A symposium entitled “The Future of Female Oral and Maxillofocial Surgeons Part II” was held at the 62nd Congress of the Japanese Society of Oral and Maxillofacial Surgeons. The results of a questionnaire survey on the awareness and intent of female oral and maxillofocial surgeons with regards to their career were made public and a symposiast discussed the problems with working and the difficulties of work-life balance for female oral and maxillofocial surgeons. Because improvements in the work environment of female oral and maxillofocial surgeons in order to continue working cannot be said to be sufficient, it should be improved as soon as possible. It was believed that going forward the Japanese Society of Oral and Maxillofacial Surgeons should also provide support so that female oral and maxillofocial surgeons can continue their careers.

Recently, the number of female dentists who have specialized in oral surgery is increasing and many of them are being active in the front lines of the field of oral surgery. Surgeons, in general, face a multitude of challenges around work-life balance. Especially, female oral surgeons often encounter a unique set of challenges, such as female specific life events including pregnancy, childbirth and childcare, as well as family care that is not specific for female, where they need to take a leave of absence or feel pressure to give up on their jobs. It is important that we take measures to not only support female oral surgeon’s career aspirations but also to facilitate return-to-work goals that would embrace both their professional and personal objectives. Unfortunately, it remains difficult for early-stage female surgeons to make a career path plan due to lack of positive female role models. Therefore, it is important for early-stage female surgeons to set career goals in their own way. At the same time, it is important to survey what female surgeons think for their future so that the Japanese Society of Oral and Maxillofacial Surgeons can consider for assistance to female surgeons.

　The purpose of this survey was to address the following topics:

　 1. What are some of the main reasons female dentists choose to pursue the specialty of oral surgery?

　 2. To what degree each individual focuses on the specialty?

　 3. What are some of the main obstacles that female surgeons face in pursuing a career in oral surgery?

　In this review, we report the results of the survey to share the information with the members of The Japanese Society of Oral and Maxillofacial Surgeons.

We report a rare case of odontogenic fibroma that included an impacted primary molar. The patient was an 8-year-old girl. Panoramic radiography and computed tomographic imaging revealed an apparently circumscribed, radiolucent lesion that was the size of the tip of the little finger and included the crown of the left primary second molar. Furthermore, a tooth-like radiopaque structure was located alveolo-palatally adjacent to the lesion. With the patient under general anesthesia, the lesion was removed along with the tooth-like structure and the impacted primary molar. The extirpated lesion was histologically diagnosed as odontogenic fibroma, and the tooth-like structure was diagnosed as odontoma. There has been no evidence of tumor recurrence after 2 years.

Ameloblastoma is an odontogenic tumor with a high local recurrence rate, frequently recurring within the jawbones. However, when tumor cells remain in the periosteum, gingiva, or alveolar mucosa, recurrence in soft tissue near the jawbones has also been reported. We report a patient in whom ameloblastoma developed in the middle of the oral floor at the time of the 6th recurrence of ameloblastoma in the jaw. A 67-year-old woman visited our department to undergo treatment of a recurrent ameloblastoma. Contrast computed tomography showed a low attenuation area (35 × 30 mm) with internal heterogeneity in the left mandibular ramus. Magnetic resonance T1-weighted images revealed areas with signals nearly isointense relative to the muscle in the left mandibular ramus and the submucosal area of the oral floor. T2-weighted images showed a multilocular high-intensity area in the left mandibular ramus and a unilocular high-intensity area (10 ×7 mm) with internal heterogeneity in the submucosal area of the oral floor. With the patient under general anesthesia, segmental mandibulectomy with reconstruction using a vascularized free fibular flap and an excisional biopsy of the oral floor were performed. Histopathological examination revealed that both lesions in the mandible and oral floor were follicular ameloblastomas. As of 6 years from the operation to the present, no recurrence has been noted.

Eosinophilic ulcer (EU) is a rare self-limiting oral condition, frequently occurring on the tongue and appearing as an ulcer with elevated induration of the surrounding tissue. Consequently, there is risk of misdiagnosis as carcinomatous ulcer. We describe a 30-year-old man with a painful ulcer on the tongue, which reappeared one and a half months after healing. First, a lesion developed on the dorsum of the tongue. The lesion healed without active treatment after 1 month. However, two lesions were then observed on the right ventral aspect of the tongue. Histopathological examination of the lesions showed ulceration and inflammatory deterioration with distinct eosinophilic infiltration extending into the deep underlying connective tissue and muscle fibers. Immunohistochemical analysis revealed a large number of CD30-positive large atypical cells among inflammatory cells. As a result, an eosinophilic ulcer was diagnosed. The recurrent lesions also healed without active treatment, similar to the primary lesion.

Central mucoepidermoid carcinoma is an uncommon tumor, accounting for 2% to 3% of all mucoepidermoid carcinomas. Meanwhile, a head and neck tumor rarely causes an attack of syncope. We describe a case of syncope considered to be caused by a large central mucoepidermoid carcinoma in the mandible. A 66-year-old man was referred to our clinic to receive treatment for a right mandibular lesion and to determine the cause of repeated attacks of syncope. Computed tomography showed that the right side of the mandible was remarkably expanded, and the parapharyngeal space was compressed by an expanded right mandibular tumor. Tumor biopsy was performed, and a mucoepidermoid carcinoma of the mandible was definitively diagnosed. No evidence of metastasis was evident on positron emission tomography. With the patient under general anesthesia, we performed a right hemimandibulectomy, right neck dissection, and immediate reconstruction using a pectoralis major myocutaneous flap and a reconstruction plate with condyle. We found no evidence of local recurrence or regional and distant metastasis at the 4-year postoperative follow-up. In addition, no attack of syncope occurred after the operation.