We studied the usefulness of Lomefloxacin in the field of oral surgery at 11 institutions in Tokyo. The subjects were 83 patients with periodontitis, 86 patients with pericoronitis, and 69 patients with osteitis of the jaw. Iifferent doses of the drug were administered depending on the institution, with 118 patients receiving 400 mg/day and 120 patients receiving 600 mg/day.
In the 234 patients suitable for analysis, there was a clinical improvement rate of 81.3 % for periodontitis (marked improvement in 26 cases and improvement in 39 cases), 79.1 % for pericoronitis (marked improvement in 21 cases and improvement in 47 cases), and 83.8 % for osteitis of the jaw (marked improvement in 19 cases and improvement in 38 cases) . The efficacy rate was 83.8 % for periodontitis, 86 % for pericoronitis, and 88.2 % for osteitis of the jaw. Gram-positive bacteria accounted for 63.0 % of the isolated bacteria. Adverse reactions and abnormal laboratory test values were noted in 4 patients, but were mild to moderate in severity.
When administration was discontinued, the usefulness rating was “very useful” in 67 patients, “useful” in 121 patients, and “slightly useful” in 28 patients. The “useful” or better rate was 81.3 % in patients having periodontitis, 79.1 % in those having pericoronitis, and 80.9 % in those having osteitis of the jaw. There were no significant differences between the results obtained by using doses of 400 mg/day and 600 mg/day.

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Clinical studies of Roxithromycin (RXM) in the treatment of odontogenic infections were performed, and the results were obtained as follows :
1) One hundred six patients having odontogenic infections were treated with RXM at a dose of 300 mg (150 mg × 2) per day. The clinical efficacy rate judged by the comparative score was 83.0% (“ excellent” in 19 cases and “good” in 69 cases), and that judged by the doctors was 84.0 % (“ excellent” in 20 cases and “good” in 69 cases) .
2) Side effects were observed in 4 (3.8 %) out of 106 patients and all were mild in severity.
3) Twenty strains were isolated from 11 patients.The MIC₈₀ of RXM against gram-positive aerobes was 0.78 μg/ml, and that against anaerobes was 0.39 μg/ml. Against graim-negative aerobes, RXM had no antibacterial activity.
From the above results, RXM was judged to be a safe and useful drug in the treatment of infections in dentistry and oral surgery.

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We studied the clinical effectiveness and usefulness of Roxithromycin (Rulid^®) in the treatment of odontogenic infection. Results obtained are summarized as follows: 1) Clinical efflcacy rates according to the doctor's subjective judgement were 89.4% in periodontitis, 92.9% in pericoronitis and 88.6 % in ostitis of jaw. The overall result was 90.1 %. 2) Clinical efficacy rates according to the committee judgement on the 3 rd day of treatment in 62 cases were 85.2 % in periodontitis, 87.5 % in pericoronitis and 73.7 % in ostitis of jaw. 3) Some side effects were observed in 4 cases (2.5 %) . No severe symptoms were observed. These results suggested that Roxithromycin is a useful antibacterial agent against odontogenic infections.

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To evaluate the utility, safety and feeling of patients with respect to the use of SIM-990 (a double-layer film containing Triamcinolone Acetonide for application to the oral cavity), clinical trials were carried out at Second Department of Oral and Maxillofacial Surgery, School of Dental Medicine, Tsurumi University and Department of Oral and Maxillofacial Surgery, Yokohama City University School of Medicine. The following results were obtained.
1) Of the 58 cases, 23 were males and 35 were females. The 20- to 29-year old group (26 cases) and 30- to 39-year old group (12 cases) were the most numerous. (21 aphthous stomatitis and 37 chronic rerurrent aphtha.)
2) One to two pieces of SIM-990 were applied to the affected part.
Application periods were 4 to 6 days in 49 cases and 7 to 9 days in 9 cases.
3) With respect to clinical improvement, improvement of contact pain was observed in 94.8 % (55/58), improvement of pain at meals of 94.8 % (55/58), reduced size of the lesion was 89.7 % (52/58) and alleviation of flare 94.8 % (55/58) .
4) With respect to the feeling of pain, 100.0 % (58/58) of the patients felt “no pain or a little pain” during application.
94.8 % (55/58) had “no specific feeling” or “slight feeling of a foreign matter”for feeling of adhesion.
Average duration of adhesion was more than 3 hours in 75.9 % (44/58) .
Adhesion to lesion for a long time had a superior parmaceutical property of this product.
5) Side effects were not reported in any of these cases.
6) Global improvement, global safety and utility were determined by clinical observation, feeling of patients and side effects.
For global improvement, “marked improvement” and “improvement”were 93.1 % (54/58) .
7) For global sefety, all cases were proved to be “safe.”
8) For utility rating, the cases considered to be “very useful” and “useful” were 93.1 % (54/58) .

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Oral dose of 200 mg Sparfloxacin (SPFX) was administrated before exodontia was performed on 70 patients. The drug concentration of Sparfloxacin in the effusion from the tooth extraction wound was measured from 615 to 1090 minutes after peroral administration. And in 7 cases, the drug concentration in the gingival crevicular fluid was measured.
In SPFX, it has been recognized that 80 % of MIC against Oral Streptococci was 0.39 μg/ml. SPFX was valued≥0.39μg/ml in 61 out of 70 cases (87.1 %) in the effusion from the tooth extraction wound and in all cases in the gingival crevicular fluid.

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Odontogenous infection in a diabetic patient often progresses to an abnormally severe state due to, among other reasons, lowered resistance to infection.
We were recently confronted with a case of mouth floor phlegmon in an undiagnosed diabetic patient. This rapidly progressed to upper mediastinitis and sepsis, although we were able to save the patient.
The following report describes our studies of the clinical symptoms and treatment of odontogenic infections in diabetic patients.

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