A clinical study was performed for pediatric patients with oral and maxillofacial lesions who visited the emergency unit of the oral and maxillofacial surgery section of Tokyo Dental College, Ichikawa General Hospital between April 2004 and March 2006.
Six hundred and sixty-nine pediatric oral and maxillofacial emergency patients have attended the section for two years. The ratio of the male to the female were 1.4: 1. By age distribution, 1-year-olds showed the highest incident of injuries (155 cases, 23%). The most common cause of oral and maxillofacial injury was fall (293 cases, 44%). The most common injury of soft tissue was lower lip (87 cases, 20%). The time of visiting the clinics showed a peak at 21: 00.

抄録全体を表示

This study investigated the effect of the occlusal relationship in the deciduous dentition stage on the occlusion and dental arch morphology of the mixed dentition stage in children with unilateral cleft lip and palate.
The materials consisted of plaster models obtained from 26 unilateral cleft lip and palate patients (UCLP) who were treated in our clinic. We divided UCLP into the normal bite group (12 examples) and the cross bite group (14 examples) in an occlusion relationship in the deciduous dentition stage. In addition to the cast model measurements, dental arch length, dental arch width, and occlusal relationship were measured by mixed dentition stage.
The results obtained were as follows:
A normal tegmental case of the deciduous dentition stage, maintained good occlusion in mixed dentition stage, but a reverse tegmental case of deciduous dentition stage maintained poor occlusion in mixed dentition stage.
Conclusion: This study showed that the occlusal relationship in deciduous dentition stage influenced the future occlusal relationship.

抄録全体を表示

Supernumerary teeth are often found in the incisor or molar region of the maxilla. However, bilateral multiple supernumerary teeth are rare. The present report describes a case of four supernumerary teeth in the bilateral impacted wisdom teeth region of the maxilla.
A 14-year-old boy was referred to our hospital by his orthodontist because of radiopaque lesions in the maxilla. The lesions were not associated with asymptomatic, and the patient was not aware of any abnormality. Physical examination revealed no unusual findings. Radiographic examination demonstrated several radiopaque lesions in the bilateral wisdom teeth regions of the maxilla. Extraction of bilateral impacted wisdom teeth associated with four impacted supernumerary teeth was performed under general anesthesia on March 28, 2006. Histopathologically, two wisdom teeth, four supernumerary teeth and fibrous connective tissue with odontogenic epithelium were recognized. The postoperative course was uneventful, and six months after the operation there is no sign of recurrence.

抄録全体を表示

Von Willebrand disease (vWD) is a congenital coagulopathy with the second highest incidence after hemophilia. It is an autosomal dominantly inherited disease caused by a quantitative or qualitative abnormality of von Willebrand factor (vWF) due to genetic mutation. We treated a vWD patient who had difficulty in communication due to postresuscitation encephalosis, for whom we performed tooth extraction and multiple caries treatment under general anesthesia after replenishing the vWF.
A 17-year-old male, who was initially referred to the Department of Pedodontics of our hospital with the chief complaint of multiple caries and then to our department. He went into respiratory distress due to nasal bleeding of unknown cause and developed cardiopulmonary arrest at 6 months old, and was given a diagnosis of post-resuscitation encephalosis at that time. After confirming the amount of vWF consumption before surgery, we supplemented it in accordance with the guidelines for substitution therapy stipulated by the Ministry of Health, Labor, and Welfare of Japan. Whole body control was carried out in collaboration with the Department of Pediatrics. As local hemostasis by pressure was difficult following extraction, an absorbent gauze was sutured to the alveolar mucosa to attain satisfactory hemostasis. The postoperative course was favorable without abnormal bleeding.

抄録全体を表示

Using a plate for mandibular fractures of pediatric patients after reduction are considered in regard to mandibular growth extent of the permanent tooth germ, and induction of osteomyelitis. Recently, some reviews reported about using metal miniplates in the cases which have too much deviation, incomplete fixation with non open reduction, or which have the possibility of causing redeviation by the use of only circumferential wiring. However, as for the metal plate, the removal is necessary, and the surgical stress is large, too. PLLA bioabsorbed miniplates and screws were superior in the treatment of patients with a mandibular fracture, because they do not need removal and strength at the same level as a cortical bone that is maintained for two or three months.

抄録全体を表示

Schizophrenia is one of the most important diseases in the psychiatric field, however childhood onset is rare in schizophrenia. In this report, we describe a case of multiple traumas in a 13-years-old female with schizophrenia. She jumped from a sixth-floor window, and then was taken to our emergency center in an ambulance on December _??_, 1999. She had a medical history of emotional disorder. At the initial medical examination, she said that an alien had ordered her to jump from the window.
Radiographic examination showed bilateral pubic and ischial bone fractures of the pelvis, the greater trochanter and the neck of the left femur. Oral examination demonstrated fractured teeth and gingival bleeding on the mandible. Fractured teeth were from the lower first incisor on the left side to the contralateral lower first premolar, and accompanied with alveolar bone fractures. Head x-ray examination showed fractures of the median mandibular body and angle on the left side. However, occlusion was stable and there was no deviation of the mandibular fragments. Thereafter hemorrhagic shock developed, and the systolic blood pressure ranged from 35 to 45mmHg because of bleeding from the internal iliac artery on the left side. Then she underwent embolization of the artery. Airway intubation to control respiration was performed by a transnasal approach because of her maxillofacial injuries. Thereafter, we extracted the fractured teeth and performed alveoloplasty. The mandibular fractures were treated by external fixation for 2 weeks. The prognosis was good after fixation. Her general condition recovered, and she was diagnosed as having schizophrenia by a psychiatrist at our center. It is considered that dentists should participate in the emergency care of patients with multiple traumas including maxillofacial traumas, and cooperate with other departments.

抄録全体を表示

We recently encountered a 3-year-old boy with a large buccal abscess after toothbrush sticking into the right cheek. While brushing his teeth he fell down with his toothbrush still in his mouth. Four days later injury he had severe swelling in his right cheek and CT examination revealed a large abscess in the right buccal space. The abscess was incised and he was given antibiotics by intravenous drip and one week later the abscess had disappeared clinically. Since a toothbrush is usually polluted, a wound of oral mucosa with a toothbrush needs enough follow-up.

抄録全体を表示

Traffic injuries in infant are rare. We report a case of tongue laceration in spite of using a child restraint system in an infant. An 8-months old girl was in a traffic accident and she was taken to the emergency room. Her consciousness was clear, but she had bleeding from her tongue. After clinical examination, the tongue laceration was sutured under local anesthesia. After the operation, there have been no complications.

抄録全体を表示