Japanese Journal of Oral and Maxillofacial Surgery
Online ISSN : 2186-1579
Print ISSN : 0021-5163
ISSN-L : 0021-5163
Volume 49, Issue 4
Displaying 1-14 of 14 articles from this issue
  • Comparison with atelo-peptide collagen (Cellmatrix LA®) as a carrier
    Shinji KAIHARA, Kazuhisa BESSHO, Kazuma FUJIMURA, Yasunori OKUBO, Juny ...
    2003 Volume 49 Issue 4 Pages 241-245
    Published: April 20, 2003
    Released on J-STAGE: April 22, 2011
    JOURNAL FREE ACCESS
    We evaluated the usefulness of atelo-collagen sponge (ACS)(TERUPLUG®, TERMO CORPORATION, Tokyo) as a carrier for Escherichia coli-derived recombinant human bone morphogenetic protein-2 (ErhBMP-2) as compared with that of atelo-peptide collagen (CL)(Cellmatrix LA, Nitta Gelatin Inc., Osaka, Japan), which we previously demonstrated to be useful for bone induction. Five micrograms of ErhBMP- 2 with either 3 mg of ACS (ACS group) or 3 mg of CL (CL group) was implanted into the calf muscle of 13 10-week-old Wistar rats. The implanted material was sampled on days 7, 14, and 21 after implantation (5 specimens each per time, group). Radiographic evaluation, histological analysis, and biochemical examinations were performed. On radiographic evaluation, no opaque shadows were observed 7 days after implantation in either group. Oval shadows were observed 14 days after implantation. Twentyone days after implantation, the area of the shadows had increased. On histological analysis, much new cartilage was observed 7 days after implantation in both groups, but immature endochondral ossification was observed in only the ACS group. Endochondral ossification was found on the outermost edge of the implant after 14 days in both groups. After 21 days, mature bone had formed. On biochemical examinations on days 7 to 14 after implantation, alkaline phosphatase (ALP) activity and the calcium (Ca) content had increased markedly in both groups. On days 14 to 21 after implantation, ALP activity and Ca content increased gradually. These findings were similar in both groups.
    Our results suggest that, similar to CL, ACS is useful as a carrier for ErhBMP-2 designed to promote new bone formation.
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  • Shinya YURA, Yasunori TOTSUKA, Kazuhiro OOI, Akiko MABUCHI, Hiromasa H ...
    2003 Volume 49 Issue 4 Pages 246-251
    Published: April 20, 2003
    Released on J-STAGE: April 22, 2011
    JOURNAL FREE ACCESS
    We describe procedures for arthrocentesis based on arthroscopic findings and report the therapeutic usefulness of these procedures in 46 patients with closed lock of the temporomandibular joint.
    Arthroscopic examination was done under local anesthesia in the outpatient clinic. An 18-gauge needle and a trocar for a 0.8-mm rod-lens fiberscope were inserted into the anterior and posterior compartments of the upper joint space, respectively. The anterior compartment was then observed with special respect to the presence of adhesion. In joints without adhesion, irrigation was done under low hydraulic pressure. In joints with adhesion, irrigation was performed under sufficient hydraulic pressure (maximum pressure exerted, 40 KPa) to widen the upper joint space. Manipulation was performed after irrigation.
    Eight weeks after these two procedures, the range of maximum mouth opening increased from 2 to 20 mm and averaged 10.3 mm in 18 patients without adhesion. In 28 patients with adhesion, the increase in maximum mouth opening ranged 3 to 25 mm and averaged 9.1 mm. There was no significant difference in the increase in maximum mouth opening between these two groups.
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  • Hidetaka YOKOE, Keisuke TASHIRO, Toshihide WATANABE, Katsunori OGAWARA ...
    2003 Volume 49 Issue 4 Pages 252-256
    Published: April 20, 2003
    Released on J-STAGE: April 22, 2011
    JOURNAL FREE ACCESS
    In this study, we evaluated the effect of postoperative pain relief witha PCA (patient controlled analgesia) pump system in patients with head and neck cancer. Fifteen patients underwent surgery for head and neck cancer and were subsequently given analgesia via continuous intravenous infusion of morphine (0.5 to 1.2mg/hr, for 48 hours). Pain was assessed by means of a visual analogue scale (VAS), pain score, and sedation score at 12, 24, 36, and 48 hours after surgery. The occurrence of side effects was studied. Pain intensity evaluated according to the VAS was under 5 cm or less in all 15 patients and 2 cm or less in 7 patients (46.7%) 12 hours after surgery. Forty-eight hours after surgery, 8 of the 15 patients were pain free. The use of other analgesics such as opioid analgesics, nonsteroidal anti-inflammatory drugs, or both was lower in the PCA pump system group than in patients who did notuse a PCA pump system. Deep sedative status did not develop in any of the 15 patients. Suppression of enterokinesis occurred in some patients, but responded to glycerol enema, and adynamic ileus did not develop. Continuous infusion of morphine with a PCA pump can be highly effective and safe for the control of postsurgical pain in the head and neck region.
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  • Satoru SHINTANI, Junya YANO, Koh-ichi NAKASHIRO, Hiroaki KAYAHARA, Nag ...
    2003 Volume 49 Issue 4 Pages 257-263
    Published: April 20, 2003
    Released on J-STAGE: April 22, 2011
    JOURNAL FREE ACCESS
    Sentinel lymph node biopsy (SLB) is a rational method to avoid unnecessary neck dissection in patients with clinical N 0 oral cancer. At our department, dye-guided SLB has beencarried out since 2000. Since March 2002, we combined dye-guided and radioisotope (RI)-guided techniques.We describe the introduction and present status of this new technique.
    When adopting this RI technique, we encountered difficulties in understanding and cooperation by related personnel, including the nurses of the operating room. The problems pointed out focused on exposure of operators, nurses, and anesthesiologists to radioactivity, custody and disposition of radioactive waste, and radioactive contamination of operative and anesthetic instruments. We estimated that the average radiation dose to which the operators were exposed was 3.8 μSv. Radiation exposureof the nurses and anesthetists was negligible. The average radioactivity of the operation wastes was 1.3μSv/hr, and that of the operation instruments was 0.3 μSv/hr. These results indicate no problematicradioactive contamination, and we believe that this procedure causes no radiological damage to clinicalcoworkers. At present, we carry out combined dye-guided and RI-guided SLB with the cooperation of relatedpersonnel, including the nurses of the operation room.
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  • Takashi MIMA, Syoichiro ISHII, Toyomi OKAUCHI, Atsuyuki MORI, Yukiko Y ...
    2003 Volume 49 Issue 4 Pages 264-267
    Published: April 20, 2003
    Released on J-STAGE: April 22, 2011
    JOURNAL FREE ACCESS
    Malignant schwannoma is a malignancy of a peripheral nerve. This tumor rarely occurs in the oral region.
    We report a case of malignant schwannoma arising in the mandible of a 60-year-old man. The tumor and regional mandibular bone were excised. On microscopic examination, the tumor was mainly composed of short spindle-shaped cells, arranged in dense, interlacing fascicles or whorls. Immunohistochemically, the tumor cells were positive for S-100 protein and neuron-specific enolase. Ultrastructurally, the tumor cells contained fibrous long-spacing collagen. The relevant literature is discussed.
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  • Toshinori WAKATSUKI, Hiroshi YUSA, Mayu NAKANO, Toru YANAGAWA, Kojiro ...
    2003 Volume 49 Issue 4 Pages 268-271
    Published: April 20, 2003
    Released on J-STAGE: April 22, 2011
    JOURNAL FREE ACCESS
    A case of synchronous double cancers of the tongue and esophagus in a 57-year-old man is presented. The tongue cancer was histologically diagnosed as squamous cell carcinoma and successfully treated with preoperative radiochemotherapy and repeated operations. Endoscopic examination performed before treatment of the tongue cancer revealed no abnormal features in the esophagus. One month after completion of treatment for the tongue cancer and 3.5 months after initial endscopic examination, an advanced esophageal cancer was detected and histologically diagnosed as carcinosarcoma. He died of uncontrolled esophageal cancer and metastasis. The patient's history, such as heavy smoking, overconsumption of alcohol, preoperative radiochemotherapy, and repeated operations for tongue cancer, suggested that he might be an immunocompromised patient with a high risk of synchronous double primary cancers.
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  • Yasuhito ARAI, Yoko SAKUMA, Shigeru YOKOZAWA, Minoru UCHIDA, Hiroki FU ...
    2003 Volume 49 Issue 4 Pages 272-275
    Published: April 20, 2003
    Released on J-STAGE: April 22, 2011
    JOURNAL FREE ACCESS
    Pleomorphic adenoma is the most common tumor of the salivary glands. In the major salivary glands, the parotid gland is the most common site of this tumor, followed by the submandibular gland. Pleomorphic adenoma shows remarkable variation of histopathological characteristics and often contains mesenchymal components, including myxoid or chondroid tissues. We present a rare case of pleomorphic adenoma in the submandibular gland with remarkable bone formation. A 37-year-old Japanese man was referred to us because of a mass in the submandibular gland, measuring 70×60 mm. The mass had first been noticed more than 10 years previously and thereafter slowly increased in size. It was removed under general anesthesia, and the entire surgical specimen was processed for microscopic examination. The tumor was diagnosed to be a pleomorphic adenoma. Histologically, the main components were duct cells and sheets of tumor cells. In stromal regions, cartilage and remarkable bone formation were observed with myxomatous changes. The patient is presently doing well 10 years after surgery. We report the histopathological findings and describe the diagnostic images of this case.
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  • Hideto SATOH, Kazutoshi OHTA, Takehisa OHBAYASHI, Hironori MIGIYAMA, M ...
    2003 Volume 49 Issue 4 Pages 276-279
    Published: April 20, 2003
    Released on J-STAGE: April 22, 2011
    JOURNAL FREE ACCESS
    Multiple endocrine neoplasia (MEN) include three genetically distinct disorders: MEN 1, MEN 2 A, and MEN 2 B. These three syndromes are inherited as autosomal dominant traits, although each may also occur sporadically. MEN 2 B is characterized by medullary thyroid carcinoma, pheochromocytomas, mucosal neuromas, ganglioneuromas of the intestinal tract, and Marfan's syndrome. The case of a 27-year-old man with MEN 2 B is reported. The lips were diffusely enlarged, with distinct projections at the central part of the upper and lower lips caused by neuromatous enlargement. The chief involvement of the tongue affected the dorsum and appeared as multiple nodules of varying size. Biopsies of some nodules of the tongue were obtained. Histological and immunohistochemical studies (HE, S-100 protein and NSE) showed hyperplasia and hypertrophy of nerves, suggesting neuroma. The oral aspects of MEN 2 B are important since they are the initial manifestations of this disorder, preceding thyroid carcinoma by as much as 10 to 20 years. Failure to recognize the syndrome may have unfortunate consequences for the patient, since proper treatment of the thyroid tumor that may arise in childhood will not be provided. Therefore, it is vary important for dentists and physicians who treat oral diseases to carefully examine the oral cavity.
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  • Futoshi IWAKI, Michiya NAGANO, Masanobu OHNISHI
    2003 Volume 49 Issue 4 Pages 280-283
    Published: April 20, 2003
    Released on J-STAGE: April 22, 2011
    JOURNAL FREE ACCESS
    A case of arteriovenous malformation (AVM) of the upper lip is reported. A 47-year-old man complained of swelling and spontaneous bleeding of the right upper lip, without pain. Physical examination showed a 10×20mm palpable soft mass in the lesion. Angiograms of the external carotid arteries revealed a diffuse AVM involving the right upper lip. The AVM was supplied by both facial arteries. Superselective embolization of the feeding arteries was performed preoperatively. Surgical excision of the AVM was done simultaneously. Blood loss was 65ml. The patient remained asymptomatic 34months after the procedures.
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  • Yoshinori KANOH, Naoyuki KAKAMI, Mitsuhiro AMANO, Chikako TANAHASHI, Y ...
    2003 Volume 49 Issue 4 Pages 284-286
    Published: April 20, 2003
    Released on J-STAGE: April 22, 2011
    JOURNAL FREE ACCESS
    We describe an infant with polydactylia who presented with a mucous cyst of the floor of the mouth that was associated with thumb sucking.
    A 8 -month-old boy with a ventricular septal defect, pulmonary atresia, and polydactylia was referred to us because of a cystic swelling in the right side of the floor of the mouth. There was no history of trauma, but thumb sucking became frequent before the swelling had occurred. When the infant sucked this thumb, his left thumb and radial duplicated thumb were placed in the oral cavity. His thumb was put between the maxilla and the tongue, but a small radial thumb was placed on the right side of the floor of the mouth. This manner of thumb sucking, with the duplicated thumb rubbing against the floor of the mouth, apparently caused the mucous cyst of the floor of the mouth.
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  • Yoshiko MITSUYASU, Takeshi MITSUYASU, Norifumi NAKAMURA, Akihiko NAKAS ...
    2003 Volume 49 Issue 4 Pages 287-290
    Published: April 20, 2003
    Released on J-STAGE: April 22, 2011
    JOURNAL FREE ACCESS
    The marsupialization technique is a useful method for the treatment of odontogenic cysts, especially in young patients. However, we sometimes have trouble in controlling impacted teeth associated large cysts. We report the case of a large mandibular odontogenic cyst that was treated by marsupialization and tooth traction technique. The patient was a 12-year-old boy with a swelling of the right side of the mandible. Radiographically, the lesion showed a well-defined unilocular radiolucent area, including three impacted teeth. The lesion was marsupialized and the impacted teeth were moved by tooth traction technique. Histologically, the cyst wall was composed of stratified squamous epithelium, with infiltration of inflammatory cells in the subepithelium. In some areas, we found zonal or proliferating rete processes. After marsupialization, the cyst wall showed stratified squamous epithelium. There has been no recurrence, and masticatory function has improved.
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  • Masashi HARADA, Takashi SEKIGUCHI, Shingo KAWAMURA, Hisayuki SINOHARA, ...
    2003 Volume 49 Issue 4 Pages 291-294
    Published: April 20, 2003
    Released on J-STAGE: April 22, 2011
    JOURNAL FREE ACCESS
    It is well known that secondary hyperparathyroidism (secondary HPT) systemically induces fibrous dysplasia (FD) in bone throughout the body. However, FD commonly occurs in a single bone and rarely extends to the maxillofacial bones. We describe, a case of FD that widely extended to the maxillofacial bones and caused facial deformity, associated with secondary HPT.
    A 66-year-old woman was referred to our clinic because of facial deformity characterized by bilateral enlargement of the maxilla, the zygoma, and the mandible. The patient had bee receiving regular hemodialysis therapy for 9 years because of chronic renal failure. The enlargement was hard and not tender on palpation. The hard palate was pushed down and flattened. X-ray computed tomographic examination revealed a diffuse radiopaque area in the maxillofacial bones, and a marked cotton-wool appearance in the mandible. A biopsy of the mandible was performed, and the pathological diagnosis was FD. To reduce the lesion, surgical resection of the mandible and of the maxilla and zygoma was performed. There was no evidence of regrowth of the lesion 1 year month after surgery. Full dentures were able to be successfully used. Furthermore, the patient is satisfied with the improved appearance of her face.
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  • Kazuhiro ONO, Ritsuo TAKAGI, Akihiko IIDA, Jun-ichi FUKUDA, Shuichi MO ...
    2003 Volume 49 Issue 4 Pages 295-298
    Published: April 20, 2003
    Released on J-STAGE: April 22, 2011
    JOURNAL FREE ACCESS
    We describe the treatment of an ankylosed infraverted tooth by distraction osteogenesis after Epker's single-tooth dento-osseous osteotomy. There appear to be a number of advantages to this procedure, despite the high surgical invasiveness. This procedure is designed to correct malposition of ankylosed teeth and is more reliable than replantation or subluxation with orthodontic treatment, reported previously to be effective. Furthermore, malpositioned teeth can be transferred irrespective of distance and direction to their correct position. This procedure has a low risk of pulp devitalization and gingival recession. Distraction osteogenesis after single-tooth dento-osseous osteotomy may be a new useful method for treatment of tooth ankylosis.
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  • Atsushi NAKAYAMA, Kazuhisa TANGE, Yuichiro KUROIWA, Kota FUKUTA, Takes ...
    2003 Volume 49 Issue 4 Pages 299-302
    Published: April 20, 2003
    Released on J-STAGE: April 22, 2011
    JOURNAL FREE ACCESS
    We report a case of pulmonary embolism that occurred at the 12th day after maxillectomy. A 72-year-old woman presented with a mass of the upper gingiva. It was diagnosed as a carcinoma of the upper gingiva, and partial maxillectomy with a skin graft was performed. At the 12th day after operation, chest pain suddenly occurred. We administered nitroglycerin for a suspected diagnosis of angina pectoris, but the symptoms persisted. Therefore, ultrasonic cardiography and cardiac catheter examination were performed. The diagnosis was pulmonary embolism. The patient received heparin sodium and urokinase as anticoagulant therapy and successfully recovered.
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