Operative procedures of the cleft palate have been improved to manage issues.
  However, clinical manifestation of cleft palate is not necessarily uniform, and the present status is that standardized operative procedures to manage it have not achieved a certain level of consensus. Therefore, in this article, I have reported on operative procedures currently performed by relatively many surgeons, including our own opinions.

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  Despite recent developments in cleft surgery, a surgical method for secondary correction of cleft lip and nose deformities has not been yet established. Since postoperative deformities are varied persistent in cleft patients, correction should be made following a surgical strategy that approaches each anatomic and pathologic abnormality that possibly causes the lip and nose deformities. In this review article, the surgical methods for correction of cleft lip deformities including notched and bulky vermilions, short and long lips in a unilateral cleft lip, unbalanced lip in a bilateral cleft lip, and whistling deformity, that are often used in our department are described. Furthermore, the surgical method for definitive correction of unilateral and bilateral cleft lip-nose deformities by open rhinoplasty through a bilateral reverse-U incision and transcolumeller incision, correction of the columella base with or without septoplasty, nasal tip cartilageous graft, medial-upward advancement of nasolabial components with nasal vestibular expansion by free mucosal graft are introduced.

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  The bone grafting to the alveolar cleft was once performed during the primary cheiloplasty. However, it was pointed out that this primary（early）bone grafting to the alveolar cleft affected the growth of the middle face and maxilla. Then, this procedure has been popularly performed to induce the eruption of the upper lateral incisor or canine（secondary bone grafting to the alveolar cleft: SBG）. The main purposes of the bone grafting to the alveolar cleft are closure of oro-nasal fistula and stabilization of the dental arch. However, the most significance of this procedure is to make space for the eruption of the upper canine. Therefore, the SBG is now established to be one of the important treatment strategies for the cleft lip and palate children. In this review, the purposes, optimal timing, surgical procedure, and postoperative management of the popular SBG are described for trainees of oral and maxillofacial surgery.

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  Submucous cleft palate is a subgroup in the cleft palate population with special clinical and anatomic features.
  The diagnosis is usually made by clinical findings of the classic triad described by Calnan: (1) bifid uvula, (2) translucent zone in the midline of soft palate, (3) bony notch in the posterior edge of the hard palate. The muscles in the soft palate of these patients are displaced anteriorly, which leads to velopharyngeal insufficiency in some patients. This congenital deformity is frequently undetected by physicians until the child has developed abnormal speech.
  The submucous cleft palate patient with abnormal speech caused by velopharyngeal insufficiency usually needs surgical intervention. However, the timing of surgical correction of submucous cleft palate is controversial.
  This paper outlines the main point about the surgical correction of submucous cleft palate.

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  This study examined multidimensional alveolar distraction as a treatment method for correction of implant malposition and as an alternative to augmentation procedures. The prosthetically unfavourable implant positions were due to growth-related implant malposition (in the context of treatment of young patients with CLP) or primary bone-driven implant insertions. The radiographical and clinical findings obtained with this alveolar distraction technique are presented and discussed. A tooth-supported alveolar distraction device for multidimensional distraction with custom-fabricated distraction abutments was used for treatment of two patients with maxillary edentulous segments. One case has malpositioned implants at maxillary incisors due to primary bone-driven implants placement, the other has a growth-related implant malposition at the alveolar cleft area which has received a secondary bone graft. They underwent an osteotomy at a minimum distance of 1 mm from the implant surface. Following primary wound healing, distraction was carried out by 0.5 mm in vertical direction daily until the prosthetically optimized position was achieved. During and after the 12-week retention phase, the patients were evaluated clinically and radiographically. Multidimensional alveolar distraction was carried out successfully in both patients. The distraction distances were 7 and 6 mm. The malpositioned implants were brought into a prosthetically optimized position in both cases. The results of this study show that this multidimensional alveolar distraction technique allows both augmentation of edentulous segments with a clearly compromised implant host site and correction of unfavourable implant positions.

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  Objective: To elucidate the details of impalement injuries of the oral soft tissue in children, we present a clinico-statistical study of those encountered in a single institution.
  Patients and Methods: Children below 13 years old, who visited our oral surgery clinic with the complaint of an impalement injury of oral soft tissue from December of 2001 to February 2009, were included.
  Results: Among 248 impalement injuries of the oral soft tissue, the one-year-olds were most affected and the frequency in boys and girls was 146 (59%) cases and 102 (41%) cases, respectively (boy to girl ratio 1.4:1). Toothbrush (81 cases, 33%) was the most frequent object responsible, followed by a stick-like object (59 cases, 24%). The most frequent direct cause of the injury was fall with the object in the mouth (203 cases, 82%). Soft palate (96 cases, 39%) was the most frequent site, followed by hard palate (31 cases, 13%). Most injuries occurred between 18:00 and 21:00 (105 cases, 42%) followed by 21:00 to 24:00 (66 cases, 27%). 162 cases (65%) had a laceration that was smaller than 10 mm. In cases with a laceration that was larger than 10 mm (68 cases, 27%). 148 cases (60%) was treated with antibiotics, 70 cases (28%) without treatment and 30 cases (12%) with suture and antibiotics.

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  Cone-beam computed tomography (3DX) is more effective than conventional radiography to locate impacted teeth and to observe their relationships to adjacent teeth.
  We investigated impacted teeth with 3DX to understand their location, their relationships to adjacent teeth, and the treatment method.
  We investigated 3DX images of one 125 patients (65 males and 60 females) who visited the Division of Pediatric and Orthodontic Dentistry Fukuoka Dental College Medical and Dental Hospital, between 2004 and 2008. In particular, we investigated impacted maxillary canines (51 teeth) because they form the majority of impacted permanent teeth.
  The results were as follows.
  1. Maxillary canines were the most impacted teeth followed by maxillary central incisors and first premolars.
  2. Among the impacted maxillary canines, 53% were on the buccal side in alveolar bone, 16% were on the center line in alveolar bone, 31% were on the palatal side in alveolar bone.
  3. Forty percent of cases of impacted canine cause resorption of the dental root of adjacent teeth.
  4. The most of common treatment methods for maxillary impacted canines were traction (37%), followed by extraction (18%), and observation (14%).
  5. The average traction time was 14.4 months.
  3DX image enabled us to correctly observe and easily determine the location of impacted teeth and their relationship to adjacent teeth.

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  We evaluated the Velopharyngeal function and articulation disorder following primary palate-plasties investigated in 159 cleft palate subject at our insitute from 1990 to 2004.
  1. Velopharyngeal function at the 4 years was evaluated as good in 88.7%, marginal in 7.5%, mild in 7.5%, and poor in 1.3% of patients with cleft palate.
  2. About the type of cleft, 45 cases (85%) bilateral cleft lip and 67cases (93%) unilateral, 29cases (85%) only cleft.
  3. Articulation disorders were observed in 68 out of 159 cases, 91cases of all cases acquired normal speech at the age 4 years.
  4. About the frequency of outbreak of articulation disorders at 4 years only, cleft palate 15cases (28%) were lower than the bilateral cleft lip and palate 18cases (53%) and unilateral cleft lip and palate 35cases (49%).

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  Simple bone cyst mainly occur in long-bones such as humerus and femur, and rarely arise in the jaw.
  We report a case of simple bone cyst induced infection after tooth extraction.
  A 13-year-old girl was referred to our hospital because of swelling and pain of the right buccal region after tooth extraction. Radiological examination showed a cyst-like radiolucent area in the mandible. The clinical diagnosis was mandibular cyst or tumor. We performed surgical extirpation under general anesthesia. Although cystic cavity of simple bone cyst is empty generally, it was filled with granulation tissue in this case.
  Histologically, epithelial element was not observed, it was composed of fibrous connective tissue associated with inflammatory cell infiltration. The histopathologic diagnosis was simple bone cyst from a comprehensive diagnosis. The patient's postoperative course has been good, with no evidence of recurrence.

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