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Volume 61, Issue 3
Displaying 1-7 of 7 articles from this issue
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ORIGINAL ARTICLES
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Atsushi DANJO, Yoshio YAMASHITA, Keisuke MORI, Nobuhiro NOGUCHI, Daiji ...2012 Volume 61 Issue 3 Pages 243-250
Published: 2012
Released on J-STAGE: September 28, 2012
JOURNAL RESTRICTED ACCESSBACKGROUND: Vascular malformations of the oral and maxillofacial region may stand out, and can cause speech or chewing disorders and bleeding. In addition, in some cases it is difficult to excise the entire lesion and to reconstruct cosmetically, and the remaining lesions may recur. Recently, sclerotherapy has been suggested as the primary treatment for vascular anomalies, instead of surgery. This study examined the effects and complications of sclerotherapy in treating vascular malformations of the oral and maxillofacial region.
METHODS: We treated ten vascular malformations in nine patients using sclerotherapy. We used 5% ethanolamine oleate as the sclerosing agent, which is used for the endoscopic treatment of esophageal varices. To confirm the safety of the treatments, the patients were hospitalized during the treatment and the treatments were performed under fluoroscopy and contrast-enhanced computed tomography guidance.
RESULTS: Magnetic resonance imaging (MRI) examination after treatment revealed that all of the lesions had improved. Furthermore, seven of the lesions had disappeared. Complications after treatments were pain in six cases and swelling in all ten cases. One patient developed hemoglobinuria, but intravenous haptoglobin protected against renal dysfunction.
CONCLUSIONS: Intralesional sclerotherapy of vascular malformations using ethanolamine oleate is an effective treatment, enabling the restoration of cosmesis and function.View full abstractDownload PDF (881K) -
Shigehiro TAMAKI, Yasutsugu YAMANAKA, Hiroyuki SHIMOMURA, Nobuhiro YAM ...2012 Volume 61 Issue 3 Pages 251-257
Published: 2012
Released on J-STAGE: September 28, 2012
JOURNAL RESTRICTED ACCESSWe report the clinical analysis of 33 hemodialysis patients who underwent tooth extractions (63 extractions in total) at Takai Hospital during the 4-year period from April 2007 to April 2011.
The patients were divided into two groups: those who were administered an antithrombotic agent (antithrombotic group; 20 cases; 39 extractions), and those who were not (non-antithrombotic group; 13 cases; 24 extractions). For both groups, the anticoagulant was switched to low-molecular-weight heparin or nafamostat mesilate for dialysis on the day before extraction. Local hemostasis was achieved in both groups with tight suturing and astriction. With respect to local inflammation prior to extraction, both groups involved mostly grade 0 cases. For post-extraction bleeding, both the antithrombotic and non-antithrombotic groups had 4 cases each with bleeding greater than grade 1. The 8 cases with post-extraction bleeding also had local inflammation greater than grade 2, with inflammation seen as the reason for the bleeding.
In conclusion, appropriate local hemostasis among hemodialysis patients undergoing antithrombotic therapy is essential for achieving hemostasis.View full abstractDownload PDF (1176K)
CASE REPORTS
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Hiroaki HIROTANI, Masatoshi CHIBA, Seishi ECHIGO2012 Volume 61 Issue 3 Pages 258-264
Published: 2012
Released on J-STAGE: September 28, 2012
JOURNAL RESTRICTED ACCESSWe report a case of trigeminal sensory neuropathy that was thought to have occurred with cold stimulation, and was successfully treated with Kampo medicine started one year after onset. A 37-year-old male noted heat sensation in the right infraorbital region and upper lip that developed after exposure to cold wind at midnight on February X-1, followed by hypoesthesia and dysestesia in the same area and the right gingiva of the maxilla. There were no other significant abnormalities on ophthalmic, otorhinolaryngological, and neurological examinations. He was referred to our department on February X because neuropathy persisted despite taking a vitamin B12 preparation and undergoing root canal treatment of the right canine of the maxilla which was performed because he had felt swollenness of the gingiva and unpleasant sensation during mastication. He was diagnosed as having neuropathy of the second branch of the right trigeminal nerve because he presented with hypoesthesia and dysestesia in distribution of the right infraorbital nerve. Contrast-enhanced magnetic resonance imaging of the craniofacial region showed no abnormalities. He showed some improvement with Goreisan and stopped taking it after 3 months because he was no longer troubled by the neuropathy, which made satisfactory progress thereafter. The cause of trigeminal sensory neuropathy could not be identified, however, cold stimulation might have served as the trigger. Improvement in neuropathy, when the treatment is started after an extended period after onset, is usually difficult. However, Kampo medicine produces a good response to it in some cases, and we consider that Kampo medicine may be a useful option for the treatment of neuropathy.View full abstractDownload PDF (16K) -
Koji KASHIMA, Motohiro MATSUDA, Koichi TAKAMORI, Kaori IGAWA, Izumi YO ...2012 Volume 61 Issue 3 Pages 265-270
Published: 2012
Released on J-STAGE: September 28, 2012
JOURNAL RESTRICTED ACCESSWe report a case of drug-induced interstitial pneumonitis probably due to hangeshashinto prescribed for cheilitis. An 84-year-old woman came to our dental clinic complaining of erosion of the lower lip. She had a history of treatment for lumbar canal stenosis and had been prescribed limaprost alfadex for 3 years. Although she had been treated with steroidal ointment, vitamin B and cepharanthin by her dermatologist for 2 years, her symptom had not improved. Clinical examination revealed both erythematic and keratotic legions, and combined partially with desquamative erosion and crusting formation in the lower lip. A clinical diagnosis of cheilitis related to xerostomia was made, and we gave 15 mg of pilocarpine hydrochloride daily as well as steroidal ointment and several agents for oral rinse for 10 months with modest clinical efficacy. She then received 7.5 mg of Hangeshashinto daily for 3 weeks, which resulted in a complete response in the lip. However, she started to suffer dyspnea after 26 days from taking the medicine, and was referred to the regional general hospital. Since fine crackles were audible on auscultation and chest X-ray films showed widespread ground-glass shadows in both fields, drug-induced interstitial pneumonia was suspected. After cessation of the medicine and steroid pulse and successive oral steroidal therapies, her subjective symptoms improved considerably and the interstitial shadows observed on the chest X-ray films and chest CT were resolved.View full abstractDownload PDF (586K) -
Shoichiro KITAJIMA, Kazuhisa TANGE, Katsuhito NAKASHIMA, Tsubasa YAMAM ...2012 Volume 61 Issue 3 Pages 271-274
Published: 2012
Released on J-STAGE: September 28, 2012
JOURNAL RESTRICTED ACCESSTranscatheter arterial embolization (TAE) is recognised as an effective hemostasis and pre-surgery tumor reducement procedure. We have in the past applied it as part of superselective intra-arterial chemotherapy for selected cases of oral cancer. The case discussed herein involved end-stage lung cancer that had metastasized to the oral cavity. The patient had not been told that the oral lesion was malignant, but desired treatment due to malodor and bleeding. His family wanted to free him from pain and other discomfort without disclosure.
We performed TAE using Histoacryl®, the goal being to eliminate the bleeding and malodor emanating from the necrotic tissue. Three days after commencement of TAE it was evident that the necrotic tissue was shedding. After six days the discomfort that the patient and his family had complained of had disappeared.
We consider that this technique can improve the quality of life of patients with end-stage cancer and is thus useful in their treatment.View full abstractDownload PDF (525K) -
Atsushi UESUGI, Eriko MARUKAWA, Yutaka MARUOKA, Ken OMURA2012 Volume 61 Issue 3 Pages 275-282
Published: 2012
Released on J-STAGE: September 28, 2012
JOURNAL RESTRICTED ACCESSHerpes zoster of the trigeminal area has been reported as a possible, but rare cause of alveolar bone necrosis and spontaneous tooth exfoliation. We report a case of mandibular alveolar bone necrosis and tooth exfoliation following herpes zoster in a patient infected with HIV.
The patient was a 23-year-old man who had been diagnosed with herpes zoster and who had been treated by a dermatologist.
Twenty-five days after developing herpes zoster, he was aware of mobility of his left lower premolars. Within a few days, the mobility had spread to the left lower incisors and canines. He subsequently visited our hospital, and we recognized marked gingival swelling and tooth mobility from the left lower central incisor to the second premolar, and also found pus discharging from the marginal gingiva and the alveolar bone cropping out. HIV, HBV and Treponema pallidum were found by a blood test. Panoramic X-ray showed that the alveolar bone around the canine and first premolar was widely absorbed. A biopsy specimen revealed no malignancy. The area affected by bone necrosis matched that of the mandibular nerve herpes zoster. He was diagnosed with alveolar bone necrosis and tooth exfoliation that occurred secondarily to the herpes zoster. Antibiotics therapy and local irrigation were done, but the left lower canine and first pre-molar were spontaneously lost with sequestrum. The left lower second pre-molar and first molar were extracted, but the left lower incisors and second molar still remain.View full abstractDownload PDF (968K) -
Shigeaki TORATANI, Yasutaka HAYASHIDO, Ikuko OGAWA, Takashi TAKATA, Te ...2012 Volume 61 Issue 3 Pages 283-290
Published: 2012
Released on J-STAGE: September 28, 2012
JOURNAL RESTRICTED ACCESSOsteochondroma is a rare benign bone tumor in the maxillofacial region. The common site in the mandibular bone is the condylar and coronoid process, and it is important to differentiate between osteoma, osteochondroma and condylar hyperplasia. Osteochondroma is considered to be an exophytic bone torus having a cartilaginous cap. Therefore, the radiographic appearance and morphology at the time of operation are useful in the differential diagnosis of osteochondroma and hyperplasia, because of resemblance in the pathological findings.
We experienced a case of osteochondroma of the right mandibular condyle of a 22-year-old male. We review the summary and clinical findings of 23 cases of osteochondroma reported for the past 30 years in Japan.View full abstractDownload PDF (1028K)
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