Japanese Journal of Oral and Maxillofacial Surgery
Online ISSN : 2186-1579
Print ISSN : 0021-5163
ISSN-L : 0021-5163
Volume 55, Issue 6
Displaying 1-11 of 11 articles from this issue
Preface
Invited review article
  • Mitsuyoshi IINO
    2009 Volume 55 Issue 6 Pages 268-275
    Published: June 20, 2009
    Released on J-STAGE: August 28, 2012
    JOURNAL FREE ACCESS
    Dental rehabilitation using endosseous implants in cases of traumatic dento-alveolar defect and bony defect caused by tumor ablation surgery is highly useful. However many such cases cannot be treated with dental implants because of an inadequate height and width of the alveolar ridge or total loss of bony tissue. To enable the implant restoration, these cases need to undergo jawbone reconstruction. Many techniques have been introduced including the graft of cortico-cancellous bone block and vascularized bone flap. Among these methods, particulate cancellous bone and marrow(PCBM)with titanium mesh tray is one of the well accepted procedures. Iliac PCBM contains highly osteogenic cells. After PCBM grafting, active new bone formation occurs from osteogenic stem cells followed by bone remodeling and incorporation into the recipient bone. This process means that PCBM grafting is the method of bone regeneration that is based on in vivo tissue engineering. Because PCBM lacks intrinsic form and strength to resist deformation by externally applied forces, it has used in combination with titanium mesh for the reconstruction of maxilla, mandible and alveolar ridge. Titanium mesh has excellent biocompatibility and mechanical strength. It can be easily cut with scissors for precision fitting and has malleability for three-dimensional adaptation and can rigidly be fixed to the bone with low profile titanium screws. It is simple to remove and does not leave a residue. It also permits the exchange of body fluids that is advantageous for bone regeneration and has no adverse effects on bone remodeling. In this paper, alveolar ridge augmentation by titanium micromesh with iliac PCBM and reconstruction of large mandibular defect by titanium mesh tray and iliac PCBM harvested from bilateral posterior ilia are introduced.
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Case report
  • Yoshitaka TANIGUCHI, Hiroshi KOHARA, Mari NAMIKAWA, Yoshiko HIRANO, Ju ...
    2009 Volume 55 Issue 6 Pages 276-280
    Published: June 20, 2009
    Released on J-STAGE: August 28, 2012
    JOURNAL FREE ACCESS
    Epignathus is an extremely rare congenital teratoma that arises from the upper jaw, palate, or pharynx.It usually protrudes through the mouth, leading to obstruction of the upper airway and death soon after birth. We report a case of epignathus combined with cleft palate. The patient weighed 2040 g in the 34th week 2nd day of gestation. The stalk of the tumor developed from the oropharynx through the cleft palate. Surgical removal of the tumor was performed when the patient was 60 days old. Histopathological examination revealed that the tumor was a mature teratoma containing three germ layers, including nerve tissue, squamous epithelium, cartilage, mucous glands, and respiratory epithelium. Cleft palate repair is planned.
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  • Toshiharu YAMADA, Kou KAWAHARA, Daisuke SANO, Hiroshi WATANABE, Nobuyo ...
    2009 Volume 55 Issue 6 Pages 281-285
    Published: June 20, 2009
    Released on J-STAGE: August 28, 2012
    JOURNAL FREE ACCESS
    External dental fistula originating from the maxilla mainly occurs at the alar base in the anterior tooth region and at the buccal region in the posterior tooth region. We describe a patient with a fistula at the nasal vestibule. The patient was a 50-year-old woman who had tenderness and swelling from the right nasal vestibule to the alar base. A dome-shaped nodular erythema of 3 mm in diameter was found at the nasal vestibule. The probe was guided toward the apex of the upper lateral incisor. A CT scan showed periapical trabecular bone loss at the upper lateral incisor, uniform radiolucency, and thinning of cortical bone on the labial aspect with partial loss of continuity. The lesion was adjacent to the nasal cavity floor. Surgery was performed for a diagnosis of radicular granuloma at the upper lateral incisor and external fistulation at the nasal vestibule. Below the piriform aperture, a white fibrous restiform structure 3 mm in diameter and 10 mm long extended from the apical lesion to the nasal vestibule. The suppurative inflammation at the apical lesion was blocked by the muscularis depressor septi and the muscularis nasalis but extended upward, resulting in a fistulation at the nasal vestibule.
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  • Taketomo TOH, Makoto YAMBE, Makoto TAKAHASHI, Mikiko ARAKAWA, Yuichi M ...
    2009 Volume 55 Issue 6 Pages 286-290
    Published: June 20, 2009
    Released on J-STAGE: August 28, 2012
    JOURNAL FREE ACCESS
    We describe the clinical features of a case of oral and facial lacerated wounds exposed to the organic solvent-based paint.
    A 58-year-old man fell into an organic solvent-based paint storage tank while at work and sustained oral and facial lacerated wounds. The white paint contaminated his whole body, including the facial wound. He was taken to an emergency room by an ambulance immediately after the accident. The wound contaminated by the chemicals was sutured after cleaning with a large amount of saline. It was not associated with central nervous system damage or digestive and respiratory system damage. He experienced severe ocular pain and eye-opening disorder in both eyes. An ophthalmic surgeon diagnosed corneal ulcers and immediately irrigated the eyes with saline. To prevent infection and chemical injury, an antibiotic was given, and irrigation was continued. He was discharged on the 7th day after the injury because wound healing was acceptable. Outpatient hospital visits were ended 7 months after the injury because there were no more functional or aesthetic problems.
    In patient with lacerated wounds exposed to chemicals, the tissue damage depends on factors such as the type of chemicals, the concentration, the quantity, the exposure time, and the temperature. Special attention should be given to oculary injuries and central nervous system damage, besides the wound.
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  • Osamu IWAMOTO, Moriyoshi NAKAMURA, Satoko MAKIHARA, Midori KUSANO, Chi ...
    2009 Volume 55 Issue 6 Pages 291-295
    Published: June 20, 2009
    Released on J-STAGE: August 28, 2012
    JOURNAL FREE ACCESS
    We report two cases of intracranial tumor causing neural symptoms as incipient symptoms in the maxillo-oral region.
    Case 1: A 39-year-old woman presented with right deviation of the tongue when it was protruded. Metastasis to the cranial base was diagnosed after surgery for cervical cancer of the uterus. Cranial nerve disorders in Ⅸ-Ⅻwere identified on neurological examination.
    Case 2: A 54-year-old woman presented with sensory disorders of the right hemifacial and hemiglossal regions.
    A primary cerebral tumor in the right cerebellopontine angle area was diagnosed. Hypoesthesia, nystagmus, and deafness were noted in the Ⅰ-Ⅲ branch regions of the trigeminal nerve on neurological examination. Cerebral tumor excision was performed, and the histopathological diagnosis was schwannoma. Tumors arising in the central nervous system can cause various neural symptoms in the maxillo-facial region, resulting in complicated, multiple neural symptoms, as observed in our patients. Imaging diagnosis is therefore important in addition to detailed neurological examination.
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  • Kozo YAMAMOTO, Eiji HIRAI, Toshiaki KOHNOE, Yoshihide KONDOH, Hideo KU ...
    2009 Volume 55 Issue 6 Pages 296-299
    Published: June 20, 2009
    Released on J-STAGE: August 28, 2012
    JOURNAL FREE ACCESS
    Cartilaginous choristoma is a benign tumor of cartilage that was previously called chondroma and very rarely occurs in the tongue. We report on a 56-year-old woman who had an asymptomatic tumor at the right lateral edge of the tongue and review the literature. The patient had been aware of the mass for a year, but did not receive treatment. At presentation, the tumor was approximately 15 mm in diameter. The tumor was extirpated under local anesthesia. Histological examination revealed that the tumor had mature cartilatinous tissue and was diagnosed as cartilaginous choristoma. Postoperative healing was uneventful, with no sign of recurrence during22 months of follow-up.
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  • Hiroyuki NAITO, Ryo SEKIYA, Yoshihide OTA, Kazuo SHIIKI, Hiroko SATO, ...
    2009 Volume 55 Issue 6 Pages 300-304
    Published: June 20, 2009
    Released on J-STAGE: August 28, 2012
    JOURNAL FREE ACCESS
    We report a rare case of chronic expanding hematoma(CEH)that formed a mass in the temporomandibular region 15 years after injury. A 37-year-old man presented with a subcutaneous, painless mass in the right preauricular region. He had suffered a blow to the right temporomandibular region during a martial arts match 15 years earlier. From 3 years after the trauma, he noticed a painless, subcutaneous swelling in the right temporomandibular region, which showed repeated enlargement and reduction while growing slowly. An X-ray film of the head revealed pressure resorption of bone in the condylar process of the right mandible. CT showed an ovoid lesion in the masseter muscle lateral to the condylar process of the right mandible. The mass margins showed low signal intensities on T1- and T2-weighted MR images, and the interior of the mass displayed a mixture of high and low signal intensities on T2-weighted images. The clinical diagnosis was a soft tissue tumor arising in the temporomandibular joint. Under general anesthesia, the mass was resected with the surrounding normal tissue. The histopathological diagnosis was CEH. The patient remains free of recurrence 6 years after surgery, without motor impairment of the mandibular joint.
    It is difficult to diagnose CEH preoperatively; however, this condition should be considered in the presence of a history of surgery or trauma in a patient with a gradually enlarging mass.
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  • Shin-ichi KURAHARA, Seiji NAKAMURA, Mitsuho ONIMARU, Hiroaki ISHIBASHI ...
    2009 Volume 55 Issue 6 Pages 305-309
    Published: June 20, 2009
    Released on J-STAGE: August 28, 2012
    JOURNAL FREE ACCESS
    Neuroblastoma, Ewing sarcoma, rhabdomyosarcoma, and malignant lymphoma consist of undifferentiated small round cells with scanty cytoplasm and are classified as so-called small round cell tumors. These tumors are often difficult to distinguish on light microscopy and to make a definitive diagnosis because they have poor histological characteristics.
    We report a case of a small round cell tumor arising in the mandible of a 1-year 9-month-old girl. She was referred to our department because of swelling in the left side of the mandible in November 2003. Computed tomographic(CT)scans revealed a soft tissue density area expanding buccolingually in the mandible. An incisional biopsy was done under general anesthesia for a suspected diagnosis of an intra-osseous carcinoma of the mandible. A neurogenic malignant tumor was suspected from the biopsy specimen because of CD56 activity.
    Based on clinical, radiological, and histopathologic findings, a radical resection of the tumor was performed via a submandibular approach in March 2004. Following hemimandibulectomy, primary reconstruction of the defect was performed, using a titanium plate.
    Because the tumor cells were positive immunohistochemisty for neural markers in the surgical specimen, the definitive diagnosis was a malignant small round cell tumor with nueroendocrine features. Five years after surgery, there has been no evidence of recurrence or metastasis.
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  • Etsuro NOZOE, Takako OKAWACHI, Kiyohide ISHIHATA, Kazuhide NISHIHARA, ...
    2009 Volume 55 Issue 6 Pages 310-314
    Published: June 20, 2009
    Released on J-STAGE: August 28, 2012
    JOURNAL FREE ACCESS
    Maxillary anterior teeth are very prone to traumatic injuries. Labial alveolar bone defects in areas of lost teeth may necessitate distraction osteogenesis or/and bone grafting before dental implant therapy. In patients in whom the alveolar bone requires distraction in an anteroinferior direction, bone distracted is sometimes insufficiently when the distractor is attached on the labial side.
    We report a case of alveolar distraction osteogenesis via a palatal approach in the maxillary anterior region. A32-year-old woman presented with alveolar bone defects and missing maxillary anterior teeth caused by a traffic accident. It was necessary to increase the bone in an anteroinferior direction. A Martin Distractor Track 1.0(KLS Martin , Germany )was turned inside out and attached on the palatal side. The latency period was 5 days. Distraction was performed twice daily at a rate of 0.3 mm per session for 15 days. The consolidation period was 16weeks. The bone was lengthened anteroinferiorly, and the height was restored adequately. Eight months after the end of distraction, implants were placed successfully.
    When alveolar bone defects are on the labial side of maxillary anterior teeth, performing distraction via a palatal approach technique will provide a more desirable alveolar ridge for dental implant therapy.
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  • Masaki IIDA, Takeshi SHIMIZU, Hideki GOTO, Taketo SAKURAI, Toshio YOKO ...
    2009 Volume 55 Issue 6 Pages 315-319
    Published: June 20, 2009
    Released on J-STAGE: August 28, 2012
    JOURNAL FREE ACCESS
    We report two rare cases of iatrogenic foreign bodies(inlay)in the upper lip and tongue induced during dental treatment.
    Case 1: A 48-year-old woman was referred to our hospital because of metal inlay impaction into the upper lip. The inlay could be touched from the oral side and was surgically removed without complications. Case 2: A 68-year-old woman was referred to our hospital because of a suspected foreign body in the mandible. An occlusal radiograph revealed a foreign body in the tongue. Inflammation was not present at the site of foreign body impaction. The foreign body was surgically removed without complications and was found to be inlay.
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