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The aim of this study was to investigate the condition of the maxillary lateral incisors and evaluate the methods used for cleft closure in patients with cleft lip and palate, including the treatment of the maxillary lateral incisors. A total of 214 patients (260 clefts) with alveolar clefts who had started Phase II treatment and entered the maintenance period at the Department of Orthodontics at Tokyo Dental College, Chiba Hospital, between 1975 and 2014 were included. Panoramic, intraoral, and occlusal radiographs, as well as intraoral photographs and medical records, were used to investigate cleft classification, the presence or absence and location of maxillary lateral incisors, and frequency and treatment method for peg lateral incisors in the cleft region. There were more unilateral cleft cases (78.5%) than bilateral cleft cases. The prevalence of congenital absence of the maxillary lateral incisors was similar between unilateral (53.0%) and bilateral cases (53.3%). Peg laterals occurred frequently, with 89.9% occurring in unilateral cases. The maxillary lateral incisors were more commonly found in the secondary than in the primary palate. The number of non-extraction cases was larger than that of extraction cases, regardless of cleft type or the location of the peg laterals. In many cases, the peg laterals were treated with non-extraction and space closure or crown modification. These results suggest that, depending on their condition, the peg laterals should be preserved as much as possible in devising a treatment plan.

The postgraduate training course at the Department of Orthodontics of Tokyo Dental College, which started in April 1975, comprises a 3-year curriculum aimed at fostering orthodontic specialists. A system of Accreditation for Orthodontists was introduced by the Japan Orthodontic Society in 1990, since which time, this postgraduate training course has also sought to provide the basic training required to obtain such certification. The purpose of this study was to investigate the demographics of the students on this course and the current work status of its graduates by means of a questionnaire-based survey. The results revealed that, when the fortieth intake of students graduated in March 2017, the total number completing the course had reached 326. The annual mean number of students on this course was 8.2, and recent years have seen a marked increase in the number of women enrolling. In total, 37.5% of the questionnaire respondents had opened orthodontic clinics; 14.8% had opened general dentistry clinics; and 42.6% were working as employees. In addition, 46.2% had an additional place of employment other than their principal place of employment, mainly at a general dentistry clinic. Regarding the field of treatment, 82.4% provided solely orthodontic treatment. We believe that this may because all the responders had completed the postgraduate orthodontics course. The rate of earning accreditation as an orthodontist was high (82.4%), with no difference in the rate of acquisition between men and women. The rate of qualification as a Board-certified orthodontist was 17.9%, with the rate of acquisition by women approximately half of that by men. The number of female orthodontists is rising, and no difference was observed between sexes in the rate of acquiring accreditation as an orthodontist. Women were found to be lagging behind men, however, in regard to the rate of advancement to masters/PHD programs; qualifying as a Board-certified orthodontist; opening an orthodontic practice; and number of days worked. These findings suggest that there are differences in regard to the actual working conditions among the alumni of our postgraduate orthodontic training course, and that these differences are sex-based.

Since the fee for orthodontic treatment of malocclusion caused by cleft lip and palate (CLP) became covered by national health insurance in 1982, orthodontic treatment from school age has become the norm. However, in some CLP patients, orthodontic treatment is commenced in adulthood. A number of studies have reported on orthodontic treatment in adult CLP patients. The purpose of this study was to clarify the number and age of new patients, chief complaint, referral status, cleft type, malocclusion, history of orthodontic treatment, and acceptance and planning of orthodontic treatment. The study investigated new CLP patients aged over 18 years who visited the Department of Orthodontics, Suidobashi Hospital of Tokyo Dental College, between April 1, 2001 and March 31, 2006. During the investigation period mentioned above, 235 new CLP patients visited our department. Among them, 23 were aged over 18 years, accounting for 9.8% of the 235 CLP patients. In terms of chief complaint, occlusion-related complaints and occlusal dysfunction accompanying malocclusion were noted in 14 cases (61%). Eighteen patients were referrals. Unilateral CLP was the most prevalent cleft type. In terms of malocclusion type, reversed occlusion was noted in 13 cases (57%), accounting for over half of all cases. Patients with a previous history of orthodontic treatment accounted for half of all cases. Ten patients accepted orthodontic treatment. In terms of treatment plan, surgical orthodontic treatment was planned in 10 cases.

We witnessed outbreaks of multidrug-resistant (MDR) and drug-resistant Pseudomonas aeruginosa at a hospital in Tokyo, Japan, during the period September 2004 through May 2005. The first outbreak occurred in September and October 2004. Three isolates of MDR P. aeruginosa were identified from urine samples obtained from three nonambulatory immunodeficient patients in one ward. After 3 weeks, another outbreak of P. aeruginosa occurred in the hematology ward on the same floor of the hospital. During the outbreaks, environmental surveys were conducted twice in each of the two wards, at 2-week intervals, to identify the sources of the pathogens. A total of 23 P. aeruginosa isolates, including 11 from environmental sources, were analyzed for chromosomal DNA typing by pulsed-field gel electrophoresis, for O-antigen serotyping, and for other typing. Results revealed two causative clones, as well as environmental contamination by P. aeruginosa clones on the surfaces of urine volume-measuring devices in rooms where urine is handled, which may have been sources of the pathogens during the outbreaks. To prevent further outbreaks, we performed the following: (a) environmental surface monitoring for drug-resistant P. aeruginosa, (b) active surveillance of specimens, (c) strict isolation of infected patients or carriers of MDR P. aeruginosa, (d) rigorous contact precautions, and (e) disinfection with 70% alcohol on the surfaces of apparatuses contaminated by MDR or drug-resistant P. aeruginosa and in the rooms where urine is handled. As a result, the outbreaks were contained.