101 cases of squamous cell carcinoma of the oral cavity were investigated in regard to the relationship between tumor extent and (1) lymph node metastasis and (2) histological grading of malignancy. Immunohistochemical studies with laminin and type IV collagen were also carried out to assess the relationship between tumor extent and lymph node metastasis. It was suggested that five histological parameters (differentiation, nuclear polymorphism, mitoses, mode of invasion and mononuclear cell infiltration) and the basement membrane distribution pattern were not significantly related with tumor extent. In contrast, the mode of invasion and the basement membrane distribution pattern were closely correlated with lymph node metastasis.
We previously reported a rare case of recurrent gingival carcinoma with sarcomatous changes occurring after chemotherapy and irradiation as initial treatment. Immunohistochemical staining by the avidin-biotin-peroxidase complex (ABC) method for keratin and vimentin revealed that the primary tumor diagnosed as squamous cell carcinoma was only positive for keratin while the recurrent tumor was positive for both keratin and vimentin. In this paper, we report the in vitro isolation of a tumor cell line, designated as SCCHT from the recurrent tumor. SCCHT was short, spindle shaped with dendrite-like processes in culture. This cell line had colony forming ability in semisolid agar and produced a tumor by inoculation into nude mice, which was diagnosed as squamous cell carcinoma with sarcomatous changes, similar to the surgical specimen. I mmunocytochemical staining detected keratin and vimentin but not desmin in SCCHT and its tumor in nude mice. These findings were confirmed by Western blot analysis performed using two oral squamous cell carcinoma cell lines, SCCKN and SCCTF, and gingival fibroblasts as controls. SCCHT demonstrated a broad band of keratin ranging from 56 kDa to 64 kDa similar to SCCKN and SCCTF, but showed four bands of vimentin at 57, 52, 47 and 43 kDa in contrast to the 57 kDa band obtained for control fibroblasts. These results indicated that SCCHT is a squamous cell carcinoma cell line which possesses keratin and vimentin, resulting in sarcomatous changes in morphology.
In this experiment, we have studied macroscopically and histopathologically the effect of diode laser (Ga-Al-As, 810 nm) irradiation after a single application continuous application, and the time course after completing continuous irradiation, on the tissues surrounding the stellate ganglion of rats. Single irradiation: The submandibular gland, thyroid and common carotid artery of rats were directly irradiated by a diode laser at 300, 500 and 700 mW for 10 or 20 min. No abnormalities of irradiated areas were observed macroscopically or histopathologically. Continuous irradiation: Irradiation was given for 20 min at 300, 500 or 700 mW to the skin surrounding the rat's stellate ganglion, every other day (3 times/week) for 2 weeks (total six times). The skin of the irradiated areas was observed macroscopically, before, immediately after, and 24 hours after irradiation. No changes were detected at 300 and 500 mW either macroscopically or histopathologically. At 700 mW, erythema and edema were observed on the skin which had been irradiated 2 or 3 times. By the end of six applications of continuous irradiation, crust formation was observed in 20/28 (71. 5%) rats. Time course after continuous irradiation: Macroscopic and histopathological examinations of the skin, submandibular gland, thyroid and common carotid artery were made immediately after, and 24 hours, 3 days, 1 week, 2 weeks, 1 month and 6 months after continuous irradiation. The crusts on the skin at 700 mW remained 3 days after completing irradiation. After 1 week, the crusts had almost completely disappeared. After 2 weeks, no abnormalities were observed. Histopathological observation of the skin showed the same tendency. No changes were detected at 700 mW in the submandibular gland, thyroid or common carotid artery.
The correlation between the oxidation-reduction potential (Eh) and number of viable cells was studied using aerobes and anaerobes from clinical materials to investigate the mechanism of oral mixed infections. Eh of aerobes and anaerobes in single culture did not drop below 0mV. Though the viable cells of aerobes increased time dependently, anaerobes did not increase. In mixed culture viable cells increased for all combinations and synergy was observed. Eh decreased dramatically below 0mV for combinations of S. constellatus and various anaerobes. Furthermore, viable cells increased favorably. For combinations of S. mitis and two species of anaerobes and for combinations of rarely isolated organisms Eh did not fall below 0mV, and the proliferation rate of viable cells tended to be slightly inhibited. Combinations of S. constellatus and various anaerobes, showing strong synergism, are commonly detected from clinical oral mixed infections. These combinations may therefore serve as a model for clinial infection. These results suggested a close correlation between the occurence of oral mixed infections and Eh. Differences in the combination of aerobe and anaerobe species were suggested to play an important role in the occurrence of oral mixed infections.
A long-term in vivo study on α-tricalcium phosphate (α-TCP) mixed with 11 weight % of calcium phosphate dibasic and hardened by hydration was performed. Hardened materials prepared in the form of columns (2×10 mm) were implanted on the inferior surface of the mandible and in the back muscle of rabbits. The materials were harvested with surrounding tissues after 1 or 1. 5 years' implantation and embeded in polyester resin (Regolac®). Serial thin sections were cut and hand-ground for microscopic and microradiographic evaluation. The material was shown to be well tolerated by bone and muscle tissue after long-term implantation. Direct bone contact to the material was seen when implated on the mandibular bone, and a very thin fibrous capsule was formed when implanted in the back muscle. All specimens showed resorption, though the resorption rate decreased in comparison with that reported in previous short-term experiments. The materials from the mandibular bone were no longer resorbed once the surface was covered with bone tissue and the materials from the back muscle showed diffuse signs of resorption throughout almost the entire surface. These findings suggested that dissolution of the material into body fluid is involved in resorption. The degree of the material resorption differed greatly depending on the material, even when implanted in the same tissue of the same rabbit, which may indicate that various kinds of calcium phosphate salts were formed and distributed irregularly in the material. In microradiographic study, a thin white zone was noted in the outer layer of the material implanted on the mandibular bone. It was not apparent or disappeared in severely resorbed areas. The formation of this zone may be related to bone formation or bone attachment to the material.
Although radiographic examination is generally used to diagnose lesions in the temporomandibular joint (TMJ), its reliability is still controversial. In this study, radio tomographic and single-contrast arthro tomographic findings were compared with arthroscopic findings in 34 joints of 28 patients with TMJ closed lock. The patients included 6 males and 22 females. Their ages ranged from 15 to 69 years old, with an average of 33 years. With regard to disk displacement, arthrographic findings agreed with arthroscopic findings in 33 out of 34 joints (97%). Regarding disk movement, both findings coincided in 29 out of 30 joints (97%). On the other hand, concidence of arthrographic and arthroscopic findings in disk deformation, anterior joint compartment adhesion and disk or retrodiscal tissue perforation were 53%, 66% and 74%, respectively. Moreover, tomographic and arthrographic examinations did not show abnormality on the surface of the mandibular fossa or articular eminence. These results suggest that tomography and single-contrast arthrography do not necessarily provide high reliability in the assessment of intracapsular lesions of the TMJ.
Several authors reported differences in the tissue response, biocompatibility, stability and osteoconduction of hydroxyapatite (HAP) granules depending on their chemical composition, type (porous or non-porous), shape, solubility behaviour, conditions of production or implant site. Bonetite is one type of non-porous, unabsorbable hydroxyapatite (HAP) granules. We used Bonetite to fill bone defects caused by extraction of erupted teeth (erupted tooth group, 75 cases) or impacted teeth (impacted tooth group, 14 cases) and removal of jaw cysts, apical granulomas or benign tumors (cyst group, 49 cases), and evaluated the usefulness of this material in nine clinics. The following results were obtained: 1) Inflammation of the implant site was comparable to general wound healing after the operation. 2) No side effects were noted. 3) Secondary surgical treatment was done in 4 cases (2.9%), who showed good progress. 4) The incidence of wound dehiscence was 9.9%, leakage of HAP granules 27.5% and infection 2. 9% within 1 month after operation. However, the incidence of these findings decreased 3 months after operation, and they were not noted 6 months after operation. 5) The mean final retention rate of HAP granules was 84.5% in the erupted tooth group, 92.5% in the impacted tooth group, 90.0% in the cyst group and 86.7% overall. 6) As a result, Bonetite was evaluated to be markedly useful or moderately useful in 119 cases (86.2%). 7) In conclusion, Bonetite was considered to be one of the most useful implant materials to fill bone defects in the oral and maxillofacial region.
123 mandibular condylar fractures treated at our department from January 1986 to December 1991 were reviewed and analysed. Their characteristics were as follows: 1. Condylar fractures occurred in 49. 6% of the mandibular fractures and the male: female ratio was 1.5 to 1. The largest age group of patients was from 15 to below 20 years (24. 4%). 2. The most frequent cause of condylar fracture was traffic accidents (51.2%). 3. Of 123 cases, 99 (80.5%) were unilateral, 24 (19.5%) were bilateral, and 61 (49.6%) were complicated by other mandibular fractures. The overwhelning majority of cases (95.0%) were indirect fractures. 4. Fractures with displacement and/or dislocation occurred most frequently in the condylar superior neck region (22.0%). 5. Of 147 condyles, closed reduction for mandibular condylar fracture was performed in 122 (83.0%) condyles and open reduction was perfomed in 25 condyles (17.0%). 6. As for the clinical results in 106 cases, 91 (86.0%) were completely healed and 15 cases (14.0%) had disorder 1. Results in the patients treated were generally good.
A case of angiomyoma arising in the hard palate is presented. A 69-year-old man was referred to our clinic complaining of a painless, localized, dark purple mass in the hard palate. The excised lesion was histopathologically diagnosed to be an angiomyoma. Previous cases of oral angiomyoma reported in the Japanese literature are also reviewed.
Benign cementoblastoma is a mesoblastic-odontogenic tumor which shows increased cementum. This tumor has been called “true cementoma” by many workers and is a very rare odontogenic tumor. We recently encountered a case of benign cementoblastoma at the 65 root in a 50-year-old male. Enucleation of the tumor was performed and the bone defect was repaired by an autogenous ilium graft.
Inverted papilloma is an uncommon, benign epithelial tumor of the paranasal sinuses and nasal cavity. The patient, a 32-year-old male, came to our clinic because of discomfort in the palate. Radiography showed clouding of the left maxillary sinus. Contrast radiography showed a large well-defined oval radiopaque structure at the apex of the upper left canine. Computed tomography revealed a mass covering the posterior wall of the left maxillary sinus. The clinical diagnosis was a maxillary sinus tumor coexisting with a large radicular cyst. The mass of polypoid tissue and the cyst were removed from the left maxillary sinus by Caldwell-Luc sinusotomy. The pathological diagnoses were inverted papilloma and radicular cyst. Postoperative course was uneventful, and the patient has remained free of disease for one year following surgery.
A clinico-statistical analysis was carried out on the 341 patients with primary cleft lip and palate who visited our clinic during the 10-year period since 1981. The results were as follows: 1. The body weight at birth of 324 patients averaged 3, 061. 6 g (ranged from 1, 350 to 4, 380 g). The incidence of low-weight babies less than 2, 500 g accounted for 10. 8 percent of the patients, which was higher than in the normal. 2. The mean age of the 290 mothers at delivery was similar to the normal distribution. High-aged mothers over 35 years old accounted for 6. 6 percent. No relationship was suggested between the mother's age and the occurrence of cleft lip and palate. 3. Bottle feeding was being used in most patients at the first medical examination (72.4% of 301 patients). 4. Other congenital malformations were detected in 71 patients (20.8% of all 341patients). The cleft palate (CP) group showed the highest incidence among the three (CP, CL and CLP) groups. 5. A family history was found in 49 (14. 4%) of 341 patients.
We extracted a large number of teeth in a patient with severe aplastic anemia, who had not responded to conventional therapy and was in platelet-transfusion refractor, status as result of repeated platelet-transfusions. As a general hemostatic measure for postextraction bleeding, high doses of gamma-globulin were intravenously injected to enhance the response to platelet-transfusion. Pressure hemostasis using a surgical guide plate and sutures were applied for local hemostasis. Antibiotics were administered by intravenous drip infusion to prevent infection during and after the operation. Consequently, good healing without postextraction abnormal bleeding and infection was obtained. This treatment is therefore considered to be effective in such cases.
Reconstructive methods for maxillofacial defects can be broadly classified into:(1) surgical reconstruction such skin flap grafting and (2) prosthetic reconstruction with a maxillofacial prosthesis. The most popular method for orbital, auricular and nose defects is prosthetic reconstruction. It is importnt for facial prostheses to be esthetically appealing securely retained. Our study on usefulness of facial prostheses using pure titanium dental implants for retention and fixation has yielded good results. This report summarizes our experience and presents two cases we have treated. Case 1 was an 80-year-old female with an orbital prosthesis using dental implants for retention and fixation. Case 2 was a 75-year-old female with an orbital prosthesis using dental implants and a small permanent magnet for retention and fixation. Both cases showed good fixation of the prosthesis, which was easy to fit and remove.