We treated 22 pediatric patients (younger than 15 years old) with jaw fractures during the 13 years from 1986 to 1998. The following is our report on these cases.
The yearly mean number of fractures is 1.7, and this number is decreasing. Classification by sex shows that patients in 13 cases were male and patients in 9 cases were female. Classification by age shows that patients who were 10 years old or older and younger than 15 years old were in the majority.
There were four causes: traffic accidents (11 cases), falls (6 cases), sports accidents (3 cases) and violence (2 cases). Eight of the 11 traffic accidents were bicycle accidents. For patients who were younger than 10 years old, the main cause of the fracture was a fall. For patients who were 10 years old or older, a bicycle accident was the main cause.
Most of the patients were referred patients; 11 cases were patients referred from other clnical institutes and 10 cases were referred from other departments of our hospital. Eighteen cases were hospitalized in our department, 3 cases were outpatients, and 1 patient was hospitalized in the orthopedics department of our hospital.
As for the time when the patients received fractures, all fractures happened between 9 a. m. and 9 p. m., the period from noon to 3 p. m. being the peak time. As for the day of the week, fractures occurred mostly on Thursdays and Sundays. As for the month of the year, August and November were the months in which the most fractures occurred.
All cases were mandible fractures. Twelve cases were mandibular body and / or mandibular angle fractures and 10 cases were condylar fractures.
For mandibular body and / or mandibular angle fractures, we conducted open reduction in 8 cases, closed reduction in 3 cases and follow-up in 1 case. For condylar fractures, we conducted closed reduction in 9 cases and follow-up in 1 case. Open reduction was not conducted for condylar fractures.
As for complications, facial laceration occurred in 9 cases, alveolar fractures in 4 cases, limb fractures in 3 cases, and tooth displacement in 2 cases.

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Most ameloblastomas occur as intraosseous tumor arising from residues of odontogenic epithelium. A few peripheral ameloblastomas, however, appear to arise directly from the surface epithelium or dental lamina lying outside the bones. Moreover, peripheral ameloblastoma in children is relatively uncommon. The case presented here is a very rare peripheral ameloblastoma occurring in the gingiva of an infant.
A swelling of gingiva with bleeding appeared at the right mandible of a 21-month-old boy. Clinical diagnosis was benign tumor. The tumor was excised under general anesthesia. A dental sac like mass under the tumor was conserved. Pathological diagnosis was peripheral ameloblastoma. His intra-oral swelling recurred at seven years old. In the radiograph three impacted supernumerary teeth were recognized in the lesion. Then the teeth were extracted, and orthodontic therapy has been treated.
It is thought that the radical surgical excision is not necessary in children ameloblastoma. The good occulusion can be obtained by the orthodontic treatment after the conservative surgical excision or curettage.

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Thyroglossal duct cyst is an uncommon developmental cyst and may be derived form an embryonic thyroglossal duct between the foramen caecum of the tongue and the thyroid glands.
An 8-years-old boy was referred to our hospital on April 3, 1997, because of dysphagia and swelling of oral floor. Patient demonstrated a middleline palpable fluctant lesion, which was clinically diagnosed as dermoid cyst.
The cyst was removed surgically under general anesthesia on July 23, 1997. It was located from submandibular to sublingual space, neither being penetrated to hyoid bone nor attached to it and was about 65mmx40mm in size. Cyst wall was lined by stratified squamous and ciliated columnar epithelium and contained a few mononuclear cells and sero-mucous glands. Pathological findings coincided with thyroglossal duct cyst.
No recurrence has been noted for 2 years after the operation.

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Although impaction of the lower first molar is extremely rare, we have encountered three cases of lower first molar impaction. Case 1 involved a 9-year-old girl with the chief complaint of retarded eruption of 6·Ê. Orthopantomography revealed dental follicular cyst originating from 6·Ê. Case 2 involved an 11-year-old boy, who consulted our department hoping to undergo induced eruption of 6·Ê. Orthopantomography revealed that 6·Ê was submerged and inclined distally. Case 3 involved a 9-year-old boy with the chief complaint of retarded eruption of 6·Ê. Orthopantomography revealed that the roots of 6·Ê were crooked distally. In cases 1 and 3, fenestration was performed, and in case 2, traction was performed. In all cases, the impacted first molar was successfully aligned in the dental arch.
There are various etiologic factors of tooth impaction, and they are largely divided into systemic factors and local factors. In case 1, a dental follicular cyst impeded the eruption of 6·Ê. In case 2, the displacement of the tooth germ, insufficient eruption force, and anomalous direction of eruption were thought to have prevented the normal eruption of 6·Ê. In case 3, decreased eruption force caused by the crooked roots was thought to have led to impaction of 6·Ê.
If impaction of the lower first molar is discovered before eruption of the lower second molar, treatment can be easy. Therefore, pediodic examination including radiography during the eruption period of the lower first molar will be helpful, especially when the eruption of a lower first molar is delayed compared to the others. In such cases, careful examination should be recommended to the patient. We also think that induced eruption is certainly worth trying in cases presenting no marked malformation or ankylosis of the tooth.

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The patient was 11-year-old boy who had Angle class I bimaxillary protrusion multiple, impacted supernumerary teeth, odontoma and dentigerous cyst. The impacted supernumerary teeth, odontoma and dentigerous cyst were removed and 4_??_14_??_5 were extracted to facilitate orthodontic treatment. Following orthodontic treatment, good class I occlusion was obtained and facial convexity was completely improved.
There has been no evidence of cyst recurrence in about 4years.

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Impacted supernumerary teeth are found in any position of the jaws, sometimes in the vicinity of a impacted permanent tooth. In order to make a diagnosis and design of orthodontic and surgical procedures in the above case, it is necessary to synthesize the whole situation in each case, especially a satisfactory prognosis.
We report all procedures of orthodontic treatment both on the maxillary incisal and mandibular premolar regions. Impacted bilateral incisors were retracted down to the dental arch after extraction of impacted supernumerary teeth positioned superficial to these incisors. Four premolars also were extracted as crowding cases.
Following 1.5 years, a bicuspid-like, supernumerary tooth surprisingly has appeared in each extracted socket of 4_??_4. This case has been still observed carefully as post-treatment, including newly appeared supernumerary teeth.

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A case of malignant suspected pleomorphic adenoma in a 13-year-old girl is presented. The painless tumor in her left palate had gradually progressed. Computed tomography, magnetic resonance imaging, and radionuclide imaging revealed the possibility of malignant tumor, because they pointed out aggressive bone absorption of the maxilla. In addition, the cytodiagnosis was class III. The biopsy was carefully made to avoid dissemination. Since it proved benign pleomorphic adenoma, the tumor was completely removed. The underlined osseous surface was cauterized with Carnoy's solution and laser to reduce the recurrence.

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A case involving a 13-year-old girl with chronic graft-versus-host disease after allogeneic peripheral blood stem cell transplantation as a treatment of acute lymphoblastic leukemia is presented to describe oral symptoms. We found a variety of oral symptoms, such as: xerostomia, rampant caries, lichenoid lesion, cheilitis, atrophy of tongue papillae, and disturbance of mouth opening. First of all, we extracted a tooth with severe dental caries, and applied fluorides to the decay to control dental caries. Plaque control, including professional mechanical teeth cleaning by dental hygienist, facilitated the complete resolution of the oral pain and unpleasant feeling.
Considering quality of life, plaque control is very significant in oral care of GVHD patient.

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