Japanese Journal of Oral and Maxillofacial Surgery
Online ISSN : 2186-1579
Print ISSN : 0021-5163
ISSN-L : 0021-5163
Volume 42, Issue 1
Displaying 1-21 of 21 articles from this issue
  • Correlation with prognosis
    Hideo KUROKAWA, Yoshihiro YAMASHITA, Hiroaki ISHIBASHI, Minoru KAJIYAM ...
    1996 Volume 42 Issue 1 Pages 1-7
    Published: January 20, 1996
    Released on J-STAGE: July 25, 2011
    JOURNAL FREE ACCESS
    We evaluated the histological malignancy score using a modification of Jacobson's method (1973) in 202 patients with primary episodes of oral squamous cell carcinoma, and investigated the relation between the histological malignancy score and the clinical features and outcome.
    There was a correlation between the histological malignancy score and prognosis, with a higher malignacy score being associated with a poorer prognosis.
    Futhermore, progressive carcinomas were associated with a very low survival rate even within cases assigned the same malignancy score.
    A high malignancy score was associated with a high frequency of lymph node metastasis on initial examination, suggesting a correlation between histological malignancy score and lymph node metastasis.
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  • Takeo SHIOZAKI, Hiroyasu NOMA
    1996 Volume 42 Issue 1 Pages 8-21
    Published: January 20, 1996
    Released on J-STAGE: July 25, 2011
    JOURNAL FREE ACCESS
    The purpose of this study was to elucidate the relationship between clinicopathologic malignancy and the distribution of both cytokeratin 19 (CK19) and type IV collagen in tongue carcinoma. The localization of CK19 and type IV collagen was examined immunohistochemically in biopsy specimens of 44 cases of squamous cell carcinomas of the tongue. The positive rates of both CK19 and type IV collagen were measured using a multipurpose image processor. CK19 expression was evaluated by (1) the ratio of number of positive cases to the total number of cases, (2) the ratio of area of positive sites to the area of the tumor, and (3) the expression pattern. The localization of type IV collagen was estimated as the ratio of the segmental length of positive sites to the external length of the tumor. We alsoexamined the relationship between the immunohistochemical results and prognostic factors, including the degree of differentiation, the size of the primary tumor, the mode of invasion, the presence or absence of lymph node metastasis, and the malignancy grading score of Anneroth. The correlation in the positive rates between CK19 and type IV collagen was also examined.
    The positive rates of CK19 were higher in poorly differentiated carcinomas than in other lesions. Expression pattern III, in which the positive cells were distributed over the entire of tumor cell nest, was more commonly detected, although no significant difference was evident. No correlation was found between the size of the primary tumor and the expression of CK19. Invasion mode 4 C/D and a high grade of histological malignancy were observed primarily in cases with the expression pattern DI for CK19. A high positive rate and CK19 expression pattern DI were prominent in the group with lymph node metastasis. Expression pattern Ill for CK19 was more frequently found in lymph node metastasis than in the primary tumor. Low positive rates for type IV collagen were noted in cases of differentiation grade HI, tumor size T 3/4, invasion mode 4 C/D, and lymph node metastasis. The positivie rate for type IV collagen was lower in cases with a CK19 expression pattern DI than in those with patterns I and II, although the correlation coefficient between the areawise positive rate for CK19 and the positive rate for type IV collagen was not high.
    These results suggest that the distribution of CK19 and type IV collagen may be related to clinicopathologic malignancy in tongue carcinoma.
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  • Comparison of effects between cisplatin and carboplatin
    Sumio SAKODA, Ryosuke SHIBA, Masato HAMADA, Mitsuhiro KOMURA, Yoshitak ...
    1996 Volume 42 Issue 1 Pages 22-28
    Published: January 20, 1996
    Released on J-STAGE: July 25, 2011
    JOURNAL FREE ACCESS
    The effects of two different neo-adjuvant chemo- and radio-therapies against squamous cell carcinomas of the head and neck were compared histologically.
    Group A consisted of 15 patients who received intra-arterial cisplatin (20 mg/m 2) on day 1 and 8, and intrarectal tegafur (1500 mg/day) from day 1 through 14, and irradiation of 2 Gy from day 1 through 5 and from day 8 through
    Group B consisted of 14 patients, who received intra-arterial carboplatin (100 mg/m 2) on day 1 and 8, and intrarectal tegafur (1500 mg /day) from day 1 through 14, and irradiation of 2 Gy from day 1 through 5 and from day 8 through 12.
    There was no difference between the groups in sex, age, T- and Stage-classification, and tumor cell differentiation.
    Therapeutic effects were evaluated according to Oboshi's classification on the basis of resected tumor tissues. A grade of II B or more was judged as respondent, and a grade of less than Grade II A as nonrespondent. Seven out of 15 patients (46.7%) in group A and 8 out of 14 patients (57.1%) in Group B were judged as respondent. There was no significant difference in the respondent rate between the two groups. Mucositis occurred frequently, but surgery was not delayed in any patient.
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  • Masahiko MATSUURA
    1996 Volume 42 Issue 1 Pages 29-41
    Published: January 20, 1996
    Released on J-STAGE: July 25, 2011
    JOURNAL FREE ACCESS
    Tumor infiltration to the tongue, metastasis, and the cellular reaction of cervical lymph nodes were studied histologically in a rabbit VX 2 tongue cancer model to examine the process of lymphatogenic metastasis.
    Rabbits were killed on the 3 rd, 7 th, 14th, and 21st days after transplantation of a VX 2 cancer cell suspension into the left lateral border of the tongue. The tongue and cervical lymph nodes were removed, and all deparaffininized sections prepared by a routine method were stained with hematoxylin-eosin and observed by light microscopy. Particularly, the cellular reaction of cervical lymph nodes was examined for signs of sinus histiocytosis (SH), paracortical area hyperplasia (PH), and germinal center hyperplasia (GCH).
    The transplanted tongue cancer showed increased proliferation and infiltration with time; lymph node metastasis also increased. Metastasis was not always found in lymph nodes with a positive cellular reaction. However, the cellular reaction of cervical lymph nodes was already observed on the 3 rd day after transplantation of the VX 2 cancer cell suspension, and it became more marked with time. SH and PH were initially remarkable, and then GCH developed. The cellular reaction of lymph nodes distal to the tongue was weaker than that of proximal lymph nodes. It was suggested that the route of lymphatogenic metastasis can be estimated before cancer formation by evaluating the cellular reaction of cervical lymph nodes.
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  • Part 1. Relation to smoking, drinking and dietary habits
    Makoto YAMBE, Iwai TOHNAI, Minoru UEDA, Yoshiyuki OHNO, Tetsuya TAGAWA
    1996 Volume 42 Issue 1 Pages 42-50
    Published: January 20, 1996
    Released on J-STAGE: July 25, 2011
    JOURNAL FREE ACCESS
    To survey the etiological factors of oral cancer, we conducted a case-control study. One hundred patients with newly diagnosed oral cancer, histopathologically confirmed, who were treated at the Department of Oral Surgery, Nagoya University Hospital between 1986 and 1993 were studied as cases. One hundred controls were randomly selected from among in -patients and outpatients without oral or lip cancer who were treated at the same department during the study period. Both groups were matched for sex, age (± 1 year), and residential area. Epidemiological information on living habits was collected by personal interviews of the subjects, using a standardized questionnaire.(a) Current smoking significantly in -creased the risk of oral cancer by 4.26 times (95% confidence interval (CI): 1.54-11.76) in males and by 5.28 times (1.19-23.36) in females. A significant dose-respose relation between the risk of oral cancer and the Brinkman index was noted in males.(b) Current alcohol drinking also increased the risk by 3.09 times (1.19-8.05) in males and by 2.69 times (0.85-8.48) in females. A significant dose-respose relation between the risk of oral cancer and the Sake index was noted in males.(c) Men who prefer a salty taste were at significantly higher risk (Odds ratio=2.82; 1.35-5.91), as were men who prefer a hot taste (2.19; 1.07-4.47). Men who ingested soup or pickles three times or more per week also had a significantly increased risk (3.58; 1.73-7.44 and 2.06; 1.01-4.21, respectively).
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  • Naritaka MIZUTANI, Yukihiko KINOSHITA, Hideyuki MIZUNUMA, Shin-ichi FU ...
    1996 Volume 42 Issue 1 Pages 51-55
    Published: January 20, 1996
    Released on J-STAGE: July 25, 2011
    JOURNAL FREE ACCESS
    A human melanoma cell line was established from the metastatic tumor tissue of a cervical lymph node, which originated from a malignant melanoma of the hard palate in a 63-year-old man. Eagle MEM supplemented with 15% FCS was used as a culture medium, and the tumor tissue was cultured in an atmosphere of 5% CO2. The spindle-shape cells which produced melanin were noted 2 weeks after the beginning of culture. The cell line was named SSM-1 after 55 passages. The doubling time was 70 hours, and the cell density was 3 × 105cell/cm2. Electron microscopy revealed the presence of immature and mature melanosomes on the cytoplasm of the cultured cells.
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  • Analysis of chemical mediators
    Michio TOKUHISA, Naohiro TOMINAGA, Motoki NAKAMURA, Toru FUJIKI, Yoshi ...
    1996 Volume 42 Issue 1 Pages 56-64
    Published: January 20, 1996
    Released on J-STAGE: July 25, 2011
    JOURNAL FREE ACCESS
    In order to investigate the mechanisms of the many favorable properties of chitin membrane on wound healing, human gingival fibroblast-like cells (HGF) were cultured on chitin membrane or other wound dressing materials, and the chemical mediators in the supernatant of HGF cultures were analyzed. Furthermore, the supernatants of macrophage cultures on each wound dressing material were added to the HGF cultures on the same materials, and the chemical mediators in the supernatant were analyzed in a similar manner to examine the interaction between macrophages and human gingival fibroblasts. Monocyte chemotaxis assay was carried out by a membrane filter method, and the production of interleukin-1 (IL -1) was measured by enzyme-linked immunosorbent assay using monoclonal antibodies to human IL-1 α and IL-1 β Furthermore, the production of prostaglandin E 2 (PGE 2) was measured by enzyme immunoassay (EIA). When HGF were seeded on a chitin membrane, chitin induced less production of chemical mediators than the other wound dressing materials. Similarly, when the supernatant of the macrophage culture on chitin was added to the HGF culture on chitin, these mediators were induced to a lesser degree than the others. These results suggest that after the resolution of acute inflammation at the injured sites and the formation of granulation tissue, localized inflammatory response mediated by the activity of inflammatory mediators induced by the wound dressing material might become exessive. Therefore, one of the mechanisms responsible for the favorable properties of chitin might be related to its lower ability to induce inflammatory chemical mediators arising from the interaction between monocytes and fibroblasts.
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  • Masahiro UMEMURA
    1996 Volume 42 Issue 1 Pages 65-71
    Published: January 20, 1996
    Released on J-STAGE: July 25, 2011
    JOURNAL FREE ACCESS
    It has been suggested that basic fibroblast growth factor (bFGF) is involved in wound healing. However, the location and demeanor of bFGF in postoperative scar tissue are still unknown. The purpose of this study was to identify bFGF and to examine the physiological significance of bFGF in human postoperative scars after lip replasty.
    Twenty-four samples of human scar tissue were collected at the time of lip replasty. Five samples of adult normal skin were used as control.
    The samples were thawed and homogenized in 0.15M (NH4) 2SO4. The homogenate was ultracentrifuged, and the supernatant was adjusted to pH 7.0 (crude sample). An aliquot of the crude sample was assayed by enzyme-linked immunosorbent assay (ELISA) for bFGF activity. The crude sample was applied to a heparin-sepharose column, and eluted with a stepwise gradient of NaCl (purified sample). BFGF activity of each fraction was measured by ELISA. The recovery rate was expressed as the ratio of the purified sample to the crude sample. The purified sample having the highest bFGF activity by ELISA was measured for its effect on BALB/3 T 3, Clone A 31 growth. The distribution of bFGF was studied immunohistochemically in fresh frozen sections.
    Comparable colorimetric activity was obtained for both purified samples and crude samples by ELISA. The highest bFGF activity by ELISA was eluted at about 2.0M NaCl. BALB /3 T 3, CloneA 31 growth was accelerated by purified samples having the highest bFGF activity. Immunohistochemically, bFGF was detected in basement cells and epithelial glands. As mentioned above, the bFGF was identified and was then highly purified with a heparinsepharose column.
    The bFGF activiy of the scar tissue was significantly higher than that of the adult normal skin.
    We surmised that bFGF released passively into the tissue continues to accumulate throughout the wound healing process, not only in the early stage but also in the late stage.
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  • I. Changes in joint morphology
    Shigeyuki TAKATSUKA, Masayoshi NARINOBOU, Yoshiyuki KUBOTA, Kiyomasa N ...
    1996 Volume 42 Issue 1 Pages 72-78
    Published: January 20, 1996
    Released on J-STAGE: July 25, 2011
    JOURNAL FREE ACCESS
    Imaging technique advancements have contributed to improved understanding of the pathogenesis of internal derangement of the temporomandibular joint. Although repositioning of the dislocated disc is the most commonly employed to treat this condition, discectomy is indicated for degenerated discs. Arthritic changes have been observed in joints after disc removal, suggesting the need for interpositional material. Since silicone implants placed after discectomy have caused osseous destruction, there is controversy about the use of interpositional materials after discectomy. Recent studies recommend the use of autogenous materials for replacement. Among them, auricular cartilage seems one of the best suited materials for disc replacement. The purpose of this study was to investigate morphological and functional changes after auricular grafts were placed in temporomandibular joints after disc removal. Rabbits for this experimental study were divided into two groups: rabbits in one group underwent discectomy alone, and the other group underwent auricular grafting after discectomy. H & E stain and toluidine blue stain revealed complete resorption of the articular cartilage with surface flattening in the discectomy alone group. Finally, regeneration of the fibro-cartilage cells resulted in retention of the articular cartilage layer on the condyle with a flattened articular surface. In contrast, a virtually normal shape was maintained in the auricular graft group, but the implant underwent resorption and fragmentation after 6 weeks. Finally, a depression was formed only on the surface of eminence. The results indicated that grafted auricular cartilage protected the rabbit condyle from early degenerative changes and suppressed morphological changes after discectomy.
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  • Yasunobu FURUYA, Kojiro ONIZAWA, Koichiro SUZUKI, Yuko NOGUCHI, Hirosh ...
    1996 Volume 42 Issue 1 Pages 79-81
    Published: January 20, 1996
    Released on J-STAGE: July 25, 2011
    JOURNAL FREE ACCESS
    A rare case of synchronous multiple cancers of the mandibular gingiva and the breast is presented. A 62-year-old woman was referred to our department complaining of tenderness in the right mandibular gum. Oral examination revealed a mass with ulceration and induration at the site of tenderness. The mass was histologically diagnosed to be a squamous cell carcinoma. On admission, she complained of a firm mass in her breast. Examination of a biopsy specimen taken from the lesion indicated a malignancy. Consequently, the patient was given a diagnosis of synchronous multiple cancers of the mandibular gingiva and the breast. Based on consultation with endocrinologic surgeons, the oral cancer was initially resected, followed by mastectomy 2 weeks later. Eight months after the completion of treatment, there has been no evidence of local recurrence or distant metastasis.
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  • Tomokatsu SAITO, Yoshimi ISHIKAWA, Ryoichi KAWABE, Susumu OMURA, Kiyoh ...
    1996 Volume 42 Issue 1 Pages 82-84
    Published: January 20, 1996
    Released on J-STAGE: July 25, 2011
    JOURNAL FREE ACCESS
    The occurrence of acinic cell carcinoma in the minor salivary glands is rare. This paper describes the clinical behavior and pathological findings of two such cases. The first case was a 72-year-old woman complaining of an asymptomatic mass in the left retromolar region. The mass measured approximately 21× lO× 4 mm. The second case was a 70-year-old woman complaining of an asymptomatic mass just beneath the left buccal mucosa. The mass measured approximately 12× 9 × 8 mm. No regional lymph nodes were palpable in either patient. The masses were resected in both patients and recovery was uneventful. As of 15 months after operation, there have been no signs of local recurrence or distant metastasis. Histologically, the tumor consisted of large cuboidal and cylindrical cells with a pale eosinophilic cytoplasm and small, hyperchromatic nuclei. Most of the cells were arranged in a solid alveolar pattern. A papillary-cystic pattern was partly observed in the second case. Since acinic cell carcinoma is a loe grade malignancy, long-term follow-up is mandatory in both patients.
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  • Hiroyasu TAMAKI, Jun-ichi YASUDA, Seiji TANIGUCHI
    1996 Volume 42 Issue 1 Pages 85-87
    Published: January 20, 1996
    Released on J-STAGE: July 25, 2011
    JOURNAL FREE ACCESS
    Ameloblastoma, especially peripheral ameloblastoma, which arises in oral soft tissue and usually develops extraosseously, is a very rare odontogenic tumor. We describe a case of ameloblastoma that originated in the anterior mandible and persisted for 15 years. The case was in a 61-year-old man, who presented with a 22× 18× 10 mm tumor on the lingual surface of the anterior mandible. Radiographic examination revealed no intraosseous destruction of the mandible. The preoperative clinical diagnosis was an epulis, and the tumor was resected under local anesthesia. The resected tumor was histologically diagnosed to be a peripheral ameloblastoma. Histologically, cord-like or meshwork-like nests of tumor cells were observed below the epithelium. Distinct continuity was noted between the epithelium and the nests. Histologically, the tumor basically showed a plexiform pattern, but an acanthomatous pattern was also noted frequently. There have been no signs of relapse as of two years after operation.
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  • Masashi SUZUKI, Jun-ichirou NARA, Koichi KUBO, Masanori TAKEKAWA, Mits ...
    1996 Volume 42 Issue 1 Pages 88-90
    Published: January 20, 1996
    Released on J-STAGE: July 25, 2011
    JOURNAL FREE ACCESS
    Conventionally, an ameloblastoma with metastasis was diagnosed as a malignant ameloblastoma. In the new classification of odontogenic tumors revised by the WHO in 1992, the diagnosis of malignant ameloblastoma is based on cytological criteria. Malignant ameloblastoma is defined as a neoplasm in which the pattern of an ameloblastoma and the cytological features of malignancy are shown by the primary lesion in the jaws and/or any metastatic lesion.
    We reported a case of recurrent ameloblastoma of the right mandibule with metastatic lymph nodes six years after primary treatment. There was metastasis to the buccal and submandibular lymph nodes on the right side. There were no cytological features of malignancy in either the mandibular lesion or metastatic lymph nodes.
    According to general concepts of pathology, the criteria for malignancy includes recurrence and metastasis as well as cytological features. The criteria for malignant ameloblastoma require further discussion.
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  • Takao IMAI, Tadao OHTANI, Masatami KATO, Yuji KAMIYA, Kenzou ONO
    1996 Volume 42 Issue 1 Pages 91-93
    Published: January 20, 1996
    Released on J-STAGE: July 25, 2011
    JOURNAL FREE ACCESS
    Hemangiopericytoma is extremely rare in the oral cavity. We encountered and treated a case of hemangiopericytoma of the lower lip. The patient was a 1-year 9-monthold girl. She visited our department with the chief complaint of swelling of the lower lip. The tumor was surgically enucleated under general anesthesia. Histopathologic study revealed a hemangiopericytoma. Recurrence and metastasis have not been detected, and progress is good as of 3 years 6 months after operation.
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  • Mikiko TAKANO, Kazuhiro TOMINAGA, Yasuaki SHIBATA, Haruo OKABE, Akio M ...
    1996 Volume 42 Issue 1 Pages 94-96
    Published: January 20, 1996
    Released on J-STAGE: July 25, 2011
    JOURNAL FREE ACCESS
    Central fibroma of the jaw is a rare benign tumor. A case of central fibroma of the mandible in a 59-year-old woman is presented.
    Physical examination disclosed a slight and diffuse swelling in both premolar and molar regions of the right mandible. Radiographic examination revealed multi-locular radiolucency in the right mandible. It also revealed bulging of the bone cortex. Histopathologically, the tumor consisted of spiral collagen fibers, which contained many fibroblastic cells. There was no odontogenic epithelium or calcified components.
    It was impossibie to determine whether the origin of the fibroma was odontogenic or nonodontogenic. The patient's postoperative course is satisfactory, without recurrence.
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  • Wakako OHTSUKA, Yoshihito ISHIKAWA, Yonosuke SUZUKI, Katsunori SEKI, K ...
    1996 Volume 42 Issue 1 Pages 97-99
    Published: January 20, 1996
    Released on J-STAGE: July 25, 2011
    JOURNAL FREE ACCESS
    A case of central giant cell granuloma of the bilateral mandibular angle is reported. The patient was a 12-year-old girl. The differential diagnosis of this case was difficult. The lesion developed at 11-years of age, which is too old for cherubism. This patient had mild, painless swelling at the bilateral mandibular angle. The eyeballs were normal; the patient did not have a “cherubic look.” The patient had no family history of similar lesions and no abnormal dental findings. A central giant cell granuloma was therefore diagnosed. The lesion was removed completely under general anesthesia. The patients postoperative course was good. There have been no signs of recurrence as of almost one year six months after surgery.
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  • Hiroaki ISHII, Hajime SHIMIZU, Susumu ARUGA, Yasuhiro MATSUMOTO, Masar ...
    1996 Volume 42 Issue 1 Pages 100-102
    Published: January 20, 1996
    Released on J-STAGE: July 25, 2011
    JOURNAL FREE ACCESS
    We report a case of candidiasis occurring in the maxillary sinus.
    The patient was a 53-year-old woman who presented with a major complaint of a strange feeling of the right cheek. Computed tomographic examination revealed an opaque, softtissue-like mass in the right maxillary sinus, which contained a high-density region. The clinical diagnosis was right chronic maxillary sinusitis accompanied by a foreign body in the maxillary sinus.
    Caldwell-Luc operation was performed under general anesthesia. Caseous material was found in the sinus, and it was removed. The postoperative histopathological diagnosis was candidiasis. Three years have passed since operation, and the patient's progress has been good.
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  • Kazuhisa TANGE, Munetaka ARAO, Mikio SHIMIZU, Kayoko OKUMURA, Susumu O ...
    1996 Volume 42 Issue 1 Pages 103-105
    Published: January 20, 1996
    Released on J-STAGE: July 25, 2011
    JOURNAL FREE ACCESS
    In our department, approximately 40% of the patients with temporomandibular disorders voluntarily discontinue treated. This led us to conduct a follow-up study.
    Two hundred nine patients were mailed a questionnaire an average of two years after treatment. One hundred fifteen patients responded. Among the 115 respondents, we examined the following two groups: one group with 45 patients who completed treatment, and another with 40 patients who voluntarily discontinued treatment. The result showed few noticeable differences between the two groups in terms of current joint condition, except for joint noise.
    The major reason for discontinuation of treatment was that symptoms had resolved partially, although not completely.
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  • Arthroscopic findings
    Norihiko TAKADA, Hisamichi GOHKE, Hideki SEKIYA, Toshirou KONDOH, Nobu ...
    1996 Volume 42 Issue 1 Pages 106-108
    Published: January 20, 1996
    Released on J-STAGE: July 25, 2011
    JOURNAL FREE ACCESS
    Rheumatoid arthritis (RA) is a chronic inflammatory disease.
    We have attempted diagnostic arthroscopy in a patient with RA associated with symptoms in the temporomandibular joint.
    Arthroscopic examination showed synovial hyperplasia, inflammation, chondromalacia, fibrosis, and adhesion of the upper joint space.
    A biopsy specimen was taken from one region with synovial hyperplasia, and the histological examination revealed chronic inflammatory changes.
    The histological findings were consistent with the arthroscopic findings.
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  • Hiroyuki SAKAMAKI, Masakazu AKIBA, Mutsuhiro SEKI, Hiroaki KUJIRAOKA, ...
    1996 Volume 42 Issue 1 Pages 109-111
    Published: January 20, 1996
    Released on J-STAGE: July 25, 2011
    JOURNAL FREE ACCESS
    The basic principles of treatment for fractures are restoration of the original position, anatomical form, and functions of the affected bone; surgical damage should be minimized. A modified surgical method, closed reduction under fluoroscopy, was used to reduce a condylar process fracture. A 15-year-old man presented to our hospital with a fracture of the right condylar process. The maximal interincisal distance of mouth opening was 37mm. Radiography showed dislocation and anteromedial deviation of the process fragment. Closed reduction was performed applying a blunt-tip trocar for arthroscopic surgery with its outer sheath as an elevator. The elevator was inserted through the skin in front of the fractured process, and the fragment was reduced with manipulation under fluoroscopy. Intermaxillary fixation was maintained for 48 days. The patient's postoperative course was excellent except for slight transient hypoesthesia of the right lower lip. This procedure has the advantages of minimizing the length of the incision, skin scaring, and risk of injury to the facial nerve and parotid gland.
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  • Eiji NAKAMURA, Tadashi MIKOYA, Noriyuki TAKASHI, Fumiko DEYAMA, Yasuno ...
    1996 Volume 42 Issue 1 Pages 112-114
    Published: January 20, 1996
    Released on J-STAGE: July 25, 2011
    JOURNAL FREE ACCESS
    For secondary reconstruction of the alveolar process in a 19-year-old woman with left cleft lip and palate, a bone graft was performed using new bone formed in bony cavities in the mandible. First, the maxillary oral-nasal fistula was closed with a labial sulcus flap, and large bony cavities were created by removing the bone in the third molar area of the mandible. Three months later, when new bone was formed in the cavities, it was harvested and packed into a defect of the alveolar process. The new bone closely filled all corners of the defect. Bone-bridge formation was completed 9 months after grafting. The advantages of this procedure were an intraoral approach, easy access to the donor site, and high plasticity of newly formed bone. Thus, bone newly formed in the mandible is considered a very useful material for the reconstruction of alveolar clefts.
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