Children can expect physical and mental growth through play. For children, play is an essential action. However, challenging and unexpected actions sometimes cause danger. In this study, we report 60 cases of oral and maxillofacial trauma in children caused only by playground equipment.
The breakdown of the 60 cases was 37 boys and 23 girls （male：female ratio of 1.6：1）. The age ranged from 1 to 11 years and no injuries were observed in children of 12 years old. The most frequent age was 4 and 5 years old with 12 cases. Younger children of 1 to 5 years old accounted for 75.0％ of the total. The most common playground equipment that caused injuries was the pull-up bars in 12 cases, followed by the swings in 10 cases and the slide in 9 cases. By gender and type of playground equipment, there were many injuries in boys on the slide and seesaw, whereas there were many injuries in girls on the pull-up bars. The causes of injuries were falls in 31 cases, followed by collisions in 25 cases, with fall and collisions accounting for more than 90％.
The most common injuries were soft tissue injuries alone （41 cases）, followed by tooth＋soft tissue injuries （15 cases）, and tooth injuries （4 cases）. All cases were minor injuries, with none requiring hospitalization or long-term treatment.
For children, danger is also essential for growth, and it is not necessary to eliminate all dangers. There are other dangers for children to experience, and failures in the playground provide an opportunity for the child to learn to understand, foresee and avoid danger. However, the danger of leaving serious residual disability or losing life must be avoided. It is important to create an environment where children can play safely by grasping and understanding the actual situation of damage caused by playground equipment through such examinations.

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Forming a pierce hole is called piercing. We describe a case of piercing needle migration into the tongue in a 25-year-old woman who presented with a painful tongue and dysphagia after self-piercing. Physical examination revealed slight edema of the tongue and submental region without any airway obstruction. Computed tomography revealed a sharp and straight radiopaque object extending from the tongue to the floor of the mouth, and she was diagnosed with a foreign body embedded in the tongue. We removed the foreign body from the patient’s tongue under general anesthesia using an intraoral approach. She was administered antimicrobial therapy and was discharged from the hospital 3 days after admission, following complete resolution of symptoms. The foreign body was a metal needle measuring 3mm in diameter and 50 mm in length. Prompt removal of the needle is warranted in patients with piercing needle migration into the tongue.

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In recent years, it has been reported that the number of cases of facial trauma due to falls among the elderly has increased. Here we report a case of a super-elderly patient with severe dementia who was able to be discharged soon after being treated with open reduction internal fixation and an interdisciplinary approach. The patient was a 92-year-old woman with severe dementia. She sustained injury as a result of a fall and was brought to our hospital. Upon X-ray examination condyle and mandibular fractures were observed. The patient was admitted on the same day and open reduction internal fixation was performed under general anesthesia. Following the surgery, an interdisciplinary approach including swallowing training, dementia care, and rehabilitation were performed. It is necessary to decide the indication for open treatment of a fracture based not only on the patient’s age but also the eating state before injury. It is also important to set goals at the beginning of hospitalization and to share information and collaborate among professionals with different specialties.

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Traumatic carotid-cavernous fistula is a disease in which an arteriovenous fistula forms between the cavernous sinus of the brain and the internal carotid artery passing through it. It is often associated with severe cases of head trauma, especially with skull base and mesofacial fractures. Here we report a case of mandibular fracture alone with an internal carotid cavernous sinus fistula.

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We report a case of orthognathic surgery for a Class III malocclusion patient with facial asymmetry following a condylar fracture that occurred in early childhood.
A 15-year-old male was referred to our department for correction of facial asymmetry. At the age of 3 years, he experienced a right condylar fracture that was treated conservatively. Thereafter, the mandibular growth was disturbed, resulting in mandibular deviation and maxillary canting, and orthodontic treatment was started from 11 years old. At the age of 15 years, the patient was referred to our hospital for orthognathic surgery. Following the preoperative orthodontic treatment, the facial asymmetry and malocclusion were corrected by bimaxillary orthognathic surgery at the age of 17. The 18-month postoperative course was uneventful, and the result of treatment was satisfactory.

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