Subrenal capsule assay (SRCA) is an in vivo chemosensitivity test which has been reported to be rapid and have high evaluability and clinical correspondence. However, chemosensitivity may be affected by infiltration of inflammatory cells derived from host imm une response and by poor tumor growth.
We have developed an SRCA which was evaluated by measuring the specific activity of succinate dehydrogenase (SD). This novel method for evaluating SRCA was tentatively named the “SSDI method” because it was evaluated by determining the inhibition rate of specific activity of SD (SSDI) in a test group relative to a control group. In this investigation, fundamental and clinical studies on the SSDI method were carreid out.
In SRCA, relative tumor weight (RW) and total activity of SD increased day by day, but the specific activity of SD (SSD) was almost constant.
SSDI method was not influenced by the host immune response, compared with TGIR method.
Furthermore, SRCA was carried out for 60 cases of malignant tumors in the oral region which were resected at our department. SSDI method showed a high evaluability rate (91.8%). For patients, the overall positive sensitivity rate was 42.2% by SSDI method and 28.6% by TGIR method. For drugs, the overall positive sensitivity rate was 25.4% by SSDI method and 17.3% by TGIR method. The positive sensitivity rates of anticancer agents evaluated by SSDI method were closer to the clinical sensitivity rates for malignant tumors in the oral region than those obtained by TGIR method. The predicitive accuracy rate was 73.9% by SSDI method and 52.2% by TGIR method.
Therefore, SSDI method may be a useful assay to correctly evaluate chemosensitivity in SRCA.

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Serial frontal and lateral roentgenocephalograms of 140 infants with cleft lip and/or palate were taken at cheiloplasty, palatoplasty and at four years old at Kyushu University Dental Hospital. The subjects consisted of 36 unilateral cleft lip and alveolus (UCLA), 58 unilateral cleft lip, alveolus and palate (UCLP), 14 bilateral cleft lip, alveolus and palate (BCLP) and 32 isolated cleft palate (CP). Twenty-six dimensions and seven angles were measured on each set of cephalograms. Changes in the measurements were evaluated by ANOVA to characterize the craniofacial growth patterns of each cleft type. Twenty-five male complete UCLP subjects were classified by cluster analysis to investigate the presence of several growth patterns in the same cleft type.
The results were as follows:
1. Changes in the cranial base length in UCLP were significantly larger than in UCLA.
2. Among UCLA, UCLP and BCLP, there was no difference in the changes of maxillary length. Forward growth of the anterior and posterior margins of the maxilla were significantly larger in UCLA than in CLP (UCLP and BCLP). However, there was no difference in the forward growth of the maxilla in UCLP, BCLP and CP.
3. The changes of mid-facial height in UCLA were significantly smaller than in CLP. There was no difference in those of UCLP, BCLP and CP. However, when the mid-facial height was separated into upper and lower mid-facial heights, changes of the upper mid-facial height in BCLP were significantly larger, and those of the lower mid-facial height were significantly smaller than in UCLP and CP.
4. Differences in changes of the mandible and the posterior maxillary height were not significant in any cleft type.
5. Changes in the nasal and maxillary breadth in UCLA were significantly larger than in CLP, and those in CP were also significantly larger than in CLP.
6. By cluster analysis, male complete UCLP subjects were classified into three subgroups.Their craniofacial growth patterns were significantly different. It was suggested that all infants with the same cleft type did not necessary follow the same growth pattern.

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Hyperthermia in combination with radiation and chemotherapeutic drugs is known to be an effective treatment for human cancer.
However, it is not clear whether hyperthermia inhibits or promotes carcinogenesis in premalignant lesions adjacent to carcinomas. In this study, the author investigated the effect of hyperthermia on carcinogenesis which was experimentally induced on the back skin of mice by repeated application of 9, 10-dimethy1-1, 2-benzanthracene (DMBA). The mice were then exposed to hyperthermia using a 43°C water bath.
The ffect of hyperthermia was evaluated by tumor incidence (the percentage of tumorbearing mice), tumor yield (the average number of skin tumors per mouse), histological results (the percentage of carcinomas to tumors and the carcinoma incidence expressed as the percentage of carcinoma-bearing mice) and the damaged skin's reaction to hyperthermia (the percentage of mice showing signs of erosion or redness).
1) The tumor incidence in groups heated at 43°C from weeks 6 to 10 was repressed during the period of hyperthermia, although all groups reached 100% at week 15.
2) The tumor yield in groups exposed to 43°C from weeks 6 to 10 was markedly reduced at the end of the experiment.
3) The skin reactions in groups heated at 43°C were significantly decreased compared to the groups heated at 37°C and those that were unheated.
4) The percentages of carcinomas to tumors in the two groups which were heated at 43°C from weeks 6 to 10 and from weeks 11 to 15, respectively, were markedly lower than in the control groups.
5) The carcinoma incidence in the groups heated at 43°C from weeks 6 to 10 was slightly lower than that of the groups heated at 37°C and those that were unheated; however, the difference was not significant.
These data indicate that hyperthermia using a 43°C water bath has inhibitory effects on the tumorigenesis and malignant conversion of mouse skin treated with DMBA.

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The mechanism of bone resorption in cystic lesions in bone tissue still remains to be elucidated. As various cytokines have recently been shown to be involved in bone resorption, the present study was undertaken to examine the relationship between cytokine production and bone resorption in cystic lesions.
Tissues were obtained from 19 patients with histopathologically confirmed jaw cysts (7 with odontogenic keratocysts, 5 with radicular cysts, and 7 with dentigerous cysts). The cystic tissues were aseptically resected, cut into approximately 2-mm square pieces, and cultured for 48 hours in α-MEM containing 1% fetal bovine serum in 24-well plates. IL-6 and IL-1 in the supernatant were assayed by enzyme linked immunosorbent assay (ELISA). Northern blotting analysis was also carried out to study gene expression of the cytokines.
The production of IL-6 was significantly greater in the radicular cysts than in the odontogenic keratocysts (p< 0.05). However, no correlation was found between the levels of IL-6 and IL-1, the latter of which is regarded to be an inducer of IL-6 production. Northern blotting analysis showed gene expression of IL-6 in cystic tissues, and TGF-β gene was expressed in the odontogenic keratocysts only. These results suggest that these cytokines are associated with the growth of jaw cysts.

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A new tumor cell line designated KGK was established from a metastatic submandibular lymph node of a patient who had a gingival squamous cell carcinoma. It has been continuously subcultured 350 passages during 6 years and 2 months. KGK cells showed a polygonal shape and grew in multiple layers without contact inhibition. Scanning electron microscopy indicated that KGK cells had numerous microvilli and intercellular bridges. Transmission electron microscopic observation exhibited cells that were joined by desmosomes. The population doubling time of KGK cell line was 19hr, and the saturation density was 9.3×10⁵ cells/cm². The planting efficiency on plastic dishes was 19%, and the colony-forming ability in semi-solid agar was 6.4%. The chromosomal number ranged around 62, and no abnormal karyotype was found in G-band staining. Inoculation of the KGK cells into BALB/c nude mice resulted in tumor formation which histologically closely resembled the original structure of the poorly differentiated squamous cell carcinoma.
We also examined the binding capability of epidermal growth factor (EGF) and the effect on growth in KGK cell line. Scatchard analysis of [¹²⁵I]-EGF binding indicated 2 components with high (5nM) and low (2nM) sites. The total number of EGF receptors per cell was 3 × 10⁵ sites/cell. The effect of EGF on growth was studied by the incorporation of [³H]-thymidine. The inhibitory activities of 1.0 and 10.0 ng/ml of EGF on the proliferation of KGK cell line were 62.7% and 68.7%, respectively.

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Although numerous studies have been reported concerning the antimicrobial properties of minocycline, inhibition of neutrophil function by minocycline has recently been the focus of a number of investigations. However, the effect of minocycline on fibroblast function is not clearly understood.
Cell proliferation and fibroblast migration are basic biological processes in wound healing.
We therefore investigated the influence of minocycline on cell proliferation and migration, using two cell lines derived from oral tissue (gingival fibroblast, palatal mesenchyme).
The following results were obtained:
1. Minocycline inhibited cell migration dose-dependently.
2. Minocycline inhibited cell proliferation.
3. We surmised that this inhibition of cell function was due to the ability of minocycline to bind to Ca²⁺ in the medium.

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⁵¹Cr-release assay has been used to measure cell-mediated cytotoxicity. However, this method requires an RI facility and the half-life of ⁵¹Cr is only 28 days, making it unsuitable for routine application. We therefore labeled target cells with carboxyfluorescein diacetate (c FDA), convertionally used to determine cell survival, to measure cell-mediated cytotoxicity by flow cytometry, and obtained the following results.
1. c FDA did not adversely affect the proliferation of K562, Daudi and Raji cells. cFDAlabeled cells also proliferated well.
2. The most stable histograms of flow cytometry were obtained under the conditions of 150 μg/ml cFDA concentration and 30 minutes of labeling time.
3. A high correlation was found between this method and ⁵¹Cr-release assay.
4. The above results suggested that this method was very useful for measuring cellmediated cytotoxicity.

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To evaluate mandibular condylar displacement and changes in angulation of the condylar longitudinal axis to the transverse line running through both auditory canals after sagittal splitting ramus osteotomy, 15 dried human skulls were tested.
In the first five test specimens (M-DP group), the mandibles were split with the vertical external cortical bone splitting line situated medially to the mandibular second molar. In the next five specimens (D-DP group), the vertical external splitting line was placed at the distal part of the second molar. In the other five specimens (OB group), the splitting line was made from the distal part of the second molar to the mandibular angle.
Among these three groups, the effects of the position of the external cortical bone splitting line on the position of the condyle and the change in condylar angulation were also compared. In addition, the effects of the magnitude of mandibular setback and the methods for repositioning of external segments (flexible type and firm type) were examined. The amount of condylar displacement was detected three-dimensionally using two Saphon visitrainers. The change in condylar angulation was measured with a protractor.
The following results were obtained:
1) The magnitude of mandibular setback did not influence condylar position or angulation.
2) In the M-DP group, the magnitudes of condylar displacement and the change in condylar angulation were larger than those in the D-DP and OB groups. These results indicated that it is desirable to place the external cortical bone splitting line at the posterior portion of the second molar.
3) The angulation of the condylar axis changed as the external cortical bone splitting line moved. The M-DP group changed by 7-8°, the D-DP group by 6-7° and the OB group by 4-5°.
4) The angulation of the condylar axis was not affected by the method for external segment repositioning. However, the amount of condylar displacement with firm repositioning was larger, especially in the lateral direction, than that with flexible repositioning. This fact indicated that the repositioning device should be flexible. Furthermore, since this flexible type appliance, sufficient to maintain the antero-posterior position of the condyle, could not completely prevent lateral movement of the condyle, a new technique to reposition the proximal segment should to be established.

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The free scapular flap can be used for mandibular reconstruction, including the repair of soft tissue defects, but there have been few clinicoanatomical studies on this flap. The purpose of the present study was to clarify the anatomical basis of the free scapular flap. The following results were obtained from examinations of forty-two cadavers.
Results of morphological examination: 1) Scapular vessels were classified into two types, with angular branches being observed in every case: the common trunk type and direct type. The common trunk type (the subscapular artery branched into the circumflex scapular artery and the thoracodorsal artery) accounted for 95% of cases. The direct type (the circumflex scapular artery and thoracodorsal artery arose from the axillary artery) accounted for 5%. 2) Each of the above types was cross divided into two types. The straight type, in which the circumflex scapular artery ramified into a few branches on the periosteum of the lateral border on the costal surface, accounted for 95%. The circuitous type, in which the circumflex scapular artery ramified into a few branches on the periosteum of the glenoid, accounted for 5%. 3) Venous valves appeared most often at bifurcations. 4) Most valves were bicuspid. Results of morphometric examination:(1) In the common trunk type, the maximum lengths that could be used as flap pedicles were 9.3 cm for arteries and 9.1 cm for veins. In the direct type, the maximum lengths that could be used as flap pedicles were 9.5 cm for arteries and 7.1 cm for veins.(2) In the common trunk type, the mean inner diameters of the vessels 2 mm distal from the bifurcation of the subscapular vessels were 2.8 mm for arteries and 3.3 mm for veins. In the direct type, the mean inner diameters 2 mm distal from the bifurcation of the circumflex scapular vessels were 1.8 mm for arteries and 3.3 mm for veins.(3) The maximum superior-inferior dimension of the scapular graft was 2.8 cm.(4) The maximum lateral dimension of the scapular graft was 1.2 cm.

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Jejunal vessels which play an important role in vascular anastomoses in free jejunal tissue transfer were examined clinicoanatomically. This study included morphological and morphometrical examinations of the jejunal artery and the jejunal vein. The jejunal artery branches into the primary arcade, which is formed together with branches of the jejunal veins. Mural trunk branches, venous valves, the inner diameters of jejunal vessels, and the lengths of vessels were studied. The following summarizes the results of these observations:
1. Morphological examination: 1) Medial branch Type-a (the jejunal artery branching into the primary arcade) accounted for 50%. 2) Medial branch Type-a (the jejunal veins joining to form the primary arcade) accounted for 50%. 3) The mural trunk branches pass through the antimesenteric area to the mesenteric area. 4) No venous valves were observed.
2. Morphometric examination: 1) The mean inner diameter of the jejunal arteries was 1.4±0.5mm at 5mm distal from the jejunal artery junction. 2) The mean inner diameter of the jejunal vein was 1.8±0.7mm at 5mm distal from the junction of the vessels, the site used for vascular anastomosis (the site which corresponds to the largest diameter of the jejunal arteries), and 3.2±1.0mm at 5mm distal from the junction of the jejunal artery. 3) The mean length of artery that could be used as a vascular pedicle was 13.1±1.5cm. 4) The mean length of vein that could be used as a vascular pedicle was 13.0±1.5cm.

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A pigmented nevus is defined as a hamartomatous proliferation of nevus cells, and it is a most common skin lesion. Pigmented nevi of the oral mucosa are considered to a rare lesion with only a few cases being reported in Japan. Here, an intradermal nevus on the palate is described together with the results of immunohistochemical studies. A 44-yearold man had noted pigmentation and swelling of the palate for few years, but it was asymptomatic and not treated previously. The lesion was diagnosed to be an intradermal nevus histopathologically, and numerous melanocytic masses were seen in the connective tissue under the palatal epithelia. The melanin pigment stained with Masson-Fontana stain. Immunohistochemically, the following antibodies were tested: PoAb S-100 protein, MoAb S-100α, MoAb S-100β, MoAb or PoAb neuronspecific enorase (NSE), PoAb substance P, MoAb chromogranin A, keratin (MoAb K8.12, KL1), MoAb vimentin, and MoAb glial fibrillary acidic protein (GFAP). The melanocytes were positive to PoAb S-100 protein, MoAb S-100/β and MoAb vimentin.

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A total of 105 salivary gland tumors treated and followed up by our department from 1965 to 1987 were clinically studied. The results were as follows:
1. There were 65 benign tumors (61.9%) and 40 malignant tumors (38.1%).
2. Histologically, the tumors occurred in the following order of frequency: adenomaspleomorphic adenoma (52 cases), Warthin tumor (7 cases), oncocytoma (2 cases), basal cell adenoma (1 case) and cystadenoma (1 case); carcinomas-mucoepidermoid carcinoma (15 cases), adenoid cystic carcinoma (12 cases), carcinoma in pleomorphic adenoma (5 cases), adenocarcinoma (4 cases), squamous cell carcinoma (2 cases), acinic cell carcinoma (1 case) and epithelial-myoepithelial carcinoma (1 case); non-epithelial tumors-angioma (2 cases).
3. The tumors originated from the major salivary glands in 32 cases and from the minor salivary glands in 73 cases. Among the cases that developed in the minor salivary glands, the most frequently affected site was the palate (45 cases), followed by the oral base (8 cases) and the buccal mucosa (7 cases).
4. Clinical findings associated with a high incidence of malignancy were symptoms of pain and ulcers in addition to swelling at the first medical examination (75%). With respect to the primary site, the minor salivary glands except for the palate and lips had a high incidence of malignancy.
5. Surgical treatment was performed for all benign tumors and 90% of the malignant tumors. In 70% of operated malignant tumors, radiotherapy and/or chemotherapy used concomitantly.
6. The cumulative survival rate for all malignant cases was 78.9% at 5 years and 61.9% at 10 years. Histologically, mucoepidermoid carcinoma and carcinoma in pleomorphic adenoma had good prognoses, but adenoid cystic carcinoma, adenocarcinoma and squamous cell carcinoma had poor prognoses.
7. Misdiagnoses were made before surgery in 3% of the benign tumors (2 cases) and in 30% of the malignant tumors (12 cases). Among the misdiagnosed malignant tumors 10 had no clinical findings indicative of malignancy and their prognoses were good. Two cases misdiagnosed as benign tumors had clinical findings of malignancy and their prognoses were poor.

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Six cases who had received maxillectomy or orbital exenteration were treated with maxillofacial prostheses using osseointegrated implants. The results were as follows:
1. The patients included 4 males and 2 females, ranging in age from 40 to 78 years.
2. The primary disease was maxillary squamous cell cancer in 5 cases and maxillary ameloblastoma in 1 case.
3. Two of the malignant tumor patients had wide maxillary defects. In 2 cases there were orbital defects, and in 1 case orbital and maxillary defects remained. The 1 benign tumor patient had a hemimaxillary defect.
4. Seventeen fixtures were installed in the maxillary region, and 16 fixtures were osseointegrated. Nine flange fixtures were placed in the supraorbital region and all fixtures were osseointegrated. The success rate was 94.2 % in the maxilla and 100% in the orbital region.
5. Stability of the prosthesis was improved remarkably by implants, enhancing both speech and masticatory function. Cosmetic improvement was also remarkable using facial prostheses retained by this implant system.

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Mandibular reconstruction remains one of the most challenging problems for the head and neck surgeon. Various methods of mandibular reconstruction have been described, including free bone grafts, osteomyocutaneous flaps, free vascularized bone grafts, reimplantation of treated mandibles, and reconstruction using alloplastic materials with particulate cancellous bone and marrow grafts.
This paper describes the author's experience using a Dacron-urethane mandibular mesh tray filled with particulate cancellous bone and marrow for mandibular reconstruction.
Six patients underwent resection of the mandible for malignant tumors, 7 for benign tumors, and 1 for radiation osteomyelitis.
Immediate reconstruction was performed in 7 patients, and 5 of the 7 were successful. Delayed reconstruction was performed in another 7 patients, and 5 of the 7 were successful. The overall success rate was 71%. Mandibular reconstruction was successfully accomplished even following radiotherapy in 4 of 6 patients. The majority of the failures occurred in the first 10 days following surgery and the major factor in failure seemed to be related to intraoperative wound infection.
The Dacron-urethane mandibular mesh tray has the advantage of being malleable but stiff, and can be easily cut with scissors to fit the defect. The tray is radiolucent, faciliting follow-up examinations by routine roentgenograms and radionuclide scans. It can be used either before or after radiotherapy.
This reconstructive procedure is not technically difficult and does not require expertise in microvascular surgery. In selected patients, this procedure may significantly contribute to cosmetic and functional improvement following radical surgery of the mandible.

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Granulocyte-colony stimulating factor (G-CSF) was subcutaneously administered to 12 patients with malignant tumors of the head and neck for the prophylaxis and treatment of leukocytopenia. Based on these cases, the following results were obtained:
1. Compared to late (therapeutic) administration, the response to G-CSF was better when it was administered at the early stage of leukocytopenia (prophylactic administration) in cancer patients.
2. To avoid extremely severe leukocytopenia, it is apparently beneficial to inject about 50μg of G-CSF two or three times a week if white blood cells (WBC) decrease to less than 3, 000/mm³ during chemoradiotherapy of squamous cell carcinomas.
3. In patients who receive cis-diamminedichloro-platinum (CDDP), The dose of G-CSF should be increased and administered for a long period.
4. In CHOP therapy for malignant lymphoma, it is recommended to administer 50 to 75μg of G-CSF every two days during the first cycle, and 100 μg of G-CSF daily in the second cycle.
5. Once WBC starts to increase, the dose of G-CSF can be decreased considerably.
These results apparently indicate the clinical characteristics of G-CSF usage in head and neck malignancies. However, rational dosage regimens for the cytokine in the treatment of these regions will most likely be established by further clinical trials.

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The purpose of this clinical study was to evaluate arthroscopic eminoplasty in several temporomandibular joint (TMJ) disorders. Fifteen joints in 10 patients were studied. The diagnoses were osteoarthrosis (7 joints), habitual luxation (4 joints), internal derangement with click (1 joint), and eminence click (3 joints). The articular eminence was shaved for 2-5 mm in height by employing an electric motoring shaver and round burs. Alleviation of symptoms was obtained in habitual luxation and eminence click. On the contrary, it was difficult to assess the effect of surgery on osteoarthrosis in a short period. In conclusion, the present study indicated that arthroscopic eminoplasty can be performed clinically, however, further studies are necessary to establish the adequate indications and investigate the postoperative healing process.

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In spite of extensive research, the nature and origin of oral lichen planus (OLP) are still unknown. A clinical examination of 111 cases of OLP is presented. OLP predominantly occurred in middle-aged and elderly patients ranging in age from 40-60 years; 69.4% of the patients were women. The chief complaints of the patients were a sore or burning sensation or white lesions. Many patients seeked consultation after more than 3 month from the onset of disease. Some type of systemic disease was noted in 77 cases (69.4%), and 45 cases (40.5%) used some form of medication. A history of allergy was present in 19 cases (17.1%) and skin lesions were noted in 11 cases (9.9%). The distribution of OLP by site of occurrence was as follows; buccal mucosa 83.8%, upper and lower gingivae 32.4%, tongue 24.3%, lips 19.8%, floor of mouth and palate, less than 10%.
These lesions were distributed in a symmetrical or multiple pattern, but OLP predominantly found on the mucous membrane of the vestibule oris. The size of the lesions was often more than 3 cm in diameter. Reticular lesions were most common, followed by atrophic red lesions. Many factors have been reported to cause lichen planus. However, the present clinical study suggests that OLP is caused by other local factors than skin lichen planus.

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The classification for odontogenic tumors of the World Health Organization was revised 21 years after first being issued. The term “malignant ameloblastoma” has been especially controversial because there was special emphasis on metastasis without a statement on histology in the former WHO classification. According to the revised WHO classification, malignant ameloblastoma is a neoplasm in which the pattern of an ameloblastoma and cytological features of malignancy are shown by the primary growth in the jaws and/or by any metastatic growth.
This paper presents an extremely rare malignant ameloblastoma of the maxilla which histologically showed malignant features together with prominent new bone formation. The patient was a 46-year-old Japanese female who visited our hospital complaining of pain in the right upper premolar region. An incision had been made in the second premolar region and the second premolar had been extracted 2 months before her initial visit. At physical examination, diffuse swelling was observed in the right cheek and maxilla alveolus; the overlying mucosa of the alveolar process and palate displayed redness. Orthopantomogram revealed a ground-glass appearance extending from the canine to the second molar, and the right antrum was pushed upward. CT X-ray revealed new bone formation in the right maxilla and just outside of the anterior wall of the maxilla. The tentative diagnosis was sclerosing osteomyelitis or fibro-osseous lesion. However, biopsy specimen examination revealed an ameloblastoma with cytological malignancy. We performed right hemimaxillectomy under general anesthesia. Histologically, most of the tumor showed the pattern of a follicular ameloblastoma which consisted of basaloid cells. Atypical cells including hyperchromatism, increased N/C ratio and mitosis were also observed. Vigorous bone formation was seen throughout tumor, but bone destruction by the tumor was also observed in some parts. New bony trabeculae were surrounded by many active osteoblasts. The nests or sheets of the tumor were observed among new bone. Partial resection of the left maxilla was performed because recurrence of the tumor was detected in the resected margin of the palate about 2 years after the first operation. The postoperative course has been uneventful after the second operation, and no recurrence or metastases have been observed for 7 years.

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We recently experienced a rare case of bilateral (multiple) sialolithiasis of the submandibular gland. A 79-year-old female was referred to us for extraction of the first molar in the right mandible. While she had slight swelling in the right submandibular region, X-ray showed the presence of small calcific densities not only adjacent to the angle of the right mandible but also to that of the left. Purulent material was discharged from the right submandibular duct, but there were no symptoms in the left. Computed tomography revealed eight calculi: five calculi in the right submandibular gland, one in the right submandibular duct, and two in the left submandibular gland. After antibiotic therapy, all calculi and both of the submandibular glands were removed surgically. As of the present, the prognosis of the patient is good.

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A 19-year-old young man was referred to our hospital with a chief complaint of severe trimsus. The amount of opening was only 3 mm. While the patient was playing baseball 3 months ago, he felt a severe pain at the right part of the neck. After that, severe trismus occurred gradually. The clinical diagnosis was extracondylar ankylosis due to severe cicatricial changes of the right upper neck and retromandibular fossa.
At surgery, extensive cicatricial changes were noted in the upper superficial cervical fascia. The medial pterygoid muscle was resected and examined microscopically, because the consistency was remarkably hard. Muscular fibrils had disappeared and formed the extensive fibrosis at the lower part of the muscle.
The trismus improved remarkably 3 months after the operation.

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Ameloblastic fibromas are generally classified as odontogenic mixed tumors and their occurrence is rare.
A segmental ameloblastic fibroma was resected from the left maxilla of a three-year-old boy. The tumor was composed of seven sections, and covered with a thick membrane. Odontogenic epithelium was observed in the largest tumor segment. It surrounded the tumor and in places invaginated into it. In addition, thick epithelial strands formed small cysts, similar to ameloblastomas. The remaining six tumor sections histopathologically showed the same findings of odontogenic mesenchyme as the largest segment.
These findings suggest that the ameloblastic fibroma originated from odontogenic ectomesenchyme tissue.

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We report a case of an extremely small pleomorphic adenoma of the upper lip in a 62-year-old Japanese female. The tumor measuring 3×1mm, is the smallest one among the 72 Japanese cases of the lip to be reported in 53 papers published since 1969. Histopathologically, marked proliferation of epithelial and myoepithelial neoplastic cells predominated, with minimal myxomatous or chondromatous characteristics. These findings support the idea that the present tumor may represent a pleomorphic adenoma in the early stages of development.

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Extirpation of cysts occurring in soft tissue is generally associated with rupture of the cystic wall, making complete removal difficult. Especially in cases of a plunging ranula, where the cyst often lacks an epithelial wall, complete extirpation is frequently not feasible. Furthermore, the wall of a lateral cervical cyst has been reported to have ruptured during surgery because the cyst was fused with the internal jugular vein.
We thus injected agar hydrocolloid impression material into the cystic cavity, which facilitated complete removal of the cyst.
We treated two cases utilizing this method, an 8-year-old female (Case 1) with a large plunging ranula and a 20-year-old male (Case 2) with a lateral cervical cyst. Approximately 1 year 8 months and 1 year 3 months postoperatively, recurrence has not occurred in cases 1 and 2, respectively. We concluded that this method is effective for extirpation of cysts arising in soft tissue.

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The number of patients with syphilis in Japan had decreased gradually after reaching a peak in 1960, but an increasing trend has been evident since 1985. Since this increase has been triggered by a rise in early syphilis, a future epidemic is expected.
The patient was a 22-year-old male suffering from a mucosal lesion of the lower lip and submandibular, cervical lymph node swelling. The painless mucosal erosion had a slightly indurated margin. Serological examination revealed elevated values for the TPHA-test (titer of 1: 1, 280) and RPR-test (1: 64). By using the Warthin-Starry method and TPHA-IgM, however, Treponema pallidum could not be stained in the biopsy specimen taken from the lower lip lesion.
The patient was treated orally with ABPC 1.5g/day for four weeks, which was sufficient to eliminate the syphilitic lesion. The blood serological data entered the normal range 9 weeks after initiating the administration of antibiotics.

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Wide defects of the maxilla due to maxillary malignant tumors cause functional and esthetic disorders. To treat these disorders we designed a maxillary obturator prosthesis and an orbital epithesis using osseointegrated implants.
In conclusion, osseointegrated implants were useful for the maxillary obturator prothesis and orbital epithesis in a patient with a wide defect of the maxilla associated with orbital exenteration. As the patient had previously undergone irradiation, hyperbaric oxygen therapy to induce osseointegration done pre-and post-operatively to facilitate fixture installation.

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Bilateral globulomaxillary cysts arc a rare condition. Generally speaking, this lesion arises from epithelial elements remaining in the line of fusion of the globular and maxillary processes of the embryonic face. This lesion characteristically appears as a pearshaped radiolucency between the canine and lateral incisor of the upper jaw.
A case is reported of a 19-year-old female patient who presented with pus discharge in the area of the right lateral incisor. This case was treated by enucleation.

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Desmoplastic fibroma in the jaw bones is a rare tumor which shows small fibroblasts and abundant collagen fibers histologically.
A 16-year-old female with a desmoplastic fibroma in the mandible is presented. She was referred to us for treatment of an osteolytic lesion in the left mandible. X-ray examination revealed a well-defined region of unicystic radiolucency, associated with another small region antero-inferiorly, extending from the second premolar to the second molar. As examination of a biopsy specimen indicated fibroma, tumor enucleation was performed followed by thorough curettage. The tumor had an elastic hard consistency and measured 33×20×10mm. The cut surface was solid, greyish white. Histologically, the tumor tissue was composed of scattered small fibroblasts with narrow, elongated nuclei and abundant, dense collagen fibers showing intertwining fibrous fascicles. Odontogenic epithelium, a tooth-bud-like structure and calcifying tissue were not noted.
The postoperative course was uneventful, and no recurrence has occurred for nine years.

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Orthodontic anchorage should be performed for the movement of malpositioned teeth. It is, however, difficult to obtain a satisfactory effect when key teeth potentially suitable for anchorage are missing. As an alternative, osseointegrated implant fixtures may be used for orthodontic anchorage. A 22-year-old female with a maxillary zygomatic complex fracture and loss of the mandibular incisors, right canine and right first premolar is presented. After primary reduction and fixations on the fracture, osseointegrated implant (Brånemark system) fixutres were inserted for orthodontic anchorage to facilitate repositioning of the mandibular left canine and stabilization of the posterior teeth. Orthodontic treatment was satisfactorily achieved, and no movement of the implants was observed at the end of treatment. The implants were finally applied to bridge abutments to complete prosthodontic treatment.

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For the treatment of lower gingival malignant tumors, resection of mandible including the tumor is usually performed. Such a radical procedure may cause the functional disturbances and adversely affect the quality of life (QOL). This potential lowering of QOL should be considered, especially in aged patients and patients with low performance status, because the treatment of oral cancer directly affects the postoperative status of the patient's life.
The patient was a 77-year-old female with a squamous cell carcinoma in the lower gingival region. Her performance status was relatively low due to general osteoporosis. The patient was therefore treated with Nd-YAG laser cauterization and did not undergo radical surgical resection. The laser operation could be performed under local anesthesia, and no serious postoperative complications were noted. The tumor was completely removed by this conservative laser treatment. The QOL of the patient was well-maintained without signs of recurrence. Based on our experience, laser treatment can be indicated in cancer patients fulfilling the following criteria: 1) no evidence of bone destruction, 2) no lymph nodes metastases and 3) no distant metastases.

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