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Volume 52, Issue 3
Displaying 1-11 of 11 articles from this issue
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Shigeki MORISAKI, Gen-yuki YAMANE, Morio TONOGI, Yasuhiro OZAWA, Yuich ...2006 Volume 52 Issue 3 Pages 162-166
Published: March 20, 2006
Released on J-STAGE: April 22, 2011
JOURNAL FREE ACCESSIn recent years, surgery for jaw deformities has become common practice in the field of oral surgery, but few reports have discussed countermeasures for postoperative pain or perioperative stress-related biological responses. Nonsteroidal anti-inflammatory drugs (NSAIDs) are usually used for postoperative analgesia, but pain relief is often insufficient. We investigated the responses of stress-related hormones and assessed pain caused by surgery in patients with jaw deformities to ascertain postoperative pathological changes, which have an important role in selecting the postoperative analgesic technique. This investigation demonstrated not only severe pain, but also increases in blood concentrations of stress-related hormones such as catecholamines, vasopressin, and cortisol immediately after surgery. Therefore, when surgically treating jaw deformities, administration of analgesics mustbe started during surgery, taking into account postoperative analgesia and carefully monitoring postoperative changes in vital signs.View full abstractDownload PDF (756K) -
Taketomo SAI, Tadashi KITAJIMA2006 Volume 52 Issue 3 Pages 167-171
Published: March 20, 2006
Released on J-STAGE: April 22, 2011
JOURNAL FREE ACCESSSagittal splitting ramus osteotomy is widely used to repair maxillofacial deformities. Postoperative sensory disturbances of the lower lip, however, are becoming an important clinical problem. The most important factor related to this complication is thought to be injury of the inferior alveolar nerve during osteotomy. This study was designed to obtain clinical evidence to support this hypothesis. We studied the relations between the developmentof postoperative sensory disturbances of the lower lip and topographic anatomy of the mandibular canal on preoperative standardized CT images in 30 patients (60 sides) with prognathism. The distance from the medial border of the lateral cortex of the mandibular ramus tothe mandibular canal was 2.49±1.24mm (mean±S. D.). The peak distribution (17sides) was within the range of equal to or greater than 3.0mm to less than 4.0mm. Postoperative sensory disturbances of the lower lip developed in 20 sides. Seven sides were within the peak distribution range of equal to or greater than 1.0mm to less than 2.0mm for thedistance between the lateral cortex and the mandibular canal. Our findings indicate that the greater the distance from the lateral cortex of the mandibular ramus to the mandibular canal, the lower is the frequency of sensory disturbances of the lower lip. Innovation andrefinement of surgical techniques to reduce injury to the mandibular canal during sagittalsplitting ramus osteotomy are considered to have substantially contributed to reducting postoperative sensory disturbances of the lower lip.View full abstractDownload PDF (1679K) -
Yuichiro SAWA, Akira TAKIMOTO, Goro WATANABE, Akitoshi MANO, Masao SHI ...2006 Volume 52 Issue 3 Pages 172-178
Published: March 20, 2006
Released on J-STAGE: April 22, 2011
JOURNAL FREE ACCESSMolar sites of the mandible can provide larger quantities of autogenous bone than other intraoral sites. We clinically investigated the bone harvest procedure from the mandibular molar region. The subjects were 21 patients (28 regions) who underwent veneer grafting, onlay grafting, sinus lifting, or combinations of these procedures. The fragments were harvested from cortical bone in the mandibular body, and their mean size was 14.6×22.4 (range of minor axis 10-25, range of major axis 10-40) mm on each side. The fragments were used inblock or particulate form, and the platelet rich plasma was used to promote bone proliferation and avoid complications. As for the results of bone augmentation, we could obtain adequate bone volume for the placement of fixtures in all patients. The mean extent of augmentation was equivalent to 3.24 (range 1-8) teeth, and the mean number of implants placed was 2.81 (range 1-7) fixtures. Two cases of mental nerve paresthesia and 1 case of boneexposure occurred as postoperative complications. In addition, bone blocks cracked in 2 patients at the time of fixture placement. However, the outcome of all cases of implant treatment was uneventful. This preliminary modified technique for harvesting bone from the ramus was useful for bone augmentation in patients undergoing implant treatment.View full abstractDownload PDF (3890K) -
Keitarou TERASAKI, Toshirou KONDOH, Tsuyosi KISHIDA, Hiromi YOSHITAKE, ...2006 Volume 52 Issue 3 Pages 179-182
Published: March 20, 2006
Released on J-STAGE: April 22, 2011
JOURNAL FREE ACCESSWe reported a case of first and second branchial arch syndrome in a patient who had jaw deformity with bilateral hyperplasia of the mandibular coronoid process. The patient was a 16-year-old girl. She visited our maxillofacial orthognathic department because of masticatory insufficiency and muscular contracture in 1989 (when she was 6 years old). She had an asymmetric face, deformed ears, and a small mandible. Panoramic X-ray examination revealedbilateral hyperplasia of the mandibular coronoid process. Orthodontic treatment was started in the same year. In 1999, the patient visited our dental surgery department to undergo orthgnathic surgery. Excision of the mandibular coronoid processes was performed to relieve the muscular contracture in the same year, and sagittal split ramus osteotomy was performed to improve the mandibular deformity in 2000. Both the muscular contracture and dental occlusion improved thereafter. The patient has been under long-term observation by the two departments.View full abstractDownload PDF (2898K) -
Measurement of CT valueYutaka FUKUSHIMA, Yoko MATSUSE, Mamiko YAMAMOTO, Minoru ITO, Nobuoki S ...2006 Volume 52 Issue 3 Pages 183-186
Published: March 20, 2006
Released on J-STAGE: April 22, 2011
JOURNAL FREE ACCESSWe report on a 51-year-old man with some glass fragments as foreign bodies in the submental region. Five months after injury, he complained of swelling in the mental region, accompanied by purulent discharge and fistula formation in the submental region. Radiographic examination showed part of a glass fragment in the submental region. Detection of glass by conventional radiographic techniques is challenging because glass has a low radiopaque appearance and is usually obscured by overlying bony structures in the maxillofacial region. CT examination showed multiple radiopaque images in the submental region. We measured the CT values of these foreign bodies. The CT value was useful for establishing the diagnosis of glass fragments as foreign bodies in this patient.View full abstractDownload PDF (3375K) -
Ayako EDAHIRO, Masaya ICHIHARA, Mika SAITO, Hirohiko HIRANO, Masatsune ...2006 Volume 52 Issue 3 Pages 187-190
Published: March 20, 2006
Released on J-STAGE: April 22, 2011
JOURNAL FREE ACCESSWe report a case of airway obstruction caused by hematoma of the mouth floor following a mandibular fissured fracture due to a fall in a patient receiving antiplatelet therapy.
An 83-year-old man receiving antiplatelet therapy, fell down, resulting in a mandibular fissured fracture and hematoma of the mouth floor. Airway obstruction developed rapidly 4 hours after the fall. Intubation of the airway was performed under endoscopic guidance, with the use of hemostatic drugs and steroids. CT showed a fissured fracture in the mandible and airway obstruction of the oropharynx. Hemorrhage was treated by stopping antiplatelet therapy and administering drugs. Because renal failure worsened, hemodialysis wasstarted. Hemorrhage of the mouth floor and narrowing of the airways recurred 45 days afterthe fall. Renal failure, anticoagulant treatment with hemodialysis, advanced age, poor healing of the wound, and stimulation due to food probably caused the hemorrhage.
This case illustrates the risk of bleeding complications and the need for hemostasis including local treatment for injury, observation, and discontinuation of the responsible drug in patients receiving antithrombotic therapy. For airway obstruction due to bleeding complications, we recommend that patients are observed for at least 24 hours after injury.View full abstractDownload PDF (1645K) -
Toshinori IWAI, Susumu OMURA, Yoshiyuki OKAMOTO, Tomokatu SAITO, Satos ...2006 Volume 52 Issue 3 Pages 191-194
Published: March 20, 2006
Released on J-STAGE: April 22, 2011
JOURNAL FREE ACCESSSpreading patterns of subcutaneous emphysema and mediastinal emphysema can be detected on computed tomography (CT). As many studies have reported that CT is performed several hoursto several days after the onset of emphysema, CT findings immediately after onset remain unclear. Especially, the time course of emphysema from onset to resolution is poorly understood.
We observed the time course of emphysema by CT, starting immediately after the development of emphysema in the head, neck, and mediastinum. Emphysema was caused by the useof an air turbine handpiece during extraction of a lower impacted third molar. A CT scan obtained immediately after onset showed severe emphysema extending to many head and neck spaces, including the retropharyngeal space to the mediastinum. The next day, emphysema in the parapharygeal space, the retropharyngeal space, and the anterior cervical space rapidlydecreased. After a week, the emphysema had nearly disappeared on the CT scan, except for part of the masticator space.View full abstractDownload PDF (2868K) -
Atsushi NAKAYAMA, Kazuhisa TANGE, Kota FUKUTA, Hirotaka YONEZAKI, Hiro ...2006 Volume 52 Issue 3 Pages 195-198
Published: March 20, 2006
Released on J-STAGE: April 22, 2011
JOURNAL FREE ACCESSWe report a case of ameloblastoma of the mandible reconstructed with particulate cancellous bone marrow (PCBM) harvested from the tibia after the marginal resection of the mandibular bone. The patient was a 74-year-old woman who presented with left mandibular expansion, with no spontaneous pain. Panoramic radiography and computed tomography revealed a radiolucent lesion in the left side of the mandible. A preoperative biopsy resulted in a diagnosis of ameloblastoma. We performed marginal mandibular resection and reconstructive surgeryusing PCBM from the left tibia with a titanium plate and mesh under general anesthesia. We could harvest a sufficient amount of cancellous bone from the right tibia. The postoperative course was uneventful, with no complications. Reconstruction using PCBM may be an effective alternative procedure for repairing defects of the mandible.View full abstractDownload PDF (3171K) -
Report of 3 casesEriko MARUKAWA, Ken OMURA, Hiroyuki HARADA, Yuji KABASAWA, Akihisa FUK ...2006 Volume 52 Issue 3 Pages 199-202
Published: March 20, 2006
Released on J-STAGE: April 22, 2011
JOURNAL FREE ACCESSThe soft palate plays an important role in articulation and swallowing. Repair of large surgical defects of the soft palate is extremely difficult and it may result in velopharyngeal dysfunction.
Three cases of immediate reconstruction using a free radial forearm flap after excision of a massive pleomorphic adenoma arising in the soft palate are reported.In these patients, we evaluated articulatory and velopharyngeal functions preoperatively and postoperatively. Articulatory function was assessed by intelligibility tests involvingthe pronunciation of 100 Japanese monosyllables, and velopharyngeal function was evaluated by blowing ratio. All patients had successful restoration of articulatory and velopharyngeal functions, with normal speech, swallowing, and nasal breathing. These results indicatedthat reconstruction using a radial forearm flap was effective for preserving velopharyngeal function and speech intelligibility in patients with large defects following excision ofsoft palate tumors.View full abstractDownload PDF (2513K) -
Akira OKUMURA, Yoshio YAMASHITA, Mitsuhiro TSUJI, Masahito SHIGEMATSU, ...2006 Volume 52 Issue 3 Pages 203-206
Published: March 20, 2006
Released on J-STAGE: April 22, 2011
JOURNAL FREE ACCESSWe report a case of malignant lymphoma arising in the inferior surface of the tongue. The patient was a 53-year-old woman with a painless tumor occurring in the right side of the inferior surface of the tongue.
Clinical examination showed that the surface was coveredwith normal mucosa, and the tumor was hard, circumscribed, and movable on palpation. The patient underwent tumor excision for a tentative diagnosis of a benign tongue tumor.
Histological examination of the surgical specimen showed a non-Hodgkin's lymphoma, follicularmixed cell type. After diagnosing the malignant lymphoma, the patient was immediately screened for other tumors. There was no evidence of lesions in other sites.
The patient is free of disease as of 10 years after operation.View full abstractDownload PDF (1530K) -
Hidetaka MIYASHITA, Kaori YAGO, Shin USUDA, Taneaki NAKAGAWA, Soichiro ...2006 Volume 52 Issue 3 Pages 207-210
Published: March 20, 2006
Released on J-STAGE: April 22, 2011
JOURNAL FREE ACCESSWe report a rare case of trigeminal neuralgia caused by an ectopic impacted tooth under the mandibular notch.
A 22-year-old man visited our hospital because of lancinating pain.Panoramic radiography revealed an impacted tooth under the right mandibular notch. The right lower first premolar was missing and a radiolucent area was observed around it. Symptomatic trigeminal neuralgia caused by an ectopic impacted tooth was diagnosed. The impacted tooth and granulation tissue were removed under general anesthesia. The lancinating pain disappeared after the extraction.View full abstractDownload PDF (3239K)
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