This study aimed at establishing a practical technique for protection of proximal surfaces which are intact or incipiently carious by applying a fluoride releasing resin coating material, and to investigate its efficacy and safety as a clinical procedure as well as its acceptance in pediatric dental practice.
Ninety five proximal surfaces of children visiting three dental school hospitals, selected by visual and tactile examination with bitewing X-ray surveys, were subjected to this study.
After applying the fluoride releasing resin coating material, these surfaces were examined for three months clinically with regard to the caries susceptibility of the surfaces, the state of retention or the degree of degradation of the material applied, as well as to any undesirable effects on the adjacent gingival margin or mucous membrane of the children.
General evaluation of the clinical follow-up showed good results in 73.68%of the subjects, fair in 23.16% and poor indicating restoration needed because of dentinal involvement in 3.16%.
Based on these results, it can be said that application of a fluoride releasing resin coating material should be an effective and safe technique for protection of proximal surfaces of primary as well as permanent teeth of children, and a clinically acceptable procedure in pediatric dental practice.

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The occlusal pressure (kg/mm2), occlusal contact area (mm2) and total occlusal pressures of individual teeth (kg), at the maxillas, were investigated comparatively in Chinese and Japanese children. Adult Japanese were used as controls. "Prescale" was used in the experiment, and the subjects were asked to bite it for five seconds with maximum masticatory pressure. The following results were obtained.
In the experiment with deciduous teeth, the occlusal pressure in the Chinese children was larger for most types of teeth in boys than girls. With the Japanese counterparts, the occlusal pressure differed among the teeth in girls and was lowest with the second deciduous molars. The occlusal contact area was largest with the second deciduous molars in both Chinese and Japanese children, regardless of sex. It was second largest with the central deciduous incisors in the Chinese children. In the Japanese children, the first deciduous molars or central incisors had the second largest occlusal contact area. The total occlusal pressures of the individual teeth in the Chinese children were larger with the first deciduous molars in boys than in girls, while those in the Japanese children were larger with the first deciduous incisors and second deciduous molars in girls than in boys.
When comparing the Chinese and Japanese children, the occlusal pressure, occlusal contact area and total occlusal pressures of the individual teeth were all found larger with most types of teeth in the Chinese boys than in the Japanese boys.
In the experiment with permanent teeth, the occlusal pressure in the Japanese children was larger for all teeth except for the molars in boys than in girls. When comparing the types of teeth in the Chinese children, the second molars had the lowest occlusal pressure. When comparing Chinese and Japanese children, the occlusal pressure was larger with most types of teeth in the Chinese children. No differences between them were found in the occlusal contact area and total occlusal pressures of the individual teeth. However, considering that the Chinese children examined were younger by approximately one year, it was predicted that these values would grow larger in the Chinese children, when they reach the same age as the Japanese children. The occlusal contact area and total occlusal pressures of individual teeth in the children examined were largest with the first molars. In adult Japanese males, these values were largest with the second molars.

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In an attempt to evaluate the prognosis of pulpotomy with calcium hydroxide, a longitudinal clinical and radiographical follow-up study was made of 64 traumatized immature permanent incisors with crown fracture. The subjects included 60 patients aged 7 to 12 years at the time of the primary visit. The follow-up examination varied from 3 years 3 months to 19 years 2 months, with an average of 10 years 1 month.
The treatment was judged to be successful according to the following criterea: absence of clinical symptoms, continued root development, no radiographically pathologic changes observed, and positive response to electrical stimulation. The treatment was successful in 46 teeth (72%). In 18 teeth (28%), pulpitis or pulp necrosis was found within 5 years. However, the root development seemed to continue as long as the pulp was vital.
Dentin bridges were found radiographically in 58 teeth (91%), mostly within one year, and observed in 12 (19%) teeth which had pulpitis or pulp necrosis.
In 33 of the successfully treated teeth, calcium hydroxide paste was re-apployed. The removed paste was examined with a conventional microscope. There were dead spaces, remnants of calcium hydroxide and necrotic tissue between the filling materials and the dentin bridge. The dentin bridge was directly investigated by probing, measuring the electrical resistance and electrical stimulation. No perforation was evident on the dentin bridges with the probing. However, the values of the electrical resistance on the dentin bridge varied widely. The sensitivity to electrical stimulation on the dentin bridges was higher than on the crown surfaces in many teeth.
This seemed to justify recommending re-application with calcium hydroxide after pulpotomy, and the results suggest that dentin bridge formation does not always assure the success of pulpotomy, and pulpotomized teeth need follow-up for at least 5 years.

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The purpose of this report was to learn about the influence of the loss of pit and fissure sealant by abrasion.
As a preliminary study, we investigated the similarity of the abrasive change of the sealant in vivo and by means of the abrasion test with glass beads, by comparing the change of the surface contour.
For comparison, replicas were obtained longitudinally from the tooth with sealant. They were standardized in position using of the three-dimensional repositioner to observe the same area for each replica. The abrasive change at the same area of the sealant was measured with the surface contour analyzer.
After the abrasion test, the experimental tooth was cut off bucco-lingually at the terminal end of the fissure where the sealant material had disappeared. The section was observed by means of a scanning electron microscope.
We obtained the following findings from this study;
1) Both the sealant and the tooth material were lost by this glass bead abrasion test, and the most obviously loss was observed at the border between the sealant and the tooth surface. Such abrasive change was very similar to the intraoral change of the sealant.
2) Because of the similarity of the abrasive change between in vivo and the experimental findings, the abrasion test with glass beads was found to be a good test method producing the longitudinal change of the sealant similar to that seen in the mouth.
3) The observation by a scanning electron microscope revealed that the thin layer of sealant and resin tag remained at the terminal end of the fissure that was visibly exposed by sealant loss. The effect of preventing dental caries was thought to be maintained after visible sealant loss based on this finding.

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The purpose of this study was to investigate the influence of the light-irradiating times on the color changes of light-cured composite resins over specified periods of time.
Composite resin disks which were 10 mm in diameter and 1 mm in thickness, and made of the 3M Co. light-cured composite resin Silux Plus (shades: U, Y, DY, L, G, UO, YO) were made with 20 seconds (20 second group),40 seconds (40second group), and 120 seconds (120 secoud group) of light exposure through a l mm thick glass plate. The specimens were stored in artificial saliva at 37°C. Colorimetric values of the specimens immediately after curing and every 6 months for 3 years were measured without background color, backed by a white plate which was used to substitute for the lining material, using a fast spectrophotometer.
The following results were obtained.
1) Both in the cases of with and without background color, the ΔE* ab of all shades increased for 2 years 6 months proportionately to the time elapsed in the 20,40 and 120 second groups. However, the ΔE* ab of many shades decreased between 2 years and 6 months and 3 years, and the tendency was significant in the 20 second group.
2) For specimens without background color, compared to the ΔE* ab immediately after curing, the three-year ΔE*ab values ranged between 2.82 (DY) and 4.75(L) in the 20 second group,3.95 (YO) and 5.08 (L) in the 40 second group, and 3.82 (YO) and 6.06 (L) in the 120 second group.
3) For specimens measured against a white plate, compared to the ΔE*ab immediately after curing, the three-year ΔE*ab values ranged between 3.88 (DY)and 5.51 (L) in the 20 second group,5.01 (YO) and 6.76 (L) in the 40 second group, and 4.91 (YO) and 7.04 (L) in the 120 second group.
4) Compared to the ΔE*ab immediately after curing, three-year ΔE*ab values showed a tendency to increase in the longer light irradiation time group.
5) In the 20 second group and the 40 second group, the color of the resin disks showed a tendency to change to a chalky white color. It is supposed that the transparency changes of the composite resin might influence the color changes.

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It is important to study the change of the gingival contour and alveolus during the period while primary dentition changes to the permanent dentition. The purpose of this study was to observe the change in the gingival contour and alveolus from Dental age IIA to IIIA.50 children who had visited the Department of Pedodontics with normal occlusion, dental caries free and no periodontium participated in this study. Concerning the plaster casts of each of these participants from Dental age IIA to IIIA, the following evaluations were made.
1. level of the gingival margin in the buccal aspect.
2. horizontal and vertical distance from the gingival margin to the highest point of gingival convexity and free gingival groove.
3. level of the alveolus.
These evaluations were made on the left maxillary and mandibular teeth at the bucco-mesial angle, the lowest level of the gingival margin, the bucco-distal angle and the gingival papilla. A three-dimensional instrument (Mitutoyo Co., Ltd. Japan) was used for the evaluation. Furthermore, for the longitudinal examination, a standard plane was determined by the distal marginal ridge of the left and right second primary molars and the mid point of the primary canine.
The results were as follows;
1. The lowest point of the gingival margin was observed in the maxillary primary canine and mandibular primary first molar. From dental age IIA to IIIA, no change was observed in the level of the margin gingiva, but with the eruption of the permanent dentition, the lowest level of the gingival margin increased.
2. The horizontal distance from the gingival margin to the highest point of gingival convexity showed no major change from Dental age IIA to IIIA, but the vertical distance showed tendency toward slight increase.
3. The free gingival groove was observed on plaster casts and was clearly shown in the posterior position. From dental age IIA to IIIA, the eruption of the permanent dentition, groove was not observed clearly.
4. An inter dental groove was observed on the primate space and was clearer in the maxillary than in the mandibular. From dental age IIA to IIIA, groove was not observed clearly.
5. Close to gingivobuccal fold the anterior alveolus was concave in the palate and there was swelling in the posterior. From Dental age IIA to IIIA, the anterior alveolar was concave in the palate or lingually more clearer.

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Dietary habits are an important factor for children at the growing stage for the maintenance of health. In recent years, in addition to the use of bread and noodles as staple food, restaurant food has come to account for a large proportion of the daily diet.
For the present paper, school lunches for which the menus are planned to fulfil the nutritious requirements of energy, protein, calcium, iron, vitamins A, B1, B2, and C, etc., were investigated for differences in the content of inorganic matter due to the type of staple food, and a comparation with restaurant food was also made.
In school lunches planned to fulfil the dally requirements, even phosphorus which is unrelated to the requirements showed little variance and was in good balance with calcium with the P/Ca of about 1.9. Microelements such as manganese, zinc, and copper also showed little variance in school lunches as compared with restaurant food.
Selection of bread, rice, or noodles for the staple food did not result in much difference in the contents of the inorganic matter. Magneseum in meals was greater in content with noodles as the staple food than with rice or bread. Mg/Ca was also high. Among inorganic matter, phosphorus, zinc, and copper were less in content with school lunches than for restaurant food, and more meat was thought to be used in restaurant food.
The foregoing findings showed hardly any difference in the contents of inorganic matter in school lunches due to the type of the staple food. As compared with restaurant food, school lunches show little variance, well balanced nutrition, and less use of meat.

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We made periodical observations, during the deciduous dentition, of occlusions in 29 Japanese girls with deciduous reversed bite in order to find out what morphological characteristics the self corrected cases had.
Our previous study showed that there were self corrected (N: 13) and the non-self corrected (R: 16) groups.
The purpose of this study was to determine whether the difference between the N and R Groups occured as morphological differences at their initial visit or a result of occlusal changes.
The materials used in this study were the serial lateral cephalograms of 29Japanese girls. Angular and dimensional analyses were performed.
The following results were obtained:
1. Characteristics in the initial examination of both groups: The ptm'-ms and porion location in the R Group were significantly larger than those in the N Group. The lower facial height in the N Group was greater than that in the R Group. Other measurements did not show any significant differences between the groups.
2. Longitudinal changes in the N Group: The mean changes of this group showed clockwise rotation of the mandible caused by a decrease in SNB and SNP, and an increase in the SN-Gn and Ramus (SN) angles respectively as a skeletal pattern. Dental change caused an increase in the UA-SN angle and a decrease in the LA-MP. angle; The maxillary deciduous central incisors tipped labially and the mandibular deciduous centra incisors tipped lingually. Individual changes showed three patterns; (a) an improvement of the skeletal pattern, (b) clockwise rotation of the mandible and (c) axial changes of the maxillary and mandibular deciduous central incisors. The self corrected groups showed a combination of these changes.
3. Longitudinal changes of the R Group: The mean changes of this group showed an increase in the SN-Gn and Ramus (SN) angles. As to individual changes, some of the R Group cases showed a tendency toward improvement in some measurements which were also shown in the N Group, although many cases in the R Group showed changes toward a worsening of the intermaxillary relationship. Moreover, most cases in these changes showed a single pattern of the (a), (b) or (c).

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This study investigate the influence of thumb-sucking on the anterior and posterior of the primary dentition. The subjects were 930 patients aged from 3to 5 of the Aichi-Gakuin University Pediatric Dental clinic. They were distributed into two groups. The first group was the thumb-sucking group of 259 children, and the second group was the non-oral habit group of 671 children. The data on overjet, overbite and types of the terminal plane, were collected from the clinical records.
The summaries of results were as follows;
1. The frequencies of maxillary protrusion of the non-oral habit group were as follow; 9.5% in 3 year old children,9.8% in 4 year old children and 10.0%in 5 year old children. Those of the thumb-sucking group were as follows; 23.7% in 3 year old children,16.3% in 4 year old children and 24.2% in 5 year old children. Comparing both groups, the rates of the thumb-sucking group were higher than those of the non-oral habit group at all ages, especially there was significant difference in the 3 year old children.
2. The frequency of open bite of the non-oral habit group was approximate 2-3%in all age groups. Those of the thumb-sucking group were as follow; 12.6%in 3 year old children,7.7% in 4 year old children and 15.1 % in 5 year old children. Comparing both groups, those of the thumb-sucking group showed higher rates than the non-oral habit group at all ages, especially there were significant difference in the 3 and 5 year old children.
3. As for the frequency of the types of terminal plane in 3 and 4 year old children, there were no differences between the non-oral habit and the thumb-sucking groups.
4. As for the frequency of the type of terminal plane in 5 year old children, the mesial step type of the thumb-sucking group showed a lower rate and the distal step type of the thumb-sucking group showed a higher rate than that of the non-oral habit group. There were significant differences in these rates.

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The purpose of this study was to evaluate the effect of the water contents of the food and food bolus on the chewing time in five-year-old children.
The subjects were 10 boys and 10 girls who had normal primary dentitions. The food selected was steamed rice, sausage, mashed potatoes, cookies, apples and pickled radish. The subjects took the usual bite size portions of the food and chewed until such time as they would normally have swallowed, but instead of swallowing, they spat out the food bolus into a weighed container. The time required for all the food to be masticated and spat out was recorded. The volume of saliva secreted duling that time was determined by subtracting the initial weight of the food from that of the food saliva mixture. The water content of the initial food and food bolus was determined after freeze-drying. The percent of food swallowed or retained in the mouth was calculated by the formula described by Watanabe et al.
The mean chewing times per 1 g of each food was inversely related to the initial water content of the food (r=-0.68, p<0.05). The percent of the water content of the food after chewing showed significant correlation to the initial water content of each food (r=0.83, p<0.01). The percent of the water content of the food bolus in the same subjects showed constant values with low standard deviation. These results suggests that the water content of the food bolus may be a factor in the decision to swallow and the initial water content of food is also an important factor regarding the salivary flow and chewing time per 1 g of food. This study was supported by a Grant-in-Aid for Scientific Research (02807189,05671719)from the Japanese Ministry of Education to S. W.

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Vision is one of the most valuable tools of non-verbal communication in terms of the accuracy and speed with which information is conveyed, in addition to the amount of communication delivered in an instant. In daily clinical practice, pedodontists use their eyes to relax child patients in the chair. As a matter of fact, however, it is very difficult for the dentists to judge how much the children understand what the operators meant via the eye.
In the present experiment, we tried to find out what characteristics there are in the way child patients look at the dentist. Using a Visicon eye camera, analyses were performed on the eye movements of the young subjects when they saw a photograph of the face of a dentist who was looking straight ahead. Since there were wide differences in eye movement between the age groups of under 6 and over 6 years, the subjects were grouped into two-those aged under 6 and those aged 6 and over-for comparative analysis.
The findings of our study are as follows:
1) As for eye movement, differences were noted between the age groups in the scanning range of the eyes, the saccadic eye movements from one fixation point to another and the direction in which the subjects turned their gaze.
2) The younger group was limited in the visual range and the older group scanned a wider area.
3) The saccadic eye movements in changing the point of fixation was smaller in the children under 6 years old than the children aged 6 and over.
4) As for the direction of the gaze, the number of those in the younger group who tended to move their eyes horizontally was the largest, followed by those who moved their eyes in diagonal directions.

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To observe the child patients look at the dentist in the clinic, we tried to find out in the experiment Report 1 what characteristics there are in the way child patients look at the dentist.
In Report 2, we tried to investigate the effects of psychological and circumstantial factors on the eye movement of the children when they saw a photograph of the face of a dentist. We made multivariate analysis using Hayashi's Quantification Scaling Type I and Type II Method.
The following is a summary of our findings:
1) The factors associated with the subjects' psychology and personality had some influence upon their eye movement which reflected the gaps in their ages.
2) The mother-child relationships especially the types in the Yatabe-Guilford. personality inventory, constituted influential factors underlining the differences in the eye movement among the juvenile subjects.
3) The factors ralated to family conditions in addition to the differences in age affected the eye movement of the children, although to a lesser extent.

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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 children between Japan and China where methods of raising children, food and climate differ.
One hundred children with normal occlusion and aged from 4 to 8 who came to the out-patient ward, Department of Pediatric Dentsitry, School of Stomatology, Beijing Medical University, were used as subjects. Measurements of the cortical bone at the mandibular base were taken by means of panoramic radiographs and conversions were made in accordance with the magnifications 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,2.28±0.34 mm for age 4,2.31±0.37 mm for age 5,2.32±0.41 mm for age 6,2.61±0.28 mm for age 7,2.70±0.47 mm for age 8; and in Chinese children,2.57±0.41 mm for age 4,2.59±0.37 mm for age 2.64±0.27 mm for age 6,2.87±0.42 mm for age 7,2.95±0.38 mm for age 8.
The averages, based on sex of the thickness of the cortical bone at the mandibular base in Japanese children were, for males,2.24±0.39 mm for age 6, The averages, based on sex of the thickness of the cortical bone at the mandibular base in Japanese children were, for males,2.24±0.31 mm for age 4,2.20±0.41 mm for age 5,2.30±0.39 mm for age 6,2.58±0.24 mm for age 7,2.68±0.50 mm for age 8; and for females,2.32±0.37 mm for age 4,2.42±0.29 mm for age 5,2.34±0.42 mm for age 6,2.64±0.30 mm for age 7,2.72±0.44 mm for age 8.
The averages in Chinese children were, for males,2.54±0.37 mm for age 4,2.49±0.31 mm for age 5,2.59±0.28 mm for age 6,2.90±0.40 mm for age 7,2.90±0.46 mm for age 8; and for females,2.60±0.42 mm for age 4,2.69±0.40 mm for age 5,2.68±0.30 mm for age 6,2.84±0.44 mm for age 7,3.00±0.25 mm for age 8.
The averages of the side thickness of the cortical bone at the mandibular base in Japanese children were, for the left side,2.23±0.16 mm for age 4,2.30±0.21 mm for age 5,2.42±0.26 mm for age 6,2.57±0.29 mm for age 7,2.73±0.46 mm for age 8; for the right side,2.33±0.39 mm for age 4,2.32±11160.22 mm for age 5,2.22±0.30 mm for age 6,2.65±0.30 mm for age 7,2.67±0.46 mm for age 8.
The averages in Chinese children were, for the left side,2.56±0.36 mm for age 4,2.50±0.24 mm for age 5,2.48±0.25 mm for age 6,2.83±0.40 mm for age 7,2.98±0.28 mm for age 8; for the right side,2.59±0.38 mm for age 4,2.68±0.26mm for age 5,2.76±0.26 mm for age 6,2.91±0.38 mm for age 7,2.92±0.35 mm for age 8.
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 4 to 8 in Chinese children. For age 5 in Japanese children, girls however showed significantly higher values the boys.
Between the two ages 4 and 7,4 and 8,5 and 7,5 and 8 in Japanese children, the latter, the higher age, showed significantly higher values than the former. Between the two ages 4 and 7,4 and 8,5 and 8 in Chinese children, the latter, the higher age, showed significantly higher values than the former.
No significant difference was found for the left or right sides at any age.
3. In the t-test of the thickness of the cortical bone at the mandibular base of the children of both nationalities, Chinese children showed significantly higher values for ages 4,5.7 and 8 (p<0.01) and for age 6 (p<0.05) than the Japanese children.

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In educating patients or students, information should be given to them correctly. There are many media of communication such as words, sounds, pictures, movies or animation. The computer is a very useful instrument for combining these media into a single software. By using Hyper Card 2.2, we have been making software for teaching dental students or staffs about "Management of Pediatric Dental Patients". The purpose of this report is to demonstrate and discuss their effectiveness.

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This study was conducted to calrify the relationship between oral habits and malocclusion. The subjects were 238 children who were born during the period from May 1985 to November 1988, and who underwent oral health examination at one and a half, two, two and a half and three years of age. The prevalence of oral habits and malocclusion, the duration of the appearance and disappearance of finger sucking as well as the nursing environment were investigated.
The results were as follows:
1) The ratios of the prevalence of oral habits at one and a half, two, two and a half and three years of age were 33.6%,36.2%,38.1% and 44.3%, respectively. They increased with age. The ratios of the prevalence of finger sucking at one and a half, two, two and a half and three years of age were 24.1%,27.2%,25.0% and 23.4%, respectively. It did not significantly change with age.
2) The ratios of the prevalence of malocclusion at one and a half, two, two and a half and three years of age were 50.0%,54.8%,52.1% and 45.8%, respectively. They did not significantly change with age. Maxillary protrusion protrusion increased, deep bite, mandibular protrusion, cross bite and crowding decreased, and open bite and edge to edge coclusion did not change with age.
3) The prevalence of open bite or maxillary protrusion in children with finger sucking was significantly higher than in children without finger sucking. The children with finger sucking continuously more than one year until two and a half years of age showed a significantly high frequency of open bite or maxillary protrusion at three years of age.
4) The probability of open bite or maxillary protrusion at three years of age was significantly higher in the child who was an only child, whose father and/or mother was an office worker, who lived without grandparent(s) and/or who nursed in a day care center or kindergarten.

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We partially purified malate dehydrogenase (EC.1.1.1.37; MDH) from the dental pulp of pigs. The specific activity of MDH in the crude extract was 0.039 units/mg of protein, and was increased slightly to 0.46 units/mg of protein with ammonium sulfate fractionation and Sepadex G-150 column chromatography. The optimal pH was determined to be pH 9.0 for the oxidation of L-malate and pH 7.0 for the reduction of oxalacetate. The Km values were determined to be 7.4×10-5M,9.1×10-5M,7.7×10-5, Mand 7.9×10-5 M fbr L-malate, NAD+, oxalacetate, and NADH.

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Lactate dehydrogenase (EC.1.1.1.27; LDH) catalyzes the conversion between pyruvate and L-lactate as the last step of the glycoytic pathway. We devised methods for the separation and purification of dental pulp LDH isozyme from the first molar (M1) of pigs.
LDH-1 isozyme was purified to a specific activity of 442.2 units/mg of protein, representing an approximately 1580-fold purification from the crude extract, using DEAE Sephadex A-50 column chromatography and Blue dextran affinity chromatography. LDH-2 and 3 isozyme were also highly purified and high recovery.

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Goldenhar Syndrome is a congenital anomaly at the occurrence rate of 1 in 3,000-5,000 births. It is also known as Oculo-auriculo-vertebral dysplasia and characterized with triad of the dermoide or lipodermoide on the eye, auricular appendix and abnormality of the vertebral spine. The present findings of a fouryearold girl affected with the Goldenhar Syndrome, and who had undergone the dental caries treatment under the general anesthesia, were as follows.
1. Post-plastic surgical operation for macrostomia.
2. Bilateral eye dermoide and external ear hypoplasia.
3. Slight deformity of the vertebral spine.
4. Micrognathia and bird-like face.
5. Facial asymmetry and hypoplasia of the condyle in the mandible.

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The authors experienced cases of dental treatment for two children with liver transplants from living donors. The first case was a girl who had received the transplant from her mother, the third case in Japan, and the longest surving case after this operation.
The patient visited the Special Patient Clinic of Matsumoto Dental College Hospital at 10 years of age. She had been prescribed 100 mg of cyclosporin A and 1.5 mg of predonisolone daily, extending over a long period of time. She looked rather small but healthy, and went to school every day. Her laboratory examination data did not reveal any remarkable deviation from the normal limits.
The chief complaint was a marked gingiva swelling covering the upper central incisors. After consultation with the surgeons, we removed the enlarged gingiva to help the eruption of the teeth. The excised gingiva was examined histopathologically. Pathologists diagnosed it as an eruption cyst, and did not find any remarkable increase of the dense collagen bundles. The central incisors soon erupted satisfactorily.
We recalled her every three months to treat early caries and to give instructions on plaque control. More than two years since the initial treatment, good dental health has been maintained. No gingival hypertrophy is manifest.
The second case was a boy who underwent the transplantation operation at 6 years of age. However, his recovery was not so very satisfactory and he also had suffered from hepatitis C.
The patient visited our clinic at 8 years of age. He had been prescribed 150mg of cyclosporin A and other drugs. He looked small and not very well. While obvious edema and jaundice were manifested on his face. There was also considerable liver dysfunction and prolonged prothrombin time.
At the first visit, he suffered from bleeding from enlarged gingiva. There were many dental caries and gingivitis. The most careful medical management was required for him, and also behavior management was not so easy since he had become a very fearful child.
We treated the dental diseases gradually with the surgeon's consultation. In the end result,4 deciduous teeth were removed and 10 teeth were restored without complication. He is now checked periodically under our recall system. We are striving for controlling the enlargement of the gingiva through vigorous brushing.

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The patient was a 3-year-11-month-old boy with congenital heart disease (Tricuspid atresia). Dental treatment was performed under general anesthesia. The patient had been treated with Panaldine since undergoing Rt. Blalock-Taussing procedures. Anesthesia was maintained with nitrous oxide in oxygen and sevoflurane. The dental treatment went smoothly, and was finished within 1-hour-25-minutes. Anesthesia was administered for 2 hours. No complications were observed during and after the general anesthesia. Continuous observation of the arterial oxygen by pulseoximetry during dental treatment is of great importance with cyanotic patients. To prevent bacterial endocarditis, an antibiotic of the Penicilline series was administered before, during, and after surgery (orally before and after surgery and intravenously during surgery). There have been no clinical signs of infective endocarditis. The patient was discharged the next day.

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The thumb-sucking habit may be the direct cause of maxillary protrusion or openbite malocclusion. In patients with this habit, the malocclusion may become worse and the progress of the treatment may be arrested. So the thumb-sucking habit should be of primary clinical concern in orthodontic treatment.
To break the habit is difficult in a short time because the habit is a pattern of action that is acquired and becomes very automatic. The correction of the malocclusion is very important in the early stages for bringing about the normal functioning in young patients. Therefore, the habit-breaking treatment usually parallels the correction of malcoclusion.
We report here on a patient treated with a Bionator appliance who had severe primary maxillary protrusion with deep overbite and the thumb-sucking habit, and discuss the progress of elimination of the habit and the malocclusion, and the effect of the Bionator appliance.

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[in Japanese]

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