We reported a case of complex odontoma in a 3-year-old 1-month female infant.
She was consulted with a complaint of an unerupted mandibular left first deciduous molar. Based on X-ray examination, we found that the tooth was impacted, and a calcificated mass was observed surrounding the tooth. We enucleated the mass with the tooth surgically. Histopathologically, it was diagnosed as complex odontoma.
This is a rare case of complex odontoma, which interferred with the eruption of the mandibular first deciduous molar.

抄録全体を表示

The treatment course for a pediatric jaw fracture differs from that of an adult fracture. The mode of new addition of bone at the fracture site in a child is faster than at the site of an adult. However, a delay in primary cure of a pediatric jaw fracture can lead to more complications. Furthermore, the growth of the jaw, including unerupted teeth and germs need more attention.
We report a case of malunited mandibular fracture, in a 9-year, 7 month old child caused by a traffic accident. The treatment of the mandibular fracture was delayed over 2 months, since he had been under intensive care for resuscitation. Therefore, selected circumferential wiring and open reduction following simulation surgery utilizing a dental model was required instead of simple circumferential wiring.

抄録全体を表示

Juvenile hemangioendothelioma is a classification of papillary hemangioma in the hemangiomas, as like a lesion of hamartoma. Occasionaly, it is reported in major salivary glands (e. g. parotid gland) in the oral region, but it is rare in any other oral region. We report a case of juvenile hemangioendothelioma of the right palate in 9-month-old female baby. She was referred to our hospital with a complaint of painless tumor of the right palate. The tumor was a round mass measuring 25 × 20mm and was the same color as around mucousa. It was diagnosed as a benign tumor. The tumor had no change in size during 3 months follow-up, so it seems to be better to remove it completely by surgery.
The lesion was excised completely from intraoral approach under general anesthesia. The surgical specimen consisted of highly cellular, mitotic active endothelial cells and had poorly canalized vessels histologically.
Immunohistochemically, CD34 was positive stained obviously, but UEA-1 and Factor VIII-related antigen were attenuate. Histological diagnosis was juvenile hemangioendothelioma.
The postoperative course has been good without any evidence of recurrence for 10 months after the operation.
Juvenile hemangioendothelioma of the palate on inquiry was not found, so this case seems to be a rare case.

抄録全体を表示

Clinical observation was made on the impacted maxillary central incisors of 36 patients who had visited our pedodontic clinic.
The subjects of investigation were as follows: proportion of the operations associated with the maxillary central incisors among the minor operations performed in our pedodontic clinic, circumstances of the detection, the age of the initial visit or initial detection, causes of the impaction, the details of the treatment, the conditions of the impacted teeth (the location of the teeth, the angle of the crown inclination, crown-root angulation and the stage of root formation), the conditions of the treated teeth (the contents of the treatment in relation with the age, the conditions of the teeth in relation to the treatment and the distribution of the crown inclination and crown-root angulation).
For the traction group, the mean value of the crown-root angulation was 58.4 degrees and the mean value of the crown inclination was 15.6 degrees. With reference to the root formation stages, it was found at the initial visit or initial detection that one tooth was at Ri-R1/4 stage, ten teeth were at R1/4-R1/2 stage, five teeth were at Rc stage and one tooth was indistinct.
For the crown exposure group, the mean value of the crown inclination was -3.5 degrees and the mean value of the crown-root angulation was -1.2 degrees. With reference to the root formation stages, it was found that two teeth were at R1/4-R1/2 and one tooth was R1/2-R3/4.
For the extraction group, the mean value of the crown inclination was 110.7 degrees and the mean value of the crown-root angulation was 46.5 degrees. With reference to the root formaiton stages, it was found that five teeth were at R1/4-R1/2 and one tooth was R1/2-R3/4.
These results suggest the therapeutic course should be made according to the angle of the crown inclination, the crown-root angulation and the stage of root formation.

抄録全体を表示

We experienced 13 children (10 boys and 3 girls) with ages ranging from 8 years 2 months to 14 years 8 months, for a total of 15 traumatized teeth, who visited Department of Pediatric Dentistry, Iwate Medical University Hospital, with a chief complaint of traumatic crown fracture of permanent incisors, during the period of May 1984 to May 1992. These children were treated by reattaching the original fragments with adhesive composite resin. These cases were followed clinically and radiographically after treatment. The injured tooth was the upper central incisor in most cases and was the lower central incisor in one case only. Prior to reattachment of fragments, indirect pulp capping was performed on 9 teeth, partial pulpotomy on 4 teeth, and extirpation of pulp on 2 teeth. We used chemically-cured adhesive composite resins (Clearfil posterior^®, Microrest^® and Panavia^®) to reattach the fragments. The treatments were performed according to Ellis and Davey's classification. In the cases of class 1 (mild fracture of the crown), the sharp edges in the fracture area were smoothed. This was followed by etching the tooth and fragments, and then, reattaching the fragments to the tooth using an adhesive composite resin. In cases of class 2, indirect pulp capping was performed, using calcium hydroxide preparation Dycal^®. This was followed by a pretreatment similar to the class 1 cases, and finally by reattachment of the fragments. In cases of class 3.2, partial pulpotomy was performed using a calcium hydroxide preparation Calvital^®, followed by reattachment of the fragments. During follow-up period (ranged from 1 year 10 months to 9 years and 10 months after the treatment), in 5 cases, the reattached fragments became detached due to additional trauma, but in no case was the fragment displaced spontaneously. In cases where pulp capping or partial pulpotomy was performed, tooth root formation was completed, leading to favorable results. This technique requires only a relatively small amount of the tooth to be shaved away and restores sufficient strength to enable a smooth return to daily eating habits, it therefore provides a useful means of treating crown fractures of young permanent incisors.

抄録全体を表示

The trismus caused by the bilateral coronoid hyperplasia is described in this report. In April 1993, a 5-year-old boy visited our clinic with a chief complaint of the trismus. He was diagnosed as the TMJ-disorder suspected from clinical symptoms and pantomography at the first visit. Jaw opening exercise was applied during the period of 12 months from the point of view of patient's psychological and physiological development. His condition, however, did not improve. Tomography and CT scanning were taken to examine in more detail. From these findings, the final diagnosis of the coronoid process hyperplasia was established.

抄録全体を表示

The ameloblastoma is the most common epithelial odontogenic tumour and occurs in the 20 to 40-year-old age group. Ameroblastoma has occasionally been reported in children but under 6-year-old is extremely rear.
A case of ameloblastoma in the left mandibular region of a 4-year-old boy treated with cryotherapy is presented. Removal of tumour mass left only a thin shell of bone, which was then devitalized by freezing. Fracture was not evident. Bone healing was rapid and 4 months were needed for almost complete repair.
There is no sign of reccurent disease after 5 years of observation.

抄録全体を表示

Clinico-statistical observation was made of 31 cases of maxillofacial fracture in children under 15 years by reviewing recent results of treatment given at our hospital during the past 10 years, from January 1985 to December 1994. Results obtained were as follows:
1. 6 to 12 years old children experienced maxillofacial fractures most frequently.
2. The ratio of male to female was 2.9: 1.
3. The common causes of maxillofacial fractures were bruises (33%), traffic accidents (19%).
4. The ratio of mandible to maxilla was 2: 1.
5. The common site of mandibular fractures was molar region, condyle, symphysis.
6. Open reduction was performed on 5 cases, and conservative treatment was performed on 26 cases.

抄録全体を表示

Bone lengthening often performed in orthopedic surgery is a procedure in which bone is lengthened by gradual distraction using a lengthening device. Recently, in oral and maxillofacial surgery also, this method was performed on the pediatric patients with mandibular hypoplasia. This time, we applied this method on lengthening the shortened mandible during fracture treatment.
We experienced a case of pediatric mandibular fracture in a state of nonunion caused by infection after open surgery, which needed mandibular resection and bone graft to be cured. In this treatment, the resected mandible was intentionally shortened and fixed in order to close the opened gingiva on the fracture site, which had been the cause of the infection. And then after healing, the mandible was lengthened again, using a bone lengthening device (ORTHOFIX M-100).
In conclusion, this method was useful in reconstruction of mandible in not only mandibular hypoplasia but also mandibular defect needing bone lengthening and filling.

抄録全体を表示

We experienced and treated a 3-year-old boy with mucoepidermoid carcinoma arising from the left side submandibular gland. The child visited our clinic with his mother via the pediatric clinic of the hospital, because of swelling in the submandibular region. At first the lesion was doubted to be some inflammatory origin, but through the biopsy it was diagnosed as mucoepidermoid carcinoma histologically. We carried out an en bloc operation of the tumor excision and total neck dissection of the left side. The postoperative course was uneventful and he was discharged two months and a half later. An ambulatory examination of the patient showed us no sign of the recurrence and no local or distant metastasis for over six years, while the child received administrations of 5-FU dry syrup orally and OK-432 i. s. c. for 11 months.

抄録全体を表示

The majority of arteriovenous malformation with intracerebral hematoma are found in patients in their thirties to forties, and there are comparatively few in children who are less than 10 years old. Here we report a case of arteriovenous malformation found by intracerebral hematoma.
The patient was 8-year-old-boy. Enucreation with ameloblastoma was performed under general anesthesia on August 17, 1994. postoperatively the patient had intermittent headaches and repeated relapses of vomiting. CT scan showed intracerebral hematoma in the right occipital lobe.
He has been transferred to the department of Neurosurgery, and enucreation with hematoma and arteriovenous malformation was performed. It is in good prognosis after the operation.

抄録全体を表示