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The surgical technique and grafting materials used for sinus lift augmentation and simultaneous implant insertion were developed in the mid 1970s. New procedures were developed in the 1980s, in which iliac bone grafts were fixed to the residual ridge with implants. Today, less invasive techniques with lower morbidity have been developed for small bone defects, such as crestal elevation through the implant site. To treat severe atrophy and a bone height of less than 3–5 mm, other approaches are advantageous, such as the Caldwell-Luc entry. Depending on the severity of the situation, iliac crest bone block grafting guarantees high quantities of good bone for sinus augmentation. This report evaluates the usefulness of fixing the iliac crest bone block with implants. This technique significantly reduces the healing and waiting times and the number of operations.

舌全摘，亜全摘に片側中咽頭拡大切除を伴う症例に対して，切除側の咽頭上壁から温存側の舌根に下るスロープ型に舌根部を再建した症例を経験した。長期経過後の形態と機能を，従来のドーム型再建と比較した。ドーム型再建13例，スロープ型再建6例，平均経過観察期間は7年1ヶ月。スロープ型はドーム型と比べて構音機能，嚥下機能とも若干劣るものの，比較的良好な結果が得られた。ドーム型は長期経過後に平坦化して機能が低下する症例が見られたが，スロープ型は長期経過後も形態と機能を維持していた。スロープ型再建では，舌根を挙上する機能を失った中咽頭側壁を皮弁で塞ぎ，機能が温存される側のみで嚥下を行うことになる。るいそう症例などドーム型の形態を長期間維持するのが困難な症例ではスロープ型再建も有効な方法と思われた。

We reported a rare case of spindle cell lipoma of the tongue. A 56-year-old man was referred to our department because of a painless swelling on the right tip of the tongue. A clinical examination revealed a mobile, well-demarcated, mass of the tongue that measured 35mm in diameter. A histopathological diagnosis of a solitary fibrous tumor was made on examination of a biopsy specimen. The tumor was removed surgically with the patient under general anesthesia. Histopathological examination of the surgical specimen showed a spindle cell lipoma. There have been no signs of recurrence in the approximately 11 months since the operation.

口腔癌に対するRa針組織内照射の適応範囲を検討するため, 根治目的にRa針組織内照射を実施した口腔扁平上皮癌93例を検討した。組織内照射の適用の基準は, 長径5cm以下で深さが2cm以内とした。舌82例, 口底10例, 口唇1例に対しRa針組織内照射を実施した。Ra針全体での局所制御率は92.5%で, 後発転移率は32.3%で外科的治療に劣らない治療成績であった。5年生存率は64.9%で, 局所制御率と後発転移率の結果から考えれば満足できる結果ではなかった。この原因は, 局所再発症例の治療成績の低さによると考えられ, 局所再発と放射線潰瘍を正確に区別し, 早期に後治療を実施することが重要と思われた。初診時にリンパ節転移を認めた症例は, 局所の照射のうちに, 頸部郭清術を実施したが, N1症例の5年生存率が83.3%に対しN2以上では40.6%と大きく低下し有意差を認めた。これらの結果から長径が5cm以下で深さが2cm以内, 初診時N1までであれば, Ra針組織内照射によって, 良好な治療成績が期待できると考えられた。

A cohort survey of the occurrence of multiple primary cancers was carried out in patients with oral cancer (n=310) at Tokyo Metropolitan Komagome Hospital. The subjects consisted of 203 males and 107 females.The incidence of multiple primary cancers over the course of 20 years (1976 to 1996) was 18.4%(n=57).Among 57 multiple primary cancers, 44 primary oral cancers, (77.2%) occurred in the oral cavity, and the specific sites were the tongue (19), gingiva (10), buccal mucosa (7), floor of the mouth (5), soft palate (2), and lip (1).Multiple primary cancers occurred frequently in the esophagus (12), stomach (8), lung (6), hypopharynx (2) in males and in the uterus (3) in females.In esophageal cancer, the O/E ratio of male patients was significantly higher, than that in females, differing by a factor of 39.61 times.In males, primary occurrence in elderly patients was associated with a short period until the occurrence of a second cancer, The development of a second cancer reguired a longer period in younger patients than in older patients, i. e., 4.5 years for 40 years old, 3.3 years for 50 years old, 2.5 years for 60 years old, 1.9 years for 70 years old, and 1.7 years for 80 years old.

Cytomegalovirus infection is an opportunistic infections that occurs at an incidence of 40% in acquired immunodeficiency syndrome. It is very rare in the oral cavity. We describe the case of a 39-year-old man who had cytomegalovirus gingivitis. At presentation, the patient complained of pain of the left side of the upper and the right side of the lower gingiva. We found large depressions and edematous granulation tissue at these sites. Large bone defects appeared on panorama X-ray film. Clinically, malignant lymphoma was suspected, but pathological examination revealed cytomegalovirus gingivitis. Ganciclovir was prescribed for 4 weeks, and the right lower third molar was extracted. After treatment, edematous guanulation and gingival pain disappeared. Cytomegalovirus had apparently invaded the endothelium of blood vessels, inducing circulatory failure, which resulted in the formation of large bone defects.

To evaluate the accuracy of imaging diagnosis, we compared cervical lymph nodes with clinical evidence of metastasis on palpation, computed tomography (CT), and magnetic resonance imaging (MRI). The subjects comprised 28 patients with oral cancer who underwent radical neck dissection. The clinical criteria for positive lymph nodes was a diameter of 15mm or more in the submental and submandibular region, or 10mm or more in the deep cervical region. Lymph nodes with ring-like or heterogeneous enhancement on CT or MRI and those that were hard on palpation was also considered positive.Histopathologically, 55 lymph nodes were confirmed to have metastasis. Among these 55 positive nodes, 27 were diagnosed positive by palpation, 35 were diagnosed positive by CT, and 38 were diagnosed positive by MRI. There was a significant difference between palpation and MRI (p

We report a case where Kaposi's sarcoma was seen in the hard palate of a patient with AIDS.Kaposi's sarcoma could be controlled by radiotherapy. During follow-up, no other oral changes were found.There have been few Japanese patients with Kaposi's sarcoma in our hospital. Only one patient has died due to Kaposi's srcoma of the lung.