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This clinical report discusses a custom made tray used for fabrication of the superstructure of early load implants. The activities of the dental technician impressions and bite taking simultaneously in implant operations. The results of the observations led to the manufacture of a custom made tray with a duplicate denture made from the full denture used. The bite-seating impression was performed with the custom made tray, and the superstructure was installed in four treatment days. The progress is excellent, and the patient expresses satisfaction with the result. As a result of this study, it was possible to made the bite-seating impression by the full denture in use. After the operation, the superstructure could be made in a short time. Only very small adjustments of the vertical dimension and horizontal position were necessary because the custom made tray made from a duplicate denture.

We provide sedation and general anesthesia in the clinical department of dental anesthesia when requested for disabled patients for dental treatment, such as mental disabilities, dental phobias, gag reflexes, or dementia. This reports two cases of the induction of sedation and general anesthesia that provided relief for the patient and the accompanying persons. The two catients were mentally-disabled, and they were administered behavior therapy in cooperation with their guardians. It became possible to have the patients enter the room for dental ambulatory anesthesia at the clinical department and perform self-induction of sedation and anesthesia, and the dental treatments that were planned became possible. As a result, it was possible to provide dental treatment that was satisfactory to patients, guardians, and the family dentists of the patients.

On the basis of the dental examination of 503 first grade pupils (250 boys and 253 girls) at elementary school form 1993 to 1998 in Shiroishi, Sapporo and questionnaires to the mothers concerning nursing methods, dietary habits, tooth brushing habits, etc., factors associated with dental caries were investigated (deciduous canine and deciduous molar : C-M dmft). The Mann-Whitney U test, chi-square test, and the first class of Hayashi's quantification methods carried out discriminant analysis. The were slightannal decrease in the C-M dmft index, DMFT index, C-M dmft person rate, and DMFT person rates. 2. These were significant differences in the C-M dmft and the items "order of birth", "age at end of weaning", "frequency of between-meals", "watching TV at meals", "mother's experience of dental caries", "experience of fluoride application", "understanding of child's oral condition". 3. There was multicollinearity in some items, these relationships were surveyed and correlation between items was established. Further analysis excluding the multicollinearity showed the items causing primary canine and molar dental caries. 4. The factors associated with deciduous canine and molar dental caries prevalence were "understanding of child's oral conditions", "mother's experience of dental caries", "age at end of weaning", "experience of fluoride application", "order of birth", "frequency of between meals", "watching TV at meals" adn so on in order of partial correlation coefficients. The findings showed that dental caries of schoolchildren were affected by the mother's nursing attitude towards the child.

A case of ameloblastoma is reported. A 21-year-old male was referred to the hospital with the chief complaint a swelling in the second molar area of the left mandible. Radiographic examination showed a large radiolucent area from the left lower first molar to the middle ramus with impacted wisdom tooth and root resorption of the second molar. A clinical diagnosis of benign tumor in the mandible was made and biopsy, deflation and extraction of the impacted tooth carried out. A histopathological diagnosis of ameloblastoma (follicular type) was made. After bone formation in the bony cavity, enucleation of the tumor performed with extraction of the second molar. Dredging was applied twice over six months. Histophath ologically, no tumor cells were found in the dreged tissue. The mandible maintains normal contour and function and no signs of recurrence were found at the 2 year 8 month follow-up, examination.

Subcutaneous emphysema is a rare complication in the dental practice, including oral surgical procedures. This paper presents a case of intra-operative face and neck emphysema accompanied with double vision. A 23-year-old male was referred to our department for the removal of a horizontally impacted third molar of the mandible. The surgical procedure was performed under local anesthesia. During the separation of the tooth crown from the root, the patient complained of swelling of the right face and neck. Just after the operation, diffuse swelling of the right face and neck with a cracking or crepitant feeling on palpation was seen. In addition, double vision was noticed. The lesion was diagnosed as subcutaneous and intraorbital emphysema, and preventative antibiotic was administrated. The double vision disappeared three days after the surgery and the swelling disappeared completely after seven days.

This study is evaluatin clinical of amalgam bonded with adhesive resin (4-META/MMATBB) in primary molars. The subjects were 3 to 10 year old 34 children who visited the clinic of a general practitioner in Sapporo. A total of 46 cavities (Class II) in primary molars were erstoerd with amalgam bonded with adhesive resin. These restorations were evaluated for wear, marginal fractures, body fractures, fracture of teeth, pulp sensitivity, missing , and secondary caries. The results up to 24 months were as follows : 1) There were no post-operative pain, hypersensitivity to cold, or mastication pain. 2) There was one case of attrition of marginal restorations after 6 months, and one each was after 9 months, 12 months, 15 months 18 months, and after 24 months. 3) These was one marginal tooth fracture after 6 months, one ofter 18 months, and one after 21 months. There were no cases of fractures of the restorative body, falling materials, or of secondary caries. It is suggested that the adhesive amalgam technique is be very useful for restoring primary molars.

We report a extremely rare case of adenomatoid hyperplasia of the minor mucous salivary gland in a 53-year-old Japanese male. The patient had painless swellimg in the right junction of the hard-soft palate. The pathological findings and etiology of this complaint were discussed.

This reports a case of Trigemmy 5 minutes from the beginning of administration of 1/200,000 epinephrine in 2% Lidocame Hydrochlonde in preparation for tooth extraction in an aged dental patient with circulatory complaints at intravenous sedation. The electrocardiogram before operation indicated previous heart infarction (ST elevation, Abnormal Q wave, Left ventricular hypertrophy) of the 77-year old, male. As anesthetic premedication, 12 mg of Diazepam was administered orally. When the patient was admitted to the operating room, he was sedated well, but these were signs of premature ventricular contraction (PVC), five times/mm. Diazepam was administered intravenously (6 mg/3 mins), and sedation was achieved. Trigemmy continued for 4 minutes trom 5 minutes after the administration of 40μg epinephrine Lidocame Hydrochloride was administered (10 mg×5 times) intravenously for arrhythmia Tngeminy disappeared, but these was sporadic PVC (16 times/min), PVC occurred once a min 2 hours after the end of the operation. The epmephrme (40 μg) gave rise to occurred arrhythmia in spite of safe injection speed and safe dosage. This suggests a desirable dosage of epinephrme of less than 30 jug for aged dental patients with circulatory complaints. It is also suggests that dentists should pay attention to relax patients when using premedication or sedation to ensure the effect of the treatment.

Injured teeth are commonly encountered in daily clinical work. This report a case of 7-year 10-month old boy with traumatically shedded upper bilateral central incisors with immature roots. These teeth were replanted. We observed the progress after treatment for 9 con-secuitive years. The results are as follows: 1. Incisors' roots were observed to grow in spite of the absence of Hertwig's epithelial sheath and death of pulp tissue. 2. The apexification of roots occurred even traumatically injured replanted tooth with immature roots. 3. The teeth were in anklylosis and absorption. This is thought to be caused by twice traumatic injuies and tongue habit. From above results, when a traumatically shedding tooth with immature root was replanted. Then, it should be provided apexification using calcium hydroxide, and the bad oral habit should be also corrected.

A case of an idiopathic bone cavity is presented and discussed. The patient was a 54-year-old Japanese male with a history of stomach carcinoma operation and hospitalization two years ago. He was referred to the Department of Dental Radiology with a panoramic radiograph performed by the dentist. The panoramic radiograph demonstrated a well-defined elliptical radiolucent lesion near the right angle of the mandible, situated below the mandibular canal and slightly above the inferior border of the mandible. The patient stated that the lesion progressed asymptomatically without any sensation. From the lesion was indicated, the patient was greatly anxious about metastasis of stomach carcinoma to the mandible. To define the diagnosis of the lesion, intraoral radiography, extraoral radiography, tomography, and sialography were carried out. All results showed that the lesion was an idiopathic bone cavity without relationship to salivary gland tissue. No biopsy was carried out, but the lesion was diagnosed to be benign, and a metastatic carcinoma was ruled out.

A 71-year-old male, dental aged outpatient with consciousness disorder showed a decrease of in blood pressure and ST depression in the electrocardiogram (ECG) while muscle trimming. He has diabetes and hypertension that have been controlled by an other hospital. These was being abnormal during dental treatment and minor oral surgery. We received an emergency call from the dentist of the patient. We arrived with in 90 seconds and found him lying and moaning, without vomiting or dyspnea. It was difficult to establish the radial arterial pulse of carotid arterial pulse, the blood pressure was 77 mmHg systolic, 62 mmHg diastolic. The heart rate was a regular sinus rhythm at 52 beats/min; the respiratory rate was 10 cycles/min; body temperature 36.2℃. The ECG finding would have been ST depression, and we started nitroglycerin infusion (1.2/μg/kg/min), as these were the possibility of an angina attack or cerebrovascular disorder. The patient was sent to a neurological surgery hospital. He had angina spasms 4-days after admission and was admitted at a cardiovascular hospital. A close, medical examination led to a final diagnosis of medium vasospastic angina. This episode was first angina attack for this patient. We conclude that dental treatment of aged outpatients has to be careful and needs to be administered carefully.

A case of odontogenic fibroma of the right mandible in a 15-year-old male patient is reported. The patient came to a dental clinic because of pain at the right mandibular first molar, and X-ray radiography showed a cystic lesion around the crown of the impacted third molar, which implied a dentigerous cyst. Histopathologically, the lesion consisted of fibrous tissue with proliferation of fibroblasts and collagen fibers in which foci of odontogenic epithelial-like cells were observed. The lesion was diaernosed as a central odontoerenic fibroma.

Recently severe infections in the oral and maxillofacial regions are rare because of advances in antibiotics. However, in aged persons, such infections are still sometimes seen. We have experienced a case of severe phlegmon in the facial-temporal region in an aged person. The patient was an 88 year-old-male who came to our clinic due to swelling of the facial-temporal region. The history was that, 10 days before he visited us, pain in the left lower canine region and swelling of the left cheek had started, and these symptoms had progressed and the swelling gradually spread to the facial-temporalregion. The clinical features showed severe swelling in the left facial-temporal region, fluctuations in the left cheek and trismus was diagnosed. X-ray findings showed a radiolucent area in the apical region of the left lower canine. The lesion was diagnosed as a phlegmon in the facial-temporal region with cheek abscess. Antibiotics were administered and incisions were performed. After one week an abscess was formed in the left temporal region, and incision was also carried out here. The inflammatory findings except for trismus disappeared within 7 weeks. Subsequently mouth opening exercises gave excellent results.

A case of leiomyosarcoma of the stomach in a 66-year-old male is reported. The patient was admitted to our hospital because of pain in the upper abdomen as the chief complaint. The tumor mass was located in the greater curvature and measured 11×8.5×5cm, with a large central ulcer, and it had invaded the pancreas and spleen. Histopathological examination revealed tumor cells that formed spindle bundles arranging perpendicular to each other and which had a low mitotic index. The tumor cells as well as smooth muscle cells were stained with red color by Masson's trichrome staining, which was clearly distinguished from the connective tissue stained with blue. Muscle actin staining was demonstrated in normal and neoplastic smooth muscle cells by immunohistochemical methods. Electron microscopic observation showed that the neoplastic cells contained a large nucleus and abundant cytoplasmic organelles, and a paucity of microfilaments. From light and electron microscopic findings, we diaenosed leiomvosarcoma arising from the stomach.

Adlloy-OH was developed as a surface modification material for precious metal adherend. Excellent adhesion of dental adhesive materials to precious metal alloys is realized by the simple application of Adlloy-OH. For dental clinical applications in the fields of conservative and prosthetic dentistry, Adlloy -OH was clinically tested in Higashi-Nippon-Gakuen University Dental Clinic in accordance with the guide lines designated by the Ministry of Public Welfare. The clinical investigation of Adlloy-OH performed over more than 6 months showed the following results: (1) Good adaptability of casting to tooth was maintained. (2) Good occlusion of casting was maintained. (3) No subjective sympton appeared and objective symptons were not observed. (4) There were no side effects. (5) Procedures and handling times were suitable for dental clinical applications. The results show that Adlloy-OH is very effective in dental clinical applications.

In recent years, surgical orthodontic treatment for mandibular protrusion cases has been done prosthetically with improvement of surgical orthodontics in Japan. But on the other hand, not a few patient have refusal feeling about surgical treatment. Here, we wish to report 2 cases of patients treated for mandibular protrusion solely by Begg technique with excellent results who originally would have been treated by surgical orthodontics.

Mandibular prognathism with poor devedopment of the upper jaw was subjected to maxilla by Le Fort I osteotomy, and simultaneously the lower jaw to maxilla by sagital splitting (Obwegeser-Dal pont) osteotomy, resulting in a simultaneous two jaw surgery correction. The prognosis was satisfactory and facial shape recovered well.

A case of dentigerous cyst filling the maxillary sinus in an 11-year-old boy is presented. Radiographically the cyst involved the crown of the right maxillary second premolar and occupied the whole maxillary sinus. In addition, 8 - 3 with incomplete root apex formation were in contact with the cyst with exception of 5. In this case the remaining deciduous second molar was extracted and a surgical drain was inserted through the extraction wound. This procedure resulted in the gradual shrinking of the cyst, allowing the cyst to be removed surgically. Subsequently the maxillary second premolar was treated by orthodontic procedures. At the one and a half year review, 5 3 had erupted at the normal position.

A 75-year-old female reported to our hospital complaining of numerous nodules on the oral mucous membrane. Oral examination revealed an enlarged tongue with multiple nodules on the lateral surfaces and yellow soft excrescences on the undersurface. The buccal and labial mucosa was noted to have numerous nodules. Further examination resulted in a diagnosis of generalized primary amyloidosis.