To elucidate postoperative healing at the lateral site of palatal vault osteotomy by the modified method of Yoshizawa and Takahashi, operation was conducted experimentally on 25 adult dogs. One or two months later, the site was examined by soft X-ray radiography and contact micro-radiography, and ground sections of undecalcified bone specimens were examined after Cole's hematoxylin-eosin stain and Villanueva bone stain. These sections were then subjected to bone histomorphometry.
The direction of bone growth on cut surfaces varied depending on the postoperative arrangement of segments of hard palate bones separated by osteotomy. New bone formation proved to begin at a point where the space between the interior and exterior cutends were narrowest. In hard palate segments, bone resorption was noted on the nasal surface, and bone formation, on the oral surface.
The shape of a cut end of the original bone was classified into 4 types, and newly formed bone, into 5 types. With the exterior cut end of the original bone, most commonly, the upper part of the cut end projected (upper projecting type), and new bone formed over the projecting surface (upper forming type). With the interior cut end of the original bone, the type such that the lower part of the cut end projected (lower projecting type) was usually found, and new bone mostly formed over the projecting surface (lower forming type), except in the case of the no forming type.
Bone histomorphometry was carried out as 3 parameters, new bone volume, corrected new bone volume and mineral appositional rate. New bone volume on an exterior cut end was greater than that on an interior cut end. The volume 2 months after osteotomy was greater than that at 1 month. Corrected new bone volume on the exterior cut end was almost the same as that on the interior cut end. The mineral appositional rate 1month after osteotomy was slightly faster than that at 2 months. The rate on the exterior cut end was faster than on the interior cut end.

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Cell kinetics and distribution of Involucrin in fifteen cases of squamous cell carcinoma (SCC), eleven cases of leukoplakia, and five cases of normal mucosa in the oral region have been detected immunohistocliemically. The cell kinetics were evaluated by identifying the DNA synthetic cells (S-phase cells) by in vitro labelling method using bromodeoxyuridine (BrdU) and its monoclonal antibody. The following results were obtained:
1. BrdU positive cells were localized in one or two layers of the basal cell in both normal and hyperplastic epithelium without atypism. They were also demonstrated in the periphery of cancer nest in highly and moderately differentiated SCC. However, they were scattered diffusely in poorly differentiated SCC.
2. In normal epithelium Involucrin, there were positive to the superior forms of spinous cell layers. In highly and moderately differentiated SCC, Involucrin displayed in the cancer nest with an irregular and patchy pattern. But in poorly differentiated SCC, Involucrin were negative. In spite of the different stain ability of Involucrin between normal epithelium and SCC, the relation between Involucrin-positive cell and BrdU-positive cell was kept both normal epithelium and SCC.
3. The labelling indexes (L. I.) for BrdU were 4.8% in normal epithelium, 7.5% in the hyperplastic one without atypism, and 11.6% in that with atypism, respectively. As the degree of the epithelial dysplasia increased, the L. I. was high.
4. The L. I. was 19.2% in a highly differentiated SCC, 19.5% in the moderate one, and 19.1% in the poor one. There are, however, no correlation between the degree of cell differentiation and the L. I.

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Recently, there are variousmethods of nuclear DNA contentmeasurement andmaterial treatment. So we comparatively studied variousmethods ofmaterial treatments for nuclear DNAmicrophotometry usingmMSP-TU system (OLYMPUS).
Objects consisted of 10materials from 9 cases which were all primary squamous cell carcinoma of the oral region. Wemeasured nuclear DNA content from specimens of 5μm and 10μm thick, and cell isolation of 30μm thick paraffin. And according to t e classification of nuclear DNA pattern, we considered an error which exsisted between threematerial treatments.
Results: Identical rate of nuclear DNA pattern between groups of cell isolation of 30μm paraffin thick and specimen of 10μm thick showed 90%, which were higher compared to identical rate (60%) of nuclear DNA pattern between groups of cell isolation of 30μm thick paraffin and specimen of 5μm thick.
We think themeasurement of nuclear DNA content from the 10μm thick specimen is easy and valuable.

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Fifty-two patients treated for salivary gland tumor in our hospital during the past 18 years from 1971 to 1989 were studied in this article.
1. This study included 6 males and 11 females with benign and 15 males and 20 females with malignant, indicating that females have a higher frequency than males.
2. Their mean age was 42.2 years old with benign and 53.2 with malignant, when the diagnosis were made.
3. 17 cases of benign tumors were all plemorphic adenoma. Of malignant tumors, 12 were adenocystic carcinoma, 9 malignant pleomorphic adenoma, 8 mucoepidermoid tumor, 3 acinic cell tumor, 2 squamous cell carcinoma, and one undifferentiated carcinoma.
4. These tumors arose in the major salivary glands in 17 patients (10 submandibular gland, 6 parotid gland, and 1 sublingual gland) and in minor salivary glands in 35 (21 palate, 8 buccal mucosa, 4 retromolar, 1 floor of the mouth, and 1 lip).
5. Swelling was the most common symptom presented. Pain, ulcer, jaw trismus, and sensory nerve disturbance had a much greater frequency in cases of malignant tumors.
6. Treatment result of previously untreated malignant epithelial tumors of the major and minor salivary gland were analysed with respect to stage, treatment modality and histology.
(1) The 5-year cumulative survival rate was 93.8% in stages I and II and 40.5% in stages III and IV. The 10-year cumulative survival rate was 93.8% in stages I and II and 13.5% in stages III and IV.
(2) The treatment modality which included surgery (S, S+C, S+C+R) had better prognosis than chemo and radiotherapy (C+R).
(3) The 5-year and 10-year cumulative survival rates were found to be as follows: mucoepidermoid tumor 85.7% and 71.4%, respectively: adenoid cystic carcinoma both 78.6%: malignant pleomorphic adenoma 62.2% and 46.6% respectively.

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There have been very few reports on rnyositis ossificans traumatica of the masseter muscle. This paper deals with an experience of ours, a 32-year-old male patient with severe trismus caused by myositis ossificans traumatica. He was struck on the left side of the face and was unable to open his jaw after the injury. On admission a maximum interincisal opening of 3 mm was noticed and a mass was plapable in the injured lesion.
There were no abnormal findings via hematological studies including alkaline phosphatase. Diagnosis was made from clinical findings plus CT, echo, and soft-X-ray. Surgical treatment, partial massetectomy and excision of the mass in the left masseter, was carried out and an interincisal opening of 45 mm was achieved at the time of the operation. Microsections of the mass showed heterotopic ossificans and no evidence of malignancy.
The active physiotherapy was given postoperatively. A favorable clinical response was achieved.

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The development of factor VIII inhibitor is one of the most serious complications of replacement therapy of factor VIII in patients with hemophilia A. Mary literatures for appro aching hemorrhage are found, though there were few reports for management of tooth extraction in +hese patients.
We performed teeth extractions on six occasions in 4 hemophiliacs with factor VIII inhibitor under factor VIII bypassing therapy, using prothrombin complex concentrates (PCC) or activated prothrombin complex concentrates (APCC). Hemostatic management was achieved satisfactorily in all cases, except for the second time for case 1, in which hemorrhage continued for 17 days in spite of transfusion of PCC.
In this report, we deal of the details of these clinical courses and discuss the effect of bypassing therapy, including oral management.

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Two free vascularized osteocutaneous fibula flaps were used for reconstruction of mandibular defects in patients with squamous cell carcinoma of the lower gingiva.
One had been carried out as a secondary reconstruction nearly three years after sectional mandibulectomy including a mandibular angle. In this case complete necrosis of the skin paddle and infection surrounding the intraosseous wires occurred after the operation. The defects of the soft tissue were closed spontaneously after several weeks and infection was managed by removal of the wires. As a result, a flat contour on the reconstructed mandibular angle was obtained. It is thought that this might be because of the straight form of the fibula. As we could not improve the scar contraction caused by the first surgery, jaw movements are still limited.
The second patient had undergone an immediat e reconstruction after sectional mandibulectomy of the premolar and molar region. Hematoma and infection after operation was managed by drainage. The latest result showed a satisfactory face contour and adequate jaw movements. The morbidity of the donor site was light in both patients.
We concluded that a free vascularized osteocutaneous fibula flap is useful for reconstruction of the mandibular defects particularly in the straight part of the body, associated with limited soft tissue loss. Furthermore, immediate reconstruction is recommended.

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Tetanus has become a disease not commonly seen in Japan, but the mortality figures for the disease vary from 10 to 60 percent if unrecognized or untreated.
A 32-year-old male, carpenter, was referred to our hospital with temporomandibular joint dysfunction. Examination showed moderate trismus with a maximum opening of 22 mm, and revealed spasm of the masseter. He denied a recent history of trauma. But the muscle stiffness became more generalized and involved the jaw, neck and back musculature. Tetanus was diagnosed on clinical grounds and the patient was treated.
An early warning symptom of tetanus is trismus, so a patient suffering from this disease may initially consult a dentist or an oral surgeon. It is important to consider that trismus may be caused not only by local sepsis and temporomandibular joint dysfunction but by tetanus as well, although there was no obvious injury.

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