The incidence of temporomandibular disorder (TMD) in children increases during their high-school period. Because they are still in the stage of skeletal growth, their complaints are strongly linked to individual development. The most common TMD symptom is joint sound. This sound is frequently caused by hypertranslation of the mandibular condyle, and the so-called eminence click is a common involvement. Cases of closed lock are rare. Surprisingly, the symptoms frequently disappear naturally, so they do not require aggressive treatment. Painkiller prescription and manipulation of the mandibular condyle are the most popular treatments for them. However, if bruxism is indicated, an occlusal splint may be applied. In some patients, other factors such as mental stress or social environment may be the important cause of the TMD, in which case counseling is needed. Consequently, since TMD in children involves multiple factors, a comprehensive approach is required in treating them.

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  Diagnoses and classification of jaw cysts have long been discussed, but the theories on cyst classification have not been perfectly standardized since the pathogenesis of each jaw cyst is not clear. In this report, the diagnoses of actual conditions of jaw cysts and problematical points are discussed by studying the historical evolution of the primordial cyst and so-called fissural cyst.

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  An alveolar distraction is recognized to be a surgery in the preparation of future implant site.
  This technique can be used for not only implant treatment, but also for the natural teeth. It is "dentulous distraction" that the osteotomized bone block including teeth can be repositioned based on orthodontic criteria. This technique allows the alignment of ankylosed half-impacted tooth not treatable by orthodontics and can also use the surgical assisted orthodontics for the treatment of anterior open bite.
  Dentulous distraction was performed in two patients, a 8 years old girl who had a ankylosed half-impacted maxillary central incisor and a 21 years old lady who had a dento-alveolar deformity with anterior open bite. In both cases, successful repositioning to the ideal teeth position was achieved. Dentulous distraction can be used for surgical assisted orthodontic treatment.

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  In cleft lip cases, especially in bilateral cleft cases, the upper lip is tight and flat, lying behind the lower lip. The Abbé flap has been used in the secondary reconstruction of cleft lip deformities, often in bilateral cases in particular. The Abbé flap is one of the cross-lip flaps. The flap involves the composite transfer of skin, muscle and mucosa, along with a vascular pedicle containing the inferior labial artery and vein. This method is applied to cases of scarring or deficiency of the central part of the upper lip, thinness of the vermilion, and the absence of a Cupid's bow. In this article, the surgical method of the Abbé flap procedure is described.

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  Velopharyngeal incompetence (VPI) is a major cause of dysphonia. VPI after an operation of cleft palate has been treated with various methods, such as use of speech aid prostheses or palatal lift prostheses, retropharyngeal augmentation, repushback surgery, pharyngoplasty by muscle transplantation, the pharyngeal flap operation, and a combination of repushback surgery and the pharyngeal flap operation. Among others, in recent years the pharyngeal flap operation seems to have become the most popular secondary surgical technique for VPI. We report on the method of unified velopharyngeal plasty combined with the repushback method for patients who suffer from significant VPI after cleft palate surgery. In this report, we describe the technique in detail.
  A midline split of the soft palate is performed. In the pharyngeal flap operation, it is necessary to gain exposure of the posterior pharyngeal wall. In order to push back the palatal flap sufficiently, we bend the bilateral hamular if necessary, and perform Z-plasty on the nasal mucous membrane of the soft palate. The nasal mucosa is then supplemented with a pharyngeal flap. The flap is elevated from the posterior pharyngeal wall as a superiorly based flap. Two small rings (pharyngeal poruses) of φ 5-6 mm are made by connecting the levator veli palatini and the superior constrictor pharyngeus muscle. Consequently, the soft palate is attached to the posterior pharyngeal wall with a wide base.
  We consider that unified velopharyngeal plasty combined with the repushback method is one of the most suitable techniques for patients with significant VPI, since it results in minimal shrinkage and scar contracture of the flap.

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  Many children have tooth injuries caused by a fall. We encountered a case of an injured tooth, which we treated for 11 years. The girl fell on her way to school and bruised her face. Both of her permanent central incisors were damaged, and she received emergency dental treatment from a nearby dentist. After two weeks, she visited our office. The upper right incisor was repaired by resin filling. The fractured left upper incisor bonded temporarily. It is necessary to preserve the dental pulp as much as possible. Various treatments are possible for an injured tooth. Based on our diagnosis, we decided on long-term observation of the tooth. Eleven years later, the root of the injured tooth had completely formed.

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  A five-month-old male infant was referred to our department with a pedunculated mass lesion of 1.5×0.8×0.5 cm arising from the alveolar ridge of the anterior mandible. The mass lesion was clinically diagnosed as a congenital epulis, and was excised under local anesthesia with sedation. Histopathological findings showed the mass to be composed of fibrous connective tissue that was covered by squamous epithelium, while bone tissue was found in the neck of the tumor mass. The post-operative course was uneventful and the infant was able to be nursed without difficulty right after the operation.

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  This report describes a preservative treatment of plunging ranula by sclerotherapy with a local injection of hypertonic glucose solution (HGS). An 18-year-old man was referred to our clinic with a chief complaint of swelling of the left submandibular region on September X, 2008. At the first visit, the face of the patient was asymmetrical, with diffuse, painless swelling. The overlying skin of the region was of normal color, and palpation revealed a soft mass, 6.5 × 5 cm in size, with fluctuation. Oral examination showed no particularity. T2-weighted MRI findings showed a cystic lesion with a high signal intensity in the left submandibular space. A clinical diagnosis of plunging ranula was made, and sclerotherapy was performed on September X and X. Twenty milliliters of viscid internal fluid was aspirated from the cystic lesion with an 18G needle under local anesthesia, and then 50% HGS (10 ml), half the volume of the internal fluid aspirated, was injected into the lesion. The postoperative course was uneventful, with no complications. Although the swelling had increased again one week after the treatment, significant regression of the lesion started one and a half months after the sclerotherapy, and the lesion disappeared almost completely in two months. There has been no evidence of recurrence in the two years and two months since the treatment. We conclude that local injection therapy with HGS is an effective and safe method for the treatment of plunging ranula.

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  In general dental practice, an impacted supernumerary tooth is frequently observed. Its frequency of occurrence is highest in the maxillary anterior region, followed by the maxillary molar and mandibular premolar regions. Recently, cone beam CT (CBCT), which enables identification of the 3D details of impacted supernumerary teeth, has been applied for evaluation in addition to intra-oral radiography and panoramic radiography.
  We experienced a case of ectopic eruption of an impacted tooth in the right nasal cavity, which is rare in comparison with common impacted supernumerary teeth in the jaw. In this case report, we examined panoramic radiography and CBCT images of the impacted tooth, and compared the case with several cases reported in previous studies.

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  We report the case of an eight-year-old girl who had dysplasia of the teeth, suspected to be induced by chemotherapy. The patient was born at full term by normal delivery, and was diagnosed to have neuroblastoma (stage IV-S) by ultrasonography. Tumor resection was performed 15 days after birth, and chemotherapy was performed for 12 months after that. She has had a good prognosis since then.
  The examination of the oral cavity revealed morphological abnormalities of the crowns of the right and left upper central incisors. X-ray showed findings of morphological abnormalities of the four central incisors and deficiencies in tooth germs of the right and left lower lateral incisors.
  The dysplasia of the teeth in this patient was considered to be caused by chemotherapy, because the period of chemotherapy doses coincided with the formation period of those teeth.

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  We investigated tooth formation in three cases in which chemotherapy and radiation therapy had been performed for pediatric malignant neoplasm.
  Case 1: A 12-year-and-11-month-old girl, who had suffered from acute myeloblastic leukemia (M4) at the age of five months, had been treated with high-dose chemotherapy for five months and an autoserum stem cell graft at the age of eight months.
  Case 2: A seven-year-and-one-month-old girl, who had suffered from adrenal neuroblastoma at the age of one year and three months, had undergone high-dose chemotherapy for a period of six months, an autoserum stem cell graft at the age of one year and 11 months, and total body irradiation (Σ 10 Gy) at the age of two years.
  Case 3 : A five-year-and-two-month-old boy, who had had sarcoma of the lower jaw at the age of one year and six months, had been treated with chemotherapy for seven months and with a tumor resection. He had also received radiation therapy to the left lower jaw (Σ 56Gy) until the age of two and a half.
  Our results reconfirmed that chemotherapy and radiation therapy for pediatric malignant neoplasm severely disturbed tooth formation: there was deficiency of permanent teeth and shortness of dental roots. Patient-tailored dental management is essential because the kinds and degrees of disturbance differed from patient to patient.

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