Japanese Journal of Oral Diagnosis / Oral Medicine
Online ISSN : 2188-2843
Print ISSN : 0914-9694
ISSN-L : 0914-9694
Volume 27, Issue 3
Displaying 1-22 of 22 articles from this issue
Original
  • HISAZUMI IKEDA, NAOMI IMAYAMA, TAKESHI SHIRAISHI, SOUICHI YANAMOTO, SE ...
    2014 Volume 27 Issue 3 Pages 211-215
    Published: October 01, 2014
    Released on J-STAGE: October 31, 2014
    JOURNAL FREE ACCESS
    We investigated the frequency of double primary cancers in association with oral and maxillofacial regions and also studied the modality for detection of the lesions in 108 patients with primary oral squamous cell carcinoma referred to the Department of Oral and Maxillofacial Surgery at Nagasaki University Hospital from January 2008 to December 2011. Ninety nine of the 108 patients were examined by 18F-fluoro-2-deoxy-D-glucose positron emission tomography (FDG-PET) and/or esophagogastroduodenoscopy (EGD). Six patients (6.6%, 6/99) with 8 double cancers were detected. Five patients (8.2%, 5/61) with 6 double cancers were detected by EGD and 4 patients (5.3%, 4/75) with 5 double cancers were detected by FDG-PET. EGD was superior to FDG-PET in sensitivity, but FDG-PET was superior to EGD in specificity. While EGD could diagnose cancer in the upper digestive tract, distant metastasis and colon cancer were detected by FDG-PET scan alone. FDG-PET was suggested to be an effective diagnostic tool for distant metastasis and colon cancer. These results suggest that FDG-PET and EGD are equally suitable diagnostic tools for the detection of double cancers.
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  • AKIHIDE NEGISHI, AIKO NOBUSAWA, MASARU OGAWA, YU TAKAYAMA, AKINORI GOM ...
    2014 Volume 27 Issue 3 Pages 216-222
    Published: October 01, 2014
    Released on J-STAGE: October 31, 2014
    JOURNAL FREE ACCESS
    The control of cervical lymph node metastasis is an important prognostic factor in patients with oral squamous cell carcinoma (SCC). Determining whether neck dissection is indicated before initial treatment is essential for improving the success rate and maintaining patients' quality of life. However, criteria for elective neck dissection remain undecided. In this study, we analyzed the predictive factors for cervical lymph node metastasis in 256 patients undergoing treatment for oral SCC at the Department of Oral and Maxillofacial Surgery, Gunma University Hospital. Cervical lymph node metastasis was present in 29.3% of the patients. Prevalence was not significantly correlated with primary sites or T stages. In histopathological findings for the SCC cells, cervical metastasis was observed more in cases of poorly differentiated type or infiltrative growth pattern (INF) c than for other types or patterns, and the odds ratio of metastasis was 6.96 or 4.80, respectively. For patients with cervical metastasis, plural metastatic nodes involved in plural levels with extracapsular invasion were observed more for INF c than for INF a-b. In INF c cases, the survival rate of patients with resection of the primary site and neck dissection simultaneously was higher than that of patients with secondary neck dissection after metastasis. These results suggest that elective neck dissection is applicable in cases of INF c because of a potential link to cervical lymph node metastasis.
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Clinical Reports
  • IWAO HARA, RYUJI UCHIDA
    2014 Volume 27 Issue 3 Pages 223-226
    Published: October 01, 2014
    Released on J-STAGE: October 31, 2014
    JOURNAL FREE ACCESS
    We report a case of sialolithiasis of the upper lip in an elderly person. A 78-year-old male was referred to our hospital because of a painless mass at the upper lip. Upon palpation, a painless mass at the left-side upper lip with the size of a grain of rice, elastic hardness, and mobility from the surrounding tissue was found. We diagnosed the lesion as a benign tumor of the upper lip, and excised it under local anesthesia. In the tumor, there was a hard calcification-like substance of about 2.5 mm in size and yellowish white in color. In the pathological examination and X-ray microanalysis, the material was diagnosed as caused by sialolithiasis of the upper lip over a long time, under the stable situation of little foreign stimulation.
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  • YUKIKO SHINOHARA, AKINORI MOROI, YURI ISHIHARA, MEGUMI SOTOBORI, HIROU ...
    2014 Volume 27 Issue 3 Pages 227-230
    Published: October 01, 2014
    Released on J-STAGE: October 31, 2014
    JOURNAL FREE ACCESS
    We report a case of a huge nasopalatine duct cyst that was the biggest one we have ever investigated. The patient was a 66-year-old male. He was referred to our hospital complaining of swelling of the maxillary mucosa. X-ray CT examination revealed extensive radiolucency reaching the maxillary sinus. Under a diagnosis of maxillary cyst by biopsy, we performed cyst resection with root end resection under general anesthesia. All teeth that were in close proximity to the cyst were treated conservatively. Since the operation, no infection has been found and the course has been uneventful.
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  • KENICHI HANAUE, YOSHITO TAKASAKI, MOTOAKI INAGAWA, RYOICHI HAGIHARA, M ...
    2014 Volume 27 Issue 3 Pages 231-236
    Published: October 01, 2014
    Released on J-STAGE: October 31, 2014
    JOURNAL FREE ACCESS
    Sensory disturbance resulting from denture pressure may be caused by advanced alveolar ridge resorption in a patient with an edentulous jaw. We report our observations of a patient with complete dentures with inferior alveolar sensory nerve disturbance due to alveolar ridge resorption associated with a mandibular canal.
    The patient was a 65-year-old woman, who had begun using complete lower dentures six years earlier. She had become aware of dysesthesia of an area innervated by the right mental nerve, and also hypoesthesia, and thus consulted the Tokyo Dental College Suidobashi Hospital for oral surgery.
    Hypoesthesia of the area innervated by the mental nerve, i.e. dysesthesia, and gingival area dysesthesia in response to pressure on the right mandibular molar tooth were noted at the time of the first medical examination. Medical treatments performed included denture adjustment, medications, and rehabilitation guidance to restore sensation. The hypoesthesia disappeared progressively within two months, and the dysesthesia resolved three weeks thereafter. The sensory testing method used for this patient enabled both quantitative assessment of the disorder and evaluation of the recovery process over time. Based on the features of each laboratory procedure, the author considers it to be important to assess perception disorders comprehensively.
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  • YASUSHI KAWAGUCHI, KOUJI TAKAHASHI, YOSHIMASA KITAGAWA
    2014 Volume 27 Issue 3 Pages 237-240
    Published: October 01, 2014
    Released on J-STAGE: October 31, 2014
    JOURNAL FREE ACCESS
    The patient was a girl in her teens. A panoramic radiograph revealed an impacted canine and a mixture of radiolucency and radiopacity in the right sinus. The patient was referred to the Dental Clinical Division, Hokkaido University Hospital. She had no subjective symptoms. A slight bone expansion from the base of the right ala of the nose to the infraorbital region was palpable, but no tenderness or paresthesia was noted. A CT image indicated a tumor mass shadow with fine-grained sand radiopacity contained in the impacted canine in the right sinus.
    The patient was pathologically diagnosed as having an adenomatoid odontogenic tumor by biopsy and underwent tumor resection. The 40 × 28 mm tumor had a capsule and contained the canine and sand granule-like hard materials. The tumor cavity was washed out with a saline solution through the bone defect formed after tumor extirpation in the anterior wall of the maxillary sinus, and the cavity was closed 1 year later. Approximately 5 years since the operation, neither relapse of the tumor nor deformation of the maxilla has been observed.
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  • TAKENORI OMOTE, SHINICHI NOZAKI
    2014 Volume 27 Issue 3 Pages 241-243
    Published: October 01, 2014
    Released on J-STAGE: October 31, 2014
    JOURNAL FREE ACCESS
    Calcifying epithelioma is a benign tumor derived from hair matrix cells. It more commonly involves the face and upper extremities in children and females and rarely occurs in individuals aged > 50 years. It can be detected at an early stage, with a typical clinical presentation of a hard mass under the skin, and can be surgically resected.
    Here we report the case of a 50-year-old male who presented with a scleroid-like tumor mass that could be palpated in his left neck. He had been aware of the tumor for approximately 30 years, and it had been progressively increasing in size. The tumor was located over the left sternomastoid muscle, was approximately the size of the tip of the fifth finger, and was hard and mobile. Two sharply demarcated oval opacities were demonstrated on computed tomography (CT), with the same CT value as that of bone. We diagnosed neck calcifying epithelioma and resected the tumor under local anesthesia. Histological examination revealed calcified material containing shadow cells with marginal ossification. The surface skin showed no apparent abnormalities. We report this rare case of neck calcifying epithelioma that went undiagnosed for more than 30 years and discuss the relevant literature.
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  • —Clinical and Histopathological Examination—
    SHINYA TAKAHASHI, TOMOHIRO HAMADA, HIDEKI KON, ICHORO KAWAHARA, SATOSH ...
    2014 Volume 27 Issue 3 Pages 244-248
    Published: October 01, 2014
    Released on J-STAGE: October 31, 2014
    JOURNAL FREE ACCESS
    We report a case of a cyst similar in characteristics to postoperative maxillary cysts which do not require surgical care such as maxillary sinus radical operation and trauma. The patient was a 57-year-old woman in whom spontaneous pain and swelling of the left gena and left maxillary gingival occurred. Left-sided maxillary sinusitis was suspected, so cyst enucleation was performed under general anesthesia with the diagnosis of upper jaw cyst in the left side. The cyst wall consisted of fibrous connective tissue. On the surface of the connective tissue, a hyalinized band-like structure was seen. The surface opposite to the cyst inner surface was partly covered by respiratory epithelium and squamous epithelium, and was found to be similar in appearance to a postoperative maxillary cyst and surgical ciliated cyst.
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  • HIROAKI ISHII, KAORU OOSUGA, YUUGO FUKAYO, YUKI KURIHARA, HIDEO KASAHA ...
    2014 Volume 27 Issue 3 Pages 249-252
    Published: October 01, 2014
    Released on J-STAGE: October 31, 2014
    JOURNAL FREE ACCESS
    This paper reports a 35-year-old female patient with a relatively large pulp polyp in her mandibular third molar, who was referred to our department for examination of a tumor in her oral cavity. The oral examination confirmed the presence of a tumor of 30 × 20 × 7mm in her left mandibular third molar; however, its detailed observation was difficult due to mental retardation. In May 201X, the patient's oral cavity was observed under general anesthesia, revealing that the tumor was growing from the carious cavity of the left mandibular third molar. Therefore, tooth extraction was performed to remove the tumor. It was histopathologically diagnosed as a pulp polyp. The patient's difficulty in reporting her subjective symptoms due to mental retardation may have prevented early identification of the polyp, allowing its extensive growth.
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  • EIJI IWATA, TAKUMI HASEGAWA, TSUTOMU MINAMIKAWA, YASUYUKI SHIBUYA, TAK ...
    2014 Volume 27 Issue 3 Pages 253-256
    Published: October 01, 2014
    Released on J-STAGE: October 31, 2014
    JOURNAL FREE ACCESS
    We herein report a case of a granular cell tumor arising from the dorsal side of the tongue in a 45-year-old female. The patient had noticed a mass on the left dorsal side of the tongue seven months earlier, but had ignored it as it was painless. The lesion exhibited a hard, elastic, clear boundary measuring approximately 15 × 15 mm on the left side of the back of the tongue. A biopsy was performed, and the lesion was diagnosed as a granular cell tumor. The tumor was resected, including the surrounding normal tissue. Histopathologically, it consisted of uniform cells with many eosinophilic granules in the cytoplasm and pseudoepitheliomatous hyperplasia. On immunohistochemistry, the cytoplasm and nucleus displayed immunoreactivity for S-100 protein and CD68. No evidence of any local recurrence was observed during the one-year follow-up period.
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  • ATSUSHI ABE, MORIYASU ADACHI, YU ITO, YOSHIKO KATAYAMA, TETSUSHI OGUMA ...
    2014 Volume 27 Issue 3 Pages 257-261
    Published: October 01, 2014
    Released on J-STAGE: October 31, 2014
    JOURNAL FREE ACCESS
    The incidence of malignant lymphoma has recently increased and it is becoming more common to encounter multiple primary carcinomas including the present case. In a case with multiple primary carcinomas with malignant lymphoma, it is necessary to determine the priority and treatment plan according to the clinical stage and the prognosis of the diseases. We therefore report a case with multiple primary carcinomas of the mandibular gingiva complicated by malignant lymphoma. Patient: 75-year-old male. Chief complaint: fecal occult blood. The patient visited the department of gastrointestinal medicine due to fecal occult blood in December 2006. A biopsy was conducted because the endoscopy revealed adenomatoid lesion. Consequently, the patient was diagnosed with diffuse large B-cell lymphoma and was transferred to the department of hematology to receive R-COP therapy. After two courses of the chemotherapy, an ulcerative lesion was detected on the buccal gingiva of the lower left molars in February 2007, which was diagnosed as squamous cell carcinoma of the mandibular gingiva (T2 N0 M0) by pathological examination, CT and MRI. Subsequently, marginal resection of the mandible was performed. Three months after the operation, four courses of R-COP therapy were conducted.
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  • CHIAKI OHTAKA, FUMIHIKO MATSUSHITA, NAOSHI SONODA
    2014 Volume 27 Issue 3 Pages 262-266
    Published: October 01, 2014
    Released on J-STAGE: October 31, 2014
    JOURNAL FREE ACCESS
    We report a case of a neurilemmoma in the parapharyngeal space, and describe some valuable information concerning its preoperative diagnosis. A 71-year-old man who had a painless mass in the left cheek region was found to have another tumor in the right cervical region. MRI showed that the tumor had shifted the common carotid artery ventrally and the jugular vein anterolaterally; we hypothesized that the tumor originated from either the deep lobe of the parotid gland or from a cervical nerve. Clinical diagnosis was pleomorphic adenoma of the parotid gland or neurilemmoma of some cervical nerve. We exposed the tumor under general anesthesia. Histopathological diagnosis was Antoni A and B type neurilemmoma. The patient did not develop any complications. Based on preoperative images and intraoperative findings, we supposed that the tumor was derived from the cervical sympathetic nerve.
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  • ATSUSHI TAKANO, AKIHIDE NEGISHI, AIKO NOBUSAWA, NORIKO KAMADA, SATOSHI ...
    2014 Volume 27 Issue 3 Pages 267-271
    Published: October 01, 2014
    Released on J-STAGE: October 31, 2014
    JOURNAL FREE ACCESS
    Lateral cervical cyst is a relatively rare cystic lesion in the head and neck region. There are two theories as to the location of its origin: branchial arches or glandular epithelium, but there is no established theory. We report a case with a lateral cervical cyst which presented gradual growth caused by long-term symptomatic treatment. A 61-year-old woman was referred to our hospital because of swelling in the lateral cervical region about 30 years earlier. The lesion was diagnosed as benign, and so puncture and aspiration were continued in another hospital for 27 years. At presentation, the lesion measured 80 × 60 × 20 mm, and was soft elastic and fluctuant without tenderness, in the right side of the cervical region. MR images revealed a cystic lesion compressing the jugular vein in the range of the omohyoid muscle to the submandibular region in front of the sternocleidomastoid muscle. The large cystic lesion was extirpated under general anesthesia. Histopathologic examination of the surgical specimen revealed glandular epithelium and lymphoid follicles, and the diagnosis was a lymphoepithelial cyst. There has been no recurrence during the 3 years since surgery.
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  • SHINPEI MATSUDA, HITOSHI YOSHIMURA, MINAKO AIKI, JUNICHI KOBAYASHI, SE ...
    2014 Volume 27 Issue 3 Pages 272-278
    Published: October 01, 2014
    Released on J-STAGE: October 31, 2014
    JOURNAL FREE ACCESS
    Actinomycotic osteomyelitis of the mandible is a rare disease and often is difficult to diagnose and treat. We report a case of actinomycotic osteomyelitis of the mandible treated by segmental resection. An 83-year-old man was referred to our hospital because of swelling and pain of the mandible. An X-ray examination revealed bone destruction of the left side of the mandible. In the affected bone marrow, magnetic resonance imaging revealed a heterogeneously lower intensity on the T1-weighted image (T1WI) and a heterogeneously high intensity on the T2-weighted image (T2WI). Bone scintigraphy demonstrated accumulation of technetium-99m methylene diphosphonate (99mTc-MDP) in the region of bone destruction. We administered antibiotics and performed the following two surgical treatments: intraoral sequestrectomy and extraoral decortication. Despite those treatments, the inflammatory condition continued; therefore, we performed a segmental resection of the mandible including the condylar process. Histopathologic examination of the resected specimen revealed some colonies of actinomycotic organisms in the inflammatory granulation tissue of the sequestra. Reconstruction of the mandible was not performed because of its infectious state, and the occlusal status was maintained with a metal guidance flange. The postoperative course was uneventful, and no recurrences were observed during the three-year follow-up period.
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  • RYOHEI ITO, WATARU KOBAYASHI, NORIHIKO NARITA, YUKI SAITO, AKINARI INU ...
    2014 Volume 27 Issue 3 Pages 279-284
    Published: October 01, 2014
    Released on J-STAGE: October 31, 2014
    JOURNAL FREE ACCESS
    Disseminated intravascular coagulation syndrome (DIC) is an acquired disorder in which intravascular coagulation may lead to microvascular fibrin formation and a hemorrhagic diathesis. Since there are various underlying diseases, the balance of the coagulation system and fibrinolysis system differs case by case. DIC is often encountered as disseminated hemorrhage in the field of oral surgery. When the underlying disease is clear, the diagnosis is comparatively easy, but otherwise the diagnosis may be difficult. We report a case of DIC with advanced fibrinolysis caused by prostatic cancer presenting as a gingival hemorrhage. The patient was referred to our department complaining of prolonged hemorrhage from the gingiva. The clinical examination of bleeding tendency (platelet number, prothrombin time, fibrinogen level, bleeding time) did not show remarkable abnormal values. An additional examination of FDP and D-dimer yielded a diagnosis of DIC, and it became clear that prostatic cancer was the underlying disease of DIC. Therefore, hormone therapy was carried out, and the hemorrhage arrested quickly and spontaneously. When treating unexplained hemorrhage, it is important to conduct an appropriate screening examination and to consider a differential diagnosis of DIC.
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  • SHUNSUKE KIMURA, MORIYASU ADACHI, TETSUSHI OGUMA, YOSHIKO KATAYAMA, AT ...
    2014 Volume 27 Issue 3 Pages 285-289
    Published: October 01, 2014
    Released on J-STAGE: October 31, 2014
    JOURNAL FREE ACCESS
    We report a case of multiple osseous dysplasia with simple bone cysts in the jaw bones of both sides of the maxillary molar part, right maxillary front tooth part and part from the right lower second molar to the left lower second molar part, with long-term follow-up. The patient was a 61-year-old woman. Although she had no subjective symptoms, the patient underwent surgery because the simple bone cysts tended to enlarge during the 18-year follow-up period. The surgical treatment consisted of cystic fluid evacuation, filling the cavity with blood, and primary closure. After repeated surgery, the simple bone cysts of the patient eventually filled with normal bone tissue. We therefore consider this treatment to be effective.
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  • YUICHIRO NAKAI, YOSHINORI JINBU, YASUHIRO UENO, YOSHIYUKI TSUCHIYA, HI ...
    2014 Volume 27 Issue 3 Pages 290-294
    Published: October 01, 2014
    Released on J-STAGE: October 31, 2014
    JOURNAL FREE ACCESS
    We present the case of a 60-year-old female patient who had been treated for angioimmunoblastic T-cell lymphoma (AITL) at the hematology department of our hospital. The patient had been suffering from tenderness on the right margin of the tongue since one month before, for which she was referred to our department. Histopathological examination performed at our department pathologically revealed the presence of cytomegalovirus antigen positive cells, which, along with the clinical findings, led to the diagnosis of stomatitis caused by cytomegalovirus. Because the lesion showed a tendency toward improvement, the decision was made to conservatively follow this patient, since when her tongue has been in good condition without relapse of stomatitis. We herein report our experience with this case of cytomegalovirus stomatitis, and discuss the relevant literature.
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  • HIROUMI IKAWA, AKINORI MOROI, KOHEI MARUKAWA, YURI ISHIHARA, MEGUMI SO ...
    2014 Volume 27 Issue 3 Pages 295-299
    Published: October 01, 2014
    Released on J-STAGE: October 31, 2014
    JOURNAL FREE ACCESS
    Mallory-Weiss syndrome is characterized by laceration of the gastro-esophageal junction caused by high intra-abdominal pressure. We report an 82-year-old male who was suspected to have Mallory-Weiss syndrome after an extraction. The extraction was performed under local anesthesia and antiplatelet drugs as the patient was diagnosed with severe periodontal disease. Three days after the tooth extraction, bleeding appeared in his mouth. Endoscopy revealed bleeding at the infection site of the gastro-esophageal junction. After blood was transfused, the symptom improved. This case report suggested that cooperation with other departments could assist rapid intervention. Postoperative infection was not found and the prognosis was good.
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  • SHURI HADA, JUNKO NAKAJIMA, HIROSHI NOZAWA, TSUGUO SANO, YASUNORI SATO
    2014 Volume 27 Issue 3 Pages 300-303
    Published: October 01, 2014
    Released on J-STAGE: October 31, 2014
    JOURNAL FREE ACCESS
    Phlebolith in venous hemangioma is relatively rare and there are few reports of venous hemangioma in the tongue. We report a case of venous hemangioma with phlebolithiasis.
    A 75-year-old man was referred to our department with the complaint of a tumor in the left side of the tongue. There was a red elastic hard tumor measuring 18 × 15 × 8 mm with a rough surface. Hard tissue was not palpable around the tumor. Enhanced CT showed that there was a highly enhanced lesion with a high-density area in the left posterior part of the tongue. Clinical diagnosis was tongue tumor (suspected hemangioma). Excision of the tumor was performed and the histopathological diagnosis was venous hemangioma with phlebolithiasis. The postoperative course was uneventful and no evidence of recurrence has been observed for two years until now.
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  • SHOICHIRO KITAJIMA, AKIO YASUI, HISANOBU MARUO, KEIJI NIWA, SADANOBU K ...
    2014 Volume 27 Issue 3 Pages 304-306
    Published: October 01, 2014
    Released on J-STAGE: October 31, 2014
    JOURNAL FREE ACCESS
    Intractable ulcer is a frequently encountered symptom in daily practice. However, it is very difficult to identify the cause of an intractable ulcer of the oral cavity. In the present case, the patient had received medical treatment with antibiotics for pneumonia. At the first examination at the Department of Oral and Maxillofacial surgery (OMFS), an ulcer 20 mm in diameter on the dorsum of the tongue was found. Though we started treatment with mouthwash, steroid cream, and vitamin B6 for this ulcer as usual, it seemed resistant to treatment. Therefore, mycology culture was performed and Candida albicans was found, which we treated with antifungal medication. The medication was successful and the ulcer disappeared in four weeks. This case suggests that Candida may play an important role in oral ulcer.
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  • MASAJI MORI, YUUSUKE HIGUCHI, SATORU AIZAWA
    2014 Volume 27 Issue 3 Pages 307-310
    Published: October 01, 2014
    Released on J-STAGE: October 31, 2014
    JOURNAL FREE ACCESS
    We present a case of tooth extraction for a 25-year-old patient with a history of secondary methemoglobinemia at 6 months of age caused by Acetaminophen.
    The tooth extraction was performed under local anesthesia using 2% lidocaine with 1:80,000 epinephrine in an operating room equipped with respiratory support.
    As a result, the treatment was successfully completed and we found no significant signs of secondary methemoglobinemia such as cyanosis, dyspnea and rise in blood methemoglobin concentration.
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  • AKIO YASUI, SHOICHIRO KITAJIMA, HISANOBU MARUO, KEIJI NIWA, SADANOBU K ...
    2014 Volume 27 Issue 3 Pages 311-315
    Published: October 01, 2014
    Released on J-STAGE: October 31, 2014
    JOURNAL FREE ACCESS
    Many cases of accidental insertion of an iatrogenic foreign body during dental therapy involve radiopaque items such as dental bars, syringe needles, inlays, implants, etc. In such cases, the size and shape of the foreign body are determined by plain X-rays, and upon confirming the location of the accidental insertion in the CT, the surgical procedure is considered in detail to avoid causing secondary damage while extracting the foreign body. We report two cases we experienced, in which we extracted a metallic foreign body that had been accidentally inserted in the inside and outside of the mandible during tooth extraction.
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