontal osteotomy in the mandible was completed just below the neurovascular bundle. The lateral cortex overlying the mandibular canal was removed in order to identify the neurovascular bundle and the vertical osteotomies to M2 and PM1 were done carefully with fine osteotome and chisel to preserve the rami dentalis. The segment was then mobilized and fixed with wire.
In the B group (6 segments), the same osteotomies were performed, but the horizontal osteotomy was done just above the neurovascular bundle.
The opposite site of the mandible without operation was served as control. The monkeys were sacrificed according to schedule, by perfusing with barium sulfate through bilateral common carotid arteries. Microangiographic and histologic studies were carried out after each mandible was decalcified. Especially for the pulp, sections were stained with H-E, and Bodian's stain.
In the majority of A group, all surgical wounds healed well without any dehiscence and all segments were stable with no mobility. In the B group, however, the dehiscence was partially observed in three of six segments. When horizontal osteotomy was done below the neurovascular bundle, the vascular supply to the segment and pulp was maintained, and on the one year specimen, there was no difference compared with control animals. But when the horizontal bone cut was above the neurovascular bundle, the vascular supply to the segment diminished. The pulp especially was not revascularized and the nerve fibers were not found according to the Bodian's stain.

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The role of Epidermal Growth Factor (EGF) and the expression of its receptor in human squamous cell carcinomas (SCC) were studied. EGF was found to inhibit the growth of 14 cell lines derived from SCC of the oral cavity, skin, esophagus and vulva, at doses that stimulated the growth of epidermal keratinocytes and dermal fibroblasts. However, EGF did not inhibit the growth of other tumor cells, such as adenocarcinomas of the stomach, cervix, and breast and sarcomas.
The number of EGF receptors on SCC cells were measured by immunoprecipitation of labeled proteins with anti-EGF receptor polyclonal antibody and binding assay of membrane preparations using ¹²⁵I-EGF. Of 13 SCC cell cultures tested, all except 3 of esophageal SCC showed to 50 times higher level of EGF receptors than normal epidermal keratinocytes. The values of the equilibrium dissociation constant (Kd) of these cells were on the order of nM.
The sensitivity to the growth inhibitory effect of EGF correlated well with the elevated level of EGF receptors in 12 SCC cell lines.
By use of two murine monoclonal antibodies (528 IgG, B4G7) which react with the binding domain of human EGF receptor, EGF receptors were immunostained. All of the SCC cell cultures showed strong staining at their membrane, in contrast, normal fibroblasts showed no staining. In immunohistological study, all of the SCC tissues showed strong staining of EGF receptor without staining of their cancer pearl. In normal epithelium of skin and oral mucosae, positive staining was found in the basal layer and no staining in the keratinized layer.
Southern blot hybridization of DNAs from 7 SCC cell lines demonstrated amplification of EGF receptor/c-erbB gene. In contrast, DNAs of primary tumors of 4 SCC and 1 mucoepidermoid tumor showed no amplification of EGF receptor/c-erbB gene. Besides EGF receptor gene, no amplification of c-H-ras, c-src, c-fos, c-K-ras was found. However, amplification of c-myc was detected in some SCC cell lines and 2 primary tumors of SCC.
These results suggest that EGF and EGF receptors play a role in the development of SCCs, and over-expression of EGF receptor has high incidence in SCC cell lines resulting from amplification of its gene. In addition, cells with an amplified EGF receptor gene may more readily adapt to growth in tissue culture, and the detection of EGF receptor may histologically be a useful tool as a tumor marker of SCC.

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Tuberculosis is an infectios disease due to mycobacterium tuberculosis mainly affecting the lung. Therefore, extrapulmonary tuberculosis might be an essentially secondary infection from the primary complex in the lung.
Two patients with chief complaint of painless swelling at the right submandibular and cervical region were referred to the clinic. The first case was a 25 year-old married woman with a movable elastic firm tumor at the right cervical region. Infectious foci at the hilus were not observed at the head and neck area indicating only the slight elevation of BSR and positive sign of PPD. The second case was a 49 year-old married woman with movable elastic firm tumor adjacent to the right submandibular gland. Infectious foci was not detected as in the first case indicating only the slight elevation of BSR and positive sign of PPD. Both cases showed no signs of primary complex at the lung area roentogenologically, so direct invasion of mycobacterium tuberculosis to the lymph node through the upper respiratory tract and/ororal cavity was strongly suggested.

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The radicular cysts are the most common cysts of the jaws, but these arising from deciduous teeth are very rare.
The patient was a 7-year-old boy. A was a tooth stump. X-ray examination indicated a cyst-like radiolucency at the apex of the tooth (A) and displacement of the impacted teeth (12) superior-posteriorly. Histopathologically, the cyst wall covered externally with a layer of connective tissue infiltrated inflammatory cells was lined with stratified squamous epithelium.
The differential diagnosis between these two cysts, the radicular cyst arising from deciduous tooth and the dentigerous cyst from succedaneous permanent tooth, is difficult. Diagnosis; A radicular cyst arising from deciduous tooth (A) based on clinical and histopathological findi

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We report on a case with disseminated histiocyosis X (Letterer-Siwe dissease) which manifested chiefly in the gingiva and the cervical skin, and was diagnosed from biopsy of the lesions. The patient, a twenty-month old female, had also some lesions of the lung, rib and lymph nodes systemically, accompanied by anemia and otitis media as well.
The patient was remrttep with chemotherapy consisted of VBL and 6 MP, although the prognosis was considered to be poor at the initial stage.
In the electron micrograph of proliferating histiocytes which were obtained from the lesions of the gingiva or the cervical skin, there were Birbeck granules in the cytoplasma, and immunohistochemically, OKT 6 and S-100 protein were detecte.

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A case of Massive osteolysis affecting of the mandible was presented in a 46 years old female whose chief complaint was a depression on the left mandibular region. Radiographs revealed a large radiolucency of the left ramus of the mandible and histopathologically, the affected site consisted of only numerous dense connective tissues.
The left mandible body was resected and reconstructed with autogenous bone and reconstruction metal plate.
At the present situation, the prognosis is good for mastication and cosmetic form.

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The angiomyoma is a rare tumor which is most frequently observed on the skin, especially that of the lower extremities of women over the age of 30 years. In the oral cavity it constitutes a rare lesion because of less smooth muscle.
A 37-years-old man was referred by a surgeon with a swelling in the left side of his upper lip. The patient had first noticed the swelling about six years previously and awared that it gradually enlarged during the last year. At no time had the swelling been painful.
The lesion was painless, approximately 2.5×2.0cm in size and normally colored without induration. The regional lymph nodes were not enlarged. The clinical diagnosis was benign tumor. It was easily excised under local anesthesin and the specimen, a whitish-yellow smooth encapsulated mass of 2.0×1.5cm in diameter, was sent for histological examination. The final histologic diagnosis was angiomyoma of the upper lip.
There has been no recurrence as of eight months after operation.

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87 oral surgical procedures, by careful local treatments with hemostatic splints without platelet transfusion, were done to 48 cases of thrombocytopenia. In some cases, corticosteroid or anti-fibrinolytic agent or both were used as a supportive treatment. Postoperative complications, such as bleeding or difficulty in hemostasis, were not encountered in any of the cases. The wound healings were good.
The platelet counts and tromboelastograms (TEG) of these patients were examined. Even the cases with platelet count of 0.8×10⁴/mm³ or thromboelastograms of k: 30mm, ma: 30mm and k: 13mm, ma: 28mm were able to undergo dental surgeries.
These clinical experiences suppose that the indication of dental surgeries for thrombodytopenic cases can be extended with references to thromboelastograms.

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A case is presented of a little girl with incontinentia pigmenti.
The patient had seen a dermatologist soon after birth because of erythematous eruption of the whole body.
At 7 days old, desquamation occured on extremities, body and face.
At 14 days old, pigmentation occured on same lesion of the eruption.
A panoramic film showed, at age of two, eight missing milk teeth and shortage of permanent teeth and deformity of some teeth.
General condition was good and physical features were medium. But vertical hair was falling out within 2.7cm×1.2cm area, and on trunk and legs and arms, pigmentation were observed.
At 4 years of age, she had denture put in, and problems of beauty and function of occulusion were solved.
Now the patent is 5 years old, the pigmentation is still existent and no resuscitation is shown of the vertical hair. Denture is now stabilized.

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Septicemia caused by phlegmone arising from acute suppurative apical periodontitis was reported.
A 53 year-old male emergency patient was admitted to our hospital with the complaint of pain in left temporal region and marasmus. Anaerobic gram positive coccus was isolated by bacteriologic examination of blood and pus.
The lesion was diagnosed as septicemia caused by phlegmone arising from apical periodontitis of left maxillary cuspid and was treated with antibiotics, incision and drainage. Postoperative course was uneventful and no recurrence was observed.

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Clinico-statistical observations were made of 45 cases of squamous cell carcinoma of oral cancer at our clinic from 1981 October to 1986 September.
25 males and 20 females, with about 78% ranging from 40 to 70 years old.
The primary sites of cancer were tongue 13 cases, oral floor 10 cases, gingiva 13 cases, cheek 5 cases and hard palate 4 cases.
The clinical stages were: stage I 4 cases, stage II 17 cases, stage III 14 cases, stage IV 10 cases.

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The primary sites of cancer cases were: 5 tongue, 6 oral floor, 5 gingiva, 3 hard palate and 1 cheek.
The clinical stages were: stage I 2 cases, stage II 10 cases, stage III 5 cases and stage IV 3 cases.
The clinical results obtained were recorded as excellent (complete response) in 11 cases (55%), effective in 7 cases (35%) and moderate in 2 cases (10%).
9 of 11 cases observed complete response were treated with Peplomycin (intra-arterial infusion) combined with radiation therapy.
We present the results and complications of 20 cases.

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Congenital deficiencies of both factor V and VIII represent a rare blood coagulation disorder. The hemorrhagic management of this disease has been performed by transfusion of fresh plasma and factor VIII concentrate by this time.
In this report, the administration of 1-deamino-8-D-arginine-vasopressin (DDAVP), which is effective for the bleeding in patients with mild and moderate hemophilia A and von Willebrand's disease, resulted in the hemostasis of oral bleeding in two patients with this disorder. Factor VIII coagulability (VIII: C) and von Willebrand factor antigen (vWF: Ag) rose significantly but factor V coagulability in both cases showed no change after DDAVP administration. These findings suggested that DDAVP might have other hemostatic effects of unknown mechanism in addition to the rise of plasma VIII: C and v WF: Ag levels.

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Two Cases of False Trigeminal Neuralgia due to Intracranial Tumor.
Case No.1 was a 29-year-old male who visited our department with a main complaint of masticatory pain on the right temporomandibular joint region. CT scanning inthe department of cerebrosurgery revealed a high density mass in the right cerebropontine angle region. Under the suspicion audiatory neurinoma, resection was done, which was then confirmed histopathologically.
Case No.2 was a 56-year-old male who visited our department with a sricking pain on the right buccal region. CT scanning revealed a high density lesion in the parasellar. Under the suspicion of cerebral tumor, biopsy from the mass and trigeminal tractotomy were done and the histopathological diagnosis was metastatic adenoid cystic carcinoma. Although a detailed examination was performed, the primary lesion of this carcinoma could not be found.

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This paper reported a rare case of acinic cell tumor which arose in the left parotid gland that seemed to infiltrate and proliferate along the parotid duct and formed a ulcer at the orifice of the parotid duct.
The patient was a 75 year-old woman. She noticed a swelling with dull pain in the posteroinferior region of the left auricle 23 years previously.
Pathological diagnosis of the ulcer by biopsy was acinic cell tumor.
Only the tumor was excised followed by chemotherapy with FT-207 and PSK.
The tumor was multinodular and encapsulated in the greater part but infiltrated out of the capsule in a part. In spite that the capsule was broken at the operation which seemed to worsen the prognosis, there is no evidence of recurrence or metastasis in the patient as of 3 years 7 months after operation.

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In the field of Oro-Maxilloface, epidermoid cysts are found in the blottom of the mouth, cheek, lips and tongue, but simultaneous multiple epidermoid cysts are rare.
This case was a 40-year-old female who had 3 independent epidermoid cysts in the regio submentalis and her chief complaint was swelling of this place.
In Japan, as far as we examined, multiple epidermoid cysts were reported in 6 cases in Oro-Maxillofacial region. However, only 1 case of multiple epidermoid cysts in the regio submentalis was reported.
Therefore, we report this rare case.

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A 19-year-woman was referred to our Department of Oral Diagnosis in February, 1983 for investigation of a swelling on the labial gingiva of the lower left canine region.
Upon clinical and radiographic examination, clinical diagnosis made as cystic odontoma.
The lesion was surgically excised and examined by both light and electronmicroscopy.
Histological findings included a cyst lined with odontogenic epithelium containing numerous ghost cells, a calcified mass, and melanin.
The ghost cells which showed numerous tonofilaments were examined electronmicroscopically.
Immunohistochemical study was performed by the peroxidase-anti-peroxidase (PAP) technique.
When the technique was used to detected keratin, positive staining was found around the ghost cells.
Our case was associated with impacted teeth, odontoma and melanin.
Only four cases out of the 78 cases of odontoma and melanin described in the Japanese literature are similar to the one reported here.

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The aneurysmal bone cyst is an uncommon bone lesion in the jaws. This lesion is a solitary cystic lesion of bone and was first described as a distinct clinicopathologic entity by Jeffe and Lichtenstein in 1942.
We experienced a case of aneurysmal bone cyst of the right mandible in an 11-year-old girl. In April, 1983 she received a blood transfusion to treat a massive hemorrhage that arose from the gingiva at 7 of the mandible. Her course of recovery was without incident and no abnormal bleeding was seen. On April, 1984 she was admitted to The Dental Department of The Hakodate Municipal Hospital because of massive hemorrhage of the gingiva of Ti of the mandible. Roentogenography findings revealed a pear sharped radiolucent area between roots 6 and 7. Angiographical findings showed a coincidence with this roentogenography image and aggregation of contrast medium. We suspected the lesion of blood vessels, and embolization of the maxillary artery was conducted using gelform, but haemostasis was not obtained. After ligation of the right external carotid artery, fenestration of the 7-4 buccal cortid bone of the mandible was conducted.
The lesion extended widely from 76 alveolar crest to the diaphysis of the mandible, and a bone cavity of the little finger in size wase found at this site, a large artery branching from the inferior alveolar artery was seen. The extraction of 76 and curettage of the affected site was conducted. On August 3 rd she was admitted to Higashi-Nippon-Gakuen University Hospital for detailed examination and treatment.
Roentogenography findings of the 5 site showed a multiloculer radiolucent area of the mesial bone of the mandible. The radiolucent of the roentogenography coincided with the angiographic image of the left externar carotid artery. On August 10, a marginal resection of the mandible was conducted, and the histopathologic findings revealed an cvidence which led to the diagnosis of anrurysmal bone cyst.
At present alter a two year lapse nn signs of recuriance wrre seen.

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Authors modified the palatal osteotomy of hard palate compression correcting marked atorophic maxilla. This improved method ensured the union of a palatal bone.
The modified hard palate compression, tuberplasty, zygomaticoalveolar crest compression and vestibuloplasty were applied simultaneously for two cases of severe maxillary alveolar atrophy, that had successful results.

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A case of radiation-induced cancer was reported. A 46-year-old man developed buccal mucosal and maxillary cancer (squamous cell carcinoma) 19 years after external radiation therapy for buccal papilloma. Previous irradiation was ⁶⁰Co, 186.5 Gy. Latent period was 19 years, but 7 years after the irradiation osteomyelitis arose in the mandible. X-ray films of the mandible revealed an osteolytic and osteosclerotic lesion.
Conservative treatment of the osteomyelitis was not so effective. Partital resection of the mandible and resection of buccal scar tissue combined with reconstructive surgery of the cheek using a pectoralis major myocutaneous flap were performed in September, 1984. The histological examination of the resected specimen showed squamous cell carcinoma and the ultrastructural study on this case was further performed.
In spite of wide excision and intra-arterial chemotherapy combined with irradiation, the patient died of the carcinoma in October, 1986.

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Of the tumors that occur in the salivary gland, very few onset in the sublingual gland. However, if it does occur in the sublingualgland, a high rate of malignancy of the tumor is most likely. Adenoid cystic carcinoma is believed to be a more common type of malignant tumor occurring in the sublingual gland, but there have been very few detailed reports on this disease as the primary cancer of the sublingual gland, probably due to the small number of cases and difficulty in differentiating this tumor from the primary tumor of minor salivary glands. We report here our findings together with some discussion on a case of adenoid cystic carcinoma occurring as the primary cancer of the sublingual gland which we encountered clinically.
The subject is a 48-year-old female, seen at our department with the chief complaint of swelling in the left floor of the mouth. As a result of resection of the swelling partly for biopsy, it was found to be adenoid cystic carcinoma histopathologically. Partial neck dissection, extensive resection of the floor of the mouth and partial resection of the tongue followed. Chemotherapy was initiated postoperatively but radiation therapy was not undertaken as no tumor was detected at the edge of the resected tissues. 4-years have passed to date and the clinical course of this case is favorable, as no recurrence or metastasis has been observed. However, due to the nature of this tumor, we feel that adequate follow up the patient should be continued.

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The ameloblastroma is one of the most common odontogenic tumors. It has received much interest histologically and clinically. We recently experienced a case of ameloblastoma with interesting radiographic and histological findings.
The patient was a 72 year old man. Radiological examination showed punctual or flaking metaplastic mineralization and the tumor extended from the right first molar region to the left third molar region. The histological examination showed a multilocular tumor surrounded by fibrous connective tissues with many fibrous bone in the interstice.
After the operation, there has been no recurrence of the tumor and prognosis is good.

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A very rare case of cementifying fibroma, which arose in the maxilla and the mandible, was reported. The patient, who was a 27-year-old man, had indolent bone-like hard diffuse swellings from the buccal to palatal site of 6-1 region and in the mucobuccal fold of 6-3 region. Each overlying mucosa was intact. Radiographic examination revealed diffuse mottled radiopaque lesions in the entire right maxillary sinus and relatively well defined radiolucent lesion of egg in size containing cloud-like radiopaque shadows in the body of mandible for 6-3 region.
The lesions were diagnosed as polyostotic fibrous dysplasia from the clinical course and findings, and palliative removal, that was, partial resection or curettage of the lesions was performed under general anesthesia.
Macroscopic findings of the lesions were tumorous, light greyish color, smooth surface and comparatively elastic hard in consistency. Soft X-ray photograph of removed lesions showed existence of calcareous substances which varied in shape and size.
Microscopically, the tumorous lesion consisted of dense fibromatous tissues with numerous round cementicle-like calcareous substances and irregularly shaped cementum-like hard tissues varying in size. Tumor cells were generally spindle-shaped. No bone tissue was seen in the tumor. Therefore, the tumor was histopathologically diagnosed as cementifying fibroma.
It is necessary that discussion on differential diagnosis of this tumor from similar diseases is based on a close correlation of the present history to clinical and radiograhic findings. But, clinically it seems very difficult to discriminate among cementifying fibroma, fibrous dysplasia and ossifying fibroma and these diseases should be histologically diagnosed in the end.

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Trismus may be caused by acute or chronic inflammation, ankylosis of TMJ, scar tissue, and neoplastic, myogenic, neurologic and traumatic changes including fracture.
This paper described a rare case of trismus caused by hyperplastic coronoid process.
A 12-year-old girl complained of restricted mandible movement and swelling of the right coronoid region in our clinic. A routine x-ray examination and computed tomography revealed bony masses at the top of the right coronoid process, zygomatic arch and the posterior part of the lateral wall of the maxilla. An operation was performed to resect bony masses of the right coronoid process and zygomatic arch.
Histologically, the resected specimen showed a well-arranged cartilage cells on the surface with fibrous and cartilage ossification. As a whole, abnormal resorption and formation of bone tissues were observed. The histological diagnosis of hyperplasia of the right coronoid proces was made.
Among various cases of trismus due to coronoid process change, our case of trismus due to hyperplasia of the coronoid process seems to be rare.

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