Proper imaging examination was timely applied for diagnostic imaging of dental implant treatment.Japanese guidelines for diagnostic imaging of dental implant treatment were established by a Japanese Society for Oral and Maxillofacial Radiology, and published on the web during 2007. Use of dental cone-beam computed tomography(CBCT), which rapidly became familiar to dental clinicians after the publication of guidelines in European and North America, and multislice helical computed tomography(MSCT), which has become widely used by hospitals in Japan, were considered in this Japanese guidelines. In this paper, the use of X-ray diagnostic stent, dental CBCT and MSCT were interpreted including our clinical experience. In addition, radiation dose, bone density of cancellous bone and depiction of mandibular anatomical structures, such as accessory mental foramen and retromolar canal using dental CBCT including the results of our imaging studies were interpreted.
It is known that the bacterial infection from the periodontal pocket of the adjacent dentition to a periimplant sulcus occurs in a very short term after the implant treatment. Therefore, doing the implant treatment to periodontal patients after periodontal treatment to make the risk of infection by periodontopathic bacteria from teeth a minimum becomes a condition. Moreover, bacterial flora improved by the periodontal treatment once also has the possibility to influence the implant surroundings organization according to the state of the plaque control afterwards. However, there is no scientific index that can judge the quality of the plaque control, and the bacillus in a peri-implant sulcus is encouraged to be inspected regularly. After implant treatment and periodontal treatment, maintenance is necessary for all patients, and to judge the interval of maintenance according to the situation in the mouth. In these days the implant treatment is widely common compared with other odontotherapies. However, a peri-implantitis has occurred in some the cases. The method of treatment to a new disease has not been established yet. A basic clinical consideration in addition will be a pressing need when the future to establish the method of prevention and the treatment method to the peri-implantitis, and it is thought that it is necessary to do the prevention of this disease and standardization of the treatment method.
The purpose of this study was to evaluate the efficacy of postoperative radiation therapy of the neck in patients with oral squamous cell carcinoma who had lymph node metastasis on pathological examination. The following results were obtained. 1 )Eighteen patients received postoperative radiation therapy(RT + group), and 42 patients did not receive postoperative radiation therapy(RT － group). The recurrent rate in the neck was 11.1 % in the RT + group and25.6 % in the RT － group. 2 )The overall survival rate was 76.9% in the RT + group and 60.6 % in the RT － group. This difference was not significant. 3 )There were significant differences in the overall survival rate between the RT + group and RT － group when nodal metastases were found at multiple levels or when nodal metastases were associated with extracapsular spread. The overall survival rate did not differ significantly between the RT + group and RT － group when the number of nodal metastases was three or more or when the farthest metastatic nodes were found at levels III, IV,or V.
A rare case of endogenous fungal endophthalmitis(EFE)in a 73-year-old woman with recurrent tongue cancer is presented. The patient had terminal-stage disease and underwent insertion of a central venous catheter(CVC)for nutritional support. Her visual acuity decreased 10 days after the onset of a high fever. The bacterial cultures from blood and catheter were positive for Candida albicans. Fundal examination revealed characteristic features compatible with fungal endophthalmitis. The serum β-D glucan value was elevated .Consequently, this case was diagnosed as EFE subsequent to catheter insertion. Her visual acuity recovered after removal of the catheter and treatment with intravenous fluconazole for 6 weeks. The case suggests that oral and maxillofacial surgeons should consider the risk of EFE in compromised patients with CVC.
Hereditary angioedema(HAE)is a rare disease caused by functional disorder or a reduction in C1inhibitor(C1-INH). HAE was first described by Osler in 1888. Dental treatment and oral surgery in HAE patients can trigger life-threatening laryngeal edema. C1-INH is effective for both the prevention of HAE and the treatment of acute attacks. Since C1-INH is a blood product and very expensive in Japan, C1-INH should be used carefully.Other drugs or methods should also be considered to prevent attacks of HAE. We report a male patient with HAE who required tooth extraction. To prevent angioedema associated with tooth extraction, the patient was given tranexamic acid before operation. He underwent tooth extraction after receiving intravenous propofol and midazolam. He was observed during the night after the operation and was discharged from the hospital the next morning, without any complications.
A pedicled buccal fat-pad graft was used to repair defects after resection of oral lesions in 8 patients(1case of mucoepidermoid carcinoma of the palate, 2 cases of pleomorphic adenoma of the palate, 2 cases of squamous cell carcinoma of the left buccal mucosa, 1 case of squamous cell carcinoma of the right upper gingiva, 1case of sialoadenitis of the minor salivary glands in the left buccal mucosa, and 1 case of ameloblastoma of the right maxilla). A pedicled buccal-fat pad was carefully prepared by making a vestibular incision in the upper molar region after primary surgery. The most important step in preparation was to preserve the surrounding connective tissue to supply nutrition to the pedicle. The size of the reconstructed area ranged from 15 ×10 mm to 43 ×38mm. The grafts used in this study were long enough to cover the anterior buccal region. Postoperative epithelization of the grafts and donor sites was uneventful in all patients. There was no severe contraction of soft tissues during follow-up, ranging from 4 months to 5 years 11 months. In conclusion, buccal fat-pad grafting is considered feasible for the repair of surgically induced defects in the maxilla, palate, and buccal mucosa.