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Objective To elucidate the details of impalement injuries of the oral soft tissue in children caused by toothbrush, we present a clinico-statistical study of those encountered in a single institution. Patients and methods Children below 13 years old, who visited our oral surgery clinic with the complaint of an impalement injury of oral soft tissue from December of 2001 to August of 2008, were included. Results Among two hundred and thirty oral soft tissue injuries, toothbrush (73 cases) was the most frequent object, followed by a stick-like object (51 cases) and eating utensils (27 cases). In toothbrush injuries, the 1-year-olds were most affected and the frequency in boys and girls was 30 cases and 43 cases, respectively. Soft palate (31 cases) was the most frequent site, followed by buccal mucosa (17 cases) and gingiva (7 cases). All of the injuries occurred when the children were in standing position and a fall was the most frequent cause ( p Conclusion Toothbrush was the most frequent object responsible for impalement injuries. Caution must be taken while managing a toothbrush injury with a wide laceration to avoid advanced infection. To prevent toothbrush injuries, we recommend that children should use a toothbrush in sitting position.

Angina bullosa hemorrhagica (ABH) is an oral mucosal blood blister that develops without blood dyscrasia or vesiculobullous disorder. Although a minor mucosal trauma has been suggested as a triggering factor for ABH, its etiopathogenesis, especially the causative role of systemic conditions, is largely unknown. We investigated the presence or absence of local factors as well as systemic background disease in 16 patients with ABH arising in the soft palate. All the lesions were solitary, and 75% of them (n = 12) appeared during the ingestion of hard or crispy food. With regard to underlying systemic conditions, hypertension was the most common (n = 6), and asthma, insomnia, diabetes mellitus, rheumatoid arthritis, gastrointestinal disorder and hyperuricemia were also recorded (n = 1 each). Five patients had no significant background disease. There were no recalcitrant or recurrent cases. In conclusion, the present study has revealed that scratching of the oral mucosa during eating plays an important role in the formation of ABH. Hypertension appears to be the most frequent background condition, but its pathogenic relationship with ABH remains speculative, as hypertension is fairly common in adults. (J. Oral Sci. 50, 33-36, 2008)

Clinicopathological studies and flow cytometric analyses were performed for 62 cases of odontogenic keratocyst obtained from the file of the Department of Oral and Maxillofacial Surgery, Nihon University School of Dentistry between 1984 and 1998. The Patients ranged in age from 12 to 74 years, and the peak incidence was in the third decade. The male: female ratio was 1.5: 1. Cysts were most frequently found in the third molar region, including the ramus. Most cysts were found incidentally on radiographic examination and appeared as unilocular, smooth bordered, radiolucent lesions. Most lesions were less than 4cm in diameter. Impacted teeth were found in 24 of 70 cysts, and 18.6% of the cysts were associated with root resorption of neighboring teeth. When classified according to the keratin type of the cyst-wall epithelium, most cysts were type II (58.5%).Flow cytometric analysis was performed for lining epithelial cells isolated from paraffin embedded specimens. Nuclear staining was done with Ki-67 antibody. The Ki-67 antigen labeling rate of odontogenic keratocysts was significantly higher (7.9±5.7%) than that of radicular cysts (2.9±1.3%). The number of cysts with a high Ki-67 antigen labeling rate was higher in type III than in the other three groups. We found a significant correlation between the Ki-67 antigen labeling rate on flow cytometry and the Ki-67 antigen positive cell rate on immunohistochemical examination. An advantage of flow cytometric analysis is that it can precisely enumerate proliferating cells of odontogenic keratocysts.

中国チベット自治区の1軒の民家における屋内外の自然放射線の照射線量率を測定した。宇宙線線量率とγ線線量率を見る限り, 屋内線量率はそれぞれ3群に分類できた。すなわち, 第1群は2階部分, 第2群は1階入口の部屋, 第3群はその他の1階部分である。第1群の平均宇宙線線量率は4.079nC/kg/h (15.81μR/h) , 平均γ線線量率は4.515nC/kg/h (17.50μR/h) であった。一方, 第3群の平均宇宙線線量率は2.740nC/kg/h (10.62μR/h) , 平均γ線線量率は5.284nC/kg/h (20.48μR/h) であった。第3群の宇宙線線量率が第1群より低かったのは, 第3群の方が第1群より建築材料によって宇宙線が余分に遮蔽されたからだと考えることができた。第3群のγ線線量率が第1群より高かったのは, 第3群の方が第1群より大地に近いこと, および石 (1階の壁材) が土 (2階の壁材) よりも天然放射性核種の濃度が相対的に高かったからであると考えることができた。第2群は宇宙線線量率およびγ線線量率ともに第1群および第3群のほぼ中間の値であった。また, 高地チベット民家屋内外の自然放射線の空気吸収線量率を求め, 世界各国の屋内外の自然放射線の空気吸収線量率と比較した。

To examine the expression of p53 protein and gene alterations in oral epithelial lesions including epithelial dysplasias and primary squamous cell carcinomas, immunohistochemical and temperature gradient gel electrophoresis (TGGE) methods were applied to formalin-fixed and paraffin-embedded tissues. Morphologically normal mucosal epithelium stained negatively for p53 protein. Three out of 11 (27.3 per cent) epithelial dysplasias and 19 out of 57 (33.3 per cent) primary squamous cell carcinomas stained positively for p53 protein. Although more than half of the cases were positive for p53 protein in stage I, the positive cancer cases were found at other stages with variable frequency. Immunoreactive products were localized in the nucleus, especially in the basal and suprabasal layers. The analysis by TGGE revealed gene alterations in exons 5-8 in 3 out of 3 epithelial dysplasias and 17 out of 19 (89.5 per cent) primary squamous cell carcinomas which were immunohistochemically positive for p53 protein. These results suggest that p53 gene mutation may be involved in carcinogenesis in the oral squamous epithelium even in the early stage of the dysplasia-carcinoma sequence.

The treatment of closed jaw locking due to temporomandibular joint (TMJ) arthrosis is described. Conventional mandibular manipulation of the lower and/or upper joint compartments was performed using hydraulic pressure from an imaging X-ray medium. The procedure was used in 40 patients with closed locking (5 acute and 35 chronic). The results of the treatment are evaluated and factors affecting the results are examined. In four of the five patients with acute closed locking, the lock was successfully released after use of the pumping technique on the lower joint compartment. In patients with chronic locking, an average improvement of 6.6 mm in the degree of interincisal opening was observed within 3-4 days of treatment with the pumping technique. In 13 of these patients, satisfactory opening (at least 40 mm) was achieved immediately. All the patients underwent further forward and contralateral manipulation to assist mouth opening, and after a period of 2-3 months 16 patients showed a further average improvement of 5.4 mm in interincisal opening.

The expression of ras-P21 protein and gene alteration of the K-ras gene were examined in 12 cases of pleomorphic adenoma of the salivary gland. The tumor cells in all 12 cases were strongly stained for ras-P21 protein by the indirect immunoperoxidase method, suggesting the enhanced expression of ras-P21 protein in pleomorphic adenomas. Analysis of the PCR products for the K-ras gene by temperature-gradient gel electrophoresis (TGGE) revealed that gene alterations such as point mutations occurred in 4 out of 12 pleomorphic adenoma tissues examined.

Calcium phosphate cement (CPC) consisting of Ca4 (PO4)2O and CaHPO4 (2H2O) was recently developed. This study evaluated in vivo aspects of CPC and CPC mixtures compared to those of commercial hydroxyapatite (HP) and several endodontic materials: Grossman's cement (GC), calcium hydroxide-iodine paste (CHP) and gutta-percha plate (GP). Biocompatibility of subcutaneous implants in Donryu rats was evaluated after one month. Results showed very slight inflammatory reactions from CPC, CPC mixtures and HP. The materials were surrounded by thin fibrous connective tissues with a small number of lymphocytes and plasma cells. Severe inflammatory reactions were provoked by GC. Granulation tissues induced by CHP resembled those of pseudoxanthomatous granuloma. The GP material was encapsulated by relatively thick fibrous connective tissues with little inflammatory reactions.

We reported three cases of lymphoepithelial cyst which arise on the base of the tongue.These cases were three females of 44, 50, and 54 year olds.Histological examination of all three cases exhibited representative lymphoepithelial cyst.The cyst was lined with squamous epithelium, and lymphoid tissues with particular germinal center appeared beneath the lining epithelium.Immunohistochemical analysis for the lymphoid tissues revealed that T cells existed in the cystic wall and mantle zone of the lymphoid follicle, while B cells mainly accumulated in the germinal center.A large number of immunoglobulin containing cells were found between the lining epithelium and follicles, which IgG containing cells were seen most frequently. Anti-lysozyme positive cells were found just under the epithelium.These results suggest that an antibody production of lymphocytes occured directly against localized antigens from lumen or secondary infection.

Fibrosarcoma is a rare non-epithelial malignant tumor in the oral cavity. We describe a case of intraosseous fibrosarcoma of the mandible in a 37-year-old man. Diffuse swelling of the left side of the mandible and hypesthesia of the left side of the lower lip were present. X-ray examination revealed a poorly defined radiolucent lesion in the left side of the mandible. Histologically, the tumor was composed of atypical spindle cells resembling fibroblasts. There was no evidence of metastasis to the regional lymph nodes. Histopathological examination indicated that the tumor arose within the central portion of the mandible. There has been no evidence of recurrence as of 4 years 6 months after surgery.

A peripheral calcifying odontogenic cyst (PCOC) was observed in a 9 year-old Japanese boy. The patient visited our hospital with a chief complaint of swelling on the palatal aspect of the oral mucosa. He had felt the slowly growing lesion without pain for 3 months. Physical examination showed a firm submucosal mass approximately 1 cm in diameter in the palatal mucosa between the maxillary right central and lateral incisors. Based on clinical data, the lesion was thought to be an epulis; however, histological examination revealed a calcifying odontogenic cyst (COC). Follow-up examinations for over 1 year indicated no recurrence of the tumor. Although many cases of COC have been reported, this is the first case of PCOC in Japan suggesting racial differences in the incidence.

We reported here a case of Lymphoepithelial cyst arising at the ventral surface of the tongue in a 34 year old male.Histopathological examination revealed that the cyst was composed of fibrous tissue, thin squamous epithelium and lymphoid tissue with a prominent germinal center. This case was considered to be a typical, oral lymphoepithelial cyst.We also examined the distribution of immunoglobulins, T and B cells and lysozyme.Immunohistological examination revealed that immunoglobulin-positive cells (IgG, IgA and IgM) were distributed between the lining epithelium and lymphoid tissue with a variation in number. Localization of lysozyme-positive cells was similar to that of immunoglobulin-positive cells. Similar to tonsil and lymph node, B cells were observed in the cap area and medulla of lymphoid tissue while decreased numbers of T cells were found in fibrous connective tissue beneath the lining epithelium.

Autologous blood injection around the articular capsule and/or into the articular cavity, which is one of the treatments for recurrent temporomandibular joint dislocation, was recently reintroduced. Here, we present the management of recurrent temporomandibular joint dislocation by autologous blood injection in an 84-year-old female. After the treatment, although the right condylar process had settled just beneath the articular tubercle, the dislocation had improved and the patient was able to close her mouth without difficulty.

Spindle cell carcinoma is considered a subtype of squamous cell carcinoma that has a sarcomatoid appearance. In the head and neck region, cases of spindle cell carcinoma of the larynx have occasionally been reported. However, spindle cell cacrcinoma of the maxillary sinus is extremely rare. We describe a case of spindle cell carcinoma of the maxillary sinus in a 53-year-old woman. Surgical treatment was performed under the clinical diagnosis of a maxillary neoplasm. During the operation, a biopsy specimen was taken, and the histopathological diagnosis was a spindle cell carcinoma. The lesion was removed under general anesthesia. Radiotherapy and chemotherapy were additionally given to prevent recurrence and metastasis of the tumor.There has been no evidence of recurrence as of 5 years 6 months after surgrey.

The patient was a 48-year-old man with an unusual papillary tumor of maxillary sinus origin extending from the left premolar to the right molar region of the maxilla. Clinical examination suggested that the tumor was malignant, because of repeated recurrence and extensive bone destruction. The tumor was removed en bloc after chemotherapy with pepleomycin, which was ineffective. Histopathological examination revealed an inverted papilloma with moderate atypism.Immunohistochemically, p53, Ki-67, and PCNA were positive in tumor cells. The labeling indices of these markers were between those of leukoplakia and squamous cell carcinoma. This is the first reported case of inverted papilloma of the maxillary sinus with extension into the oral cavity.

Suppurative arthritis usually occurs by hematogeneous dissemination of an infection localized in some other organ of the body. Much less frequently, bacteria may invade the joint either by direct spread of a neighboring infection or through a perforating injury. We reported an unusual case of suppurative arthritis in the left temporomandibular joint of a 53-year-old woman. The arthritis presented after a certain period after tooth extraction of the left lower 2nd molar tooth, and detachment of the cartilage cap. The joint was surgically removed because of resistance to long-term antibiotic therapy.

We describe a case of unicystic ameloblastoma in the left lower wisdom tooth region in a 16-year-old girl. Clinical examinations showed typical features of a dentigerous cyst. Although a lining epithelium was observed in the unicystic lesion, tumor nests characteristic of an enamel organ were also present as lining epithelial elements, and island-like and mass-like regions of ameloblastoma were found in the connective tissue of the cystic wall. Small amounts of calcified materials were noted in the tumor nests. These findings suggested that this case was an unusual unicystic ameloblastoma derived from the epithelium lining a follicular detal cyst.

We report a case of neurofibroma that was considered to be a solitary lesion at the left submandibular region.A 44-year-old female patient complained of swelling at the left submandibular region. Her physique and nutritive status were good and there were no signs of dermal abnormalities. An elastic hard tumor, the size of the tip of the forefinger was detected by paplation at the left submandibular region.The clinical diagnosis was a benign tumor of the left submandibular region. The tumor was surgically resected under local anesthesia.The result of histopathological examination was neurofibroma. Although almost one year has passed since the operation, there has been no evidence of recurrence.

A 14-year retrospective study was performed on 47 odontomas from the files of the 1st Department of Oral and Maxillofacial Surgery at Nihon University School of Dentistry. Fifty-seven percent of the patients were male and 42.6% were female. The age distribution was 8 to 48 years with a mean age of 22 +/- 9.0 years. There were no particular symptoms associated with the odontomas, and 63.8% of our patients had no symptoms. However, 12 patients complained of swelling and 9 of pain. The tumor was found in the maxilla in 42.6% and in the mandible in 57.4%. According to the WHO histological type classification, 53.2% of the tumors were classified as compound odontoma and 46.8% as complex odontoma. The size of the tumor ranged from 5 mm to 42 mm in diameter. The average complex odontoma was much bigger than the average compound odontoma. Ghost cells were found 11 cases in our series. In addition, odontogenic epithelium was found in 16 cases. Twenty seven patients had impacted teeth in association with odontoma and 24 of the 27 teeth were removed at the time of surgical enucleation of the tumor, while 3 cases were treated by orthodontically assisted eruption. There was no recurrence in any of the studied cases.

A reciprocating bone file has been developed to facilitate access to the medial surface of the mandibular ramus by avoiding trauma to the medial soft tissues and consequent bleeding prior to performing a sagittal osteotomy. This report describes the technique.

From 1970 to 1996, 129 cases of intraoral minor salivary gland tumors were diagnosed at the Department of Pathology, Nihon University School of Dentistry. The diagnosis of each case was based on the 1991 WHO classification. Eighty benign and 49 malignant minor salivary gland tumors were found in the approximately 9,300 oral biopsies submitted during the 27-year period. Pleomorphic adenomas were the most commonly histologic type of the benign tumors identified and 51% of the malignant tumors were diagnosed as mucoepidermoid carcinoma. The most common primary location of the tumors was the palate. Sixty percent of all tumors occurred in females and the peak age for incidences of all tumors was found in the third, fourth, sixth and seventh decades. These results were compared with those of the studies in different world population groups.

We carried out a detailed total body examination of a 62-year-old woman with osteoporosis who had bilateral defects in the mandibular processes. It was inferred that the defects in both articular heads were caused by resorption of small bone fragments following fracture. The quantity of bone salt was determined by microdensitometry, and a diagnosis of osteoporosis was then established. An improved bite was obtained by treatment consisting of tooth extraction and the preparation of partial dentures.

It has been well documented that various kinds of cytokines secreted from immunocytes in the lamina propria of glandular tissues play an important role in the secretory immune system.1,2 The presence of polymeric Ig receptor, SC in glandular tissues, B cell terminal differentiation factor, IL-6 in keratinocytes and carcinoma cells, and a potential IgA switching factor, TGF-β in various epithelial cells has been reported3,4,5, but little is known on the role of cytokines secreted from epithelial cells in the secretory immune system. It has been described that the synthesis of SC protein in adenocarcinoma cell line, HT-29 is up-regulated by IFN-γ, TNF-α, and IL-4.6,7,8 Our previous study also indicated that mRNA expression for SC and IL-6 was detected in HT-29 and the squamous cell carcinoma cell line, Ca9-22.9

Three rare cases of calcifying odontogenic cyst are reported here: in addition to the radiological and histopathological studies.Case 1. In the mandibul of a 9-year-old girl.(E-E)Case 2. In the maxilla of a 19-year-old male.(7-2)Case 3. In the maxilla of a 35-year-old female.(123)Radiologically, all cases showed a few radiopaque structures inside the cystic radiolucent areas. Case 1 and 2 had impacted teeth.Histopathologically, odontoid or tooth germ structures were adjacent to the epithelium of cyst in case 1.

Pleomorphic adenoma is a common Tumor in salivary gland Sheldon has originally proposed the term “myoepithelioma” to the tumors exclusively composed of basket cells in his study on so-called mixed tumor. There are two types of tumor cells derived from myoepithelial cells. One type is hyaline (plasmacytoid) cell, other type is spindle cell. We have examined a case of so-called myoepithelioma exclusively composed of hyaline cells in soft palate of 57 year-old female. In this paper we described clinicopathological feature of so-called myoepithelioma.

Although the rat is often used in experiments on bone transplantation, very few immunohistochemical studies on the distribution and proportions of lymphocyte subpopulations and subsets in rat lymphoid organs have been performed, in comparison with other animals. A preliminary immunohistochemical investigation using the immunofluorescence and avidin-biotin-peroxidase complex methods was therefore undertaken to clarify this aspect in various lymphoid organs taken from rats.The results obtained were as follows : 1. Ia-positive cells largely indicative of B cells were localized in the lymphoid follicles of lymph nodes, follicular areas of Peyer's patches and non-periarteriolar lymphatic sheath (PALS) areas of the spleen.2. T cells were densely distributed in the lymphoid pulp of lymph nodes, interfollicular areas of Peyer's patches and PALS areas of the spleen.3. Helper T-and asialo GM1-positive cells were localized in the lymphoid pulp of lymph nodes, interfollicular areas of Peyer's patches and spleen red pulp. The numbers of positive cells with these phenotypes were smaller than those of Ia-and pan T-positive cells.4. These results indicate that the distribution and proportions of lymphocyte subpopulations and subsets in rat lymphoid organs are generally similar to those of other animals such as the mouse.

We recently experienced two cases of relatively rare bilateral submandibular sialolithiasis, which are describe in ditail in this paper.Case No.1 was a 26-year-old male having a swollen submandibular region of the left only X-ray films showed a presence of salivary stone not only in the left but also in the submandibular. Both stones could be surgically removed from the oral cavity.Case No.2, a 20-year-old female, attended our department with a chief complant of diffuse swelling of the left submandibular. Symptoms appeared only in the left side but subsequent X-ray films showed a presence of salivary stone in both sides. However, neither of stones could be removed surgically.The structures of both right and left salivary stones were observed in the former case using a scanning electron microscopy.Both right and left stones were consisted of three layers (center core, laminated structure outer layer), showing a remarkable difference in the center core and outer layer between two stones.

A rare case of oral tuberculosis seen in a 47 year-old female is described. The slightly hard mass occured in the mucobuccal fold corresponding to the upper left molar and premolar region was found by intraoral examinations.Histological examination revealed tuberculous granuloma.The patient was given antituberculous drugs and the mass was resected. The patient is well without recurrence 33 months after operation.

A case of myospherulosis in a 67-year-old female is reported. The lesion appeared as a submucosal mass firmly attached to the buccal periosteum of the right molar region of the mandible. Although the records of our case did not specify what medication was placed in the lesion, clinicopathologic features further supported the hypothesis that myospherulosis may be a unique instance of iatrogenic disease caused by petrolatum-based antibiotic ointments.

A case of calcifying epithelioma arising from Regio parotideomasseterica in a 27-year-old man is presented.Reports of calcifying epithelioma from oral surgeons are rare, and we could review only 9 cases in the literature in Japan.As a parotid gland origin tumor was doubted clinically because of the location, we removed the tumor with Pars superficialis parotideus.

Two cases of oral focal mucinosis are described. Both were diagnosed clinically as fibroma of the gingiva. The clinical and histopathologic features of this unusual lesion are discussed.

The authors devised a new method for making a maxillary prosthesis with a hollow obturator, which was named the Balloon Technique. This new technique has a number of advantages over the conventional method in that it not only facilitates the molding of a soft plastic hollow obturator in a single process, but also simplifies the trial fitting of the completed obturator. Furthermore, it makes possible firm adhesion of the hollow obturator and the denture base by the hot-melt method while the denture base resin is cured. Finally, the completed maxillary prosthesis is extremely light.