Language：Japanese   Publisher：(一社)日本口腔診断学会  

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To determine the usefulness of lymphocyte-to-monocyte ratio (LMR), neutrophil-to-lymphocyte ratio (NLR), platelet-to-lymphocyte ratio (PLR), and inflammatory response biomarker (IRB) score for predicting disease-specific survival and delayed cervical lymph node metastasis in early-stage oral squamous cell carcinoma (OSCC). We retrospectively analyzed 72 patients with early-stage OSCC. Receiver operating characteristic curve analysis was used to determine the cutoff values for LMR, NLR, and PLR. IRB score was determined as follows: high LMR, high NLR, and low PLR, which were each rated as 1. These scores were added to obtain IRB score (range: 0-3). From univariate analysis, gender, poor mode of invasion, and high IRB score were identified as significant risk factors for disease-specific survival. However, there were no independent factors for poor prognosis in multivariate analysis. On the other hand, for delayed cervical lymph node metastasis, poor mode of invasion, low LMR, high NLR, high PLR, and high IRB score were identified as significant risk factors from univariate analysis, and in multivariate analysis, poor mode of invasion and high IRB score were confirmed as independent risk factors. IRB score and mode of invasion are potentially independent risk factors for delayed cervical lymph node metastasis in early-stage OSCC.

DOI： 10.1097/MD.0000000000030855

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Language：English   Publishing type：Research paper (scientific journal)  

Cytology is a simple and non-invasive screening method for oral cancer. However, this method is not yet routinely used by clinicians because of its high false negative rate (FNR) and due to lack of sufficient studies examining the factors for high FNRs. The present retrospective study aimed to compare the screening performance of conventional cytology (CC) and liquid-based cytology (LBC) through histological validation, and to elucidate factors inducing false negative screening in oral cytology. Cytological specimens with histological examination and intraoral digital images of the lesion were retrospectively collected between January 2017 and December 2018 for CC and between October 2019 and September 2021 for LBC. Oral cytological screening was conducted based on the oral Bethesda system for oral cytology. Clinical subtypes were re-evaluated using intraoral digital images. The screening accuracy of oral cytology was calculated considering the sensitivity, specificity, positive predictive value (PPV) and negative predictive value (NPV) for detecting the malignant transformation of oral lesions. No statistically significant difference was noted in the inadequate rate between CC and LBC groups. For CC and LBC, the sensitivities were 60.9 and 59.2%, the specificities were 87.3 and 79.1%, the PPVs were 85.8 and 76.2%, and the NPVs were 63.9 and 63.2%, respectively. Thus, the screening accuracy was similar between methodologies. Among the clinicopathological factors investigated, histological diagnosis and cellularity contributed to false negative results. Homogeneous findings of oral epithelial dysplasia and the superficial growth of carcinoma in situ/squamous cell carcinoma resulted in false negative findings for CC and LBC. Furthermore, LBC samples with a lower cell number (<2,000 squamous cells) exhibited statistically significantly increased FNRs. The present study found that the cytological methods did not affect the inadequate rate and screening accuracy, whereas clinical subtype and cellularity decreased screening accuracy. Therefore, cytological screening and subsequent follow-up should be performed while considering clinical findings and the cellularity of cytology smears.

DOI： 10.3892/ol.2022.13505

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Publishing type：Research paper (scientific journal)   Publisher：Elsevier BV  

DOI： 10.1016/j.oooo.2022.07.007

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Language：Japanese   Publisher：(NPO)日本顎変形症学会  

Orthognathic Quality of Life Questionnaire(OQLQ)日本語版を作成し、その信頼性と妥当性を検証した。顎変形症初診患者22名(男性2名、女性20名、平均20.1±8.7歳)から回答を得た。言語的妥当性について対象者はすべて15分以内に回答を終えていた。用いた言語については「咀嚼という言葉が少し分かりづらかった」との指摘が2名からあったが回答はできており、すべての質問の回答率は100%であった。項目テスト相関係数は-0.01から0.68であった。口腔機能(OF)に相関が低い質問項目があったが、各質問項目のCronbachのα係数は0.79〜0.82といずれも高く、口腔機能を示す質問も内的整合性は良好であった。また、SF-8の身体的サマリースコアとそれに関連する下位尺度の相関係数は-0.428〜0.004であり、OQLQのOFと相関を認める下位尺度があったが、その他三つの要素との関連は認めなかった。開発した日本語版OQLQは顎変形症患者の疾患関連QOLの尺度として信頼性があり、妥当性もあると考えられた。

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Other Link： https://search-tp.jamas.or.jp/index.php?module=Default&action=Link&pub_year=2022&ichushi_jid=J03047&link_issn=&doc_id=20220510230003&doc_link_id=1390573407618666496&url=https%3A%2F%2Fcir.nii.ac.jp%2Fcrid%2F1390573407618666496&type=CiNii&icon=https%3A%2F%2Fjk04.jamas.or.jp%2Ficon%2F00003_3.gif

Language：Japanese   Publisher：(一社)日本口腔診断学会  

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Authorship：Corresponding author   Language：English   Publishing type：Research paper (scientific journal)   Publisher：Ovid Technologies (Wolters Kluwer Health)  

RATIONALE: Melanocytic neuroectodermal tumor of infancy (MNTI) is a rare benign pigmented neoplasm that arises from the neural crest and has an aggressive growth pattern. It is predominantly seen in infants under 1 year of age, and the most common site of involvement is the maxilla. The currently accepted treatment is removal by surgical resection. Herein, we report a case of MNTI that involved the anterior alveolar ridge of the mandible in a 6-month-old infant. PATIENT CONCERNS: A case of a 6-month-old male child with a huge mass in the anterior alveolar ridge of the mandible. DIAGNOSIS: The tumor was diagnosed using histopathological and immunohistochemical techniques on the biopsy specimen obtained following incisional biopsy. Based on the findings, a final diagnosis of MNTI was established. INTERVENTIONS: Radical resection of the tumor was performed, after determining the extent of resection by referring to the mandibular 3D model created using the pre-operative CT data. OUTCOMES: The postoperative course was uneventful, and no recurrence has been observed to date for more than 4 years after surgery. LESSONS: This case emphasizes that early diagnosis and radical surgery are critical to the effective treatment, as MNTI exhibits rapid and destructive growth. It also requires careful and close follow-up because of high recurrence rates.

DOI： 10.1097/md.0000000000028001

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Publishing type：Research paper (scientific journal)   Publisher：Elsevier BV  

DOI： 10.1016/j.tranon.2021.101236

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DOI： 10.1016/j.adoms.2021.100157

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DOI： 10.1016/j.adoms.2021.100184

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Language：English   Publishing type：Research paper (scientific journal)   Publisher：Elsevier BV  

Pontin and Reptin are closely related proteins belonging to the AAA+ (ATPases Associated with various cellular Activities) family. They form a hetero-oligomeric complex, Pontin/Reptin, which is involved in protein stability and assembly of the protein complexes as a molecular chaperone. Overexpression of Pontin and Reptin in tumor cells has been reported and is implicated in the development of various cancers. However, the molecular mechanism of Pontin/Reptin function in oral squamous cell carcinoma (OSCC) development remains unclear. Here, we identify HEAT repeat-containing protein 1 (HEATR1) as a novel binding factor of Pontin/Reptin. Functionally, HEATR1 stabilizes Pontin/Reptin and positively regulates OSCC cell proliferation by activating mTOR and pre-rRNA synthesis. We also find that HEATR1 expression is markedly upregulated in tumor region of OSCC tissue. Hence, we propose that HEATR1 is involved in the regulation of mTOR and ribosome biogenesis as a potential protein stabilizer of Pontin/Reptin in OSCC.

DOI： 10.1016/j.bbrc.2021.04.021

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Authorship：Corresponding author   Publishing type：Research paper (scientific journal)   Publisher：Elsevier BV  

DOI： 10.1016/j.adoms.2021.100057

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Language：Japanese   Publisher：(公社)日本口腔外科学会  

52歳女。舌の違和感を主訴に近医を受診し、右側舌腫瘍を指摘された。他院のMRIで腫瘍性病変を認められ、当科での加療を勧められて来院した。右側舌下面粘膜下に15×15×15mm大の比較的境界明瞭な弾性硬の腫瘤を認めた。画像所見からは腺系腫瘍が示唆され、良悪性を含めた病理組織学的診断目的に生検を行ったが、組織型の確定には至らず、舌癌の診断のもと全身麻酔下に舌部分切除術を施行した。切除標本の病理組織所見は、淡明細胞の胞巣状増殖が主体ながら、粘液産生を示す二相性腺管がわずかに混在していたことから、鑑別疾患として筋上皮癌、上皮筋上皮癌、多型腺癌、明細胞癌が挙げられた。免疫染色によって筋上皮癌、上皮筋上皮癌、多型腺癌は否定され、EWSR1遺伝子のFISH解析によって明細胞癌も否定されたため腺癌NOS(not otherwise specified)と診断した。術後4年の現在まで再発・転移は認めていない。

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Other Link： https://search-tp.jamas.or.jp/index.php?module=Default&action=Link&pub_year=2020&ichushi_jid=J01073&link_issn=&doc_id=20201130470003&doc_link_id=10.5794%2Fjjoms.66.553&url=https%3A%2F%2Fdoi.org%2F10.5794%2Fjjoms.66.553&type=J-STAGE&icon=https%3A%2F%2Fjk04.jamas.or.jp%2Ficon%2F00007_3.gif

Language：Japanese   Publisher：(一社)日本口腔内科学会  

患者は60歳の女性で、右側上顎の疼痛を主訴に受診した。当科受診7年前に他院で左側舌縁部扁平上皮癌の診断で舌部分切除術と術後放射線治療を受けていた。当科初診時、右側上顎、左側頬粘膜、下顎唇側歯肉に腫瘍性病変を認め、生検の結果3部位とも扁平上皮癌の診断であった。右側上顎骨部分切除術、左側頬粘膜部腫瘍切除術および下顎骨辺縁切除術を施行したが、原発巣の再発と頸部転移を認め、制御不能となり当科における初回手術から3年後に永眠された。(著者抄録)

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Other Link： https://search.jamas.or.jp/index.php?module=Default&action=Link&pub_year=2019&ichushi_jid=J06061&link_issn=&doc_id=20190716300002&doc_link_id=10.6014%2Fjjsom.25.10&url=https%3A%2F%2Fdoi.org%2F10.6014%2Fjjsom.25.10&type=J-STAGE&icon=https%3A%2F%2Fjk04.jamas.or.jp%2Ficon%2F00007_3.gif

Language：Japanese   Publisher：(一社)日本口腔内科学会  

造血器悪性腫瘍に対する造血幹細胞移植後に慢性GVHDや二次がんを発症することがある。今回末梢血幹細胞移植後に舌癌を発症した1例を経験した。患者は57歳、女性。41歳時に急性骨髄性白血病に対し化学療法、同種末梢血幹細胞移植を施行後、慢性GVHDを発症。治療後16年経過し舌側右側縁に扁平上皮癌を認め加療を行った。造血器悪性腫瘍加療後は、主疾患治療後も長期の口腔内の経過観察の継続が必要である。(著者抄録)

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Other Link： https://search-tp.jamas.or.jp/index.php?module=Default&action=Link&pub_year=2018&ichushi_jid=J06061&link_issn=&doc_id=20190121100004&doc_link_id=10.6014%2Fjjsom.24.46&url=https%3A%2F%2Fdoi.org%2F10.6014%2Fjjsom.24.46&type=J-STAGE&icon=https%3A%2F%2Fjk04.jamas.or.jp%2Ficon%2F00007_3.gif

Language：English  

Background: The free vascularized fibula flap presents many advantages such as sufficient length of the bony segment, good vascularization, better quality of the bone, and a long vascular pedicle, but it is also associated with some disadvantages with regard to prosthetic rehabilitation because of its limited height. Improvement in bone height is necessary for ideal dental implant treatment of reconstructed mandibles. Case presentation: For two squamous cell carcinoma patients, mandibular bone reconstruction was performed secondarily with the peroneal flap after tumor resection. Since the bone height was insufficient at the time of implant treatment, occlusion reconstruction by dental implant was performed after vertical distraction osteogenesis. Conclusions: Vertical distraction osteogenesis is a suitable treatment option for alveolar ridge deficiency resulting from fibula transplantation for mandibular reconstruction following tumor surgery.

DOI： 10.1186/s40902-018-0172-2

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Language：Japanese   Publisher：日本口腔顎顔面外傷学会  

症例は67歳女性で、運転中にトラックと衝突して受傷した。口腔外所見では眼瞼周囲から顎下部にかけてび漫性の腫脹、上唇の裂傷、鼻腔からの持続的な出血を認めた。口腔内所見では、上顎両側小臼歯間での歯肉裂創と裂創部からの持続的な出血、上顎両側小臼歯部間と、下顎左側小臼歯部の開放骨折、左上中切歯、右下犬歯の歯の完全脱臼、右上第1大臼歯の破折を認めた。CTでは上顎洞内と鼻腔内に多量の液体貯留を認め、鼻骨、頬骨、上顎骨、蝶形骨と下顎骨の骨折を認めた。顎顔面の裂創と骨折以外は保存的治療の方針となった。到着8時間後、DICと診断した。DICからの脱却と循環動態の安定を目的に輸血を行った。口腔内からの出血は徐々に軽減したが、骨折部位で出血が持続していることが示唆された。受傷後10日目に骨折部位での止血と骨片の整復咬合の再構築を目的に、観血的整復術を行った。上顎整復時には顎間固定を行ったが複数個所にわたる骨折と多数歯の欠損により中心咬合位の完全な再現は困難であった。39日目に退院となった。術後6ヵ月経過し、良好な顔貌と咬合関係を得られている。

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Language：English   Publishing type：Research paper (scientific journal)   Publisher：Elsevier Ltd  

Double lip is a rare anomaly characterized by hyperplastic mucosal tissue. It may occur either congenital or acquired. Surgical treatment, carried out under either local or general anesthesia, is indicated for cosmetic reasons and produces good functional and cosmetic results. Several surgical methods have been used, such as transverse elliptical excision, W-plasty, electrosurgical excision. Post-operative recurrence is rare. The present report describes a rare case of post-surgery recurrent double upper lip, necessitating a second operation. A literature review presents the origin of this anomaly, the method of surgery, and the histology of the double lip, and the two operations are compared.

DOI： 10.1016/j.ajoms.2017.11.010

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BACKGROUND: Mandibular reconstruction is performed after segmental mandibulectomy, and precise repositioning of the condylar head in the temporomandibular fossa is essential for maintaining preoperative occlusion. METHODS: In cases without involvement of soft tissue around the mandibular bone, the autopolymer resin in a soft state is pressed against the lower border of the mandible and buccal and lingual sides of the 3D model on the excised side. After hardening, it is shaved with a carbide bar to make the proximal and distal parts parallel to the resected surface in order to determine the direction of mandibular resection. On the other hand, in cases that require resection of soft tissue around the mandible such as cases of a malignant tumor, right and left mandibular rami of the 3D model are connected with the autopolymer resin to keep the preoperative position between proximal and distal segments before surgical simulation. The device is made to fit the lower border of the anterior mandible and the posterior border of the mandibular ramus. The device has a U-shaped handle so that adaptation of the device will not interfere with the soft tissue to be removed and has holes to be fixed on the mandible with screws. RESULTS: We successfully performed the planned accurate segmental mandibulectomy and the precise repositioning of the condylar head by the device. CONCLUSIONS: The present technique and device that we developed proved to be simple and useful for restoring the preoperative condylar head positioning in the temporomandibular fossa and the precise resection of the mandible.

DOI： 10.1186/s40902-017-0113-5

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J-GLOBAL

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J-GLOBAL

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Language：Japanese   Publisher：THE JAPANESE SOCIETY FOR JAW DEFORMITIES  

Peripheral facial nerve palsy following orthognathic surgery is a rare complication. We discuss the incidence of this complication, its possible causes, subsequent treatment and ultimate outcomes.<br>A total of 910 patients underwent orthognathic surgery in our department during the period from 2001 to 2015. Five (0.55%) of those patients had peripheral facial nerve palsy postoperatively. The postoperative day when facial nerve palsy occurred ranged from day 1 to day 13. All of the cases were unilateral and included lip motility disturbance, difficulty in closing the eyes and inability to wrinkle the forehead. All of the patients received medication with an adrenocortical steroid and vitamin B₁₂. Stellate ganglion block and physical therapy were also used for the patients who had moderate to severe facial nerve palsy. Complete recovery was achieved in all but one of the patients, in whom slight palsy remained. There were several possible causes of facial nerve palsy including abnormal bleeding, postoperative swelling, and handling of operating instruments.<br>In conclusion, peripheral facial nerve palsy after orthognathic surgery is relatively rare. If it occurs, however, complete recovery can be expected in most cases.

DOI： 10.5927/jjjd.26.237

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Language：Japanese   Publisher：THE JAPANESE SOCIETY FOR JAW DEFORMITIES  

Hyperplasia of the mandibular coronoid process is a clinical condition that causes an indolent trismus by elongated coronoid processes that impinge on the zygomatic medial surface when opening the mouth. We report a case of hyperplasia of the mandibular coronoid process which was progressive temporally and was treated by bilateral coronoidectomies.<br>A 10-year-old boy consulted our department with a complaint of mouth opening limitation. Maximum mouth opening (MMO) between upper and lower incisors was 20mm. Based on the image findings a diagnosis of hyperplasia of the mandibular coronoid process was made, but he and his parents did not desire treatment. Thereafter, his trismus progressed temporally and he visited our department again for treatment of hyperplasia of the mandibular coronoid process at 15 years old. The image findings showed that both enlarged coronoid processes had extended above the zygomatic arch. Bilateral coronoidectomies were performed through an intraoral approach under general anesthesia at 16 years old, and the intraoperative MMO was 50mm. Training with a mouth opening training device was started seven days after surgery, but MMO at 17 days after surgery was only 19mm. Self-training of mouth opening was continued and MMO at 15 months after surgery was 34mm. On the other hand, new island-shaped bone formation in areas of resected coronoid processes was observed on CT images three months after surgery, and the bone fragments were enlarged and connected on CT images 12 months after surgery. Therefore, continued follow-up is required for this patient.

DOI： 10.5927/jjjd.26.214

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J-GLOBAL

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J-GLOBAL

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Language：English   Publishing type：Research paper (scientific journal)   Publisher：Elsevier Ltd  

Objective: This study was conducted to investigate the changes in maximum lip closing force and craniofacial morphology following orthognathic surgery. Methods: The subjects were 36 female patients with skeletal Class III malocclusions and 12 female patients with skeletal Class II malocclusions in whom dentofacial deformities had been surgically corrected. The control group consisted of 25 females with normal occlusion. Maximum lip closing force was measured with a strain-measuring device before surgery and 2 weeks, 6 months and 1 year after surgery. Skeletal morphologies were evaluated using lateral cephalograms taken before and immediately after surgery. Results: Mean maximum lip closing force in the Class II group was significantly lower than that in the Class III group but not significantly different from that in the control group, and correlation analysis between maximum lip closing force and cephalometric analysis items suggested that patients with protrusive maxilla and long face pattern have lower lip closing force. Maximum lip closing forces in Class II and III groups at 1 year after surgery were significantly larger than that before surgery and not significantly different from that in the control group. There was no significant difference between maximum lip closing forces in one-jaw and two-jaw surgery groups. Conclusion: Patients with protrusive maxilla and long face pattern have lower lip closing force, and orthognathic surgery improves maximum lip closing force regardless of the surgical procedure.

DOI： 10.1016/j.ajoms.2014.04.010

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Language：English   Publishing type：Research paper (scientific journal)   Publisher：SPRINGER  

Expression of keratin (K) 13 is replaced with that of K17 when squamous cells of the oral mucosa transform from normal and dysplastic epithelia to carcinoma in situ (CIS) and squamous cell carcinoma (SCC). Since 14-3-3 sigma is functionally associated with K17, we examined possible relationships between expression of K17 and 14-3-3 sigma in oral CIS and SCC tissues by immunohistochemistry. We furthermore examined whether or not K17 expression or knockdown by small interfering RNA (siRNA) modulates the behavior of SCC cells in culture in terms of cell proliferation and migration. In tissue specimens of oral SCC and CIS, the pattern of cytoplasmic expression of 14-3-3 sigma and K17 was similar but neither was expressed in normal or dysplastic epithelia. Both proteins were demonstrated in the cytoplasm of control oral SCC ZK-1 cells, but expression of 14-3-3 sigma changed from cytoplasmic to nuclear upon knockdown of K17. In carcinoma cells, therefore, cytoplasmic localization of 14-3-3 sigma seems to accompany expression of K17. In K17-knockdown cells, proliferation was significantly suppressed at 4 days after seeding. In addition, the cell size of K17-knockdown cells was significantly smaller than that of control cells; as a result of which in the migration experiments, we found delayed closure of scratch wounds but migration as such was not affected. We conclude that K17 expression promotes SCC cell growth and cell size but does not affect cell migration. K17 expression is accompanied by cytoplasmic expression of 14-3-3 sigma, indicative of their functional relationship.

DOI： 10.1007/s00428-015-1735-6

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Language：Japanese   Publisher：Japanese Society of Oral and Maxillofacial Surgeons  

Sarcoidosis is a multisystemic noncaseating epitheloid cell granulomatous disorder of undetermined etiology. It most often affects the lungs, but rarely occurs in the jaw bones. We report a case of sarcoidosis that developed in the mandible.<br>A 39-year-old woman was referred to our department to remove the right mandibular first molar because of severe caries. Multiple cervical lymph nodes were palpated in the right side of the neck. Impaired wound healing was noted after tooth extraction. Contrast-enhanced computed tomography （CT） demonstrated an osteolytic lesion in the right lower molar region and enlarged, homogenously enhanced lymph nodes in the right side of the neck. For systemic investigations, thoracic and abdominal CT scanning was performed. These examinations revealed bilateral pulmonary hilar, mediastinal, para-aorta, and hepatic portal lymphadenopathies. The suspected diagnosis was sarcoidosis or malignant lymphoma. Lymphadenectomy of the right cervical region and biopsy of the lesion of the mandible were performed to confirm the definitive diagnosis. Histopathologically, both specimens revealed noncaseating epitheloid cell granulomas. Thus, the final histopathological diagnosis was sarcoidosis. There was no evidence of disease progression 5 years after diagnosis.

DOI： 10.5794/jjoms.60.348

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Language：English   Publisher：WILEY-BLACKWELL  

Background: The aim of this report was to evaluate the outcome of autotransplantation or replantation of cryopreserved teeth clinically and radiographically. Donor teeth were slowly frozen in a controlled-rate freezer using 5% dimethylsulfoxide (DMSO) and 6% hydroxyethyl starch (HES) as protectants. Seven cryopreserved teeth, with duration of storage ranging from 4 to 36 months, were autotransplanted or replanted at Niigata University Medical and Dental Hospital. Endodontic treatment involving root canal debridement followed by interim root canal filling with calcium hydroxide was started 3 weeks after the operation and continued with replacement of the calcium hydroxide filling at 2-week to 3-month intervals. Three transplants showed periodontal regeneration clinically and radiographically, whereas replacement root resorption was observed in the remaining transplants. From the results, it can be concluded that cryopreserved tooth autotransplantation has potential for clinical use; however, the risk of replacement root resorption remains.

DOI： 10.1111/edt.12039

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Language：English   Publishing type：Research paper (scientific journal)   Publisher：Elsevier Ltd  

Objective: Adenoid cystic carcinoma (ACC) is an aggressive tumor and characterized by late development of distant metastases (DM). The aim of study was to analyze the clinicopathological predictors of DM in ACC and to determine survival after the development of DM. Methods: Thirty patients with ACC treated by surgery and/or radiotherapy were included. The impact of clinicopathological factors on DM was assessed. Factors included primary site, T stage, histological growth pattern, surgical margin, perineural invasion (PNI), postoperative radiotherapy (PORT) and local recurrence. The median follow-up was 62 months (range, 3-267 months). Results: Twenty-four patients have relapsed local and/or distant metastases. The most common pattern of tumor relapse was DM, which developed in 17 patients. The 5-year, 10-year, and 15-year disease-free survival rate was 46%, 19%, and 15%, respectively. The positive surgical margin was significantly associated with DM rate. Neither primary site, T stage, histologic growth pattern, PNI, PORT nor local recurrence influenced on DM rates. The median survival period after the detection of DM for lung metastasis alone or bone and others were 47 months and 19 months, respectively (P= 0.03). Conclusions: ACC develops DM frequently even without locoregional recurrences. Only the status of surgical margins showed an association with the occurrence of DM. The survival of patients developing DM is significantly associated with the site of metastases and better in patients with lung compared to bone and other organs. A multimodality treatment approach including chemotherapy and molecular targets therapy is warranted to treat distant metastatic disease. © 2013 Asian AOMS, ASOMP, JSOP, JSOMS, JSOM, and JAMI.

DOI： 10.1016/j.ajoms.2013.09.013

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Language：English   Publishing type：Research paper (scientific journal)   Publisher：CHURCHILL LIVINGSTONE  

Mandibular setback reduces space in the pharyngeal airway, and it has been suggested that it might induce sleep-disordered breathing. We report on its effects on space in the pharyngeal airway and respiratory function during sleep. We studied 78 patients (29 men and 49 women) in whom skeletal class III malocclusions had been corrected. The mean (range) age at operation was 24 (16-38) years and body mass index (BMI) 21.4 (16.1-30.9) kg/m(2). Morphological changes were evaluated on lateral cephalograms taken three times: preoperatively, a few days postoperatively, and more than 6 months postoperatively. Overnight arterial oxygen saturation (SpO(2)) was measured by pulse oximetry 6 times: preoperatively, and on days 1, 3, 5, and 7, and 6 months postoperatively; oximetric indices were calculated. Those immediately after mandibular setback were significantly worse than those preoperatively, although they gradually improved. There were positive correlations between BMI and oximetric indices, and little association between changes in mandibular position and oximetric indices. There was no evidence of sleep-disordered breathing 6 months after mandibular setback because most patients adapt to the new environment for respiratory function during sleep. However, some (particularly obese) patients may develop sleep-disordered breathing just after mandibular setback. In such patients attention should be paid to respiratory function during sleep in the immediate postoperative period, and careful postoperative follow-up is needed. (C) 2012 The British Association of Oral and Maxillofacial Surgeons. Published by Elsevier Ltd. All rights reserved.

DOI： 10.1016/j.bjoms.2012.07.004

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Language：English   Publishing type：Research paper (scientific journal)   Publisher：WILEY-BLACKWELL  

Objective The aim of this study is to characterize immunohistochemical profiles of lining epithelia of nasopalatine duct cyst (NPC) as well as to correlate those findings with their clinicopathological features to understand the histopathogenesis of NPC. Materials and methods Forty-one surgical specimens from NPC were examined for clinical profiles and expression of keratin-7, 13, MUC-1, and P63 by immunohistochemistry, compared to radicular cyst (RC) and maxillary sinusitis. Results Nasopalatine duct cyst was clinically characterized by male predominant occurrence: 44% of the cases involved tooth roots, and 70% with inflammatory backgrounds. Lining epithelia of NPCs without daughter cysts were immunohistochemically distinguished into three layers: a keratin 7-positive (+) ciliated cell layer in the surface, a keratin-13+ middle layer, and a MUC-1+/P63+ lower half, indicating that they were not respiratory epithelia, and the same layering pattern was observed in RC. However, those immunolocalization patterns of the main cyst lining with daughter cyst were exactly the same as those of daughter cyst linings as well as duct epithelia of mucous glands. Conclusions Two possible histopathogeneses of NPC were clarified: one was inflammatory cyst like RC and the other was salivary duct cyst-like mucocele. Oral Diseases (2013) 19, 415-424

DOI： 10.1111/odi.12022

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Language：Japanese   Publisher：THE JAPANESE SOCIETY FOR JAW DEFORMITIES  

The clinical efficacy of new resorbable plate and screw fixation devices (PLDG osteosynthesis system) for jaw stabilization in bimaxillary orthognathic surgery was evaluated in this study.<br>PLDG plates and screws were fabricated from a unique tripolymer which was a composite of poly L-Lactide/D-Lactide/Glycolide (PLDG) with a molecular ratio of 85/5/10. It was heated by immersion in hot sterilized water until it became plastic and was then fitted to the surface of the bone.<br>The skeletal stability after Le Fort I osteotomy and the bilateral sagittal split ramus osteotomy was evaluated on lateral cephalograms in 46 patients with mandibular prognathism.<br>The subjects were divided into three groups based on the types of osteosynthesis systems used. Group TI consisted of 22 patients in whom a titanium osteosynthesis system was used for bone fixation. Group LA consisted of 14 patients in whom the PLLA osteosynthesis system was used, and group DG comprised 10 patients in whom the PLDG osteosynthesis system was used for bone fixation at the bilateral border of the piriform aperture.<br>Lateral cephalograms were taken before surgery, immediately after surgery, and at least six months after surgery to examine the usefulness of bioresorbable osteosynthesis system for bone fixation in orthognathic surgery.<br>Changes in the positions of point A, ANS, point B and menton were examined in this study.<br>The postoperative changes of the maxilla and mandible were less than 1 mm on cephalograms except the horizontal changes at point B in group LA and group DG.<br>There was no statistical difference in the postoperative skeletal stability among the three groups.<br>The results of this study suggest that the PLDG osteosynthesis system is clinically useful since the system fits the bone surface tightly and maintains the postoperative skeletal stability.

DOI： 10.5927/jjjd.23.8

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Objectives: The purpose of this study was to determine the incidence of temporomandibular joint (TMJ) signs and symptoms in patients with dentofacial deformities and to assess longitudinally the changes in TMJ signs and symptoms after surgical orthodontic treatment. Materials and methods: The subjects consisted of 170 patients with dentofacial deformities. A combination of Le Fort I osteotomy and bilateral sagittal split osteotomies was used in 112 patients, bilateral sagittal split osteotomies were performed in 58 patients. The joints were examined clinically and by computed tomography. Results: TMJ signs and symptoms were recognized in 29.5% of the patients, and disk displacements and condylar bone changes were recognized in 22.1% and 13.4% of the joints, respectively. More patients with mandibular retrusion and asymmetry had TMJ signs and symptoms, disk displacements and condylar bone changes than those with mandibular prognathism. The incidence of TMJ signs and symptoms had significantly decreased to 12.1% at one year after orthognathic surgery, and there were no significant differences in the incidences of TMJ signs and symptoms among the types of dentofacial deformity. Conclusion: Surgical orthodontic treatment has a beneficial effect on TMJ signs and symptoms in most patients with dentofacial deformities. However, there is a risk of TMJ symptoms and signs developing in preoperative asymptomatic patients after orthognathic surgery though the risk is low. © 2012 Asian AOMS, ASOMP, JSOP, JSOMS, JSOM, and JAMI.

DOI： 10.1016/j.ajoms.2012.05.014

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Language：English   Publishing type：Research paper (scientific journal)   Publisher：SPRINGER  

It can be difficult to make a certain diagnosis in case of an oral borderline malignant lesion on hematoxylin-eosin-stained sections only. Furthermore, assessment of surgical margins of borderline lesions is difficult with the naked eye. We set out to determine the topographical distribution of capillary blood vessels within the epithelial zone and to assess its use as an aid for histopathological diagnosis and a framework for clinical assessment of lesional margins using optical techniques, such as narrow-band imaging (NBI) endoscopy. Capillary blood vessels entrapped in the epithelial compartment, which we have designated as intraepithelially entrapped blood vessels (IEBVs), were examined for their frequency, location, and shape in normal mucosa, dysplasia, and carcinoma in-situ (CIS) of the tongue using immunohistochemistry for CD31 and type IV collagen. When counted per unit length of epithelial surface, IEBVs increased in number significantly in CIS (5.6 +/- 2.8), which was two times more than in normal (1.9 +/- 1.6) and dysplastic (2.4 +/- 1.5) epithelia. In addition, IEBVs in CIS had compressed shapes with occasional obstruction or collapse with hemorrhage and were arranged perpendicular to and extending up to the epithelial surface. These characteristic IEBVs in CIS were considered to be generated by complex expansion of rete ridges due to carcinoma cell proliferation within the limited epithelial space determined by the basement membrane. The recognition of IEBVs was helpful in the differential diagnosis of oral CIS, and the present data provide a valuable frame of reference for detecting oral CIS areas using such NBI-based optical devices.

DOI： 10.1007/s00428-012-1224-0

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Language：English   Publishing type：Research paper (scientific journal)   Publisher：Elsevier Ltd  

Objectives: The aim of this study was to determine the effects of orthognathic surgery on middle ear condition assessed by tympanometry. Materials and methods: The subjects were 239 patients inwhomjaw deformities were surgically corrected. Bilateral sagittal split osteotomies were performed in 80 patients and a combination of Le Fort I osteotomy and bilateral sagittal split osteotomies was used in 159 patients. Tympanometry was performed before surgery and one day, three days, five days, seven days and nine days after surgery. Tympanometric peak pressure and static compliance were used to assess Eustachian tube function, and the tympanograms were divided into three basic types. Results: Tympanometric peak pressure significantly decreased one day after surgery and gradually recovered within nine days after surgery. Tympanometric peak pressure immediately after surgery in the two-jaw surgery group was significantly lower than those in the one-jaw surgery group. The percentage of normal tympanogram decreased immediately after surgery, especially in the two jaw surgery group, and gradually recovered by nine days after surgery. The percentages of normal tympanogram in the patients with ear symptoms were significantly lower than those in the patients without ear symptoms for the entire period. Conclusion: Orthognathic surgery, especially maxillary osteotomy, can cause Eustachian tube dysfunction, though it is mild and transient and requires no intervention in most cases. However, 13% of patients had Eustachian tube dysfunction at the end of the study. These results suggest the importance of careful monitoring middle ear condition in patients undergoing orthognathic surgery. © 2011 Asian Association of Oral and Maxillofacial Surgeons.

DOI： 10.1016/j.ajoms.2011.10.003

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Language：Japanese   Publisher：THE JAPANESE SOCIETY FOR JAW DEFORMITIES  

This study investigates the effects of sagittal split ramus osteotomy (SSRO) on condylar position and temporomandibular joint (TMJ) symptoms.<br>The subjects were 51 patients (13 males and 38 females) in whom mandibular protrusions were corrected by SSRO; they were divided into three subtypes on the basis of the lateral bone cut location. The joints were examined clinically for pain, sound and maximum interincisal opening before surgery and at least six months after surgery. Submentovertex radiographs were taken before and immediately after surgery. The changes in condylar position were assessed by measuring the condylar angle, intercondylar axes angle and distance between the centers of the condyles.<br>After SSRO, the condyles rotated inward (p < 0.01) on the axial plane, but the distances between their centers did not change significantly. TMJ signs and symptoms disappeared in four (31%) of the 12 symptomatic patients, worsened in one (8%) of the symptomatic patients and developed in three (8%) of the 39 asymptomatic patients six months after surgery. There were no significant differences in any of the parameters among the three subtypes of SSRO.

DOI： 10.5927/jjjd.21.225

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Language：English   Publishing type：Research paper (scientific journal)   Publisher：ELSEVIER SCIENCE BV  

To evaluate differential expressions for keratin (K) subtypes 13 and 17 in oral borderline malignancies, we examined 67 surgical specimens of the oral mucosa for their immunohistochemical profiles. From those specimens, 173 foci of epithelial dysplasia, 152 foci of carcinoma in situ (CIS), and 82 foci of squamous cell carcinoma (SCC) were selected according to our diagnostic criteria, along with 20 areas of normal epithelia. In normal epithelia, there was no K17 positivity (0%), whereas definite K13 positivity (100%) was observed. The same tendencies were obtained in mild (undefined) and moderate (true) epithelial dysplasias (K17: 0%; K13: 100%). In contrast, all CIS (100%) had K17 positivities, while K13 positivities were lost in many of them (7%). Similar tendencies were confirmed in invasive SCC (K17: 100%, K13: 4%). Simultaneous immunopositivities for K17 and K13 were found only in SCC (7%) and CIS (4%) foci with distinct keratinization. These foci also showed K10 positivities, though K10 positive areas were not identical to K13 positive areas. The results indicate that expressions of K17 and K13 are reciprocal in oral epithelial lesions and that the K17 emergence is related to malignancies. (C) 2011 Elsevier Ltd. All rights reserved.

DOI： 10.1016/j.oraloncology.2011.03.015

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Language：English   Publishing type：Research paper (scientific journal)   Publisher：KARGER  

Objective: Podoplanin, a known lymphatic endothelial cell marker, has been reported to be expressed in various types of cancer. To elucidate the expression of podoplanin in precancerous lesions, we examined the immunohistochemical profiles of podoplanin in oral squamous epithelial lesions. Method: We studied a total of 298 foci of squamous cell carcinoma (SCC), carcinoma in situ (CIS), epithelial dysplasia, and hyperplastic and/or normal epithelial lesions by immunohistochemistry using D2-40. Results: There was no positivity for podoplanin in normal or hyperplastic epithelia, while all of the CIS and SCC foci stained positive. Approximately one third of the mild dysplasia foci (10 of 36 foci, 28%) and 80% of moderate dysplasia foci (78/98) showed grade 1 positive reactions (positive only in the 1st layer). Grade 2 reactions (up to 4th layer) were seen in 4 of 98 moderate dysplasia foci (4%), 29 of 74 CIS foci (39%), and 3 of 30 SCC foci (10%). Grade 3 reactions (to more than 5th layer) were found in 35 (47%) CIS foci and 26 (87%) SCC foci. Conclusions: The relationship between the present histological categorization and podoplanin grade was statistically significant. D2-40 expression is considered to be related to the severity of oral precancerous lesions. Copyright (C) 2011 S. Karger AG, Basel

DOI： 10.1159/000324926

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Angiogenesis and lymphangiogenesis are essential requirements for tumor growth, invasion and metastasis. The vascular endothelial growth factor (VEGF) family, VEGF-A, VEGF-B, VEGF-C and VEGF-D, are thought to be specific potent angio- and lymphangiogenetic stimulators that may play an important role in tumor invasion and metastasis. Although it has been reported that the VEGF family is expressed in a variety of human tumors in different ways, their precise role in oral squamous cell carcinoma (OSCC) is not well understood. To obtain some clues as to this role, we evaluated the expression levels of the VEGF family in OSCC cell lines (HSC-2, HSC-3, HSC-4 and OSC-19) by using quantitative real-time PCR analysis and investigated the relationship with lymph node metastasis, distant metastasis and intratumoral micro vessel density (MVD) in tumor transplanted nude mice. All of the VEGF family were expressed at different levels in four OSCC cell lines. There were significant correlations between VEGF-A, VEGF-C expression and the incidence of lymph node metastasis and the ratio of MVD. These results suggest that VEGF-A and VEGF-C expression may be useful predictors for lymph node metastasis and implicated to treat patients with head and neck SCC for further aggressive therapy. © 2005, Japan Society for Head and Neck Cancer. All rights reserved.

DOI： 10.5981/jjhnc.31.84

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Other Link： http://search.jamas.or.jp/link/ui/2014161074

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