This study compared the cognitive process of letters, hands and tooth types differentiation using P300, which is a waveform component of ERP.
We instructed 17 fifth-year clinical interns to examine diagrams of teeth, letters, and hands rotated at varying degrees. Based on waveforms elicited in the medial parietal region, P300 latency and amplitude, correct response rates, and reaction times were determined. We also measured the area of twelve segments between 300 and 600 msec.
The results show that the P300 latency for tooth differentiation is longer, P300 amplitudes smaller, and reaction times longer than for letter differentiation. However, the three parameters for tooth differentiation were generally comparable to those for hand differentiation. Differences in the area for segments from 300 to 450 msec were observed between teeth and letters and between letters and hands.
The results suggest that the difficulty of cognitive processing for differentiating teeth is similar to that for hands, but greater than that for letters.

抄録全体を表示

The indication for pirfenidone is idiopathic pulmonary fibrosis. Several adverse events have been associated with oral administration of pirfenidone: photosensitivity in 51% of patients, anorexia (23%), stomach discomfort (14%), nausea (12%) and stomatitis (1-5%).
We describe an 80-year-old male who was hospitalized for treatment of pulmonary fibrosis. However, he suffered from a tongue ulcer after taking pirfenidone for 6 days, so he was referred to our department for examination and treatment of the ulcer.
After taking pirfenidone, the size of the ulcer increased gradually to 3-5mm in diameter. The border of the ulcer was clear and aphthous, the base of the ulcer was flush, and the color was milk-white. We could not recognize induration around the ulcer.
We considered the ulcer to be an adverse event due to pirfenidone administration. We consulted the attending physician, and asked him to discontinue pirfenidone administration. Two weeks later, the ulcer had disappeared and a new one had not appeared. The patient's oral intake had improved and the course was uneventful.

抄録全体を表示

We report the treatment of a 61-year-old man presenting with an indwelling tube in the left maxillary sinus. CT scans and panoramic X-ray revealed left maxillary sinusitis. He underwent surgery under general anesthesia to removal a swelling in the mucosa. During the procedure, an indwelling tube was discovered in the maxillary sinus, and was removed at the same time. After the operation, the patient had dull cheek pain, but the offensive-smelling leakage stopped completely.

抄録全体を表示

We report a case of secondary oral syphilis presenting with milk patches in the buccal mucosa. A 43-year-old man presented in our hospital because of gingival pain from brushing his teeth. In the bilateral buccal mucosa he had milk patches surrounded by painless erythema with a clear borderline. Multiple submandibular lymph node swellings were palpable, but general eruptions were absent. On serological examination, the RPR test result was x64 and the TPHA result was > 40,960, so a diagnosis of secondary oral syphilis was made. Oral lesions disappeared after the administration of AMPC 750 mg/day for three weeks.

抄録全体を表示

Reversible cerebral vasoconstriction syndrome (RCVS) is characterized by a throbbing headache and stroke. However, there is no report of such a patient receiving dental treatment.
We report the case of a 33-year-old adult with RCVS who underwent oral surgery under local anesthesia. We extracted the third left mandibular molar taking into consideration the environment and duration of operation. No symptom of the disease occurred peri- or post-operatively, and the patient is making satisfactory progress.

抄録全体を表示

Odontogenic fibroma (OF) is a rare benign neoplasm derived from the dental mesenchymal tissues. According to the World Health Organization (WHO), there are two histological types of lesion: the epithelium-poor type (formerly called the simple type) and the epithelium-rich type (formerly called the complex or WHO-type). A 45-year-old man was referred to our department due to swelling of the lower right gingiva. A panoramic radiograph showed a well-demarcated unilocular radiolucent lesion between the 45 and 46 without root resorption. CT showed slight absorption of lingual cortical bone. We underwent biopsy and suspected as fibroma, so we examined tumor excision under general anesthesia. Histopathological diagnosis was odontogenic fibroma. We diagnosed it as epithelium-poor type OF because there were mainly connective tissue lesions and scattered remnants of odontogenic epithelium. The patient has not suffered recurrence after follow-up for 1 year and 4 months.

抄録全体を表示

We report a case of left maxillary complex odontoma with crown deformation and malposition of impacted wisdom tooth. The patient was a 21-year-old man, who was referred to our hospital by a dental clinic because of a radiopaque lesion of the left-side maxilla on panoramic image. Computed tomography revealed a high-density structure of about 10mm with low-density layer area around the impacted second molar crown and impacted wisdom tooth with crown deformation and malposition in the left side maxilla. The clinical diagnosis was a complex odontoma with impaction of the second molar and wisdom tooth. Surgical extraction of the complex odontoma and impacted wisdom tooth was performed under general anesthesia. The crown form of the extracted wisdom tooth was extremely flat in the direction from the buccal to palatal side. The postoperative course has been uneventful.

抄録全体を表示

This report describes a periodontal tissue regeneration technique for an anterior maxillary intrabony defect, in which salt bone modeling and 3D-CT fusion analysis were performed for preoperative assessment and postoperative evaluation.
A 55-year-old male presented with clinical and radiographic evidence of an intrabony defect around the maxillary right central incisor. After the initial periodontal therapy, we prepared salt bone modeling from CT data to evaluate the anatomical form of the bone loss. Periodontal tissue regeneration in combination with alloplast and guided tissue regeneration (GTR) was applied at the site. Six months after the surgery, we conducted 3D-CT fusion analysis.
Conventional preoperative assessment via dental X-ray imaging and measurement of probing pocket depth is effective for assessing the 2-dimensional bone resorption level and clinically-defined pocket bottom, however, it has a limitation in assessing the anatomical form of the bone loss. Preoperative assessment employing salt bone modeling in this study enabled us to obtain a 3-dimensional image of the anatomical form. Furthermore, it reduced the operative time since it enabled us to determine the form and size of the GTR membrane. Moreover, postoperative 3D-CT fusion analysis allowed detailed evaluation of the site where bone regeneration was taking place.

抄録全体を表示

We report a case of horizontal impaction of the bilateral second and third molars, associated with a unilateral dentigerous cyst. A 20-year-old male complaining of an uncomfortable feeling in the mandibular left molar region was examined in our department. X-ray imaging revealed horizontal impaction of the bilateral mandibular second and third molars, and radiolucency around the crown of the mandibular left second molar. The bilateral mandibular and maxillary second and third molars were extracted and cystectomy was performed under general anesthesia.
This patient had no previous medical history, exhibited no evident abnormality in jaw development or facial morphology, and a dentigerous cyst was present, suggesting that the impaction had been caused by local factors. The probable cause of the impaction was considered to be that tooth germs for the bilateral second molars were located at a low level and mesial inclination was pronounced, leading to impaired eruption, and that the left second molar was more deeply impacted than the right due to the dentigerous cyst. Combined use of orthodontic treatment and surgery was considered, but based on the patient's preferences regarding treatment, the decision was made to extract all the teeth at once and perform cystectomy under general anesthesia.

抄録全体を表示

Drug fever is a fever that commonly appears after 7-10 days of drug administration and disappears after discontinuation of the offending agent. Postoperative high fever makes differential diagnosis between drug fever and infection difficult. We report a case of drug fever caused by antibiotics for postoperative infection.
A 40-year-old male underwent surgery for mandibular odontogenic tumor and suffered postoperative infection. Antibiotics were administered, and high fever appeared 8 days after removal of the titanium mesh and plate. As drug fever was suspected, vancomycin and amoxicillin were discontinued, and the fever reduced as a result. Therefore, the fever was diagnosed as drug fever caused by antibiotics.

抄録全体を表示

Two cases of osseous choristoma that developed in the tongue are reported.
Patient 1 was a 21-year-old female. She consulted us complaining of a mass at the tongue dorsum. A pedunculated lesion of 6 mm in size was observed on the left dorsum of the posterior tongue. The lesion was a bony-hard mass with smooth surface and was identified as a high-density lesion by CT examination. Clinical diagnosis of an osseous choristoma of the tongue was made, and the lesion was excised under general anesthesia. The postoperative course was uneventful.
Patient 2 was a 14-year-old female. She was referred to us for evaluation of the left molar region of the maxilla. CT examination revealed a high-density lesion at the posterior tongue in addition to an odontoma adjacent to the left wisdom tooth of the maxilla. Oral examination showed a pedunculated bony-hard mass with smooth surface of 6mm in size on the right dorsum of the posterior tongue. A diagnosis of osseous choristoma together with odontoma at the left maxilla was made, and the tongue lesion was excised under general anesthesia. The postoperative course was uneventful.
Histopathologically, both of the lesions consisted of mature dense bone with lamellar structure covered with a thin layer of squamous epithelium. These features were consistent with those of osseous choristoma.

抄録全体を表示

We experienced a case of ambulatory anesthesia for a 13-year-old boy with 47XXY Klinefelter's syndrome and systemic lupus erythematosus. He visited the Department of Pediatric Dentistry in our hospital complaining of toothache. He underwent dental treatment under general anesthesia.
The previous year, he had visited the Department of Pediatrics because of fever, and thrombocytopenia was found. A detailed examination was therefore performed and revealed that his chromosomal type is 47XXY. Additionally, he was diagnosed with systemic lupus erythematosus, since he had antinuclear antibody, anti-DNA ds antibody, anti-sm antibody, and PA IgG. He took prednisolone 5mg every day.
In the preoperative examination, the platelet count was 12.8 × 10⁴/micro-L. PT-INR was 1.32 and APTT was 57.5 seconds. Hemorrhagic diathesis, however, was not observed clearly.
Anesthesia was induced with intravenous midazolam and fentanyl and maintained with inhalation of sevoflurane and intravenous fentanyl. No severe complication occurred.
A patient with Klinefelter's syndrome is often complicated with autoimmune diseases, so it is important to pay attention to the patient's condition.

抄録全体を表示

音声入力を用いた口腔診査記録では乳歯列の“A”から“E”を正しく認識することが大切である。乳歯の“A”から“E”については“D”と“E”の音声認識ができなかったので，われわれは“A”から“E”を認識しやすい“1-（いち はいふん）”から“5-（ご はいふん）”として入力する方法（H法）を報告した。“1-”は「いち はいふん」と発音するので入力時間が長くなっていた。そこで入力時間を短くするため，乳歯の“1-”から“5-”を“1ban（いち ばん）”から“5ban（ご ばん）”として入力する方法（B法）を試みた。また，B法の用語で診査記録をExcelのひとつのセルに入力する方法（新B法）を試み，入力時間を比較した。
いろいろな口腔状態のものを20症例作成した。各症例をH法とB法で5回ずつ入力し，時間を比較した。また，入力誤り率を調べた。さらに，新B法を用いて各症例5回入力し時間を測定した。入力誤り率についても検討した。
その結果，H法の平均入力時間は128秒，B法は112秒で B法が16秒速かった。入力誤り率はH法が0.05%，B法が0.03%でほぼ同じであった。新B法の入力時間は82秒でB法より30秒速かった。新B法の入力誤り率は0.05%でB法とほぼ同じであった。
音声入力を用いた乳歯列や混合歯列の口腔診査記録には新B法が有用であると思われる。

抄録全体を表示

Sタンパク欠損症（PSD）は抗血液凝固反応を抑制するため，PSD患者はワーファリンなどによる抗凝固療法が必要である。PSD患者では，手術前後の出血や血栓形成などの合併症を生じさせないように様々な試みがなされている。PSDのためにワーファリンを内服していた62歳の女性に対して，ワーファリンを中止することなく外来で智歯の抜歯を行った。抜歯時のPT-INRは2.56であった。患者は術後の止血を目的に止血床（SAS）を装着して帰宅し，術後に合併症は認められなかった。PSD患者の場合であっても，今回用いたSASによりワーファリンを中止することなく抜歯などの小手術を外来で安全に施行することができると考えられる。

抄録全体を表示

われわれは下顎骨に生じた骨未分化高悪性度多形肉腫の2例（65歳女性と77歳男性）を経験し，その1例では術前化学療法が奏効した。下顎骨に発生する骨未分化高悪性度多形肉腫に関しては，まず速やかに病理組織学的な診断を行うことが最も重要である。そして，十分な切除域を設定できる早期に，手術療法を検討することが重要と考えられる。時に，急速な増大をとり，既に来院時に切除域の設定が困難と診断される症例がある。その際には，術前化学療法が検討されるが，下顎骨に発生する骨未分化高悪性度多形肉腫の頻度はまれな上に，詳細な報告が少ない。術前化学療法の検討にあたり，このような症例報告の蓄積は必要と考え，報告を行った。

抄録全体を表示