Ablative surgery has been a standard procedure for many years, but during the past few years there has been a significant improvement in our understanding of invasion and metastasis in oral cancer. Each procedure has to be planned individually. Before surgery, every attempt must have been made to arrive at a proper diagnosis, including the exact nature and aggressiveness of the tumor and an analysis of the patient's genetic background. These procedures and the prognosis will be discussed.

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Patients with cleft lip and palate can suffer from contraction of the maxillary arch and anterior cross-bite accompanied by skeletal growth retardation. We use an appliance called an external-expansion arch and induce maxillary protraction using a facial mask in order to correct the anterior cross-bite and maxillary retrusion. In this paper, the method of application of these appliances and the effects of this therapy are reported here. The external-expansion arch consists of a labial wire, bands and a sectional arch. The 0.045-inch stainless steel wire extends along the maxillary dental arch. Hooks are soldered immediately distal to the lateral incisor and the distal leg of the vertical loop. The brackets are bonded to the maxillary anterior teeth, and a 0.016×0.016 inch sectional arch is set. The external-expansion arch is inserted into the headgear tube and ligated with the sectional arch using elastic thread. The maxillary bone is pulled by use of the facial mask and the elastic band. For traction, the force is about 300 g on each side, applied parallel to the occlusal plane or slightly downward. The duration of use is 8 to 12 hours per day. The external-expansion arch has several advantages: it can be applied from the early period of Hellman's dental age IIIA or IIC to improve anterior cross-bite. As it is easy to expand the anterior teeth and move individual teeth to the labial and buccal sides, establishment of a dental arch from severe collapse is not difficult. When an expanding device such as the Quad-helix is incorporated, lateral expansion becomes easier. Furthermore, it is easy to control the teeth vertically, and patient compliance is not necessary. Hence, this method is effective as a phase 1 treatment for orthodontic patients with cleft lip and palate characterized by maxillary retardation.

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It has been suggested that infection by some mycoplasma species can act as possible cofactors in the acceleration of immunodeficiency in HIV-infected patients. The present study was designed to examine infections by oral mycoplasma species in HIV-seropositive (HIV(+)) patients. Mycoplasma salivarium and Mycoplasma orale were isolated from 59.5% and 16.7% of 42 HIV(+) patients, respectively. Non-M.salivarium and non-M.orale species were isolated from 40.5% of saliva samples from the HIV(+) group and 20.8% of those from 24 HIV-seronegative (HIV(-)) subjects, respectively. Although the production of superantigen by human peripheral lymphocytes in the isolated mycoplasma species from HIV(+) and HIV (-) subjects was evaluated, none of the examined mycoplasma strains, including ATCC strains of M.salivarium, M.orale, Mycoplasma buccae and Mycoplasma penetrans, were found to produce superantigen. Production of heat shock proteins (HSPs) by isolated mycoplasma strains was examined by immunoblotting using monoclonal antibodies against Helicobacter pylori HSP60. It was found that all the strains of M.salivarium, M.orale, and unidentified mycoplasma species isolated from HIV(+) and HIV(-) groups produced heat shock proteins. HSP production by oral mycoplasma may play a role in the immunomodulation of HIV(+) patients.

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This report is a retrospective study of fluid extravasation as a complication of temporomandibular joint pumping and perfusion. Contrast-enhanced 3D-CT of the upper joint compartment was performed for presurgical diagnosis before temporomandibular joint arthroscopic surgery in our hospital from 1996 to 2000. From these cases, 43 joints and 38 patients were selected because they had not improved under conservative treatment during the previous six months. Fluid extravasation of the articular capsule was recognized in 9 joints (20.9%) in 9 patients, 3 males and 6 females. Two of the nine patients had undergone arthroscopic observation before surgery. This test had revealed only thin articular capsule, not a perforation, in any of these cases. The data indicate only extremely tiny perforations or infiltration leakage due to the fluid pressure in the upper joint compartment during pumping or perfusion. Oral and maxillofacial surgeons should be aware of this complication.

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Hearing problems such as hearing loss and susurrus aurium are said to improve with occlusal treatment, but few objective clinical reports have been published in the dental field. We looked at the effect of occlusal treatment and chewing instruction on hearing ability in five patients who had an occlusal disorder and the unilateral chewing habit. The following results were obtained:
1. Unilateral chewing due to occlusal disorder may cause differences in hearing ability between the right and left sides (Cases 1, 2 and 3).
2. A reduction in the vertical dimension of occlusion is considered to be one of the factors that cause a decrease in hearing ability (Cases 4 and 5).
3. In all cases, occlusal treatment and chewing instruction lead to a improvement in hearing and to equalizing of hearing ability between low and high frequencies.
These clinical findings indicate that there is a relationship between changes in hearing ability and oral function.

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The submandibular ganglion (SMG) neuron has been well established as the parasympathetic ganglion that innervates the submandibular and sublingual salivary glands. Thus this neuron plays a key role in salivary secretion. In a previous study, we reported that SMG possessed T-, L-, N-, P/Q- and R-type voltage-dependent calcium channels (VDCCs). In this study, we analyzed the contribution of the distinct subtypes of VDCCs currents (I_Ca) using the whole-cell configuration of the patch clamp technique in SMG neurons. In addition, we also investigated the effects of a strong voltage prepulse on the contributions of the subtypes of VDCCs. In SMG neuronal I_Ca without a prepulse, the mean percentages of L-, N-, P-, Q- and R-type were 39.7, 31.5, 10.6, 7.1 and 7.9%. In SMG neuronal I_Ca with prepulse, the mean percentages of L-, N-, P-, Q- and R-type were 37.2, 34.0, 14.0, 7.6 and 7.0%. Thus, these results showed that SMG possess multiple types of VDCCs and that N- and P-type VDCCs are facilitated by a prepulse in SMG neurons.

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