Among 321 cases with oral squamous cell carcinoma （OSCC） from 2001 to 2011 in the Department of Oral and Maxillofacial Surgery, Nagasaki University Hospital, 221 cases were treated with curative intent, and local recurrence was observed in 34 （15.4％） patients. The average time to local recurrence after initial treatment was 11.3 months. The 5-year overall survival rate of the patients with local recurrence was 48.7％. In this study, univariate analysis revealed that the prognosis of salvage surgery of local recurrence in OSCC patients might be associated with neoadjuvant chemotherapy （P＜0.01）, recurrence interval （P＜0.05）, recurrence site （P＜0.01）, and postoperative adjuvant therapy （P＜0.01）. Multivariate analysis revealed that the independent prognostic factor of salvage surgery for recurrence in OSCC patients might be recurrence interval （P＜0.05）, and that NAC and recurrence site tended to be poor prognostic factors of salvage surgery, but there was no significant difference, respectively. It was suggested that the first surgery is very important for a good prognosis in OSCC patients.

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In recent years, the usefulness of polaprezinc for oral mucositis has been reported. Generally, surgical treatment, chemotherapy, and radiation therapy together or alone are used for cancer treatment. Oral mucositis occurs as a harmful phenomenon in almost 100％ of cases, and the combination of radiation and chemotherapy is accompanied by intense sharp pain and bleeding. We used sodium alginate and solcoseryl to treat oral mucositis, but these were not sufficiently effective in many cases and the treatment had to be stopped. Polaprezinc provides an antioxidant action, mucous membrane protection, wound healing promotion, and is reported to be effective for oral mucositis. We considered that administration of the drug through the oral cavity and oral mucosa by gargling rather than internal administration facilitated direct contact with the drug, and we applied this method in eight chemoradiotherapy head and neck cancer patients. We report a summary of these eight cases in which treatment did not need to be stopped due to oral mucositis by using polaprezinc gargle.

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We developed a computer system to assist the differential diagnosis of clinically important oral mucosal diseases of oral squamous cell carcinoma, leukoplakia, and oral lichen planus using intraoral photographs. In 2013, we reported the use of a fuzzy inference-based soft computing diagnostic system for oral mucosal diseases. In the current study, we replaced the fuzzy inference system with a support vector machine and used five features for identifying disease characteristics after upgrading the soft computing system. We used digital intraoral photographs of oral squamous cell carcinoma, leukoplakia, oral lichen planus, and normal mucosa to validate the soft computing system. The resultant sensitivity values for oral squamous cell carcinoma, leukoplakia, oral lichen planus, and normal oral mucosa were 90％, 90％, 87％, and 93％, respectively, and the specificity values were 97％, 92％, 98％, and 100％, respectively. Therefore, the soft computing system developed in this study can be used as a diagnosis support system for clinically important oral mucosal diseases.

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The loss of fish bones in oral tissue occurs often. If a fish bone partially sticks into tissue, part of it remains visible directly and is easily removed. However, if a fish bone completely sticks deep into tissue, it is hard to detect its precise location. We report a case of removal of a fish bone that was completely embedded in the tongue with the aid of ultrasonography. A 73-year-old female visited us complaining of tongue pain. The case history revealed that the pain was caused by a lost fish bone. The fish bone was removed under general anesthesia and ultrasonography during surgery greatly contributed to locating the position of the fish bone in the tongue. It is suggested that ultrasonography is very useful for detecting lost foreign bodies in tissue.

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Objectives: We evaluated a liquid-based method for cytology of oral mucosal lesions, based on the Bethesda system （Oral Bethesda system）.
Methods: One hundred patients with oral mucosal lesions previously diagnosed via histology （excluding salivary gland tumors） were selected and re-diagnosed using the Oral Bethesda cytodiagnostic criteria for classification. The conventional Papanicolaou criteria were used for comparison.
Results: The values obtained for sensitivity and false-negative rate for the Oral Bethesda system were 88％ and 12％, respectively, both of which were lower than those obtained using the Papanicolaou system. In addition, evaluation of high-bright, orangeophilic, keratinized cells using the Oral Bethesda system was found to be useful for screening of squamous cell carcinoma.
Conclusion: Due to the current lack of specific criteria for cytodiagnosis of the oral cavity, development of new criteria is required. The results of this study demonstrated that The Oral Bethesda system is a clinically useful tool for oral cytology.

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