We have started an early supporting system at the medical and educational handicap center in Kitakyushu city for cleft lip and/or palate babies and their mothers from 1984. In this study, we explained this system and in particular discussed the family counselling performed just after the babies with cleft lip and/or palate (CLP) were born. We obtained several findings at the first examination about the methods of feeding milk, the body growth (the Kaup Index), the experience of nasal tube feeding and so on.
The results were as follows.
1) 118 babies with CLP accepted the early supporting system and 44 of the 118were within 1 month old after birth at the first examination.114 of the 118babies used the Hotz plate.
2) Concerning the main complaint,46 babies (about 40% of the total) had feeding difficulties. As for the types of referrals, many cases were refered from the NICU of the hospitals and the maternal hospitals in Kitakyushu city and Shimonoseki city in Yamaguchi prefecture.
3) The percent of the babies who had experienced nasal tube feeding at birth was 33.0%. There was also no difference among the types of the cleft lip and/or palate. However the type that used the nasal tube longer than others was the cleft palate.
4) Concerning the Kaup Index,25.1 % was too thin.
5) Of the 118 babies, the families of 39 babies accepted the family counselling.3 cases of family counselling were performed just on the day of birth,16 cases on the 2nd day and 37 cases until the 10th day. There were 16 cases in which parents attended the counselling. There were 13 cases in which parents and other relatives and 6 cases in which just the mother attended.
6) There were 58 questions in the family counselling about speech, the operations of cleft lip and/or palate, the Hotz plate, the development of the teeth and the occlusion, the genetics of the cleft and so on. Of the questions posed by the families, there were more questions about speech than about the operation of the cleft.
The above results suggest the usefulness of the team approach containing developmental evaluations by specialists (e. g. the pediatrician, the orthopedician the oculist and the motor therapist) for the treatment of the babies with cleft lip and/or palate.

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The present study was to investigate the incidence of deciduous fused teeth in Japanese and to compare this with Caucasians, excluding congenitally missing teeth, peg-shaped and supernumerary teeth. Four thousand four hundred and twenty-two 3-6 year old children were investigated in Sasebo-City, Nagasaki Prefecture,2245 boys and 2177 girls.
One hundred twenty-four boys and girls (66 boys; 58 girls) were found to have 138 fused teeth. Fourteen children (0.32%) had bilateral fused teeth in their right and left mandibles. The frequency of the fused teeth in deciduous dentition in Japanese was 2.80%. On the other hand, according to Duncan and Helpin (Oral Surg. Oral Med. Oral Pathol.64: 82-87,1987), the frequency of fused teeth in Caucasians is about 0.5% and that of bilateral fused teeth 0.02%. An application of the chi-square test shows the differences are satistically highly significant (P<0.005). The difference between the sexes and left and right sides is not significant (P>0.05).
Fused teeth occurred ca.6 times more frequently in Japanese than in Caucasians. Bilateral fused teeth in the primary dentition occurred 16 times more frequently in Japanese than in Caucasians.
McKusick pointed out that the inheritance of deciduous fused teeth is of a Mendelian autosomal dominant trait pattern. However, the present authors have collected many cases that reject the autosomal dominant trait pattern. Therefore we support the theory that the inheritance of fused incisors is an autosomal recessive trait rather than an autosomal dominant trait. Further reports will be published.

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The purpose of this study was to find out the relationships between daily habits and the changes in dental caries experience with advancing age in young children.
68 young child patients visiting the pedodontic clinic of Ohu University Dental Hospital were surveryed for 4 years from 2 to 5 years of age. All of them had 20deciduous teeth.
The relationships between their daily habits and there caries experience were analysed by means of the first type of Hayashi's quantification methods, using the dft index as the object variables and 20 items from questionnaires as explantory variable.
The results were as follows.
1) The dental caries experience rate at 5 years of age was higher with a 27.4%df person rate,28.1 % df tooth rate and 5.6% dft index than that at 2 years of age.
2) The object variables that showed larger partial correlation coefficients and a closer dft index both at 2 and 5 years were frequency of eating snacks and drinking beverages between meals, frequency of brushing teeth, the age of the mother at birth, kinds of feeding, number of brothers /or sisters, kinds of family, occupations of the guardians, times of getting to dental clinic, chief complants and so on.

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In order to clarify the changes in function that accompany physiological root resorption of deciduous teeth in children, mandibular deciduous second molars were photographed by the standard procedure in children whose Hellman's dental stage ranged from IIA to IIIB, and root resorption was classified on the basis of the X-ray films. The occlusal force of the mandibular deciduous second molars, occlusal contact area, occlusal pressure, and distance from the mandibular deciduous second molar to the succedaneous permanent teeth germ were compared in various stages of root resorption and at various dental stages. Relationships between the occlusal force and the occlusal contact area and between the occlusal force and distance were determined, with the following results obtained.
1) The occlusal force and the occlusal contact area tended to decrease with increases in the degree of root resorption and dental stage.
2) The occlusal pressure showed only slight changes before the stage of resorption of about 1/2 of the root, but tended to decrease in the stage of resorption of about 3/4 of the root.
The occlusal pressure in each dental stage, however, showed no tendency to decrease.
3) The above results suggest that changes in physiological root resorption of deciduous teeth influence occlusal function in children.

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The deciduous tooth pulp of young dogs, which was amputated and dressed with Ca(OH)2, was investigated histologically in order to clarify the mechanism by which the calcium is deposited in the residual tooth pulp after pulptomy. According to the histological structure, the residual tooth pulp after pulptomy was classified into three layers such as the necrotic, basophilic, and vital pulp layers. The surface of the residual pulp after amputation in contact with Ca(OH)2 necrosed within 1 hour postooperatively. Angionecrosis accompanying a formation of microthrombi was observed concomitanly. Calcium that was recognized as black-brown colored granule by means of von Kossa staining, appeared in the lumina of the necrotizing capillary.
These calcium granules exduted from the necrotizing blood vessels and widely distributed over the perivascular pulp tissue at 1.5,3 and 6 hours.
Subsequently, exudated calcium granules were deposited in the pulp tissue which was located under the necrotic layer resulting in a formation of basophilic layer (the von Kossa positive layer) observed 12 hours and 1 day after the operation. Fibroblastic proliferation occured in the upper layer of vital pulp at 7 days postoperatively. Osteodentin was formed in the fibroblastic layer at 10/14 days as thin layer of hard tissue that was followed by a development to the reparative dentin bridge.
It was assumed therefore that the exudation of calcium ions from the sera in the necrotic blood vessels caused by pulp amputation procedure and/or dressing with Ca(OH)/, was responsible for the calcium deposition in the basophilic layer.

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Restoration with the use of GRAFT LC II was made for 25 deciduous molars and 25 immature permanent molars, all with C2 on the occlusal surface, and a clinical observation of these teeth was made for one year.
The results were as follows:
1. Although symptoms of dysphoria were seen at the margin from one week after restoration, no abnormal marginal adaptation was seen one year later in 21deciduous molars and in 23 immature permanent molars.
2. Both the deciduous molars and immature permanent molars showed morphological changes and breakage (damage, damaged portions) from one week after restoration in comparison with the state at the time of restoration. No abnormality at all one year later was seen in 21 cases in each group.
3. As staiming and discoloration no abnormality at all was seen in 24 cases in each group one year after restoration.
4. Marginal discoloration was seen in both the deciduous molars and immature permanent molars from six months after restoration. No discoloration was seen one year after restoration in 24 deciduous molars and in 22 immature permanent molars.
5. Secondary caries were seen from three months after restoration in both the deciduous molars were immature permanent molars. No abnormality was seen one year later in 21 cases.
6. No pulp reaction at the time of restoration was seen in either deciduous molars or in immature permanent molars.
7. At the time of recall one year later, no abnormality at all was seen in 23deciduous molars and in 24 immature permanent molars. Pulp treatment was required for one case each of deciduous molars three months after restoration and of immature permanent molars one year after restoration.
On the basis of the foregoing findings, it appears that light-cure composite resin GRAFT LC II is effective for restoration of class I cavities of deciduous molars and immature permanent molars.

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The purpose of this study was to investigate the influence of the illuminance of the illuminating lights on the chromatical values of the non-contact type spectrophotometer.
The spectrophotometer used in this study was the Hitachi Products Co. Color Analyzer C-1020. The C-1020 is the spectrophotometer which utilizes a telephoto camera lens and the reflection light of the object is received into the spectroscope. Color is measured in the natural light covered conpact room. The D65 fluorescent lamps were used for the room lights and the D65 xenon lamp was used for the spotlight. The illuminance on the color measuring surface was 481.2 lx in the case lit up with the room lights without the spotlight and the illuminance on the color measuring surface was 2867 lx in the case lit up with the room lights and the spotlight. Both in the cases of with and without the spotlight, the spectral reflectances and the chromatical values of the standard white color plate were compared between the conditions when the number of the converter of the telephoto camera lens was one and the number of that was two for measuring smaller areas. Adding to that, both in the cases of with and without the spotlight, cheek skin colors of the 24 year old female were compared between the conditions of using one converter and using two converters, and the lower lip colors and gingival colors of the same subject were measured using two converters.
The following results were obtained.
1) The influence of the illuminance of the illuminating lights on the spectral reflectance and the chromatical values was significant.
2) The chromatical values measured with the non-contact type spectrophotometer which utilizes a telephoto camera lens were influenced with the illuminance of the illuminating lights, spotlight, the number of the converter of the telephoto camera lens and the dimension of the color measuring area.
3) In the condition of using one converter for measuring relatively large areas, the precision of the chromatical values was higher in the case without spotlight than that illuminated with the spotlight.
4) When using two converters for measuring 3 mm or under 3 mm diameter small areas, the precision of the chromatical values might be higher in the case illuminated with the spotlight than that without the spotlight.

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A comparative study was made of the process of the growth and development of the cortical bone at the mandibular base in school-age children between Japan and China where race, food, and climate differ.
Eighty children with normal occlusion and age from 9 to 12 who came to the out-patient ward, Department of Pediatric Dentistry, Kyushu Dental College Hospital, or to the out-patient ward, Department of Pediatric Dentistry, School of Stomatology, Beijing Medical University, were used as subjects. Measurements of the cortical bone at the mandibular base were taken by means of their panoramic radiographs and conversions were made in accordance with magnification factors used.
The results were as follows:
1. The averages of the thickness of the cortical bone at the mandibular base were, in Japanese children,2.24±o.19mm for age 9,2.30±0.41mm for age 10,2.41±0.32mm for age 11, and 2.51±0.47 mm for age 12; and in Chinese children,2.67±0.12mm for age 9,2.90±0.29mm for age 10,2.90±0.35mm for age 11, and 2.98±0.30mm for age 12. The averages, based on sex, the thickness of the cortical bone at the mandibular base in Japanese children were, for males,2.26±0.15mm for age 9,2.10±0.26mm for age 10,2.44±0.41 mm for age 11, and 2.51±0.57 for age 12; and for females,2.21±0.24mm for age 9,2.50±0.45 mm for age 10,2.38±0.26 mm for age 11, and 2.50±0.41 mm for age 12. The averages in Chinese children were, for males,2.75±0.22 mm for age 9,2.84±0.34 mm for age 10,2.96±0.44mm for age 11,2.75±0.14 mm for age 12; and for females,2.59±0.18mm for age 9,2.95±0.25 mm for age 10,2.84±0.20mm for age 11, and 3.22±0.21 mm for age 12. The averages by the side of thickness of the cortical bone at the mandibular base in Japanese children were, for the left side,2.19±0.18mm for age 9,2.28±0.36 mm for age 10,2.50±0.26 mm for age 11, and 2.53±0.45 mm for age 12; and for the right side,2.28±0.31 mm for age 9,2.32±0.54mm for age 10,2.32±0.46mm for age 11, and 2.49±0.59 mm for age 12. The averages in Chinese children were, for the left side,2.56±0.32 mm for age 9,2.76±0.32fbr age 10,2.86±0.44 mm for age 11, and 2.96±0.37 for age 12, and for the right side,2.78±0.36 mm for age 9,2.03±0.30 mm for age 10,2.94±0.4282mm for age 11, and 3.00±0.36mm for age 12.
2. In the t-test, no significant difference was found between the sexes in the thickness of the cortical bone at the mandibular base from ages 9 to 12 in Japanese children. For age 12 in Chinese children, however, girls showed significantly higher values than boys. Between ages, Japanese children showed no significant difference between any two ages from ages 9 to 12. Between age 9 and age 12 in Chinese children, the latter, the higher age, showed significantly higher values than the former. Between sides, no significant difference was found in any age and in either nationarity.
3. In the t-test of the thickness of the cortical bone at the mandibular base in the two nationalities, Chinese children showed significantly higher values for ages 9,10, and 11 (p<0.01) and for age 12 (p<0.05) than Japanese children.

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Dog pulp cells were cultured with tetracalcium phosphate-citric acid complex cement (4CPC) which induces and accelerates reparative dentin formation after direct pulp capping, tetracalcium phosphate (4CP) and hydroxyapatite (HAP). The effects of 4CP,4CPC and HAP on dog pulp cell activities were assessed by measuring the alkaline phosphatase (ALPase) activity, DNA synthesis and protein synthesis.4CP,4CPC and HAP significantly increased the ALPase activities and protein synthesis of dog pulp cells compared to that of the control cultures, while DNA synthesis decreased significantly. In particular, the ALPase activity was increased 9.4-fold with 4CP,4.6-fold with 4CPC and 4.5-fold with HAP. These findings suggest that 4CP,4CPC and HAP induce the differentiation of the odontoblasts and induction was strongest with 4CP. Therefore, the reparative dentin formation which occurs when 4CPC is used as a direct pulp capping agent was considered dependent on the action of 4CP. Furthermore, The system used in this experiment was found to be very useful because it reflected the results of the in vivo experiment.

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The prevalence of infraocclusion of primary molars was measured using serial plaster casts of 925 children (449 males and 476 females) who had been under regular dental care at the Pediatric Dental Clinic, Tohoku University School of Dentistry.
The teeth were diagnosed as having infraocclusion when the marginal ridge was 1 mm or more below the adjascent teeth.
Serial plaster casts with severe infraocclusions of primary molars were then measured with use of the three dimensional system to determine positional changes of the affected teeth and the adjacent teeth.
The following results were obtained.
1) The prevalence of infraocclusion in primary molars was 14.5% and it was age-related with high prevalence in 6 to 8 year old children.
2) Single instances of infraocclusion in any affected dentition occured more than multiple instances. The highest number of infraocclusion in an affected dentition was six.
3) Infraocclusions of primary molars occured more frequently in mandible than in maxilla and the prevalence was not different between first primary molars and second primary molars.
4) The prevalence of infraocclusion affected bilaterally was 88.7% of the subjects who had 2 or more infraocclusions and 66.5 % of them were affected symmetrically.
5) 43.5% of the infraoccluded teeth had been restored with preformed crowns when they were recognized as infraocclusions and 45.5% of the teeth covered with crowns had been given the endodontic treatments at the same time.
6) The vertical positions of affected teeth and their adjaecnt teeth changed longitudinally in various patterns.
7) The space loss of the mesio-distal distance of the affected area was between 1 and 2 mm in the highest ratio of infraocclusions.

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Fluoride concentrations and acid solubilities at 4 different sites (mesio-buccal, disto-buccal, mesio-palatal, and disto-palatal) and 4 different layers (0.8-20μm)of the enamel surfaces in the twenty extracted upper first molars were compared with the micro-sampling and determination technique.
The results were as follows.
1) The highest fluoride concentration was found at the disto-buccal site and the lowest was the mesio-palatal site in each depth (p<0.05).
2) The acid solubilities showed an increasing tendency from the enamel surface toward the deep layer.
3) There was a tendency to a reversed relationship between the fluoride concentration and acid solubility.
4) Mean Ca/P (W/W %) values ranged from 2.02-2.13.
5) The mean etching depths were approximately 20m. The calculated depths (from Ca determination) and observed depths (determined with SEM images)showed a significant correlation (p <0.01).

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Fluoride concentrations and acid solubilities at 4 different sites (mesio-buccal, disto-buccal mesio-palatal, and disto-palatal), which are assumed to be developing at the same period, and 4 different layers (0.8-20 um) of the enamel surfaces in the twenty healthy upper first molars in situ were compared with biopsy materials using the micro-sampling and determination technique. These volunteers tested were men with an average age of 24 yr, and the molars were presumed to have 18-20 yrs of exposure time after eruption to the oral environment.
The results were as follows.
1) The results of the oral examinations of twenty subjects showed DMF=9.77%, DMFS=23.30%, PI=19.50%.
2) Fluoride concentrations of parotid saliva were 0.008±0.002 ppm.
3) The buccal side of the fluoride concentrations was higher than the palatal side in each depth, and distal sites were heigher than mesial sites at the same sides.
4) In the deeper layer, fluoride concentrations of in situ were higher than in the extracted teeth.
5) There was a tendency to a reversed relationship between the fluoride concentration and acid solubility both of the extracted teeth and in situ.
6) Mean Ca/P (W/W %) values ranged from 1.89-1.96 invariably, showed a tendency to be lower than that of the extracted teeth.

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Eating habits are an important factor for children during the growth stage for the maintenance of health. In recent years, the dependency on of mainly processed restaurant food is getting greater and this tendency is considered to be affecting the formation of bone tissue.
The authors investigated the nutrition values of food specimens obtained from eating establishments. This investigation was aimed mainly at minerals in relation to bone formation.
The results were as follows:
1. Calcium, magnesium, and iron were low in content in these food specimens. As to calcium, in particular, some contained only 1/3 to 1/4 of the required quantity. The magnesium content also in some was only 1/4 of the required. quantity. If such food is taken as a meal, there will bea great shortage of calcium, magnesium, and iron. Such food should be taken as a snack, not as a meal.
2. As to the ratio of calcium and phosphorus, the valuesvaried widely and some contained four to six times more phosphorus than calcium. As to the ratio also of calcium and magnesium, a great variation was seen from one menu to another menue.
3. Iron tended to be insufficient in any case.
4. Among the microelements zinc, copper, and magnanses, zinc and copper tended to be insufficient. Manganese, on the other hand, was close to the proper quantity for ingestion.

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Lately, investigations at the cell level of bone resorption and ossification have been very evident. This is due largely to the technical advances made in 'cell culture. ' Investigations of the characteristics of osteoblasts from the first generation culture of the jaw bones, however, have been extremely few in number.
With a view to making a comparative study of the characteristics of osteoblasts of different derivations, the authors obtained, by the enzyme digestion method, osteoblasts from the mandible and those from the calvaria of rats at the lactation stage during which mechanical stress was considered minimal.
The following, measurements were then taken:
1) ALp stain,2) ALp activity,3) volume of protein,4) ALp activity per volume of protein. The results were as follows: 1) With the ALp stain, mandible-derived osteoblasts showed higher stainability than calvaria-derived osteoblasts.
2) In the ALp activity, mandible-derived osteoblasts showed an average of 0.572±0.094 nmol/ul and calvaria-derived osteoblasts 0.288±0.044 nmol/ul. In the t-test, mandible-derived osteoblsts showed significantly higher values (p <0.01) than calvaria-derived osteoblasts
.3) In the volume of protein, mandible-derived osteoblasts showed an average of O.353±0.080 ug protein/ul and calvaria-derived osteoblasts 0.312±0.040ug protein/ul. In the t-test, no significant differences were found between the two.
4) In the ALp activity per volume of protein, mandible-derived osteoblasts showed an average of 1.636±0.140 nmol/ug Protein and calvaria-derived osteoblasts showed significantly higher values (p <0.01) than calvaria-derived osteoblasts.

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The purpose of this study was to clarify the functional difference of the masticatory muscles between 6 children with normal occlusions and 11 children with crowding dentitions, by investigating the interocclusal points and electromyographs from Hellman's dental stage IIA to IVA.
1) As the stage progressed, it became clear in IIIC and IVA that the number of interocclusal points of the group with crowding dentitions became smaller than that of the normal occlusion group.
2) From the results of the integrated value (the sum of the electric potential (S)S=TA+TP+M) of the electromyographs in the normal occlusion group, the ratio (M/S) of the electric potential in M to the total active potential became larger than that of TA/S, for the period from the IIIA to IIIB stage. In the group with crowding dentitions, however, M/S became larger than that of TA/S, for the period from the IIIB to IIIC stage.
3) The length of all masticatory rhythms (druation, interval and cycle) in the group with crowding dentitions tended to decrease as the dental stage progressed. In the normal occlusion group, however, only the duraticn tended to decrease as the dental stagc progressed. All masticatory rhythms of children with crowding dentitions were longer than in the normal occlusion group for all the stages.
4) The masticatory rhythms of the masseter muscle obtained by gum chewing tended to stabilize as the dental stage progressed in the both groups. The rhythms were more stable in the normal occlusion group than in the group with crowding dentitions for all the stages.
5) The frequency of the occurrence of the silent period in the group with crowding dentitions was lower in comparison with that of the normal occlusion group in the IIIB, IIIC and IVA stage. The duration of the silent period in the group with crowding dentitions was longer than that of in the normal occlusion group.
Based on the above-mentioned results, it is suggested that the developmental characteristics of the masticatory function in cases with crowding dentitions is retarded, compared with that in cases with the group with the normal occlusions.

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Treacher Collins Syndrome is an autosomal dominant disorder in occurrence rate of 1 in 10,000 births and also known as the mandibulo-facial dysostosis. It is a syndrome with a wide variety of manifestations characterized by hypoplasia of the zygoma, mandible, abnormal auricle and external auditory canals. It is one of the concerned congenital anomalies in dentistry, as the various abnormalities are found in the craniofacial region due to the developmental disorder of the first and second brachial arches. The present findings of a 3-year-old boy affected with the Treacher Collins syndrome, who had undergone the dental caries treatment under the general anesthesia, were as follows.
1. Oblique palpebral fissures and absence of lower eye lid.
2. Abnormal external ear deformity, closed external auditory canals, and sensoryneural hearing loss.
3. Micrognathia and bird-like face.
4. Hypsistaphylia and macrostomia.
5. Rampant caries of the deciduous teeth and dysphagia.
6. The patient received dental caries treatment under general anesthesia because he had mental retardation and could not cooperate while in the chair in the clinics.

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Eleven cases of epulis in deciduous dentition were investigated climico-histopathologically in patients who were examined at the Pedodontic Clinic of Niigata University Dental Hospital during the 13 years from 1979 to 1992.
The results obtained were as follows:
1. The patients consisted of five males and six females, and the ages of the patients ranged from 9 months to 5 years 7 months.
2. Five patients came with tumor of the gingiva as their chief complaints.
3. The period from the time epulis was noticed to the first visit to our clinic was within one year.
4. Eight cases occurred in the maxilla and three in the mandible. They were all in the area of incisors. Six cases were on the labial side, three on the palatal side and two on both labial and lingual sides.
5. The size of all epulis was smaller than 1 cm in diameter.
6. Histopathologically, two cases were epulis granulomatosa, seven cases epulis fibrosa, one case epulis osteoplastica and two cases congenital leiomyomatous hamartoma.

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Epidermolysis bullosa hereditaria, which is characterized by a marked development of the vesicles in the ectodermal tissues, is a very rare disease. As to the oral findings, morphological abnormality of the teeth, enamel hypoplasia and abnormal oral & labial mucosa in relation to vesicles have been described.
A 2 year and 7 month old girl, who suffered from the epidermolysis bullosa hereditaria dystrophica, was reffered to the Dental Hospital of Asahi University School of Dentistry for her dental care.
The oral findings of the case were as follows.
1. Numerous congenitally missing 15 teeth, which involving both primary and permanent dentition.
2. Rough surface and hypoplasia of the enamel layer of the primary teeth was observed both clinically and histologically as well
.3. Delayed eruption in 4 primary teeth.
4. The mesio-distal width of the crowns was smaller than normal, and bilateral asymmetry of frontal teeth.
5. Orofacial asymmetry and recessive growth of both jaws were obvious.6. Apparent physical undergrowth.

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Labially positioned mandibular incisors with traumatic occlusion easily cause localized gingival recession and hypermobility, because they tend to have thin alveolar bone in the labial.
In two cases of anterior crossbite with the labially positioned mandibular incisors at an early stage, we improved the crossbite with orthodontic treatment.
The result was that the localized gingival recession recovered and the hypermobility of the teeth disappeared.
We reported on the clinical signs and the process of the treatment of these two cases. We also investigated the relation between the improvement in the anterior crossbite at an early stage and the recovery and maintenance of the periodontal health.
It is thought that orthodontic treatment and professional plaque control at an early stage appeared to be the most important factors in the treatment of localized gingival recession and hypermobility of the mandibular incisors with anterior crossbite.
The "development" was a characteristic of children, and was necessary for the recovery of gingival recession. Orthodontic treatment at an early stage made the best of the "development".
Toward this treatment at an early stage contributed maintaining the normality of the occlusion and the periodontal health all through the life cycle.

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