Japanese Journal of Oral and Maxillofacial Surgery
Online ISSN : 2186-1579
Print ISSN : 0021-5163
ISSN-L : 0021-5163
Volume 36 , Issue 11
Showing 1-26 articles out of 26 articles from the selected issue
  • Noriaki IKEDA, Takuo ISHII, Hideki OCHIAI, Hideo FUKANO, Nobumi OGI, S ...
    1990 Volume 36 Issue 11 Pages 2423-2429
    Published: November 20, 1990
    Released: July 25, 2011
    The purpose of this study was 1) to show the epidemiological status of oral leukoplakia in a selected population of 3, 131 Japanese (504 women, 2, 627 men, ranging from 18 to 63 and mean age of 35. 9 years old), and also 2) to estimate the validity of the diagnosis of oral leukoplakia by general practitioners.
    1) Seventy seven individuals were detected as having leukoplakia with the prevalence rate of 2.; 2. 7% and 1.0% for men and women, respectively. The difference was statistically significant (P<0.001).
    2) The percentage of smokers was 75. 3% for patients with leukoplakia and 47.8% for individuals detected as normal with a statistically significant difference between them (P<0.001). The age-adjusted relative risk (Mantel-Haenszel odds ratio) for smokers who developed leukoplakia as compared with non-smokers in men was 3.74 with 95% confidence interval (2.14-6.55).
    3) Of 77 leukoplakia patients, 37 cases (48. 1%) received d. clinically confirmed diagnosis and 27 patients diagnosed by additional examinations as having leukoplakia. The low percentage of those who received additional examinations can be attributed to generally poor knowledge of oral precancerous lesions in Japan.
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  • Atsushi NAKAMURA
    1990 Volume 36 Issue 11 Pages 2430-2436
    Published: November 20, 1990
    Released: July 25, 2011
    Cephalometric radiography with contrast media was developed for objective visualization of the tongue and the hyoid bone in a rest position. Its reliability and the influence of tipping the head on measurements were investigated in 28 and 7 normal adults, respectively.
    The standard error for each measurement ranged from±0.3 mm to±1.3 mm, and tipping the head within±5° did not influence the measurement.
    According to these results, it is concluded that this method has excellent reliability and is useful for objective visualization of the tongue and hyoid bcne positionings at rest.
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  • Yoshibumi NAMBU
    1990 Volume 36 Issue 11 Pages 2437-2446
    Published: November 20, 1990
    Released: July 25, 2011
    A study was performed on the correlation between vascularization and osteogenesis on the interface after implantation of hydroxylapatite (HAP:) to a mandibular defect. Bone defect of 2×3×4 mm was formed on the lower edge of bilateral mandibules in each of 24 rabbits, to which a porous HAP block (porosity 55%; pore-size 5-2, 000 μm) of the same type was implanted. The result was histologically evaluated at every time of observation by means of Indian ink i.v. injection method, double labelling method and contact microradiography (CNIR).
    As the result, vascularization was observed only around the surface of HAP block on 7th day and inside the pore on 14th day. It reached a peak on 28th day and declined thereafter. On 168th day, approximately the same vascular distribution as the recipient bones were seen. Forosteogenesis, the labelling on 7th, 8th, 12th and 13th days (14-day experiment group) was observed as new cancellous bone, and the labelling on 22nd, 24th and 26th days (28-day experiment group) appeared as Haversian lamellae. Calcification of the new bones progressed with time. On 168th day, HAP block was completely covered by new bones although their calcification was still somewhat inferior to that of the recipient bones. On HAP block interface, vascularization developed first followed by the formation of new bones, indicating a close relationship between them.
    Vascularization and osteogenesis developed vigorously at the interface of HAP block after implantation and the interface was closely enclosed by new bones. It suggests that the above results exhibited an excellent tissue compatibility.
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  • Nobumi OGI
    1990 Volume 36 Issue 11 Pages 2447-2457
    Published: November 20, 1990
    Released: July 25, 2011
    It is well known that periosteum grafts have a potential for osteogenesis. In this experimental study, the author examined the osteogenic capacity of chilled periosteum and frozen-thawed periosteum grafts and compared them with that of control fresh grafts.
    Both donors and recipients of the grafts used in this study were derived from inbred star male rats of 6 weeks post partum and weighed between 180-200 g. The periosteum of the parietal bone was first removed from freshly killed donor rats using aseptic procedures. Then, a set of the grafts was incubated at 4°C for 6 hours and the other sets were frozen at-30°C and-80°C, stored for 6 hours, and thawed at 37°C. After this, all grafts were implanted into an intra-muscular site of each recipient. The animals were killed at 3, 7, 14, or 21 days after grafting. The grafts, together with adjacent muscles, were removed and examined by soft X-ray. The grafts were also examined histologically. The sections were stained with H-E and von Kossa.
    The grafts stored at 4°C for 6 hours did not differ greatly from the control fresh grafts. The grafts showed a proliferative cellular response and a new bone formation at7 days after grafting, although the rate of new bone formation was low. In contrast, the grafts stored at-30°C and-80°C for 6 hours showed a calcification in the tissues. Therefore, the short term storage of these grafts at-30°C and-80°C for 6 hours caused a loss of the osteogenic capacity and an irreversible change in the periosteum. Calcification of the grafts took place during the degenerative process. At 21 days after grafting, however, the bones and calcified tissues of all transplanted grafts started to be resorbed.
    these results mentioned above suggested the following possibilities. To obtain the best results with periosteal grafts, it is important to maintain the grafts in a viable condition. Further, a chilled periosteum appears to have a promising possibilitiy as a graft provided that it is only stored for a short period of time. As reported in earlier studies, calcification in the periosteum may have a possibility of osteogenesis. In this study, however, calcification induced no formation of new bone. Thus, it appears that osteogenesis from the calcified tissues depends mostly on the environmental factors around the graft and the recipient bed.
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  • Takashi SAKAMOTO
    1990 Volume 36 Issue 11 Pages 2458-2472
    Published: November 20, 1990
    Released: July 25, 2011
    The localization of sialic acid on human oral cancer cells was compared with that on normal cells. Primary culture cells from 16 samples of squamous cell carcinomas and 4 samples of normal gingival epithelia were used.
    HeLa and SCC-4 cell lines were also studied as a positive control. All of these cells were grown on plastic dishes in a culture medium containing 20% fetal bovine serum. Morphological changes of HeLa or SCC-4 cells were examined after treatment with neuraminidase (NAase), chondroitinase ABC (CHase) and hyaluronidase (HAase). Furthermore the combined effects of these enzymes on the cell morphology were determined. Oral cancer cells were treated with CHase-NAase.
    For HRP-LPA stain, the culture cells were fixed with 3% paraformaldehyde and 0.1% glutaraldehyde, and were immersed in HRP-LPA (horseradish peroxidase-Limulus polyphemus agglutinin) conjugate for 60 min. The cells were developed with 3, 3'-diaminobenzidine and processed by a routine method for electron microscopy. As a control study to confirm thebinding specificity of LPA, the cells were treated with HRP-LPA conjugate combined with 0.2M inhibitory sugar. The cells were also treated with HRP-LPA after pretreatment with 0.02N sulfuric acid or NAase.
    Both HeLa and SCC-4 cells were detached from dishes after treatment with NAase-CHase. A most intensive change of cell form was observed when the cells were treated with CHase-NAase. These results suggested that sialic acid on the cell surface was removed effectively by CHase-NAase treatment. Eight out of 16 cases of oral cancer showed changes of cell form by this treatment. The cells in 3 cases all became round and were detached from the plastic surface. On the contrary, normal cells horn the gingival epithelium did not change by CHase-NAase treatments.
    Surfaces of HeLa and SCC-4 cells were strongly stained with HRP-LPA. The LPA labelling intensity was diminished by the pretreatment with inhibitory sugar or sulfuric acid.
    NAase digestion also reduced the labelling intensity. Although LPA staining was seen on the surface of all kinds of cancer cells, the intensity differed with the case. None of the normal cells were stained with HRP-LPA. The results of HRP-LPA staining and enzyme treatment revealed that the cases showing intensive changes by enzyme treatment also showed a strong staining with HRP-LPA.
    In conclusion, oral cancer cells in the primary culture possessed more sialic acid on the cell suface than normal cells, and the content of sialic acid on cancer cells differed with the case.
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  • Ryutaro KOBAYASHI
    1990 Volume 36 Issue 11 Pages 2473-2490
    Published: November 20, 1990
    Released: July 25, 2011
    Orthognathic surgery has widely been employed for the treatment of dentofacial deformities in both functional and morphological aspects, and has been studied extensively with respect to the therapeutic plan and the evaluation of its therapeutic efficacy from various points of view.
    We devised an instrument on an experimental basis for the measurements of occlusal force, occlusal contact area and occlusal pressure using a pressure sensitive sheet, and then compared the occlusal states between subjects with normal occlusion and patients with dentofacial deformity with this instrument.N'Ve also quantitatively measured changes in occlusion by orthognathic surgery.As a result, our conclusion was made as follows:
    1.In the normal occlusion group, the occlusal force and occlusal contact area were largest on the second molar in both male and female subjects, and then the first molar, second premolar and first premolar in this order.
    2.The occlusion pressure in the normal occlusion group did not differ among teeth or between male and female subjects.
    3.The mean occlusal force in the entire molar area for both male and female subjects was found to be 105.9 kg in the normal occlusion group and 46.3 kg in the non-treated deformity group with the mean occlusal contact area of 21.7 mm2 and 8.6 mm2, respectively, showing markedly significant statistical differences between the 2 groups.The mean occlusal pressure was measured to be 5.05 kg/mm2 in the normal occlusion group and 5.68 kg/mm2 in the nontreated deformity group, indicating a significant difference between them.
    4. When changes with time elapsed from a preoperative period up to 1 year after the orthognathic surgery were determined, the occlusal force and occlusal contact area were found to be minimum at the time of removal of intermaxillary fixation, gradually increased to nearly preoperative levels thereafter.And reached the values more than double of the preoperative levels 1 year after operation.The occlusal pressure was measured to be highest at the time of removal of intermaxillary fixation, gradually decreased thereafter, and than showed the lowest value being almost equal to the preoperative value at 1 year after operation.
    5.Since our method can provide an accurate and simple measurement with high reproducibility even under a poor postoperative condition seen in the field of oral maxillofacial surgery, it will widely be available for the determination of occlusal condition.
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  • Makoto TABUSHI
    1990 Volume 36 Issue 11 Pages 2491-2504
    Published: November 20, 1990
    Released: July 25, 2011
    It has not been studied on the influence of cryotherapy which involved the peripheral nerve adjacent to the surgery sire. To clarify this point, changes in the facial nerve function of rabbits, of which foramen stylomastoideum was percutaneously cryo-injured, were electromyographically and macroscopically examined (group A) for 7 weeks. The same examination was also carried out after amputation of the external carotid artery to enhance the effect of cryoinjury (group B). The following results were obtained;
    1. Voluntary movement of the facial muscles and corneal reflex of the same side disappeared in both groups. Facial asymmetry appeared 1 week after cryoinjury and persisted more than 7 weeks. Necrc tic tissue dropped after 5 weeks in both groups.
    2. Various types of electric discharge showing denervation were observed after 3 days in both groups.
    3. This discharge disappeared after 5 weeks in group A and 7 weeks in group B.
    4. A discharge pattern of the voluntary movement showing a nerve regeneration was observed after 3 weeks in group A and 5 weeks in group B.
    5. Recovery of the voluntary movement was noted on the facial muscles of cryo-injured side, although being not enough as that of the control side, after 6 weeks in group A and 7 weeks in group B. At. the same time, a discharge pattern of normal NMI voltage was observed on EMG but did not reach the level of interference wave.
    6. A discharge pattern of reinnervation voltage was not found throughout the study period in both groups.
    7. From these findings, it was revealed that an indirect cryoinjury of peripheral nerves including its surrounding tissue results in axonotmesis of the nerve rather than neurotmesis. Nerve dysfunction caused by cryotherapy can he expected to he recovered.
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  • Masataka KIDA, Kanchu TEI, Yutaka YAMAZAKI, Hideaki KITADA, Masahiro E ...
    1990 Volume 36 Issue 11 Pages 2505-2508
    Published: November 20, 1990
    Released: July 25, 2011
    The intermaxillary fixation (IMF) has been frequently applied to maxillofacial fractures. The period of the fixation is however, determined empirically because we have no barometers to judge the bone unions. Thus, a method capable of determining an appropriate time of IMF removal in each case has been sought.
    The authors developed a new measurement apparatus for analyzing the transmission of vibration based on Coherence function, and bound that this apparatus could be a useful tool for the determination of the time of IMF removal. The apparatus is characterized by its abilities to judge the bone unions and to evaluate the healing process of mandibular fractures through a non-invasive and periodical measurement.
    In this paper, we report that our method was quite useful in evaluating the healing process, even in the mandibular fracture case of abnormal hone healing which was bruised and infected at the fracture site during IMF.
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  • Harusachi KANAZAWA, Ryoji TANIMOTO, Haruhito TSUCHIYA, Kikuo TAKAHASHI ...
    1990 Volume 36 Issue 11 Pages 2509-2517
    Published: November 20, 1990
    Released: July 25, 2011
    During the 10 year period 1976-1988, 189 cases of primary carcinoma in the oral cavity were seen and treated in the Department of Oral Surgery at Chiba University Hospital. One hundred and thirteen patients were male and 74 were female giving a male to female, ratio of 1.5: 1. The patients ranged in age from 26 to 89 years, and the mean age was 63.0years.
    The most commonly affected site in the oral cavity was the tongue (38. 5%) followed in a descending order of frequency by the gingiva (29. 5%), buccal mucosa (12. 8%), hard palate (11. 2%), and oral floor (8.0%). Histologically, squamous cell carcinoma accounted for 89. 4% of the eases. Stage grouping by UICC (1978) showed 64.0% of the cases were clinically in the advanced stages of III and IV. Combined modality treatments of chemotherapy and surgery with or wothout radiotherapy were performed in 75. 8% of the patients examined.
    Overall 3 and 5 year survival raw were 71. 5% and 64. 2%, respectively.
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  • Miyuki AZUMA, Takashi FUJIBAYASHI, Fujio WAKE, YUZO TAKAHASHI, Seiji T ...
    1990 Volume 36 Issue 11 Pages 2518-2526
    Published: November 20, 1990
    Released: July 25, 2011
    Metastasis of maxillary carcinoma to the cervical lymph nodes was investigated in 107 patients who had been treated at the 2nd Department of Oral and Maxillo-facial Surgery, Tokyo Medical and Dental University from 1975 to 1988.
    Primary metastasis to the cervical lymph nodes at the initial visit was found in 10 out of 107 patients (9. 3%) and secondary metastasis after treatment was found in 20 out of 97 patients (20. 6%). The overall rate of cervical metastasis was 28. 3%(30/107).
    Five years cumulative survival rate of total 107 cases was 55.0%, however, the survival rate in the patients with primary metastasis was low as 12. 5% in 2 years and that of the patients with secondary metastasis was also low as 23. 2% in 5 years. Therapeutic radical neck dissections were performed in 21 out of 30 metastatic cases, and histologically positive nodes were proved in 19 cases (90. 5%). The overall tumor control rate in the cervical lymph nodes was 60% for primary metastasis and 42. 1% for secondary metastasis.
    Examinations on the histological features of squamous cell carcinoma of primary metastatic type revealed that cervical lymph node metastases found in 83. 3% of the cases examined were classified into Grade 4D according to the mode of invasion and Grade la according to the malignancy grading by WHO. The rates of opposite side metastasis and of multiple metastasis were higher in carcinomas originating from the upper alveolus and gingiva than carcinomas from the maxillary sinus. The superior internal jugular nodes were most frequently metastasized and then submandibular nodes.
    From these results the following conclusions could be drawn: a complete treatment for the primary site is required and radical neck dissection is essential for cervical metastasis. Furthermore, prophylactic neck dissection may be indicated in some cases for the control of cervical metastasis of maxillary carcinomas.
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  • Masahiro URADE, Takashi MIMA, Hideyuki FURUSAWA, Kanemitsu SHIRASUNA, ...
    1990 Volume 36 Issue 11 Pages 2527-2530
    Published: November 20, 1990
    Released: July 25, 2011
    We studied clinicostatistically the cases of multiple primary malignant tumors in 336 patients with malignancies of the oral and maxillary region treated in the First Department of Oral and Maxillofacial Surgery, Osaka University Faculty of Dentistry during the period from 1978 to 1988. In this study, we employed the criteria for multiple primary malignant tumors presented by Hiyama et al., but omitted the tumor cases with the same histology in the oral mucosa as a multicentric cancer.
    The following results were obtained.
    1. Multiple primary malignant tumors were observed in 17 among 336 cases (5.1%), and all was of double malignancies.
    2. Thirteen cases were males and 4 cases were females. The age distribution was from 46 to 82 years, mostly in the 5th and 6th decades. The mean age was 59. 5 years.
    3. Of 17 cases, synchronous tumors with the duration of disease within 3 months were found in 2 cases (11. 8%) and the non-synchronous in 15 cases (88. 2%). The average duration was 35. 8 months.
    4. Histologically, a combination of squamous cell carcinoma and adenocarcinoma was observed in 11 cases (65%), two squamous cell carcinomas in 4 cases (23. 5%), squamous cell carcinoma/transitional cell carcinoma and malignant sclawannoma/malignant melanoma in each one case.
    5. Carcinomas in the digestive system such as stomach and esophagus were frequently combined with oral carcinoma, in which tongue carcinoma was most common.
    6. As for the prognosis, 8 cases died of the secondary tumor, 2 cases died of the initial tumor, 5 cases were alive and 2 cases were others.
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  • Koji SATOH, Hiroki KIZUKURI, Tatsuko AOYAMA, Kanzo OKUI, Hiroshi ANDOH ...
    1990 Volume 36 Issue 11 Pages 2531-2537
    Published: November 20, 1990
    Released: July 25, 2011
    We have applied a three-dimensional computed tomography (3 D-CT) system clinically in 16 patients in the oral and maxillofacial region and evaluated its usefulness.
    Compared with a conventional radiographic imaging, we could construct a three dimensional display directly, observe it from various views, and pick up some regions without image overlapping.
    The 3 D-CT system is thus considered to be useful in surface researching of the bone and skin.
    On the other hand, we could not get enough imaging of fracture lines with little deviation or details of cancellous bone.
    The 3 D-CT imaging is a useful diagnostic method in the oral and maxillofacial region, but some problems on its high exposure dose and pseudoforamina still remain to study in the future.
    So we must be selective in its application.
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  • Kanemitsu SHIRASUNA, Manami KAWAMOTO, Munehiro SAKA, Kazuya WATATANI, ...
    1990 Volume 36 Issue 11 Pages 2538-2543
    Published: November 20, 1990
    Released: July 25, 2011
    Eleven cases of adenoid cystic carcinomas arising from the minor salivary gland were surgically excised at our department between 1978 and 1987. The histologic examination revealed a tumor negative margin in 5 cases and a positive margin in 6 cases.
    The 5 tumors of negative margin were located in the tongue (T1aN0M0), palate (T1a N0N/10), oral floor (T2bN2bN.10), upper alveolar bone (TlaN0M0), and cheek (T3bN0N10). This study was attempted to determine the extent of tumor invasion by using serial sections prepared from the excised tumor tissues of negative margin. The results showed extensive and insidious infiltration of tumor cells into adjacent soft tissues, especially involving the submucocutaneous connective tissues and sheaths of muscle, fat and nerves. The degree of peripheral infiltration appeared to elevate with the increased clinical tumor size. The spread of tumor juged by microscopy was 1. 5 to 3. 5 times of the macroscopical size.
    These findings suggest that more wide excision and combination with radio-and/or chemotherapy are required for a management of this tumor.
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  • Masami MISHINA, Ryuichi NEMOTO, Michio FURUTA, Tomoya OHNO
    1990 Volume 36 Issue 11 Pages 2544-2549
    Published: November 20, 1990
    Released: July 25, 2011
    Verruciform xanthoma arising from the gingival mucosa of the upper left first premolar to first molar area of a 59-year-old female is presented. It is a rare lesion of the oral cavity which has a warty or papillary appearance. It was first described by Shafer in 1971 with histopathological characteristics of verruciform growth and proliferation of xanthoma cells in the lamina propia.
    In Japan Kikuchi et al. reported the first case in 1977. Since then almost 40 cases have so far been published.
    This article described a case of Verruciform xanthoma together with its light, immunochemical and and electron microscopic fingings. Judging from the immunochemical finding, foamy cells were negative for S-100 protein and positive for lysozyme and NCA (non-specific cross reacting antigen with carcinoembryonic antigen), all of which were suggested that they were derived from monocyte-macrophage cell lines.
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  • Masaru SHOJI, Keigo KUDO, Satoshi SHIBUI, Takabumi KOBAYAKAWA, Kiyoshi ...
    1990 Volume 36 Issue 11 Pages 2550-2555
    Published: November 20, 1990
    Released: July 25, 2011
    A follow-up investigation during a period of 2-7 years after open reduction for 6 condylar fractures of the mandible was performed. In this study including 3 males and 3 females ranging from 17 to 34 years of age, 3 cases had fracture-dislocation, 2 fracturedisplacement and one fracture-deviation. All cases were approached by preauricular and/or submandibular incision of the skin. The fragments after removal were reimplanted in the glenoid fossa. They were fixed with a Kirschner-wire pin in 3 cases, intraosseous wiring in 2 cases and miniplate in 1 case.
    All patients had a satisfactory degree of mouth opening and occlusion. Two condylar fractures-displacement and-deviation located in the lower site progressed favorably. On the other hand, the results in 4 condylar fractures-dislocation and-displacement located in the higher site were not so good because of insufficient fixation: Fragments of 2 prolonged fractures were moderately resorbed, and 2 fresh fractures-dislocation and-displacement showed a bony union transformed to the medial side. It is supposed that open reduction due to reimplantation should be indicated for immovable fragments derived from condylar fracturesdislocation and-displacement located in the lower site.
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  • Akira SUZUKI, Tadao OHTANI, Eiji OTANI, Kenzo ONO, Masahiko FUKAYA
    1990 Volume 36 Issue 11 Pages 2556-2561
    Published: November 20, 1990
    Released: July 25, 2011
    Thyroglossal duct cyst occuring in oral floor is extremely rere. This kind of cyst represents an embryological remnant of the descending thyroglossal duct and usually appears as an upper midline neck mass. In this report, we present a case of 20-year-old man with the cyst in the oral floor. A mass at the oral floor was first detected with suckling difficulities when he was a new born baby. The mass was removed 2 months after birth, and thn histologically diagnosed as a dermoid cyst. A cystic lesion at the same site was again diagnosed at his age of 20 years. The lesion was surgically removed. The cyst was free from the surrounding muscules and had histopathological features consistent with thyroglossal duct cyst.
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  • Tetsuya OGOSHI, Eiko IGAHARA, Yasuyo MISHIMA, Kazuyuki MATSUO, Keisuke ...
    1990 Volume 36 Issue 11 Pages 2562-2565
    Published: November 20, 1990
    Released: July 25, 2011
    Cystic diseases of the oral floor include retention cyst, epidermoid cyst, branchial cyst and thyroglossal duct cyst etc. They resemble each other from the clinically view and thus some difficulties are often encountered in their diagnoses.
    Thyroglossal duct cyst is a relatively common congenital anomaly which usually occurs in the anterior midline of the neck but rarely occurs in the oral floor. This cyst mostly occurs before twenties but rarely occurs after thirties.
    The authors recently experienced a case of thyroglossal duct cyst of the oral floor in a 39-year-old man.
    This type of cyst is generally approached by Sistrunk method which removes the hyoid bone together with the criminal cyst. However, only the cyst was removed in this case because it showed no adhesion to the hyoid bone.
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  • Chizuru ITO, Yutaka HASHIMOTO, Kaori SASAKI, Hiroyuki HAMAKAWA, Hiroak ...
    1990 Volume 36 Issue 11 Pages 2566-2573
    Published: November 20, 1990
    Released: July 25, 2011
    Lymphangioma, an anpmaly of the lymphatic vessels, is relatively rare in the oral cavity and usually presents clinically before the ae of 10 years. Diffuse lymphangioma of the tongue causes macroglossia, which affects the development of jaw and face.
    We describe a 7-year-old female diagnosed as lymohangioma of the tongue. Oral examination revealed a diffuse growth with numerous vesicles on the surface of the tongue. The tongue protruded and caused an open bite.
    Partial glossectomy by Egyedi and Obwegeser's method was performed for the treatment of macroglossia. Microscepic examination showed numerous dilated lymohatic vessels lined by endothelial cells in the tongue lesion. These features were consistent with a diagnosis of carvenous lymphangioma.
    Hypesthesia and hypogeusia of the tongue disappeared and dysarthria was improved as of 11 months after surgery. However, the open bite, which was attributed to the denture pattern rather than the skeletal pattern according to the analysis of the lateral cephalogram, has not been improved.
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  • Makoto NAKATSURU, Takahide KOMORI, Genichirou TAKAGI, Tetsuya AKAGAWA
    1990 Volume 36 Issue 11 Pages 2574-2577
    Published: November 20, 1990
    Released: July 25, 2011
    The first case of congenital fistulas was described by Demaruquary in 1845. Since then many cases have been reported in Europe and America. But they are still considered to be of relatively rare malformation. In Japan 90 cases have so far been reported to the best of our knowledges.
    They are usually associated with cleft lip, cleft palate or both. The etiology of the fistula is still unclear.
    We report here a case of bilateral congenital fistulas associated with soft palate cleft with some comments.
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  • Kazuya MOTOMURA, Masahiro YAMASHIRO
    1990 Volume 36 Issue 11 Pages 2578-2585
    Published: November 20, 1990
    Released: July 25, 2011
    Oral and maxillofacial surgeons should give more consideration to maxillofacial fractures from the aspect of occupational and environmental health.
    Forty-one cases with work related maxillofacial fractures treated at the Department of Oral Surgery, Ryukyu University Hospital, were reviewed.
    They were all males and the majority of the cases were in the twenties to fifties. Mandibular fractures were most frequent (46. 3%). Fracture of the maxilla occurred in 8 cases (14. 8%) and fracture of the zygomatic complex in 15 cases (27. 7%). A comparatively low number (11. 2%) of alveolar fractures was seen.
    Yearly distribution of the maxillofacial fractures remarkably paralleled with the changes in the rate of economic growth.
    The most common occupation among the patients involved was a factory worker. Thirty nine per cent of the patients sustained fractures at a construction site and falling was the most usual type of accident.
    Only 1 case (2. 4%) was referred to the Ryukyu University Hospital from a private dental clinic.
    A great number of complications such as tooth fractures, injury or paresthesia of the facial skin, unconsciousness, infection, and fractures other than facial ones were observed.
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  • Tohru OHTSUKA, Yukihiko KINOSHITA, Yoshiro HONMA, Toshifumi TABATA, Ta ...
    1990 Volume 36 Issue 11 Pages 2586-2590
    Published: November 20, 1990
    Released: July 25, 2011
    A 62-year-old woman with T1N0M0 squamous cell carcinoma of the tongue is reported in this article, who was treated by partial resection after internal irradiatin (70Gy) and chemotherapy (PEP60mg).
    But 3 years and 7 months later, she revisited us with a main complaint of painful mass in the right-side middle neck. The lesion was diagnosed as lymph node metastasis with calcification, and the total neck dissection was performed.
    This calcification was seen in a keratosis area of the cancer nest. About 1 year after the operation, she was well with no evidence of recurrence or metastasis of the tumor.
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  • Yoshiko NATSUMI, Takamichi YANAGISAWA, Akihiko SHIMIZU, Noriaki MAEDA, ...
    1990 Volume 36 Issue 11 Pages 2591-2595
    Published: November 20, 1990
    Released: July 25, 2011
    Apert's syndrome is a rare congenital abnormality characterized by acrocephaly due to craniostosis and syndactyly of the hands and feet.
    The authors report a case of Apert's syndrome with a review of the literature.
    A 16-year-old girl consulted us about a displeased feeling in the mouth caused by abnormal tooth arrangement and masticatory disturbance.
    The patient showed cranio-facial anomalies, acrocephaly, maxillary hypolasia, exophtalmus, ocular hypertelorism and syndactyly of the hands and feet.
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  • Iwao HYODO, Yasuaki OKUMURA, Takaaki NAKATA, Yoshiro ONDA, Takeshi YON ...
    1990 Volume 36 Issue 11 Pages 2596-2603
    Published: November 20, 1990
    Released: July 25, 2011
    Our experiences in the management of two cases of habitual temporomandibular joint dislocation are presented in this paper. Both patients had mental retardation, and habitual dislocation of the joint had persisted since puberty, which required multiple reduction for control.
    Buckley-Terry surgical intervention was applied with a Champy's titanium mini-plate using an Al Kayat-Bramley type approach to the joint. These patients had a favorable postoperative course to date.
    The intervention is presumably effective in the management of habitual temporomandibular dislocation particularly in a case of mental retardation, because it is easy to perform and requires no intermaxillary fixation in the postoperative course.
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  • Takao IMAI, Michio KANEKO, Yuji KAMIYA, Kenji YOSHIDA, Hitoshi KUNO, Y ...
    1990 Volume 36 Issue 11 Pages 2604-2611
    Published: November 20, 1990
    Released: July 25, 2011
    We recently experienced 2 cases of calcifying odontogenic cyst; in the mandible of a 19-year-old male (Case No.1) and in the right maxillary sinus of a 19-year-old female (Case No.2). Case No.1 had a complication of odontoma. The 2 cases showed a root resor ption in many teeth, but had no impacted tooth.
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  • Yasuhiro SAKAMOTO, Yu MIZUTANI, Kenichi YANAGIYA, Takashi KOYAMA, Koic ...
    1990 Volume 36 Issue 11 Pages 2612-2621
    Published: November 20, 1990
    Released: July 25, 2011
    Recently, a conception of neoajuvant chemotherapy including preoperative or preradiation chemotherapy has become popular in the treatment of head and neck cancers.Cisplatinum is a most popular anticancer drug used in the neoajuvant chemotherapy. Pharmacokinctics of the cisplatinum is not yet clarified sufficiently despite of its frequent was in head and neck cancers.
    This study was designed to examine the relationships between the method of cisplatinum infusion and its pharmacokinetics in 16 oral cancer patients. The infusion rate and dose were used as parameters of the infusion method, and the maximum concentrations of free and total cisplatinum were used as parameters of the pharmacokinetics. Farthermore, we also investigated the incidences of renal dysfunction and rnyelosuppression, which seem to be major side effects of cisplatinum.
    Consequently, the maximum concentrations of free and total cisplatinum in the peripheral plasma tended to rise with the increased infusion dose and rate. However, with regard to the rate of infusion, the increase in the maximum concentration by intra-arterial route was smaller than that by intra-venous route.
    The maximum concentration of free cispatinum by intra-arterial infusion was approximately the same as the level by intra-venous infusion. Therefore it was suggested that the regional intra-arterial infusion has a systemic effect as well. However, it was also indicated that the rate of intra-arterial infusion had to be considerably higher than that of intra-venous infusion to maintain the same concentration as that obtained by the latter route.
    On the other hand, with regard to the side effects of cisplatinum, it was observed thatthe half life of free cisplatinum tended to prolong in such cases as having already decreased creatinine clearance (Ccr.) before administration. The nadir of Ccr. after infusion of cisplatinum tended to appear within 10 days after infusion followed by gradual recovery thereafter. Myelosuppression was not serious in these cases.
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  • Yoshifumi KOBAYASHI, Shinichiro TERASAKI, Hiroshi MURASE, Shunichi TAN ...
    1990 Volume 36 Issue 11 Pages 2622-2627
    Published: November 20, 1990
    Released: July 25, 2011
    We carried out a clinico-pathological examination in 7 cases of minor salivary gland sialolithiasis treated in the department of Oral and Maxillofacial Surgery, Kurume University, during the past 12 years (1977.1-1988.12). The results obtained were as follows; The average age of the patients was 63 years, with almost no difference between males and females. The MSGS in 3 cases appeared in the upper lip, 2 in the lower lip and 2 in the buccal mucosa. All these lesions were originated in the labial gland. Two stones and more, mostly 12 stones were found 6 cases. The stones ranged from 0.5 to 3mm in diameter, mostly round in shape with lamella structure. Squamous metaplasia of the ductal epithelium was noted in 4 cases and oncocytes appeared in 2 cases. MSGS was observed in 7 (3.7%) among 190 cases of “sialolithiasis”, of which incidence is relatively high as compared with those reported in previous studies.
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