We previously reported that ultrasound-mediated destruction of microbubbles might be an innovative non-invasive drug delivery system. The anticancer drug doxorubicin is a potent anticancer drug that is used for many types of malignancies；however, the severe side effects associated with use of free doxorubicin has limited its clinical use. Although encapsulated doxorubicin liposomes (Doxil) strongly reduced the cardiotoxity of doxorubicin, other side effects were reported and release of doxorubicin from tumors after accumulation is difficult. We prepared encapsulated doxorubicin bubble liposomes (EDBL) from Doxil with the aim of improving cytotoxicity of Doxil for drug delivery with ultrasound. Human gingival cell carcinoma Ca9-22 cells were exposed to ultrasound in the presence of Doxil or EDBL. Cell viability was determined by trypan blue staining and evaluated by WST-8 assay. Apoptosis was evaluated using flow cytometry and Hoechst dye 33342 staining. The combination of EDBL and ultrasound enhanced the cytotoxicity and apoptosis of Ca9-22 cells. Sonoporation is a potent method to deliver doxorubicin into Ca9-22 human oral cancer cells. Our in vitro results indicate that EDBL could be a useful tool to achieve efficient ultrasound-controlled doxorubicin delivery in vivo.

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We report a case of synchronous multiple primary carcinomas of the tongue mucoepidermoid carcinoma and lower gingival squamous cell carcinoma of a 60-years-old woman. She was referred to our department with the chief complaint of a mass in the underside of tongue, which had persisted for 1 year. The mass had clear border and mobility and we found white lesion on the left lower gingiva. Pathological examination of a biopsy specimen revealed mucoepidermoid carcinoma in tongue and well differentiated squamous cell carcinoma in lower gingiva. Tumor resection was performed under general anesthesia. The patient has been well and free from the disease for 5 years.

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Fifty-three years old female visited a dental clinic with a chief complain of uncomfortable feeling during mastication at left molars in mandibular. The lower left first premolar reacted to a vertical percussion test and was diagnosed as not vital by electric pulp test. Diffuse radiolucent lesion was observed on a X-ray image at distal to the dental root. Moreover, a large lateral root canal was revealed to extend from half of the root to the lesion with dental cone-beam CT. Root canal treatment was performed as usual with application of calcium hydroxide in root canal. Root canals were finally filled with gutta-percha points and a sealer after 3-month follow-up. The diffuse radiolucent lesion was not observed on X-ray image one year after the root canal filling with good prognosis. Definite diagnosis with dental cone-beam CT is very important as there are a number of reasons for bone resorption lateral to a dental root.

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