We clinically analyzed 15 pediatric patients with Epulis who were treated at our department between 1977 and 1998. The ratio of boys to girls was 1: 1. The average age on appearance of this lesion was 9.0 years, with the range of 5 months to 14 years. Most of the lesions were located in the first incisor region in the upper jaw. Most of lesions were histopatholgically epulis fibrosa. Only one case was congenital epulis. The prognosis of most patients was favorable, and recurrence occurred in 2 patients, who were treated only by resection of epulis. However, there has been no recurrence about for thirteen years after the second operation.

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Thirty patients with temporomandibular joint disorders under 16 years old who were treated in the Department of Oral and Maxillofacial Surgery, Tokyo Women's Medical University for 4 years from April 1994 to March 1998 were studied. The infant occupied 2.9% in 30 patients in this inside the same period temporomandibular joint disorders patient 1042 example.
The chief complaint was arthralgia in 40% of the patients, joint crepitus in 33.3%, pain on mouth opening in 13.3% and trisums in 13.3%. Physical examination showed joint crepitus in 30.0% masticatory pain in 23.3% acombination of trisums and pain on mouth opening in 16.6%, and a combination of joint crepitus and masticatory pain 10%.
The result of recognizing the bad custom habit as an inducement to the TMD it in 13 cases (43.3%).
According to disease type, 10 joints in 8 patients (33.3%) were classified as type I, 3 joints in 3 patients (10.0%) as type II, and 28 joints in 19 patients (68.3%) as type IIIa.
The therapy did the conservative treatment in all instances, because they were growth and developing including temporomandibular joint. In the final efficacy evaluation, efficacy was evaluated as excellent and good in 5 patients and 17 patients, respectively. No cases of aggravation were observed.

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In the practice of oral surgery, treatment of oral injury by foreign bodies is comparatively common. Damage to the pharynx or the cranium should be born in mind, depending on the type of the foreign body and the site of injury.
A three-year-old boy was playing with bamboo sticks when he fell down and a stick of bamboo struck him in the soft palate. Bleeding from the oral cavity occurred and the boy was brought to our outpatient emergency unit. At the time of examination, however, bleeding from the site of injury had already stopped. Plain X-ray, computed tomography (CT) and magnetic resonance imaging (MRI) of the cranium showed no oral abnormalities, we diagnosed that a piece of bamboo was not still embedded in the soft palate. The boy had no subsequent problems and has been well until the time of writing this report. In relevance to this case, we experimentally inserted a disposable wooden chopstick and a plastic chopstick into the oral cavity or the cranium of a human skull model and performed plain X-ray, CT and MRI to assess the usefulness of these imaging procedures in the diagnosis of foreign bodies in the mouth. Plain X-ray did not reveal the wooden chopstick. CT showed an obscure image of the embedded wooden chopstick. Only MRI disclosed the wooden chopstick clearly. The plastic chopstick was visible on plain X-ray, CT and MRI, but it was most clearly visualized on MRI.

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Sialolithiasis occurs due to the calculous concretion in salivary ducts or glands, but it is rare in childhood.
The authors reported the cases of sialolithiasis of submandibular gland treated surgically by extraoral approach.
The patient, a 4 year 4 months old boy, was referred to our department, with chief complaint of the pain while eating. In the radiographic examination, a sialolith was not noticed because it was radiolucent. Sialography revealed that sialolith was at the hilus of left submandibular gland. The stone was removed by extraoral approach.
Although many reports showed that the salivary stone in submandibular glands of children was near the orifice of the duct, it is very rare in children that the sialolith was at the hilus of submandibular gland.

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The patient was a 12-year-old boy, who had cystic lymphangioma in his bilateral submandibular and mouth floor regions. Local injection of OK-432 was performed two times (first; 2KE, second 2KE, total; 4KE). No serious side effects were found besides the slight increase of body temperature and local inflammatory reaction. Five months after the treatment, the lymphangioma disappeared completely, and there has been no evidence of recurrence.
Our result shows that local injection of OK-432 for cystic lymphangioma is both safe and reliable. Therefore, OK-432 therapy seems to be a first choice of therapy for cystic lymphangioma.

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Mandibular fracture in infants is less common. We have encountered a case of 1 year-old patient with fractures of median mandible and right condylar head region. Circumferential fixation with plate after reduction of fracture was performed against median mandibular fracture under general anesthesia, but no treatment was done on right condylar fracture. Internal maxillary fixation was not planned. Circumferential fixation continued for 3 weeks. After this therapy, no abnormality of mandibular function has been observed in this 1 year and 4 months. Careful observation should be continued for long duration in our department.

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A case of calcifying odontogenic cyst that appeared in the maxilla of a 13-year-old boy is reported. Radiographic findings showed well-demarcated radiolucent area in which specks of radiopacities were seen. Histopathological findings were characterized by the presence of ghost cells and calcifying tissues on the epithelial layer of the cyst wall. There is no evidence of recurrence one year after the surgical removal of the cyst.

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The characteristics of asplenia syndrome is bilateral right sideness and this syndrome is a disease which is accompanied by situs anomaly, congenital heart disease and asplenia. We conducted 2 dental treatment cases in child patients with asplenia syndrome under general anesthesia. In both cases, although the children received palliative operations (Blalock-Taussing shunt operations), radical operations were not performed, and cyanosis was still observed. Because aggravation of hypoxemia due to crying during dental treatment was anticipated, we selected dental treatment under general anesthesia. As a result, we could perform dental treatment without causing circulatory system problems or any other significant problems before, during and after the operation.

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Hereditary gingival fibromatosis is an uncommon disorder characterized by enlargement of the gingiva, and its mode of transmission is usually a dominant trait. We report such a case in a Japanese family.
A 13-year-old boy was referred to our clinic for enlargement of both upper and lower gingiva. At the age of 6, his mother first noticed the symptom which was progressive till now. Family history and oral examination showed that not only the patient but his father and sister were affected revealing autosomal dominant inheritance. In consideration of mastication and the development of jaws, gingivectomy alone was performed and all teeth were preserved. The postoperative course is uneventful, however, careful follow-up is necessary because of the character of this lesion.

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In the present study, we report a case in which sialolithotomy was performed successfully for sialolithiasis in the right submandibular gland of a young patient who had chronic leukopenia with 1000/μl leukocytes or less ordinarily.
The patient was a 15-year-old boy, who had been treated for infantile asthma and was found to have decreased white blood cell count at the age of 9 years old leading to diagnosis of chronic leukopenia.
Radiograph and CT image revealed a circular impermeable shadow in the region between the submandibular gland and its duct and the disease was diagnosed as the right submandibular sialolitithiasis.
On March 4, 1997, sialolithotomy from the oral cavity was performed.
After the operation, fever was not noted and infection was prevented only by the administration of antibiotics without the use of G-CSF preparation.

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