We administered The Yatabe-Guilford personality inventory (abbr. Y-G), The Cornell Medicall Index (abbr. CMI) and The Semmantic Differential technique (abbr. SD) prior to and one year after orthognathic surgery to 100 mandibular prognathism patients (33 males and 67 females). Furthermore, we administered the same tests to general young men and women 100 persons each, and regarded them that as the respective control groups. After dividing the patients by sex, we made comparisons between the pre-operative patient group (Pre op.) and the control group between the pre-operative patient and post-operative patient group, and between the post-operative patient group (Post op.) and the control group.
The results obtained are as follows:
1. Comparison between Pre op. and control groups.
(1) According to Y-G types and personality characteristics, males showed a tendency toward emotional insecurity, social unadaptability and introversion. There were few significant differences in females.
(2) The present studies have not thrown light upon the correlation between the mandibular prognathism and the tendency of neurosis, but males had the tendency. According to the affirmed number of CMI, males and females alike of the Pre op. Scored higher marks on the mental side. And this tendency emerged stronger among male patients.
(3) According to SD, both male and female Pre op. patients clearly had inferiority complex in social activities and attractiveness.
2. Comparison between Pre op. and Post op.
(1) Male and female Post op. patients showed improvement in emotion, social adaptability and introverted activity. The degree of improvement emerged higher among female patients.
(2) In the Post op., we found decreased neurosis tendency, but there were no significant sex differences. We found the improvement in emotion also in affirmed number of CMI, and the tendency emerged higher among female patients.
(3) In self estimation of SD, the post-operative patients were conscious of becoming active. This tendency also emerged higher among female patients.
3. Comparison between Post op. and control groups.
(1) According to Y-G type, male and female alike, there were few significant differences in the control group. But males were still more introverted in the personality charactreistics. In the meantime, females in the Post op. group were much better than those in the control.
(2) In the tendency of neurosis, the Post op. differed little from the control.

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An accessory parotid gland is located anterior to the main parotid gland and occurs in about 30 per cent of human cadavers. Tumors arising in accessory parotid tissue are rare. This case report describes a pleomorhic adenoma arising in the accessory parotid gland.
A 21-year-old male was seen in 1984 with a soft tissue mass in the left cheek. A sialogram revealed a duct system of accessory parotid tissue and unusual stenosis of Stensen's duct. At operation, the mass was freed from the main parotid tissue and enucleated easily. Histologically, the mass was pleomorphic adenoma.

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Polycythemia vera is an insidious disease of unknown cause, characterized by elevation of the total red cell mass. Hemorrhages occur in about one-third of this disease. A case of 54 year old male was reffered to our clinic complaining of abnormal bleeding after gingival incision.
In his history, he lacked any apparent bleeding tendency except suspected thrombotic tendency on his left plantar which had occurred two years before. The chief clinical findings of this patient were the abnormal bleeding from gingival wound, reddish blue discoloration of face and arms, body itching and headache. Hematological examination showed remarkably elevated red cell count, hemoglobin levels, white cell count and platelet count. He was admitted to the 1st Department of Internal Medicine, Kyushu University, and is now doing well about two years after the treatment.

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We experienced a case of peripheral ameloblastoma that developed in the right palatal gingiva adjacent to the first premolor tooth in a 30-year old man.
This tumor is a very rare one that develops only in the soft tissues of the tooth bearing areas.
It is necessary for the diagnosis to have a detailed histological examination.
In this case the excised bone was examined by serial sections. “Peripheral ameloblastoma” in histopathological diagnosis was comfirmed, and we reported this case together with the literature.

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In the past 7 years reconstruction using various pedicle flaps and skin grafts for oral and maxillofacial defects was done to the following 53 patients; 15 pectoralis major myocutaneus, 15 deltopectoral and 2 scalp-forehead flaps for larger defects, and 2 sternocleidomastoid, 5 cervical island skin, 2 palatal and 2 lip flaps for moderate defects, and 10 skin grafts for superficial defects. As to results, most of the flaps used for the defects of soft tissue were able to repair their shape and satisfy these patients. However, recovery of functions concerning speech, swallowing or mastication was not always successful in the larger defects, especially after the econstruction for defects of tongue, floor of the mouth, cheek and mandible for which mandibular reconstruction was performed. It was pointed out as the main causes that less tongue mobility due to scar contracture after reconstruction and difficulty of mandibular reconstruction due to postoperative infection resulted.
Accumulated survival rates for 5 years after reconstruction for 50 patients with malignant tumor were as follows; 51.9 percent in 28 patients of pectoralis major myocutaneus and deltopectoral flaps, 61.0 percent in 12 patients of scalp-forehead, sternocleidomastoido, cervical island, palatal and lip flaps, and 100 percent in 10 patients of skin graft. The above survival rates indicated that 87.4 percent for 26 patients with primary tumor was superior to 46.1 percent for 24 ones with secondary tumor.

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Operations for malignant tumors in the oral cavities of patients being maintained by hemodialysis are extremely rare. We have been treating a hemodialysis patient for squamous cell carcinoma of the left mandible and a hemimandibulectomy was performed.
The patient is a 60 years old male undergoing hemodialysis three times a week because of chronic renal failure. On the day before the operation, to correct the anemia and the uremia, a blood transfusion and hemodialysis were carried out.
The hemimandibulectomy was performed under general inhalation anesthesia (GOF). The median incision from the center of the lower lip to the mental region was performed. Then submandibular incision from the mental region to the left mandible angle was performed, and the tumor excision with hemimandibulectomy was carried out. The reconstruction of mandible was not done.
The patient was cared for in I.C.U. for 42 hours after the operation. On the second day after the operation, hemodialysis was begun. The first hemodialysis after the operation was done with local use of regional heparin. But the hemodialysis was stopped after 4 hours because of swelling in the left face and neck region. After stopping hemodialysis, swelling was reduced slowly. From the next time, the hemodialysis was done using gabexate mesilate (FOY). After 4 treatments of FOY hemodialysis, we returned to normal heparin hemodialysis.
Antibiotics (LMOX. 1 g/day) were injected to prevent wound infection.
Removal of the stitches was started on the 10th day after the operation and was finished on the 16th day. The reason for this delay was the slow healing of the incision caused by wound healing delay.
The observation period during 2 years following the operation, reveals no signs of recurrence or metastasis.

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Malignant ameloblastoma is known to be a very rare disease. We report a case of maxillary ameloblastoma that ended in death of pulmonary metastasis after the second operation. The patient, a 51-year-old housewife was first seen for a problem extract wound at the right maxillary second molar in October 1968. A partial resection of the right maxilla was performed under the diagnosis of ameloblastoma in February 1970. Twelve years later, recurrence at primary region was observed and excision was performed again. About 8 months after the second operation, her chest roentogenogram revealed many miliary nodules in both lungs, which gradually grew. She died about 15 years and 6 moths after the initial visit. The autopsy showed that the pulmonary lesions were the metastasis of maxillary ameloblastoma.

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Lateral cervical cyst is a rare disease occuring in the head and neck region. The highest percentages of cases occur in the 20-40 year age bracket.
Although, over the years, many theories have been put forward for discussion, no agreement has been reached as to the origin of this disease.
Clinically this disease is usually called “Branchial cyst” or “Lympho-epithelial cyst”. This time, we dare to call it “Lateral cervical cyst” from the view of anatomical point.
This disease generally exhibits a benign nature, but in rare cases it degenetates into a malignant tumour.
Recently, we experienced a case of a comparatively large lateral cervical cyst from the angle of mandible to the lateral cervical region. The cyst was extirpated completely under N.L.A. modified general anesthesia.
About one and a half years after the operation no recurrence or malignant degeneration has appeared.

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This is a case of congenital epulis in the mandible of a newborn baby girl. The tumor measured 24×18×17mm and was located in the anterior region of the alveolar ridge of the mandible. As a result, the child's ability to nurse was seriously impaired. The tumor was removed on the second day after birth. Following excision, the infant was able to nurse satisfactorily. As with a previously reported case, there has been no recurrence of the problem. The tumor was diagnosed histopathologically as a benign granular cell tumor.

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The granular cell tumor is a rare lesion with a predilection for the subcutaneous region and the tongue, it's histogenesis is still controversial. A 59 year-old female presented with a granular cell tumor in the left floor of the mouth.
The tumor was excised together with a part of the sublingual gland, but invasion of the Wharton's duct was not observed. In the excised specimen, there was no encapsulation and the tumor had partially invaded the sublingual gland. Beneath the overlying stratified squamous epithelium associated with pseudo-epitheliomatous hyperplasia, the tumor cells had proliferated diffusely and/or were arranged in small nests especially around the peripheral nerve bundles. Scattered axon like dark brown fibrils were seen in the tumor nests after Bodian silver staining. The intracytoplasmic granules of the tumor cell showed either a weak or sometimes a strong PAS positive reaction which was diastase resistant. The tumor cells and Schwann cells were positive when tested by the immunohistochemical method using anti S-100 protein antiserum. Electron microscopical observation revealed granules of various sizes and shapes bounded by a membrane in the cytoplasm of the tumor cell. The tumor nest, which was bounded by a basement membrane, consisted of tightly packed spindle shaped cells with long pseudopodial-like processes. Isolated tumor cells were also found within the basement membrane of peripheral unmyelinated nerve fibers adjacent to Schwann cells and axons.
These findings suggest that histogenesis in this case is from Schwann cells of the peripheral unmyelinated nerve fibers.

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A 41-year-old man was seen in August, 1984 with a 3.6×1.6×2.8 squamous cell carcinoma (T2N1M0) on the right side edge of his tongue. He was effectively treated with irradiation and chemotherapy for the primary lesion and with surgery for the neck metastases. Several months later, however, he complained of severe chest and back pain, which probably resulted from metastatic foci at second rib and lumbar spine, with concomitant increases in serum calcium level (8.8meq/l) and white blood cell count (180, 000/mm³, >96% granulocytes). Elcitonin (80 MRC U, twice a day, im) greatly reduced pain but failed to reverse the hypercalcemia. Mithramycin (25μg/kg, single injection) demonstrated a strong hypocalcemic effect. Serum levels of parathyroid hormone and 1, 25 dihydroxyvitamin D₃ and nephrogenous cyclic AMP were all within normal range throughout entire clinical course.
Metastatic tumors of second rib obtained at autopsy were successfully implanted into athymic nude mice. Animals bearing the tumor showed marked hypercalcemia (8 meq/l) and leukocytosis (300, 000/mm³, >95% granulocytes) similar to those of the patient. Increases in serum calcium level and white blood cell count paralleled an enlargement of the tumor. Surgical excision of the tumor resulted in dramatic falls of serum calcium level and white blood cell count to normal levels. Recurrence of the tumor reproduced hypercalcemia and leukocytosis. Histologic examination demonstrated osteoclastic bone resorption at the endosteal surfaces of femur of tumor-bearing nude mice.
These results indicate that hypercalcemia and leukocytosis seen in the patient and nude mice might be attributable to not only bone metastasis but also a release of humoral factors by the tumor.

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Ossifying fibroma of the jaw is histologically very similar to fibrous dysplasia. This is a case report of ossifying fibroma which was diagnosed as fibrous dysplasia for a long time. A 24-year-old man, who had a large swelling in left maxillary region, visited our clinic. Previously this lesion which he found 9 years ago was diagnosed histologically as fibrous dysplasia and treated four times. The tumor, however, had grown gradually to fist size. It was diagnosed here as ossifying fibroma from both clinical and histological findings. Tumor was excised under general anesthesia and postoperative course was not eventful for 2 years. Tumor was ball-like mass with dimensions of 66×64×72mm and weighed 180mg. It seemed that CT finding was very useful for differential diagnosis between these to lesions.

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Twelve cases of squamous cell carcinoma of the lip were retrospectively studied, which were treated in our department between 1974 and 1985. They were 10 males and 2 females and the majority of them occured after the age of sixty. TNM classification was as follows: T 1;3, T2; 4, T3; 3, T4; 2, N 0; 10, N 1; 2, M 0; 12, M 1; 0. They were treated by external irradiation, operation, cryosurgery and chemotherapy as a initial therapy. Recurrence was found in 5 cases. The cryosurgery performed on 7 cases containing 4 recurrent cases, all of which were alive. The 2-year-crude survival rate was 75% and determinated survival rate was 90%.
Recently, the combination therapy as follows was carried out on selected cases and had favorable results cosmetically and functionally, as chemotherapy was at first done to reduce the tumor volume, then cryosurgery was added on the residual tumor.

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There are few reports about maxillofacial deformity and its developmental change caused by mandibulectomy at the childhood. The authors studied the maxillofacial deformity after mandibulectomy mainly by means of PA cephalogram.
The study objects included 8 patients who had undergone mandibulectomy in the age 5 to 15 years, at the First Department of Oral and Maxillofacial Surgery, Tokyo Medical and Dental University Hospital. Seven cases were diagnosed as ameloblastoma, and one as fibrosarcoma of the mandible.
PA cephalograms were taken at their adult ages, and analyzed. PO perpendicular was adopted as the standard of the midline of the face in analysis. Lateral cephalograms and Orthopantomograms were also used in analysis of the deformity as well as clinical findings. The results obtained are listed below.
1) The maxillofacial deformity after mandibulectomy was observed as midline deviation of the upper and lower jaws, hypoplasty of the mandibular ramus, extrusion of the upper molars, lotation and tilt to the disease site of the mandible, malocclusion and flattened angle of the mandible.
2) The degree of the maxillofacial deformity depended upon the operation method, the deformity was comparatively mild in the marginal resection cases. After hemimandibulectomy with conserving the lower border of the mandible till the mandibular angle, deformity had less than the conventional hemimandibulectomy without conserving the lower border of the mandible.
3) In the same operation group, the deformity of the patients who underwent the operation at a younger age had more severe deformity than those who underwent the operation at an older age.
From above result, we think the minimum operation is desirable at childhood. If the mandibular lesions were cyst or cystic ameloblastoma, marsupialization would be suitable in order to minimize the operation or to postpone the operation to an older age. If mandibulectomy must be done in childhood, it is important to conserve the condyle, the lower and posterior border of the mandible.

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We experienced a case of malignant lymphoma arising from the mandibular bone in a 42-year-old man. His chief complaint was swelling of the right cheek and mouth floor. We suspected it might be malignant tumor at first but we couldn't diagnose it as malignant lymphoma during the first 5 months, because every bacteriological examination was positive and histopathologic diagnosis was always osteomyelitis. We report here the clinical course and the treatment of this case which was classified as stage IE of malignant lymphoma.

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Two cases of dermoid cyst and epidermoid cyst were encountered, which occurred in rare places.
The first patient, a 4-year-old girl, noticed a mass under the left mandible. The second patient, a 60-year-old male, found a mass at the left upper lip.

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Incidences of Chondrosarcoma in the oral region are very rare.
This is a case report of chondrosarcoma which originated in the mandible. The patient was a 20-years old male with chief complaint of hard swelling of the right buccal.
We could not find the abnormal region, on an orthopantomogram. The results of a whole body ⁶⁷Ga-citerate scintigram showed an abnormal accumulation on the right side of the face. On the CT-scan, a tumor was surrounded by his right mandible and had grown into the intratemporal fossa. But, the bone of the right sinus was intact.
The histopathological diagnosis was “High grade malignancy chondrosarcoma”. After a 20 Gy of Linac irradiation, a tumor exicision with hemimandiblectomy was carried out.
For access into the intratemporal fossa, the zygomatic arch was cut off. After the operation, it was returned to original position and fixed with wire.
The tumor size was 60×70×50mm, and was surrounded by thin fibrastic tissue.
The mandible reconstruction was carried out using A-O reconstruction plate.
After the operation, adjuvant chemotherapy was given with “ADRIAMYCIN, VINCRISTINE, CYCLOPHOSPHAMIDE and PREDONINE” Chemotherapy was given 4 times every 3 or 4 months after the operation.
As of now, 20 months after operation, there is no evidence of recurrence or metastasis.

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A case of multiple fibroepithelial hyperplasias of the oral mucosa in a 46-year-old man is reported. Oral examination revealed a mouth with multiple papules and nodules on the lower lip, upper lip, commisure, buccal mucosa, tongue, and palate. Biopsy specimens from buccal mucosa showed a characteristic picture of fibroepithelial hyperplasias. He has been treated with vitamin A 3, 000 IU a day for forty-two months and the lesion flattened gradually.

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A female diagnosed as the fifth type of DeMyer's classification of holoprosencephaly is presented. She associated with the bilateral cleft lip and alveolus, hypoterolism, loss of crista galli, small prolabium in size prolabium defect of lower part of the nasal septum and flat nose in the craniofacial region. Anal stenosis, presacral meningocele and spina bifida are found in the extracranial examination. But, her chromosomal karyotype was normal and mental retardation was not found.
Cleft lip of this infant was treated successfully by modified Hagedorn's method at the age of 12 months.

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A case of ossifying fibroma of the mandible suspected as cystic lesion was reported. The patient was a 38 year-old female complaining of a swelling of the gingiva at the left lower molar region. X-ray examination showed a cystic radiolucent lesion at the left mandibular body, which included apices of left lower first and second molar. A biopsy was performed. The lesion had a unilocular cyst-like appearance with an extremely thin wall, and included light-yellowish, serous liquid. Histological diagnosis was ossifying fibroma, and surgical enucleation was carried out.
In the histological findings, the specimen showed spheroidal calcified deposits which were stained deeply by hematoxylin, and lamellar bone structures seen in normal bone tissue were not observed by polarized light microscope. They did not show the same staining tendency as normal bone in the PAM stain, so there was a difference between them in their maturity.
In this case, it was suggested that inflammation also seen in the specimen might be related to cyst-like appearance of the fibroma formation.

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Lipoma is a benign tumor derived from non-epithelial tissue origin and may arise from any portion where fat cells physiologically exist. The authors experienced a case of lipoma in a size of an infant's head on the left cervical region. This paper reports this case with a review of literature.
The patient, a nine-year-old female child noticed a thumb-tip-sized swelling on her left submandibular region at the age of three year. At that time she consulted a general surgeon because the swelling had gradually grown in size, but did not undergo any treatment being afraid of operative damage and has continued to accept follow-up. She was referred to our departmet from a dentist in the course of conventional dental treatment.
At her first visit, the patient was evidently overweight. The swelling was located between left submandibular and post-auricular regions and palpable to its fluctuation and mobility. The data from serum biochemical examination detected her hepatic damage. Puncture biopsy of the liver before our operation revealed fat liver as a causative of abnormal data of chemical analysis.
Intra-oral and plain roentgenographic examination yielded no abnormal findings. Cephalic computerized tomography (CT) and ultrasonography disclosed that the mass had a welldemarcated margin having the same homogeneity and low density. Further, vasculatures situating around the tumor were oppressed and emigrated peripherally. The tumor mass profoundly reached to the suprapharyngeal muscles.
In the procedure of extirpation under general anesthesia, the mass was encapsulated with fibrous connective tissue which was removed with ease by blunt dissection. The extirpated mass was ovoid in shape, 8×13×2cm in size and weighed 240g. The cut surface was yellow and homogenously solid. Histopathologic specimen revealed that the tumor was a lipoma consisted of mature fat cells. Possitive evidence on the relationship between the lipoma and her obesity and fat liver was not provided by our review of literature.
Lipoma on the infant submandibular region is rare and the size of the tumor of this case found to be the largest in Japanese literature.
On the diagnosis of this case, CT and ultrasonography were available and effective for the examination of characteristics, location, relation to surrounding tissue and for the selection of the operating method.
The patient has favorable postoperative course without any recurrence and had been periodically followed up by the authors.

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A case of congenital epulis of the newborn was reported. A two-month-old male infant was found to have a smooth, oval, and red mass with a pedicle, measuring 10×7×7mm in size, arising from the left upper molar region of the alveolar ridge. The mass was exicised under general anesthesia.
From the histologic examination of the epulis, it consisted of fibrous tissue with proliferating capillaries. Granular cell was not observed.

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As mandibular resection causes several kinds of oral dysfunction, mandibular reconstruction is necessary for the restoration of the continuity or augmentation of the contour of the mandible.
Recently numerous materials were developed as bone substitutes, which contributed to the advances of oral and maxillofacial surgery.
Of these materials alumina ceramics have proper physical properties, chemical resistivity, and good biocompatibility.
We applied alumina ceramics for reconstruction of the mandible in ten cases. Among six cases for ameloblastoma four cases attained satisfactory results. The remainder including irradiated cases had problems such as infection, exposure of ceramics, or fixation device loosening.
Clinical results, complications, and prospects of alumina ceramics are discussed in this paper.

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The temporal fixation or reconstruction for stumps of the mandible using A-O plate following the mandibular resection was carried out in 28 patients during the past 6 years. In 18 of 28 (68%) patients the plates are still observed clinically but in 9 (32%) patients, the plates were removed.
The removed plates had these reasons; 5 postoperative infections including the overtension of the covering skin injuries of the parotid gland and pseudoarthrosis, 2 poor fittings the plate during operation, 1 recurrent tumor and 1 complete bony union between the bone graft and the mandible.

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Epidermoid cyst occurs throughout entrapped ectodermal tissue during embryonic development, or inflammatric and traumatic implantation of the epithelium. In the oral cavity, it occurs most commonly on the floor of the mouth, but may rarely occur on the lingual frenulum.
The authors have experienced one case of epidermoid cyst on the lingual frenulum of a 47 years old woman. The lesion was surgically enucleated. This lesion was diagnosed by histopathological examination, the cyst cavity was filled with keratin, but contained no skin appendages.

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A total of 23 carcinoma of the lower gingiva treated at the Second Department of Oral Surgery, Kyushu Dental College Hospital, during 1978 to 1985, were clinical analysed.
The following results wereobtained:
1) A series of 23 primary cases with carcinoma of the lower gingiva were reported. This series was found histopathologically to be; 21 cases squamous cell carcinoma (91.3%), 1 case (4.3%) carcinoma simplex and 1 case (4.3%) adenocarcinoma.
2) The carcinoma of the lower gingiva in the majority of 23 cases was located in the molar region (73.9%). Of the 23 cases, 15 cases (65.2%) were between 60 to 70 years of age. As to sex, incidence, it was slightly higher in males.
3) The complaint most commoney reported was swelling and pain of the lower gingiva.
4) In TNM classification, the majority of 23 cases were T 2, T 3, N 0 case and stage II, stage III case.
5) Radiographically, the majority of 23 cases had bone resorption (71.5%).
6) Treatment was performed mostly by combination therapy of the partial mandiblectomy with chemotherapy and/or radiation therapy.
7) The five year absolute cure rate for all cases was 38.1%.

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Adenocarcinoma in the submandibular gland is rarely encountered. Recently, the authors experienced a rare case of submandibular gland tumor which showed undifferentiated adenocarcinoma.
Patient: S.T. 71-year-old male.
Chief complaint: Swelling in the left submandibular region.
History of the present illness: The patient consulted a dentist due to the poor fitting of full dentures on January, 1985. Though the patient was told of swelling in the submandibular region by the dentist, he had no therapy because of no pain. When he reconsulted the dentist January, 1986, the dentist recommended a detailed examination. So he visited our hospital on February, 7th.
Present condition: In general condition, the patient was of small stature and good nutrition. In local findings, the pigeon's egg-sized tumor, which had elastic hardness immobility, tenderness, was palpated in the left submandibular region. The regional lymph nodes had a moveable, pea-sized swelling without tenderness. Salivary secretion from the left Wharton's duct was not obtained. Roentgenographically, the mandible and the submandibular gland had almost normal findings. General blood tests showed no abnormality other than slight increase of ESR to 11mm/1h.
Treatment: On March 13th, the tumor was resected enblock with the submandibular gland under general anesthesia. Radiation was done to prevent recurrence after operation. The patient was discharged on April, 24th, and postoperative course is well.
Histopathological diagnosis: Undifferentiated adenocarcinoma. The tumor consisted of round and pleomorphic cell arranged compactly in bands, and proliferated infiltratively in the surrounding tissue. In addition to a part of tumor masses, pseudoglandular formation that the tumor cells are arranged circumferentially around the central destritus, near the duct basement membrane, was observed.
This histopathological finding resembled Comedo carcinoma of mammary gland, so that it considered to be a rare type in the adenocarcinoma of the submandibular gland.

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Non-surgical approach was performed in 10 cases of TMJ arthrosis with closed lock. Clinical studies on these cases gave the following results.
1. Unlocking manipulation with or without unlocking appliance after pumping the upper joint cavity with local anesthetics, were performed successfully in eight cases, failed in one case, and temporarily effective in another case.
2. Three of successfully manipulated eight patients had clicking noise in TMJ after manipulation, and one patient manifested hesitation in translation of the condyle. The other four patients had no TMJ noise.
3. The new method of unilateral pivoting on the occlusal surface of molar tooth was applied to the eight successfully “unlocked” patient, and it worked very effectively.
4. The active mouth opening exercise and extension of the TMJ were applied to the non-effective case and one recurring case and afterward the patients obtained the sufficient mobility of the condyle.

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Thirty patients with the temporomandibular disorders were treated with “Kakkonto”, one of the most famous traditional drugs for chronic diseases with pain.“Kakkon-to” was given orally in a dosage of 7.5g 3 times daily before meals for two weeks. Clinical evaluation was carried out at seventh and fourteenth day after administration about spontaneous pain, pain with jaw movement, muscular tenderness, complications, and side effects. These symptoms were rated on a scale of 0 to 3 (0=no symptom and 3=severe). Two cases were dropped because of further administration of another analgesic for severe temporomandibular joint pain. 22 of 28 (78.6%) patients were improved at the therapy completion. 6 cases (21.4%) showed significant improvement, most of those had complications such as stiff shoulder and headache. Side effects were observed in 5 cases, such as slight nausea, vomiting and so on. It is suggested that “Kakkon-to” is a useful drug for temporomandibular disorders.

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