National Action Plan on Antimicrobial Resistance was developed in 2016 accordingly by the Ministerial Meeting in Japan, because the inappropriate use of antimicrobials has been indicated as the background to the global spread of antimicrobial resistance. National Action Plan is structured around goals in the following six areas: (1) Public Awareness and Education, (2) Surveillance and Monitoring, (3) Infection Prevention and Control, (4) Appropriate Use of Antimicrobials, (5) Research and Development, and (6) International Cooperation. It is required to adopt a global “One Health” approach, which addressed both human and animal health together. We reported an outbreak of multi-drug resistance pseudomonas aeruginosa with a new antimicrobial resistant gene, GES-5, and we hypothesized that cross-contamination due to poor hand hygiene was the main cause of transmission and that sharing unsanitary portable oral-care devices may have contributed to transmission between patients. Standard precautions are applicable to all settings in which dental treatment is provided.
Sinusitis is an inflammation of the paranasal sinuses characterized by respiratory symptoms such as nasal obstruction, purulent discharge, postnasal drip, cough, as well as other symptoms including headache, facial pain, and loss of smell. Acute bacterial sinusitis, which lasts less than 4 weeks, usually develops secondarily to the upper respiratory tract viral infection. It often cause facial pain which mimics the pain of the dental origin, so the patients may visit dental clinics. Acute bacterial sinusitis can be treated by administration of antibiotics. Chronic sinusitis, in which the symptoms continues for more than 3 months, often develops irreversible thickening of the nasal mucosa and/or polyps. It is multi factorial, caused by genetic, anatomic, and immunologic, and metabolic factors of each patient. It often needs additional treatment to antibiotics, such as low-dose macrolide therapy and endoscopic sinus surgery. There are special subtypes of chronic sinusitis such as eosinophilic, fungal, and odontogenic. In particular, eosinophilic sinusitis is refractory, and hold a big issue in rhinology.
To consider the possibility of tooth preservation in patients with ameloblastomas arising in the mandible and treated by the dredging method, the relation between the recurrence of such tumors and tooth preservation was investigated.
Twenty-five primary ameloblastomas arising in the mandible that were treated between January 1983 and December 2010 and followed for more than 5 years were studied retrospectively.
Radiographic images indicated that a total of 67 teeth were involved by the tumors or had tooth roots that were included in or came in contact with the tumors in 25 patients. These teeth were divided into an extracted group and a preserved group, and the tumor recurrence rate was compared between the two groups. Of the 23 teeth involved by the tumors, 20 (87%) were extracted and 3 (13%) were preserved. Of the 44 teeth with roots that were included in or came in contact with the tumors, 5 (11.4%) were extracted and 39 (88.6%) were preserved. Overall, 42 (62.7%) of the 67 teeth were preserved. Among the 42 preserved teeth, 39 were left untreated, and 3 underwent apicoectomy. During the follow-up period, recurrence occurred in surrounding region of 3 of the 42 teeth in the non-extracted group (7.1%) and 2 of the 25 teeth (8%) in the extracted group. Of the 3 preserved teeth that showed recurrence in the surrounding area, 2 could be preserved. One preserved tooth underwent hemisection, and the other was left untreated.
A close relation between the recurrence of tumors and the preservation of teeth involved in the ameloblastomas arising in the mandible could not be established in this study. It is necessary to study the relation between the tumor and related teeth by computed tomography and histopathological examinations to establish evidence about the possibility of preserving teeth involved by ameloblastomas.
Follicular lymphoma is a type of non-Hodgkin's lymphoma and is classified as low-grade lymphoma owing to its slow progression. It rarely occurs in the sublingual gland, and only two cases have been reported to date: one case in Japan and the other case in the United States.
We report a case of follicular lymphoma arising in the sublingual gland. A 60-year-old woman presented to our department with a chief complaint of swelling of the left side of the mouth floor. Magnetic resonance imaging revealed a mass in the left sublingual gland. An incisional biopsy performed with the patient under local anesthesia led to a histopathological diagnosis of follicular lymphoma grade 2. Eight cycles of R-CHOP therapy were administered in our hospital's hematology department. The tumor underwent complete remission and disappeared after treatment. The patient is currently under observation in our department and the department of hematology in our hospital.
Thyroglossal duct cyst (TDC) is often discovered as a midline neck mass and usually develops during the first decade of life. The most common presenting symptom is an asymptomatic neck mass. We describe the rare case of a gigantic TDC that expanded and caused dysphagia. The patient was a 97-year-old man who had noticed a neck mass about 50 years earlier. After slow but progressive growth, the previously asymptomatic mass began to cause dysphagia. The mass measured 15 cm in diameter and was painless and elastic-soft. Pharyngeal exclusion and salivary effusion in the hypopharynx were seen on fiberscopic examination. Computed tomography showed a clear-margined, unilocular mass located in the left side of the neck. Under a diagnosis of TDC, cystic enucleation was performed with the patient under general anesthesia. Pathological examination confirmed the diagnosis of TDC. Dysphagia resolved within 10 days postoperatively.
Hereditary angioedema (HAE) is a rare autosomal dominant genetic disorder caused by functional decline or loss of C1-INH, which is an inhibitor of the first component of complement. HAE is characterized by a rapid onset of recurrent transient edema that occurs in the face and mucous membranes and can cause clinically significant tongue swelling and airway obstruction. The development of laryngeal edema has been reported to be associated with a mortality rate of 30%. Moreover, mental or physical stress can trigger an edema attack in patients with HAE.
We report positive results in two patients with HAE who received tranexamic acid and underwent oral surgery under sedation induced by a modified neuroleptanalgesia (NLA) method to reduce mental stress.
Patient 1: A 34-year-old woman with HAE was referred to our hospital because of pain in the right mandibular third molar. Based on a diagnosis of pericoronitis, we extracted the tooth after induction of modified NLA.
Patient 2: A 34-year-old man with HAE was referred to our hospital because of pain in the left mandibular first molar. The diagnosis were apical periodontitis and radicular cyst. We performed tooth extraction and curettage with the patient under modified NLA.
Angioedema did not develop after treatment in either patient.
We report a case of hemophilia B in a patient with radicular cyst. A 65-year-old man was referred to our department because of a suspicious circular radiolucent finding in the right maxillary sinus. On further imaging, we found a cystic lesion measuring 32 mm × 30 mm and most likely arising from the apical area of the maxillary right second premolar. Extraction of the cyst and supplementation with coagulation factor were planned. At the time of surgery, we experienced difficulty in achieving hemostasis despite supplementation with coagulation factor, but we were able to stop the bleeding using absorbable oxidized cellulose and fibrin glue as hemostatic agents. Postoperatively, the bleeding recurred and persisted, for which we again administered coagulation factor, and the bleeding stopped completely. Subsequently, no further hemorrhage occurred, and the patient has been followed up for 10 months after surgery.