The prevalence of childhood cancer has been estimated to be 1 to 1.5 per 10,000 persons. Although childhood cancer is less common than adult cancer, about 3000 new patients are registered per year. Childhood cancer is the second leading cause of death in children, after accidents. Owing to progress in diagnostic and therapeutic techniques, more than 70% to 80% of patients are now cured. Because cancer develops in 1 per 500 to 600 children aged 0 to 14 years, it is estimated that about 1 per 300 of the entire population has had childhood cancer. Childhood cancer is characterized by a high prevalence of blastomas and sarcomas, derived from fetal tissue and precursor cells. Tumors can arise in various sites, and tumor type is related to age and sex. Generally, childhood cancers are sensitive to antitumor agents and radiotherapy; however, response rates, remission rates, and long-term survival rates differ depending on tumor type, molecular biologic and cellular genetic characteristics, and tumor extension. Treatment is therefore decided according to expected outcomes, predicted on the basis of risk factors.
  The development of childhood cancer is mainly related to genetic predisposition, the fetal environment from conception to birth, and genetic abnormalities occurring during postnatal growth and development. Unlike adult cancer, the effects of lifestyle and environmental factors are minimal. Studies of genetic diseases associated with high risks of cancers such as retinoblastoma and chromosomal and genetic analyses of cancer cells in diseases such as neuroblastoma and leukemia have led to the identification of many oncogenes and tumor suppressor genes, contributing to a better understanding of the mechanisms underlying the development and progression of cancer, the identification of risk factors, and the development of molecular targeted therapy.
  Progress in epidemiology, molecular biology, and cellular genetics is changing childhood cancer from an incurable to a curable disease. How to improve patients' quality of life after treatment (i.e., a decreased rate of late complications) is becoming an important part of the treatment strategy.

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  We studied 150 consecutive patients with cleft lip and palate who presented at the outpatient clinic of the oral surgery department of a university hospital during the past 10 years to analyze recent trends. The results were as follows:
1) The 150 patients consisted of 134 primary cases and 16 secondary cases. The number of the patients decreased gradually over the course of time.
2) The total incidence of cleft lip and/or palate was 134/105,636, estimated to account for 69.7% of all cases in Miyazaki Prefecture.
3) There were 51 cases of cleft lip with cleft palate, 35 of cleft lip, and 45 of cleft palate. There were 29, 11, and 11 cases of left, right, and bilateral cleft lip with cleft palate and 21, 13, and 1 case of left, right, and bilateral cleft lip, respectively.
4) The male:female ratio was 1.6:1 for cleft lip with or without cleft palate, as compared to 1:2 for cleft palate.

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  This retrospective study reviewed the records of children younger than 16 years with maxillofacial fractures during the 10-year period 1997 through 2006 and compared the results with fractures in adults. Age, sex, causes of accidents, locations and types of fractures, and treatment methods were assessed in 24 children (19 boys and 5 girls). The largest subgroup of patients was aged 13 to 15 years (12 patients), followed by 10 to 12 years (5 patients). Most fractures were caused by traffic accidents (10 patients), followed by tumbling down (7 patients), falls (3 patients), sports (3 patients), and assaults (1 patients). Most of patients were referred from other medical facilities and visited our clinic within a week. The mandible was most frequently involved (18 patients), followed by the maxilla (6 patients). We favored conservative therapies rather than surgery as compared with maxillofacial fractures in adults.

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  We describe autotransplantation to the mandible of two third molars with incomplete root formation in a patient who had a partial mandibular defect caused by trauma and repaired with an iliac bone graft. A 15-year-old boy was referred to our department to receive treatment for a submandibular comminuted fracture and intraoral injury in September 2005. We performed fixed open reduction with the patient under general anesthesia. The lower left premolars and molars were considered impossible to preserve and were therefore extracted. Because infection and sequestration occurred postoperatively, incisional drainage and sequestrectomy were performed twice over the course of 3 months. This procedure caused a partial defect in the mandible, and iliac bone grafting with a titanium mesh plate was performed in March 2006. About 9 months later, the plate was removed, and 2 third molars with incomplete root formation were simultaneously transplanted to the graft. One molar had no infection, ankylosis, or root resorption after 21 months, while the other had suspected ankylosis.

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  There have been some reports of the treatment of hemangioma in the oral region.
  We report a case of hemangioma of the lower lip in a child.
  A 15-year-old girl was referred to our department with the chief complaint of swelling of her lower lip. MRI revealed a mass thought to be a hemangioma of the right lower lip. The hemangioma of the right lower lip was treated with photo-coagulation by a KTP laser.
  The tumor disappeared by performing photo-coagulation 3 times and bleeding was not encountered during the operation. The results suggested that KTP laser is effective for the treatment of hemangioma in the oral region in children.

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  We report a case of inflammatory myofibroblastic tumor (IMT) of the mandible in a 13-year-old girl and discuss the cases of the literature. The patient noticed an enlarging left mandiblar mass in October of 1997, and visited our department. On examination, there was an elastic hard tumor in the left side of the mandibular molar region, measuring 30 × 24mm.
  Histopathologically, the surgical removed tumor was composed of an interlacing fascicular growth pattern of spindle cells in a background of abundant collagenous stroma accompanied by an infiltration of chronic reactive inflammatory cells. Immunohistochemical analysis revealed that the tumor was reactive for vimentin and α-smooth muscle actin and negative for desmin, S100 protein, CD68 (KP-1, PGM-1), CD34, bcl-2, estrogen receptor, progesterone receptor, ALK-1, β-catenin, CD99, and pan-cytokeratin (AE1/AE3). She is well with no evidence of recurrent disease for 10 years after surgery.

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  The principal treatment for ameloblastoma is resection of the mandible. In the case of the resection of the mandible, in young patients, there are a number of complications, such as loss of jaw bone support, dysfunction, facial deformity and psychological distress.“Dredging technique” a new treatment method that eradicates the tumor and restores the normal form and function of the jaw in order to overcome these disadvantages.“Dredging technique” is a conservative surgical procedure in which, after deflation and enucleation or only enucleation, repeated dredging is applied to accelerate new bone formation by removing the scar tissue from the bone cavity. We obtained an excellent result by using this treatment method for the ameloblastoma caused in the mandibular of a 14-year-old child.

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  We analyzed the growth of the jaw by cephalogram after a hemi-mandibulectomy without immediate reconstruction. The patient was a 12-year old boy when he was referred to our department due to a rapidly growing gingival mass in the right retromolar region. The diagnosis was an embryonal rhabdomyosarcoma in the mandible. He had a radical surgery, including the hemi-mandibulectomy, followed by chemotherapy and radiation therapy. Immediate reconstruction of the mandible was not performed because of the planned high dose rate of interstitial irradiation. Six years have passed since the initial treatment, and no recurrence has been seen; however, the deformity of the right cheek has gradually been getting worse. The results of the cephalometric analysis during those 6 years indicated that the growth of both the base of the skull and the upper jaw was occurring within a normal range. Vertical growing of the ramus of the mandible was observed to be normal; however, the horizontal growth of the mandible was disturbed and also the mandible shifted abnormally to the right. We are planning to reconstruct his mandible in the near future.

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