Japanese Journal of Oral and Maxillofacial Surgery
Online ISSN : 2186-1579
Print ISSN : 0021-5163
ISSN-L : 0021-5163
Volume 35 , Issue 3
Showing 1-33 articles out of 33 articles from the selected issue
  • Naohisa TAKANO, Eiko TAKANO, Masamichi CHIKATA, Kou SATO
    1989 Volume 35 Issue 3 Pages 549-554
    Published: March 20, 1989
    Released: July 25, 2011
    The original image data of an X-ray CT scanner (Toshiba TCT-80 A) were decoded and stored into floppy disk files on MS-DOS.
    The MS-DOS files were processed with an image processing program on a personal computer (NEC PC-9801 VX 21) and the CT images were reconstructed on a display with sixteen colors. Applications of this color imaging system to several patients have demonstrated that color imaging makes it easier to distinguish lesion and tumor tissues from normal muscular and fatty tissues. Another advantage of this system is that the image data files can readily be used in other departments or hospitals for cooperative treatments.
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  • Yoshimi ICHINOKAWA, Takashi TSURUKI, Takashi MATSUI, Tadashi SATO, Kaz ...
    1989 Volume 35 Issue 3 Pages 555-559
    Published: March 20, 1989
    Released: July 25, 2011
    In this study, serial changes in mechanical strengths of allogenic bone grafts were evaluated 2, 4, 6 and 12 weeks after grafting.
    Experimental subjects were two kinds of inbred rats with different M.H.C. Femoral diaphyses of Fischer 344 rats were treated with (1) freezing at-80°C, (2) lyophilizing, (3)-defatting or (4) decalcifying. Fresh femoral diaphyses were used as controls. These treated bones were grafted into subcutaneous spaces of Brown-Norway rats and Fischer 344 rats. Fischer 344 rats were used in fresh isogenic grafts cases.
    The mechanical strengths of bones treated under various methods were measured by bending test using a strength-test machine with a microcomputer.
    1. In bending tests, the maximum load values of treated bones were low compared with that of fresh bones. The load values of decalcified bones were unmeasurable.
    2. After grafting, the bending strengths of fresh allogenic bones were extremely low, that of bones frozen at -80°C or lyophilized bones were reduced a little and that of defatted bones were not reduced. On and after 4 weeks following grafting, the load values of decalcified bones were measurable. The bending strengths of fresh isogenic bones were low compared with that of fresh allogenic bones, but after 4 weeks following grafting strengths were slightly high.
    3. The above results suggest that defatted bones are recommended for bone grafting when mechanical strength is required.
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  • Ryoichi OHYA, Kunio IKEMURA, Syouichi NAKAMURA, Toshihiko FUJIWARA, Ka ...
    1989 Volume 35 Issue 3 Pages 560-568
    Published: March 20, 1989
    Released: July 25, 2011
    The serum SCC antigen was examined in patients with malignant tumor of the oral cavity. It was evaluated whether the serum SCC antigen was useful in diagnosis of squamous cell carcinoma and the value of the serum SCC antigen was influenced by cancer therapy.
    Serum SCC antigen measurement was performed prior to therapy in 16 oral cancer patients. Ten patients (62.5%) showed values beyond cut-off level (2.0ng/ml). Twenty nine patients with benign tumor and non-neoplasic lesion were selected as control, and in 19 patients (65.5%) the value of the serum SCC antigen showed values beyond cut-off level. It seems that SCC antigen value measurement played a complementary role in diagnosis of oral squamous cell carcinoma.
    Patients who received surgery or chemotherapy showed immediate decrease of serum SCC antigen levels. In patients treated with a combination of radiation and chemotherapy, however, serum SCC antigen levels decreased later after treatment.
    The tissue SCC antigen values of 6 cases with oral cancer varied from 0.4 to 18.8ng/mg. Positive correation was found between the serum and the tissue SCC antigen value.
    In order to evaluate whether the serum SCC antigen is helpful in early detection of local recurrence or metastases, further study is necessary.
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  • Masataka KIDA
    1989 Volume 35 Issue 3 Pages 569-588
    Published: March 20, 1989
    Released: July 25, 2011
    Stages of bone healing in mandibular fractures are evaluated mainly based on clinical symptoms and x-ray appearance. However, the above evaluations are thought to be subjective by nature. An experimental and a clinical studies on the stages of healing process of mandibular fractures were performed based on Coherence function analysis utilizing a vibration test, in order to develop an objective method to analyse the healing process in the mandibular fractures.
    Intermaxillary fixations with steel wires were placed in 19 male monkeys (about 6kg body weight, with permanent dentition) soon after the mandibles were intentionally fractured. Observations on the stages of healing process were performed weekly with x-ray and checking the level of vibration for 12 weeks after the intermaxillary fixation. The monkeys were sacrificed weekly and sections were prepared for a histological examination. The level of vibration frequency on the fracture site was consistently lower than that of the non-fracture site soon after the intermaxillary fixation. The vibration frequency of the fracture site, however, increased to almost the same level as that of the non-fracture site in the fourth week. Bone unions at the fracture site were histologically evident on the fourth week after the intermaxillary fixation and increased gradually. Clinical observations on the healing process of mandiblar fractures, based on Coherence function analysis employing the vibration test, were also performed on 60 patients who were treated in the Department of Oral Surgery, Dental Clinics of Hokkaido University. The vibration frequencies of the fracture sites in the mandibles were almost the same levels as those of the non-fracture sites four to five weeks after the intermaxillary fixation. The intermaxillary fixations were removed based on the results of Coherence function analysis, and no clinical problems were encountered. Follow up observations also revealed mandibular functions to be satisfactory.
    The above mentioned data suggests that Coherence function analysis employing the vibration test is a valuable method in evaluating the stages of healing process in mandibular fractures.
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  • Hitoshi TANABE
    1989 Volume 35 Issue 3 Pages 589-598
    Published: March 20, 1989
    Released: July 25, 2011
    The distribution of immunocompetent cells in regional lymph node of 19 patients of head and neck cancer (repetition of 2 patients) was investigated by lazar flow cytometry using the monoclonal antibody against the lymphoid surface antigen. A lymphadenitis patient and a malignant lymphoma patient were also investigated.
    The monoclonal antibodies used in this study and their specificities were T 3 (CD3: mature T lymphocytes), T 4 (CD 4: helper/inducer T lymphocytes), T 8 (CD 8: suppressor/cytotoxic T lymphocytes), B 1 (CD 20: pan B lymphocytes), I 2 (B lymphocytes, activated T lymphocytes and some monocytcs), NKH-1 (natural killer cell).
    We divided the regional lymph nodes into five classes in the following way: no metastasis group (N (-) group (n=17)), negative lymph node cf metastasis cases (N (+) negative group (n=19)), positive lymph node of metastasis cases (N (+) positive group (n=14)), lymphadenitis (n=2), malignant lymphoma (n=1).
    The existence of metastasis of the regional lymph node was judged morphologically by H.E. staining.
    The percentage of T 3+, T 4+ showed tendencies of decrease in the following order: N (-) group, N (+) negative group and N (+) positive group (p<0.05, P<0.01).
    The percentage of B 1+ and I 2+ showed tendencies of increase in the following order: N (-) group, N (+) negative group and N (+) positive group (B 1: p<0.1, p<0.02).
    The “T helper/T suppressor” ratio (T 4+/T 8+) showed significant increase in the following order: N (-) group, N (+) negative group and N (+) positive group (p<0.05, p<0.01).
    They showed no specific increase and decrease of T 8+ lymphocytes in N (-) group, N (+) negative group and N (+) positive group. It was considered that the decrease of T 4+/T 8+ was mainly due to the decrease in T 4+ lymphocytes.
    NKH-1+ lymphocyte was under 5% in all lymph nodes, and its average was about 1%. In regard to the percent of N (-) group and N (+) negative group, they showed a significant increase (p<0. 1), so we considered that it was due to the defect of NKH-1+ lymphocytes in the lymph node.
    The amount of lymphocytes subsets in lymph nodes of lymphadenitis were almost that of those in N (-) group.
    In regard to the lymphocytes subscts in malignant lymphoma, they showed an extreme decrease of T 3+ & T 4+ lymphocytes, and an almost high level of B 1+ & I 2+ lymphocytes. So it was suspected to be B cell lymphema.
    We considered that the fall of the immunocompetent cells in regional lymph nodes of head and neck cancer patients with metastasis was caused by the decrease in the T 4+ lymphocytes.
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  • Tomoyuki MIZUNO
    1989 Volume 35 Issue 3 Pages 599-613
    Published: March 20, 1989
    Released: July 25, 2011
    Investigation to elucidate the histochemical characteristics of adenolymphoma using normal salivary gland tissue as control, was carried out in immunohistochemical and mucushistochemical technique and the following findings were obtained: Localization of IgA, LF and SC in normal salivary gland tissue, siuggesting the defence of acinus unit, was the pertinent finding for the tissue defence mechanism which supported the presence of SC-transport mechanism and local immune system. Localization of Keratin in tumor tissue, suggesting the characteristic picture of densely staining epithelial basal cell skin to excretory duct, is the finding strongly implicating the execretory duct epithelial origin. The fall in positive rate associated with tumorigenesis of LZ implicated involvement of LZ in tumorigenesis. Acid mucus is dominant in productive mucus in normal salivary gland tissue and sialomucin is dominent in tumor tissue. Though the presence of glycosaminoglycan was confirmed by performing enzyme digestion method in normal salivary gland tissues, the evidence of glycosaminoglycan was not observed and imvolvement of myo-epithelial cell in tumorigenesis was negatively supported. In double stain of each antibody and mucus, the tendency toward dissociation was observed in all antibodies. Its when the cell with mucus producting potential was considered as the cell relatively well-differentiated in terms of function, the possibility, that CEA, SC, IgA, K, LF, LZ were localized in the cells relatively poorly differentiated, was implicated. The localization of CEA in particular was suggested to be the possible index of cell dedifferentiation toward fetal tissue.
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  • Yutaka MIKAMI, KOZO MUSHIMOTO, Kohei MIKI, Kenji KAKUDO, Rikiya SHIRAS ...
    1989 Volume 35 Issue 3 Pages 614-623
    Published: March 20, 1989
    Released: July 25, 2011
    Serum levels of squamous cell carcinoma related antigen (SCC-Ag), immunosuppressive acidic protein (IAP), ferritin (FER), carcinomaembryonic antigen (CEA) and β2-microgroblin (BMG) were measured in 43 patients with squamous cell carcinoma of the head and neck.
    The true positive rate (sensitivity) was 11.6% for SCC-Ag, 14.0% for CEA, 16.3% fur BMG, 18.6% for FER and 27.6% for IAP. The true negative rate (specificity) was 100% for SCC-Ag, 95.2% for CEA, 90.5% for FER and BMG and 57.1% for IAP. Positive predictive value and negative predictive value of SCC-Ag were highest in another tumor markers.
    High pretreatment SCC-Ag levels declined to undectable level after treatment. In case of squamous cell carcinoma without recurrence, positive rate was 7.0% for SCC-Ag.
    Therefore SCC-Ag is more useful than other tumor markers for monitaring response to treatment and follow-up.
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  • Hiroshi ISHIHARA
    1989 Volume 35 Issue 3 Pages 624-633
    Published: March 20, 1989
    Released: July 25, 2011
    Cellular mechanism of bone formation in the central portion of a fresh rib which was grafted in a manner to bridge the lower borders of the mandibule was studied in 32 rats.
    At one week of the graft, the bone which was undergoing osteoclastic resorption was surrounded by connective tissue containing undifferentiated mesenchymal cells. The bone marrow had been replaced by granulation tissue. Evident osteoblastic bone formation was not observed.
    At two weeks, resorption of the grafted bone was still going on, but newly formed bone with osteoblastic lining was seen along the cement line. The newly formed bone was invaded by capillaries and in their vicinity osteoclastic resorption and osteoblastic formation of bone was taking place concurrently. Histochemically, acid phosphatase activity was present in osteoclasts and resorption lacunae in both of the newly formed bone and the grafted bone. In addition cartilage was observed in approximately half of the grafts and it was surrounded by layers of chondroblasts and undifferentiated mesenchymal cells. Matrix vesicles were seen ultrastructually in the areas of newly formed bone and cartilage.
    At three weeks the majority of the grafted bone had undergone resorption. Acid phosphatase activity was seen in osteoclasts and resorption lacunae of the grafted bone and adjacent to the osteoclasts. Osteoblasts undergoing active bcne formation were located along the cement line which was continuous to the resorption lacunae, whereas with hypertrophic change of chondrocytes, the cartilage was invaded by vascular endothelial cells and new bone was being formed by osteoblasts.
    Injections of EDTA-Pb showed active bone formation at the second and third weeks of the graft.
    After the fourth week cartilage was observed in no specimen and the graft had been completely replaced by newly formed bone.
    All these findings indicate that the grafted bone is incorporated into newly formed bone either by enchondral ossification or direct bone induction from the grafted bone through coupling mechanism.
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  • Kyouichi MANITA, Makoto TSUCHIMOCHI, Izumi MATAGA, Joji KATO
    1989 Volume 35 Issue 3 Pages 634-646
    Published: March 20, 1989
    Released: July 25, 2011
    Thirteen patients maintained by hemodialysis with secondary hyperparatyroidism were mainly studied using Tc 99m-MDP bone scintigraphy and lamina dura index (LDI) which was judged by dental films. After parathyroidectomy (PTX), the most prominent change appeared on the calvaria, maxilla, and mandible in scintigrams. Intensity of Tc 99m-MDP accumulation was represented by using a quantitative method of bone-to-soft tissue uptake ratio (4 hr-B/St ratio). 4 hr-B/St ratio gradually decreased and became normal within one and a half years after PTX. The accumulation of Tc 99m-MDP on the calvaria may reveal the status of bone metabolism in the patients with secondary hyperparathyroidism. Also, LDIes gradually decreased during 4 through 6 months after PTX. However it was considered that these indexes might need a long term to return to normal range. We couldn't differenciate which method was superior in the diagnostic value for detecting early skeletal changes between roentogenograms and bone scintigraphy as a indicator of post-PTX bone improvement. However, bone scintigraphy should be added to conventional examinations for following the courses of patients that underwent PTX because this procedure has many other advantages.
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  • Mikito YAJIMA, Toshikazu MINEMURA, Shuichiro NEBASHI, Osamu SUNADA, Mi ...
    1989 Volume 35 Issue 3 Pages 647-654
    Published: March 20, 1989
    Released: July 25, 2011
    Clinicostatistical study was made about 70 patients with squamous cell carcinoma of the oral cavity (including maxillary sinus and oropharynx) who underwent radical neck dissection between 1978 and 1987 in our department.
    Metastasis to the cervical lymph nodes was histologically confirmed in 42 patients (60%). In 13 of the cases, late metastasis occurred. The carcinomas of the buccal mucosa most frequently metastasized to the regional lymph nodes because many of them invaded the surrounding tissues. The ratio of late metastasis was highest in carcinoma of the tongue. As to distribution of involved lymph nodes (UICC 1978), the majority were recognized in Level I and/or Level II. In only two cases, they were distributed in Level IV (supra clavicle nodes).
    Twenty-five patients died of carcinoma. Uncontrolled cervical lymph nodes matastasis caused death in 7 cases. Clinical course of patients with advanced cancer (T 4, N 3), contralateral neck matastasis and involved lymph nodes in Level IV was not very good. Extra lymph node invasion related mainly to the recurrence rate of the matastatic tumor. A tendency was indicated that the prognosis was worse as the number of involved nodes, matastatic sites and lower level of cervical nodes increased.
    The comulative five-year-survival rate was 60.1% in patients without metastasis and 54.4% with metastasis. Although there was no significant difference between them, that of patients with late metastasis was extremely poor (14.4%). 7 cases of these patients were dead and moreover distant matastasis was recognized in 6 cases.
    Up to date, the needling irradiation therapy in carcinoma of the tongue and therapeutic radical neck dissection was performed in our clinic. Late cervical metastasis after treatment for primary tumor seemed to be controlled by careful follow-up. However, according to the results, prophylactic neck dissection should be considered especially in high grade malignant tumors.
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  • Kiyomasa NAKAGAWA, Toshihito BABA, Etsuhide YAMAMOTO
    1989 Volume 35 Issue 3 Pages 655-659
    Published: March 20, 1989
    Released: July 25, 2011
    Nifedipine is a popular medication used for the treatment of angina pectoris and hypertention. Now we report a case of gingival hyperplasia induced by the administration of nifedipine. A 63-year-old man was referred to our clinic for evaluation of a gradually growing mass on the left maxillary molar region. Examination showed the same gingival hyperplasia on the lower anterior teeth and left mandibular molar region. The gingival condition appeared elastic hard and nodular. The histopathological examination of the gingival biopsy specimen taken from the left maxillary molar region revealed marked epithelial acanthosis with varying widths, proliferation, and elongation of the rete pegs. The lamina propria showed the presence of increased numbers of fibrous tissues. These appearances were similar to those described for phenytoin-induced gingival hyperplasia. We diagnosed the side-effects of nifedipine because the patient was treated with 20mg/day for year. Nifedipine was discontinued and gingival therapy which included scaling, oral hygiene resulted in healing with no signs of recurring hyperplasia.
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  • Tatsuo Tsuji, Yasuyuki UENO, Kohsuke SASAKI, Kasuke NAKASHIMA, Fumihik ...
    1989 Volume 35 Issue 3 Pages 660-663
    Published: March 20, 1989
    Released: July 25, 2011
    A 42-year-old female had consulted several hospitals about her incurable ulcer of the upper palatal gingiva. However, it was diagnosed as a benign lesion. 5 years leter, she visited our hospital and it was diagnosed pathologically as adenoid cystic carcinoma. Partial resection of left maxilla was performed. Unfortunately, she suffered lung metastasis and local recurrence 6 years later. In the present case, serum SCC antigen level were above cut off value. We presented a case of adenoid cystic carcinoma and investigated about expression of SCC antigen in this paper.
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  • Mitsuhiro NAKAZAWA, Tomoaki KAWAMOTO, Kinya HIGUCHI, Motohiro TSUJINO, ...
    1989 Volume 35 Issue 3 Pages 664-672
    Published: March 20, 1989
    Released: July 25, 2011
    Two cases of peripheral ameloblastoma were reported. The first case was a 60 year-old-woman whi complained the tumor formation at 1-5 region lingual gingiva. The second case was a 70 year-old-man who had tumor at 543 palatal gingiva. Both patients were treated by surgical excision of the tumors including underlying bone and surrounding normal soft tissues.
    No recurrence was seen in either patient.
    In the second case, the findings that peripheral ameloblastoma invaded the underlying bone and that tumor tissues connected to oral surface epithelium were seen in the histopathological examination.
    These findings gave suggestions about the treatment and the origin of this tumor. Peripheral ameloblastoma has capacity to invade to underlying bone as central type ameloblastoma, so it is an adequate treatment to excise the tumor including underlying bone. We discussed whether or not peripheral ameloblastoma and basal cell carcinoma of oral mucosa were the same lesion.
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  • Masayuki FUKUDA, Kohsaku MATSUDA, Makoto ITOH, Hajime SHIMODA, Seishi ...
    1989 Volume 35 Issue 3 Pages 673-679
    Published: March 20, 1989
    Released: July 25, 2011
    Lymphangioma is not rare in the body, but is very rare in the oral cavity. Here, we reported a case of lymphangioma in an infant's lower lip and buccal mucosa.
    The patient was a male one year and 2 months old. A month after his birth, his mother noticed multiple granular vesicles of right lower lip of the patient. Thereafter, the mother scratched the lesion with her nails, but the lesion recurred several times and gradually proliferated.
    The patient was referred to us with a chief complaint of swelling of the right lower lip. During the course of the first medical examination, a difluse, elastic soft, thumb-tip sized tumor with numerous vesicles on the surface was found in the region of lower lip and buccal mucosa. The clinical diagnosis was lymphangioma. The lesion was excised several times, treated with cryosurgery many times, was vaporized by laser irradiation, and treated with free transplantation of buccal mucosa, but the lesion recurred every time.
    Histologically, the excisional specimen consisted of dilated lymphatic vesseles, therefore the lesion was diagnosed cavernous lymphangioma.
    A year and 6 months after the last operation, the lower lip of the patient revealed relative symmetry without proliferation of the recurrent tumor.
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  • Munetaka ARAO, Yoshiki TAKAI, Hajime NAGATA, Shuhei MATSUMOTO, Michihi ...
    1989 Volume 35 Issue 3 Pages 680-683
    Published: March 20, 1989
    Released: July 25, 2011
    In this report, we presented a case of median cleft of the upper lip with morning glory syndrome.
    Morning glory synarome is a congenital optic nerve anomaly. It may be bilateral, hereditary and associated with other congenital anomalies. In this case, the upper-lip median cleft was associated with it.
    The patient had a flat broad nasal tip, short wide-ridged columella and an incomplete median cleft of the upper lip.
    Slight abnormalities of CT scanning were detected.
    Operation was done by triangular flap method for the construction of median cleft lip. The post operative course was good.
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    1989 Volume 35 Issue 3 Pages 684-688
    Published: March 20, 1989
    Released: July 25, 2011
    We encountered a patient whose chief complaint was swallowing pain due to elongated styloid process.
    We describe a report of this case with some discussion. The patient was 51-year-old male who visited our hospital with chief complaint of swallowing pain.
    Clinical examination of the oral cavity showed slight redness mucosa of the left tonsillar fossa.
    The X-ray film showed the left styloid process abnormally elongated, the tip of which extended to the mandiblar angle.
    Under a clinical diagnosis of the elongated styloid process, this process was removed by a intraoral approach. Whithin 1 week after operation, swallowing pain disappered.
    Recently the incidence of laryngo-pharyngeal neurosis is increasing, and it should be kept in mind that an elongated styloid process is not rare. In the diagnosis of this abnormality, orthopantomography seems to be better than another radiography.
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  • Kazuyoshi SATO, Youichi IKEDA, Katsumi NISHIJIMA, Masayuki MORIKAWA, H ...
    1989 Volume 35 Issue 3 Pages 689-692
    Published: March 20, 1989
    Released: July 25, 2011
    Pemphigus is a serious, chronic, vesiculobullous disease that may affect skin and mucous membranes.
    The four major forms of pemphigus are pemphigus vulgaris, pemphigus vegetans, pemphigus foliaceus and pemphigus erythematosus.
    Pemphigus vegetans is considered to be a variant of pemphigus vulgaris and there are two types of pemphigus vegetans: the types of Neumann and Hallopeau.
    In this paper, a rare case of pemphigus vegetans-Hallopeau type was reported and the literature was reviewed.
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  • Takeshi UCHIYAMA, Tadashi SATO, Haruhisa HORIKAWA, Shiro SHIGEMATSU, N ...
    1989 Volume 35 Issue 3 Pages 693-699
    Published: March 20, 1989
    Released: July 25, 2011
    Generally limited to a period of 4 or 5 years, histiocytosis X may last 10 or 15 years. However, there may be no long-term follow up report whose signs were observed primarily in oral region.
    We experienced case of eosinophilic granuloma of mandible in a 3 year-old girl. We performed surgical therapy, irradiation and chemotherapy. Two times recurrence was observed in 11 years follow-up. However we judged this case cured, because 5 years passed after intraosseous lesion disappearance.
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  • Hideharu KUNIYOSHI, Masashi YOSHIDA, Hiroshi MUKAI, Yuuichi TOMORI, Hi ...
    1989 Volume 35 Issue 3 Pages 700-712
    Published: March 20, 1989
    Released: July 25, 2011
    We have attempted clinico-statistical observation on 415 cases of benign tumors during past 10 years period from 1976 to 1985. Results obtained were as follows:
    1) The 415 cases consisted of three groups, 59 odontogenic tumors, 302 non-odontogenic tumors and 54 salivary gland tumors (1.1:5.6:1). There were 161 males and 254 females, a 1:1.6 sex ratio.
    2) Histopathologically, 28 cases (47.5%) of odontogenic tumors were diagnosed as ameloblastoma, 106 cases (35.1%) of non-odontogenic tumors as hemangioma and 42 cases (97.8%) of salivary gland tumors as pleomorphic adenoma.
    3) The age at onset of symptoms revealed a perdilection for second and fourth decades (mean age: 34.3 years) as whole, and as to each group, odontogenic tumors for second and third decades (mean age: 24.7 years), non-odontogenic tumors for second and fifth decades (mean age: 34.6 years) and salivary gland tumors for under second and sixth decades (mean age: 43.0 years).
    4) The age at first visit revealed a perdilection for fourth and fifth decades (mean age: 38.0 years) as a whole, and as to each group, odontogenic tumors for second and third decades (mean age: 28.9 years), non-odontogenic tumors for fourth and fifth decades (mean age: 38.4 years) and salivary gland tumors for sixth and over eighth decades (mean age: 46.6 years).
    5) The duration of symptoms ranged from 1 to 3 years as a whole, and as to each group, under 1 month in odontogenic tumors, from 1 to 3 years in non-odotogenic tumors and also in salivary gland tumors.
    6) The chief complaints were swelling in 320 cases (82.3%), pain in 33 cases (8.5%) and further exact examination in 20 cases (5.1%).
    7) As a whole, the prevalent locations were the tongue (28.6%), followed by the mandible (13.2%) and the lips (11.6%), Odontogenic tumors occured only in the maxilla and the mandible, non-odontogenic tumors in the tongue, the lips and the buccal mucosa and salivary gland tumors in the palate and the parotid regions.
    8) Of the removed 286 tumors, 72 tumors (26.9%) were sized between 10 and 20mm, 66 tumors (24.6%) between 5 and 10mm and 64 tumors (23.9%) between 20 and 40mm.
    9) The most common treatment in this series was surgical excision except for fenestration (7 cases) and mandibulectomy or maxilloectomy (5 cases) of ameloblastoma.
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  • Izumi MATAGA, Atsuo OKANO, Yutaka SAITO, Kohzo TSUCHIKAWA, Joji KATO
    1989 Volume 35 Issue 3 Pages 713-719
    Published: March 20, 1989
    Released: July 25, 2011
    Significance of an application of the transmandibular implant (TM-Implant) which was devised by Dr. Hans BOSKER, Netherlands, for the reconstructed edentulous mandible following excision of oral cancers and report of an experienced case is described in this paper. It is well known that the reconstruction of the mandible and the functional repair when a big or anterior site of mandibular defects existed, so called Andy-Gump appearance, is so difficult even if cosmetic reconstruction could be achieved. TM-Implant was installed in the grafted bone of which had been reconstructed for the anterior site of mandibular defect using vascularized iliac osteomyocutaneous flap. The patient, 68-y.o., Japanese male, who had carcinoma of the floor of the mouth, the tumor including anterior site of mandible initially resected and immediately had his soft tissue defects reconstructed using in combination two major flaps, that is, delto-pectoral flap and pectoral major myocutaneous flap. Thirty months after the first reconstruction, the mandible was reconstructed by vascularized iliac osteomyocutaneous flap. 31 months after reconstruction of the mandible, TM-Implant was installed in the grafted iliac bone.
    Superstructure (denture) was made 5 months after installation. Not only masticatory function but speech and swallowing function was improved thanks of the denture stabilization attached with this implant. TM-Implant is considered very useful for functional repairment, when dysfunction remained postoperatively following excision of oral cancers.
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  • Arifumi MIKAMI, Yoichiroh HAMADA, Masako FUKUMOTO, Takeshi HAMADA
    1989 Volume 35 Issue 3 Pages 720-723
    Published: March 20, 1989
    Released: July 25, 2011
    Intracranial chordoma is very uncommon and rarely invasde the oral area.
    This is a report of a case with recurrent cranial chordoma, which is diagnosed from biopsy specimen of cheek tumor.
    A 43-year-old female visited the department of Dentistry, Matsue Red Cross Hospital on August 18, 1986. She complained of facial spasm and left cheek swelling. Ordinary X-rays (P-A View, Panorama View) demonstrated partial defect of left temporal bone by resection of cranial chordoma 6 years before. The cheek region was suspected to be something like benign tumor involving the facial nerve.
    But computed tomography findings showed a continuous mass extending from intracranial to pharynx. An intra-oral biopsy specimen showed large-sized physaliphorus cells, then she was diagnosed as recurrence of cranial chordoma with cheek invasion.
    Cheek tumor was reduced under local anesthesia and facial spasm disappeared after reducion. This should be the first report from oral region of this tumor in Japanese literature.
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  • Hideaki SAKASHITA, Masaru MIYATA, Masako ARAKAWA, Morimoto HAYASHI
    1989 Volume 35 Issue 3 Pages 724-731
    Published: March 20, 1989
    Released: July 25, 2011
    The patient, a 32-year-old woman, was referred to our department with the chief complaint of painless swelling of the left side of her face. Radiological examination showed a unilocular radiolucent area in the left side of the mandible from the ramus to the premolar region. Pathological examination of the biopsy revealed a picture of a cystic ameloblastoma.
    The left half of the mandible was resected and was reconstructed with a free vascularized osteocutaneous iliac graft and also with a free greater auricular nerve graft. The result was satisfactory, because the postoperative deformity of the face was minimized.
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  • Norihiko ICHIKAWA, Kiyofumi FURUSAWA, Masahiko KIGA, Masaya YAMAMOTO, ...
    1989 Volume 35 Issue 3 Pages 732-736
    Published: March 20, 1989
    Released: July 25, 2011
    One day early in May, 1988, a 31-year-old man noticed a burning pain at the right hard palate, and the lesion became a swelling with spontaneous pain by the middle of that month. On May 20, the swelling of the patient received an abscess incision by a dentist, but the suppuration did not come out.
    The patient was referred the Department of Oral and Maxillofacial Surgery 11, Matsumoto Dental College on May 30. The swelling was 15×20mm in size with well demarcation and an incision wound in the center. No abnormality was observed in the radiograph. Under the clinical diagnosis of pleomorphic adenoma, the lesion was extracted on June 1, and was examined histopathologically.
    Salivary glands showed necrosis in large area keeping their lobular structures, and adjacent epithelial components, consisting of both acinar and ductal cells, became squamous metaplasia and grew large by forming cell nests. These cells showed no atypism but keratinization. The lesion, therefore, was diagnosed as necrotizing sialometaplasia.
    No abnormality nor recurrence was seen 4 months after the operation.
    Our case clinically resembles a pleomorphic adeoma in appenarance. So differentiation of necrotizing sialometaplasia from pleomorphic adenoma was discussed in this article.
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  • Motoaki HANZAWA, Mitsugu KURODA, Ken-ichi NOTANI, Yasunori TOTSUKA, Hi ...
    1989 Volume 35 Issue 3 Pages 737-744
    Published: March 20, 1989
    Released: July 25, 2011
    A case of tuberculosis of the tongue with active pulmonary tuberclosis is presented. Tuberculosis of the tongue is uncommon and generally considered to be derived front the pulmonary disease. In this case the pulmonary disease went unnoticed till the tongue lesion was recognized.
    53-year-old man came to our hospital because of a contact pain of the tip of the tongue. A painful, irregularly shaped ulceration, 15×18mm in size with the edge undermined, was noticed on the tip of the tongue. The surface of the ulcer was covered with a grayish-white coating.
    The clinical diagnosis of malignant tumor was made, so a biopsy was performed. The pathological diagnosis was suggestive of tuberculosis of the tongue. The chest X-ray film showed extensive active pulmonary tuberculosis and the cultures of the sputum showed a tubercle bacilli.
    A diagnosis of tuberculosis of the tongue secondary to pulmonary tuberculosis was made. The patient was given antituberculosis drugs. The ulcer was completly disappeared in 3 weeks.
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  • Nobumi OGI, Kiyoshi OHTSUJI, Kazuo SHIMOZATO, Tsuyoshi KAWAI, Hatsuhik ...
    1989 Volume 35 Issue 3 Pages 745-754
    Published: March 20, 1989
    Released: July 25, 2011
    The adenomatoid odontogenic tumor (AOT) is a rare benign tumor. In this paper, a case of AOT which was histologically different from the previously reported cases was described.
    A 34 year-old male was referred for evaluation of a swelling in the mandible. The patient had been aware of the swelling for several months but never felt pain or paresthesia. The patient's past medical history was noncontributory. Local examinations disclosed an expansion of the cortices of the lower anterior region. The overlying mucosa was normal in color and texture. Radiographs revealed a radiolucent monolocular lesion in the anteriorpremolar area of the mandible. The lesion was interpreted as a benign tumor of the mandible. Under general anesthesia, surgical enucleation and curettage were carried out. The teeth from the right central incisor to the left premolar were extracted. Pathological diagnosis of the surgical specimen was an adenomatoid odontogenic tumor associated with dentinoid formation. The patient has been free of disease for two years after the surgery. From the following analysis of the previously reported cases, the current case was characterized by several unusual features, such as sex (male) and age (34 years old) of the patient, location of the lesion (mandible), absence of the impacted teeth and presence of dentinoid formation.
    From a search of the Japanese literature, the authors chose 84 well-documented cases of AOT including our own case to characterize clinical features of AOT among the Japanese. The following analysis is based on our study.
    1. AOT occurs most frequently in the second decade of life, though cases have been reported in the range of 3-46 years of age. The mean age is 18. 2 years.
    2. AOT affects females with greater frequency than males, a ratio of 3. 4: 1.
    3. The maxilla is involved more frequently than the mandible, a ratio of 1. 3: 1.
    4. Sixty-seven percent of AOT is associated with the impacted teeth and the canine is most frequently affected (58.9%).
    5. AOT is usually asymptomatic and causes jaw enlargement.
    6. AOT often resembles a follicular cyst radiographically.
    7. The size of AOT is less than 3.0 cm in diameter.
    8. Calcified material is usually present within AOT (96.4%).
    9. AOT does not show invasive tendency, metastasis and malignant transformation.
    10. Enucleation is a curative treatment for AOT.
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  • Junji MACHIDA, Yasuharu SHICHIRI, Masami UENO, Seiji IIDA, Masumi SATO ...
    1989 Volume 35 Issue 3 Pages 755-760
    Published: March 20, 1989
    Released: July 25, 2011
    As cleidocranial dysplasia is one of the systemic bone disorders characterised by anomalies of clavicle, cranium, maxilla and mandible, complications are rarely found in other than the bone system.
    We have examined a boy, 8 years and 3 months old when first seen, of this disease accompanied with pseudohypoparathyroidism I, who is perhaps the second reported case in Japan. He was diagnosed to be pseudohypoparathyroidism I based on the attacks of tetany, calcified bodies in the brain found by CT, low Ca and high P levels in the blood, and on the Ellsworth-Howard examination. He was diagnosed to have cleidocranial dysplasia because of the specific motion of approaching shoulders, late existence of the anterior fontanell, and teeth anomalies as written below.
    At the examination of 9 years and 4 months, D+D/D+D and cuspids of E/E/E/E erupted, but no permanent tooth had erupted, all remaining in the jaws ascertained by roentgenography. Several serious carious deciduous teeth were extracted at this time. At the examination of 12 years and 3 months, however, no permanent tooth was seen except for the incisor edges of the lower central incisors.
    Cephalometric x-ray analysis at 9 years and 4 months revealed maxillary maldevelopment to anterior and down directions, progenia, and maldevelopment of the mandibular angle. These were also found at the 12 years 3 months examination, but the amount of the maxillary and mandibular developments during these periods were nearly the same as that of normal boys.
    The etiology of cleidocrnial dysplasia was discussed based on the present case and on some literatures reporting the complications that accompanied this disease.
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  • Junichi ISHII, Teruo AMAGASA, Keizou SHINOZUKA, Shigetoshi SHIODA, Tad ...
    1989 Volume 35 Issue 3 Pages 761-767
    Published: March 20, 1989
    Released: July 25, 2011
    The aim of this study is to establish whether intraoral ultrasonogram is useful in diagnosis of diseases of the floor of the mouth. Thirty-three patients (12 ranulas, 4 cysts, 6 sialolithiases, 3 benign tumors and 6 malignant tumors) were examined on a Toshiba SAL-30 A ultrasonic image processor. A phased array transducer assembly of 5 MHz (Toshiba model JOB-SET-A) was used.
    Intraoral scanning ultrasonogram showed higher level of internal echo and delineated more clearly than extraoral scanning ultrasonogram. Intraoral scanning ultrasound proved highly efficacious as an adjunctive procedure in the preoperative evaluation of patients with diseases of the floor of the mouth.
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  • Masaharu SUGITA, Yukihiko KINOSHITA, Yoshiro HONMA, Mitsuhiro KIRIGAKU ...
    1989 Volume 35 Issue 3 Pages 768-773
    Published: March 20, 1989
    Released: July 25, 2011
    A case of ossifying fibroma arising in the bilateral sides of the mandible of a 26-year-old female was reported.Radiographic findings, revealed multicystic radiolucent image with a sharp demarcation of 8-4 1, and an oval radiopaque image surrounded with a radiolucent layer of 1-6 Histopathological findings of both lesions presented the images of ossifying fibroma Formation of the hard tissue in the left lesion was more remarkable than in the right.
    We performed mandibular marginal resection and immediate reconstruction by an artificial bone that consists of HAP-PTFEMA-Titanium on the right lesion, and extraction of a tumor on the left lesion.
    This case shows a favorable course without relapse at present, for one year and six months after resection.We carried out further review of literature on this tumor, comparing it with other cases of fibro-osseous lesion.
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  • Jingo KUSUKAWA, Shunichi TANAKA, Ken YAMAGA, Tadamitsu KAMEYAMA, Choku ...
    1989 Volume 35 Issue 3 Pages 774-777
    Published: March 20, 1989
    Released: July 25, 2011
    Solitary neurofibroma in the oral cavity is rare. We have experienced one case of solitary neurofibroma on the hard palate. The patient was a 25-year old man. He visited our clinic with a chief complaint of mass formation of the right hard palate. We found neither cafe-au-lait spots nor tumors on the skin of his whole body. The tumor was totally excised under local anesthesia. From Histopathological findings it was diagnosed as a neurofibroma.
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  • Yasutomo YAJIMA, Akira KATAKURA, Makoto TANIGUTI, Takahiko SIBAHARA, Y ...
    1989 Volume 35 Issue 3 Pages 778-784
    Published: March 20, 1989
    Released: July 25, 2011
    A rare case of cementifying fibroma was reported. The tumor arose in the maxilla and mandible of a 13-year-old male, occupying the right region of the maxilla, the maxillary sinus and also the left second premolar to the right canine in the mandible. The lesion was treated surgically, with resection of tumor from the maxilla and mandible. The patient had no incidence of recurrence at present.
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  • Youichi NAKAGAWA, Katsunori ISHIBASHI, Ken-ichirou KUTSUNA, Kazushige ...
    1989 Volume 35 Issue 3 Pages 785-792
    Published: March 20, 1989
    Released: July 25, 2011
    The treatment of facial bone fracture complicated with other severe traumata, head and/or viscera injury, is often postponed because of the emergency care for survival.
    A case of 45-year-old male who had a chief complaint of malocculusion caused by malunited mid-third facial fracture of Le Fort II and Le Fort II type was reported. Surgical treatment of Le Fort I osteotomy was selected for the correction of malocclusion. In the osteotomy, pre-traumatic occlusion and mandibular position were presumed by the observation of facial expression, mandibular rest position, denture model and roentogen cephalogram, and the position was reproduced by using face bow.
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  • Masahiro NAKAJIMA, Shosuke MORITA, Takumi ARIKA, Mitugu MATUSITA, Koic ...
    1989 Volume 35 Issue 3 Pages 793-797
    Published: March 20, 1989
    Released: July 25, 2011
    Intraosseous carcinoma is known to be a very rare lesion. We present 2 cases of squamous cell carcinoma which occurred in the mandible. Case 1. 52-year-old male. This case was considered that the tumor arose from residual cyst of 167 region. We performed segmental resection of the mandible and now the patient was uneventful 5 years and 4 months after operation.
    Case 2: 47-year-old female. The origin of this case was obscure, but we diagnosed this tumor as a intraosseous carcinoma, because the oral mucosa was intact and no other lesion which causes metastasis was detected. We performed neck dissection and segmental resection of mandible. Metastatic lesions were found in the skull, ileum and lumbar vertebrae and the patient died 3 months after operation.
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  • Kanemitsu SHIRASUNA, Takashi TSUDA, Masaya OKURA, Masahiro URADE, Toku ...
    1989 Volume 35 Issue 3 Pages 798-801
    Published: March 20, 1989
    Released: July 25, 2011
    Nine patients with oral cancer were treated with one or two courses of chemotherapy using cis-platinum (CDDP; 80mg/m2), vincristin (VCR; 1mg) and peplomycin (PEP; 5mg×4 days). Of 9 patients 4 were combined 30mg of bestatin for 7 days (combined group). A decrease in the count of white blood cells (leukocytes) was observed in all patients after the chemotherapy. The count of white blood cells at the nadir was significantly (P<0.01) higher in the combined group (4, 857±780/mm3, n=7) than that of control group without bestatin (3, 478±507/mm3, n=9). Analysis of leukocytes showed that compared to control group, the combined group showed higher counts of neutrophils and lymphocytes. These findings suggest that bestatin prevents leukopenia induced by antitumor agents.
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