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Volume 61, Issue 6
Displaying 1-9 of 9 articles from this issue
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Preface
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[in Japanese]2015 Volume 61 Issue 6 Pages 309
Published: June 20, 2015
Released on J-STAGE: October 28, 2015
JOURNAL FREE ACCESSDownload PDF (806K)
Original articles
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Shizuko FUKUHARA, Toru YAMAZAKI, Katsu TAKAHASHI, Keita ASAI, Masashi ...2015 Volume 61 Issue 6 Pages 310-318
Published: June 20, 2015
Released on J-STAGE: October 28, 2015
JOURNAL FREE ACCESSMaxillary sinusitis is a frequent complication of bisphosphonate-related osteomyelitis of the jaw （BROMJ）, which is caused by bacterial infection in the maxilla. In some cases of BROMJ with maxillary sinusitis, the infection can spread from the involved sinus and damage the orbit or intracranial structures.Therefore, early diagnosis and appropriate therapy are required.
In this study, we report a case-series of patients who had BROMJ with maxillary sinusitis who were successfully evaluated with the use of 99m Tc-bone scintigraphy combined with panoramic radiography and computed tomography, enabling early diagnosis and surgical treatment.
We studied 13 BROMJ patients with maxillary sinusitis at the Department of Oral and Maxillofacial Surgery,Kyoto University Hospital, from March 2006 through March 2011. We classified the degree of BROMJ inflammation according to the degree of maxillary sinusitis, inflammatory changes of the maxillary bone, and abnormal uptake of 99m Tc-hydroxymethylene diphosphonate. Among the 13 patients, the range of inflammation was limited to the maxillary sinus floor in 9 patients, who were completely cured by sequestrectomy with hyperbaric oxygenation. In the 4 remaining patients, the range of inflammation uniformly extended to the maxillary sinus. One patient showed improvement after curettage. In the other 3 patients, who were followed up with conservative therapy, there was no apparent change in their symptoms.
Our results suggest that our classification of severity based on image diagnosis and treatment by sequestrectomy for cases in which the inflammation is limited to the maxillary sinus floor are effective for the treatment of BROMJ patients with maxillary sinusitis.View full abstractDownload PDF (1122K) -
Keiko MAEDA, Narikazu UZAWA, Satoshi YAMAGUCHI, Teruo AMAGASA, Kiyoshi ...2015 Volume 61 Issue 6 Pages 319-324
Published: June 20, 2015
Released on J-STAGE: October 28, 2015
JOURNAL FREE ACCESSWe examined the usefulness of a double-staining method using iodine solutions of different concentrations for the excision of T1, T2 squamous cell carcinomas （SCCs） of the tongue. We studied 127 patients who were given a diagnosis of T1, T2 SCCs of the tongue at Maxillofacial Surgery, Tokyo Medical and Dental University from 2000 through 2010. The patients were classified into 2 groups. One group, consisting of 89 cases, underwent staining once with 3% iodine solution （single-staining group: Group I）. The other group, consisting of 38 cases, underwent staining with 3% iodine solution and then with 5% iodine solution （double-staining group: Group II）. The excision margin of the lesion was designed to be about 10 mm outside of the border of the unstained areas （USAs） and stained areas （SAs）. Then the lesion was excised. In addition, the borders of the SAs and USAs were examined, and any recurrence after excision was noted. The type of lesion, type of epithelial dysplasia at the surgical margin, and recurrence rate were compared between the two groups. Local recurrence and the presence of epithelial dysplasia at the surgical margin in SCCs cases were seen in 12/127 cases （9.4%） and 58/127 cases （45.7%）, respectively. The numbers of the surgical marginpositive cases were 47/89 cases （52.8%） in Group I and 11/38 （28.9%） in Group II. The rate of SCC recurrence was significantly lower in Group II than in Group I （p=0.01）. The number of cases with local recurrence was 12/89 （13.5%） in Group I, but 0/38 （0%） in Group II. These results suggest that the double-iodine-staining method indicated the border of epithelial dysplasia more clearly than the single-staining method. Therefore,the double-iodine-staining method is useful for determining the excision margin of SCCs of the tongue.View full abstractDownload PDF (954K)
Case reports
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Seiji OHNO, Kojirou SASA, Mayu TAKAHASHI, Naoya KITAMURA, Tomohiro YAM ...2015 Volume 61 Issue 6 Pages 325-329
Published: June 20, 2015
Released on J-STAGE: October 28, 2015
JOURNAL FREE ACCESSWe report a case of mucocele with bone formation in the maxillary sinus. A man in his fifties was referred to our clinic because of a radiopaque lesion in the right maxillary sinus. Computed tomography showed a 25 × 18 mm soft tissue density lesion that was surrounded by thin bone in the right maxillary sinus. The clinical diagnosis was a cyst in the maxillary sinus, and the lesion was extirpated via the canine fossa with the patient under general anesthesia. The lesion was a cyst surrounded by thin bone and contained brown and mucinous fluid. Histopathologically, the cyst was lined by thin ciliated columnar epithelium, which was cytokeratin 8-positive. The surrounding bone had an irregular structure, and cancellous bone with a lamellar structure and fatty marrow was seen outside the surrounding bone. The histological diagnosis was a mucocele with bone formation. No recurrence has been observed during 2 years of follow-up.View full abstractDownload PDF (1036K) -
Hisanobu MARUO, Kenichi KURITA, Hiroshi WATANABE, Mitsuo GOTO, Atsushi ...2015 Volume 61 Issue 6 Pages 330-334
Published: June 20, 2015
Released on J-STAGE: October 28, 2015
JOURNAL FREE ACCESSAn 11-year-old girl was referred to our clinic for the assessment of a radiopaque lesion in the left maxillary molar region. We clinically diagnosed this lesion as a compound odontoma, and surgical removal was performed with extraction of the left upper first molar. Histopathological examination of the removed specimen, which measured 40 × 35 × 30 mm, also confirmed the diagnosis of a compound odontoma. There was no evidence of recurrence or complications after surgery. Odontomas tend to be less than 30 mm in diameter. As for previous articles from Japanese institutions, only two cases of compound odontoma more than 30 mm in diameter that arose in the maxillary molar region have been reported. We think that the present case is the largest reported case of compound odontoma occurring in the maxillary region in Japan. We therefore report a summary of this case and review the literature on odontomas in the maxillary molar region that were more than 30 mm in diameter and reported during the past 53 years from 1960 through 2013.View full abstractDownload PDF (908K) -
Masakazu HAMADA, Hidetaka SHIMIZU, Fumihiko KOUNO, Atsushi MASUI, Syus ...2015 Volume 61 Issue 6 Pages 335-339
Published: June 20, 2015
Released on J-STAGE: October 28, 2015
JOURNAL FREE ACCESSSialolithiasis is caused by the formation of a calcified structure within salivary ducts or glands. Sialoliths of the salivary gland occur commonly in adults, but are rare in children. Bilateral sialolithiasis of the salivary glands in children is very rare. We report a 14-year-old patient with bilateral sialoliths in the submandibular ducts. An X-ray film revealed one calcified body near the orifice on the right side and two calcified bodies on the left side, one of which was located near the orifice of the duct and the other near the salivary gland. When the anterior sialolith on the left side was removed, the posterior sialolith moved to a position near the orifice of the salivary duct. Thus, the patient could receive the second operation on the left side without the risk of damaging the lingual nerve located close to the salivary duct deep in the oral floor.View full abstractDownload PDF (851K) -
Takamitsu KOGA, Tokutaro MINAMIZATO, Kei-ichiro MIURA, Yousuke KAWAI, ...2015 Volume 61 Issue 6 Pages 340-345
Published: June 20, 2015
Released on J-STAGE: October 28, 2015
JOURNAL FREE ACCESSLangerhans’-cell histiocytosis （LCH） is caused by monoclonal proliferation of Langerhans’ cells, a type of antigen-presenting cell, and affects multiple organs. We report a case of LCH arising in the mandible of a young boy.
The patient was an 11-year-old boy who referred to our hospital because of swelling of the right cheek. Computed tomographic examination showed a destructive bony lesion extending from the right mandibular body to the mandibular angle, with resorption of the buccal and lingual cortical plate. Gadolinium-enhanced T1-weighted magnetic resonance imaging showed contrast enhancement in a large portion of the right mandibular body, with soft tissue extension. A biopsy of the lesion was performed with the patient under general anesthesia because the radiographic findings suggested malignancy. Histopathological examination revealed that the lesion was composed of eosinophilic cells and histiocytes, which were positive for S-100 and CD1a immunohistochemically. These findings led to the diagnosis of LCH. PET-CT showed no evidence of lesions in other organs or bone.
Patients with unifocal LCH arising in one organ generally have a high chance of spontaneous remission and favorable outcomes. The present case spontaneously remitted 3 months after the biopsy, without additional treatment. Currently, 1 year 9 months after the biopsy, the patient has made favorable progress, with no recurrence.View full abstractDownload PDF (1074K) -
Jun SUMINO, Yutaka SATO, Yoshinori INABA, Narikazu UZAWA, Kiyoshi HARA ...2015 Volume 61 Issue 6 Pages 346-349
Published: June 20, 2015
Released on J-STAGE: October 28, 2015
JOURNAL FREE ACCESSA 48-year-old woman presented at our university hospital for her dental treatment. She had a past history of hypokalemic shock during dental treatment. We consulted the division of diabetes, metabolism, and endocrinology of a hospital concerning her tooth extraction. Then, she was given a diagnosis of Gitelman syndrome. We performed extraction of a third molar using propitocaine hydrochloride-felypressin（Citanest-Octapressin®） as a local anesthetic while monitoring the serum potassium level during extraction. We measured the serum potassium level preoperatively, after local anesthesia, and postoperatively. There were no complications during or after tooth extraction.View full abstractDownload PDF (816K) -
Shoichiro KITAJIMA, Akio YASUI, Hisanobu MARUO, Keiji NIWA, Sadanobu K ...2015 Volume 61 Issue 6 Pages 350-354
Published: June 20, 2015
Released on J-STAGE: October 28, 2015
JOURNAL FREE ACCESSOsteoblastoma is a rare bone tumor that involves abnormal bone and osteoid tissue formation. It was classified as an intermediate（ locally aggressive） tumor by the WHO in 2013. We describe a case of mandibular osteoblastoma in a 9-year-old boy whose chief complaint at initial consultation was facial asymmetry. Radiographic examination showed a well-defined radiopaque region measuring approximately 26 × 21 mm in diameter that was partially surrounded by a radiolucent area. In the right side of the mandible, the second premolar was impacted by the tumor. Biopsy findings suggested an osteoblastic neoplasm with an MIB-1 index of about 1%. Based on these findings, we planned to perform curettage of the tumor. A histologic examination of the excised specimen revealed it was mainly composed of abundant connective tissue showing active angiogenesis and osteoid bone covered with osteoblast-like cells, thus confirming our initial diagnosis. The postoperative course was uneventful. One year 8 months after the operation the impacted tooth had erupted spontaneously. This case suggests that it might be feasible to preserve permanent teeth impacted by an osteoblastoma.View full abstractDownload PDF (964K)
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