Fracture morphology of maxillofacial trauma is often complex, so the clinicians should be familiar with the imaging findings. Various radiographic methods have been used for diagnosing maxillofacial trauma. In recent years, multidetector computed tomography (MDCT) with multiplanar reformation (MPR) and three-dimensional (3D) images has become a standard part of the assessment of maxillofacial injury because of the exquisite sensitivity of this imaging technique for fracture. In this review, I will summarize the oral and maxillofacial fractures using MDCT, especially mandibular fractures and midfacial fractures including maxillary fractures.

Fall in child is relative more as a course of injuries on tooth, gingiva, alveolar bone, lip, tongue and buccal mucosa in house. In adult, fall on walking, hits in sports and working accidents are most courses. Injuries of oral and maxillofacial region should be repaired correctively on short times to be anatomical tissue situation just before accident.

　It is good points to preserve the dislocated tooth as far as possible, to repair the bone fragments and to suture the muscle and epithelium correctively. Drainage is necessary on infected wounds. It needs to observe the color of tooth crown, absorption of tooth root-apex.

　We have to observe the development of mandible on child. Treatment of trigeminal and facial nerve injuries are usually dosage corticosteroids and vitamin B12.

Low-grade central osteosarcoma, a rare subtype of osteosarcoma, is less aggressive than conventional osteosarcoma. We report ac case of low-grade central osteosarcoma of the mandible. A 52-year-old woman presented to our department for treatment of a swelling in the right side of the mandible. Computed tomography revealed ground glass radiopaque lesions associated with an expansive growth pattern in the mandibular bone. Because a suspicion of low-grade central osteosarcoma was diagnosed In the biopsy sample provided from the previous hospital, the lesion was surgically resected. Histopathologically, the tumor consisted of a dense proliferation of spindle cells with mild atypia. At the periphery of the lesion, the normal cortical bone was invaded by tumor nests. Low-grade central osteosarcoma was diagnosed in the surgical specimen. Tumor recurrence has not been observed for more than 6 years after surgery. Low-grade central osteosarcoma is hard to differentiate from osteogenic benign neoplasm or bone malformation. Therefore, when radiographic findings reveal an expansive ground glass appearance, a bone biopsy including the normal cortical bone and the central part of the lesion is essential.

Congenital unilateral soft palate aplasia is a congenital disease in which the soft palate of the affected side is significantly shorter than the other side. It is difficult to obtain complete velopharyngeal competence after palatoplasty, because of dysplasia of the palatal levator muscle. We performed palatoplasty in a 2-year-old girl for right soft palate aplasia and assessed the long-term outcome. We report the results of assessing velopharyngeal closing movement by nasopharyngeal endoscopy 16 years after operation. Velopharyngeal competence was not complete during articulation, but speech intelligibility was clear. In addition, she acquired a characteristic velopharyngeal competence assisted by the tongue.

Nodular fasciitis is a reactive proliferative lesion arising from the fascia. The predilection site is the upper extremity or trunk. Nodular fasciitis arising in the head and neck region is rare. We report a case of nodular fasciitis occurring in the mental region. A 33-year-old woman was referred to our department because of a mental region mass. The mass was located in the subcutaneous tissue of the left mental region, and it was painless, elastic hard, and measured 18 × 14-mm. Computed tomography and magnetic resonance imaging revealed that no obvious bone resorption in the mandible. For a diagnosis of a left mental region tumor, we performed tumor resection with the patient under general anesthesia. Histopathological examination showed a dense, loose proliferation of spindle cells. Immunohistochemical study revealed that the cells were positive for α-SMA, and negative for CD34, desmin, S-100, β -catenin, STAT6, and ALK. The Ki-67 labeling index was 10%. The presence of the MYH9-USP6 fusion gene was analyzed by reverse transcription polymerase chain reaction, but was not found. Nodular fasciitis was diagnosed histopathologically. There was no recurrence for 5 years 3 months after operation.