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Surgery, chemotherapy and radiotherapy are main treatment methods for malignant tumors. However, adverse reactions to radiotherapy, such as mucitis and impairment of saliva secretion and gestation, are likely to occur. In the presence of oral mucitis, oral ingestion becomes difficult due to pain, which may reduce the nutritional state and QOL, affecting the treatment plans. The importance of the oral care of patients undergoing radiotherapy has been increasingly recognized, with the expectation that the reduction and prevention of adverse reactions in oral will increase the treatment effects. In this study, we investigated the effect of oral care for reducing adverse reactions to radiotherapy. Fourteen patients with head and neck cancers who underwent radiotherapy at our hospital since January 2004 to December 2007 were divided into 2 groups, oral hygiene and control group with 7 patients respecively, with or without specialized oral care, and oral mucitis was evaluated with regard to the progression of stomatitis and grade of inflammation. There was difference in the severity of stomatitis between the 2 groups, the occurrence of mucitis tended to be delayed in the oral hygiene group than the occurrence in the control group and there are no severer mucitis more than grade 2 in the oral hygiene group.The CRP level increased sharply at a radiation dose of 20 Gy and higher in the control group, while it increased gradually and slightly in the oral hygiene group. The oral hygienic condition deteriorates may be a essential factor patients undergoing radiotherapy for oral cancer due to the adverse effects of radiotherapy. This finding suggested that oral care may be a essential factor that contributes to the therapeutic effects by reducing adverse reactions in patients undergoing radiotherapy because of its positive effects on the nutritional state, QOL.

In recent years, the medicinal significance of oral healthcare leads to an improved QOL, for example by preventing systemic severe infectious diseases, feeding, deglutition, rehabilitation and so on, has been regarded as important. In particular, it is now recognized that oral healthcare of an inpatient occupies an important role as part of their healthy maintenance, not only in terms of the prevention of oral infectious diseases but also of systemic severe infectious diseases. On the other hand, however, oral healthcare may prove problematic, since each patient has specific oral and body states based on their disease. Therefore, we conducted a questionnaire survey to assess the present circumstances of oral healthcare for each ward for nurses having direct relations to inpatients in the University of Ryukyu hospital. Consequently, most nurses who responded had experience in oral healthcare. In addition, the problems of performing oral healthcare and the need for a dentist and oral hygienist in connection with oral healthcare were positively recognized, as well as the need of oral healthcare on each ward based on the condition of a patient, was systematized.

In our department, consistent treatment using a team approach has been done for patients with cleft lip and palate since 1985, and we have generally reported a satisfactory outcome for each process to date. Surgical orthodontic treatment assumes an important role as a final stage of treatment in the team approach. In patients with cleft lip and palate, the advancement of maxilla is limited by scar tissue having formed in the palate region and for various other reasons. The concept of orthognathic surgery involving distraction osteogenesis has already been established. The first patient reported on have had cleft palate and maxillary hypoplasia, skeletal mandibular prognathism, open bite and mandibular asymmetry who was treated by a two-Jaw surgery. The second patient who had cleft lip with severe maxillary hypoplasia and skeletal mandibular prognathism was treated with maxillary distraction osteogenesis. Satisfactory facial profile and occlusal condition were obtained, suggesting that Le Fort I osteotomy and distraction osteogenesis of the maxilla using the subcutaneous device could be a useful method in patients with cleft lip and palate.

We report on a 22 years old female patient who underwent orthodontic treatment after mandibular distraction osteogenesis. The mandibular distraction osteogenesis was used successfully to treat the patient's obstructive sleep apnea syndrome which was due to mandibular micrognathia. The orthodontic treatment was carried out to resolve the crowding of the front teeth that remained after the distraction osteogensis. Resolution of the crowding was achieved by the lateral expansion of the maxillary dental arch and the distal movement of the molar into the mandibular dental arch. No mandibular relapse was observe after the distraction osteogensis. The sleep apnea syndrome remained well controlled during the orthodontic treatment.

One of the most important aspects of secondary bone grafting is to allow for the closure of a cleft defect and provide a more ideal arch form orthodontically, without any prothesis. Recovery of the form and function by teeth movement to the bone grafted site was possible, if such anomaly was not severe. It was difficult to reconstruct the alveolar cleft, if large anomalies, such as missing teeth, existed. Almost all severe cases had previously received prosthodontic treatment. This study evaluated the dental occlusion pattern affecting resorption of the transplanted bone. A total of 107 alveolar bone graftings were performed in our clinic between 1994 and 2002. The age range at the time of bone grafting was 8 to 25 years. Results: Dental occlusion was performed in 50 (47.0%) out of 107 cases after bone grafting and was classified into 7 categories as follows : 14 cases of only orthodontic space closure with canine or lateral incisor, 11 cases with canine or lateral incisor and bridgework, 4 cases with canine or lateral incisor and partial denture, 8 cases of only partial denture, 2 cases with canine or lateral incisor and application of an implant, 4 cases of only bone grafting, 7 cases of unknown occlusion. Dental occlusion after bone grafting is important from the perspective of a team approach for cleft lip and palate patients.

Neurilemmoma occurs m all parts of the body, but occurrence in the oral and maxillofacial regions is relatively rare. In the oral and maxillofacial region, tumors usually arise on the tongue and rarely on the lip. The upper lip especially is a rare site of occurrence. Recently, we treated a case of neurilemmoma located in the upper lip. The patient, a 48-year-old woman, visited our hospital with a complaint of a mass formation on the left side of the upper lip. Excision of the tumor was done under local anesthesia. Up on examination under the light microscopy, it was found to be Antoni A type neurilemmoma. In addition, immunohistochemical study using S-100 protein antibody showed a positive reactivity in the tumor cell. There was no evidence of recurrence 6 months after the operation.

Oral surgeons sometimes encounter patients with foreign bodies in their jaws who undergo dental treatment. Occasionally it is difficult to extract them. This paper reports a rare case of a displaced dental implant into the maxillary sinus. An 83-year-old man was referred to our department for a displaced dental implant. Radiographs showed a displaced dental implant in the left maxilla. We removed the dental implant from the maxillary sinus under local anesthesia. The patient recovered uneventfully with no evidence of sinus infection.