Language：English   Publishing type：Research paper (scientific journal)   Publisher：John Wiley & Sons Australia, Ltd  

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Authorship：Lead author   Publishing type：Research paper (scientific journal)  

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Publishing type：Research paper (scientific journal)   Publisher：MDPI AG  

(1) Background: In oral cancer staging, ultrasonography (US), computed tomography (CT), magnetic resonance imaging (MRI), and 2-deoxy-2-[fluorine-18]fluoro-D-glucose (FDG) with positron emission tomography/computed tomography (PET/CT) are routinely used in clinical practice. The present study is a retrospective examination of the diagnostic accuracy of cervical lymph node metastasis using US, CT, MRI, and PET/CT, with histopathological diagnosis as a reference, to compare the different diagnostic imaging modalities. (2) Methods: The participants included 16 patients with oral squamous cell carcinoma who underwent US-, CT-, MRI-, and PET/CT-based preoperative diagnostic imaging and simultaneous primary lesion resection and neck dissection, including 82 level regions and 424 lymph nodes. We compared the sensitivity, specificity, accuracy, positive predictive value, and negative predictive value of each imaging modality based on the imaging results and the pathology results of metastasis. (3) Results: Of the four diagnostic imaging modalities, PET/CT exhibited the highest sensitivity but the lowest specificity and accuracy. US, CT, and MRI had high specificities. Comparing each level region and lymph node showed that differences were observed in PET/CT. (4) Conclusions: PET/CT to diagnose lymph node metastasis requires a comprehensive evaluation because it produces more false positives than other diagnostic imaging modalities. Using US, CT, and MRI, which have excellent spatial resolution, improves diagnostic accuracy at the lymph node level.

DOI： 10.3390/biomedicines11123119

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Language：Japanese   Publisher：(一社)日本顎関節学会  

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Language：Japanese   Publisher：(一社)日本顎関節学会  

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Language：English   Publishing type：Research paper (international conference proceedings)  

DOI： 10.1007/s00520-023-07786-4

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Publishing type：Research paper (scientific journal)   Publisher：Springer Science and Business Media LLC  

Abstract

Background

Masticatory muscle tendon-aponeurosis hyperplasia (MMTAH) is a relatively newly identified clinical condition that manifests as trismus with a square-shaped mandible. Herein, we report a case of MMATH that was initially misdiagnosed for polymyositis due to trismus and simultaneous lower limb pain, with literature review.

Case presentation

A 30-year-old woman had a history of lower limb pain after exertion for 2 years. Initial physical examination had been performed at the Department of General Medicine in our hospital. There was also redness in the hands and fingers. Although polymyositis was suspected, it was denied. The patient visited our department for right maxillary wisdom tooth extraction.

Clinical examination revealed that the patient had a square-shaped mandible. The maximal mouth opening was 22 mm. There was no temporomandibular joint pain at the time of opening. Furthermore, there was awareness of clenching while working. Panoramic radiography revealed developed square mandibular angles with flattened condyles. Computed tomography showed enlarged masseter muscles with high-density areas around the anterior and lateral fascia. Magnetic resonance imaging also showed thickened tendons and aponeuroses on the anterior surface and inside bilateral masseter muscles. Finally, the patient was diagnosed with MMTAH. Bilateral aponeurectomy of the masseter muscles with coronoidectomy and masseter muscle myotomy was performed under general anesthesia. The maximum opening during surgery was 48 mm. Mouth opening training was started on day 3 after surgery. Histopathological examination of the surgical specimen showed that the muscle fibers were enlarged to 60 μm. Immunohistochemistry testing for calcineurin, which was associated with muscle hypertrophy due to overload in some case reports, showed positive results. Twelve months after surgery, the mouth self-opening and forced opening were over 35 mm and 44 mm, respectively.

Conclusions

Herein, we report a case of MMATH. Lower limb pain due to prolonged standing at work and overload due to clenching were considered risk factors for symptoms onset of MMATH.

DOI： 10.1186/s40902-023-00386-6

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Other Link： https://link.springer.com/article/10.1186/s40902-023-00386-6/fulltext.html

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

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

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

(1) Background: The impacts of metal artifacts (MAs) on the contouring workload for head and neck radiotherapy have not yet been clarified. Therefore, this study evaluated the relationship between the contouring time of the MAs area and MAs on head and neck radiotherapy treatment planning. (2) Methods: We used treatment planning computed tomography (CT) images for head and neck radiotherapy. MAs were classified into three severities by the percentage of CT images containing MAs: mild (<25%), moderate (25-75%), and severe (>75%). We randomly selected nine patients to evaluate the relationship between MAs and the contouring time of the MAs area. (3) Results: The contouring time of MAs showed moderate positive correlations with the MAs volume and the number of CT images containing MAs. Interobserver reliability of the extracted MAs volume and contouring time were excellent and poor, respectively. (4) Conclusions: Our study suggests that the contouring time of MAs areas is related to individual commitment rather than clinical experience. Therefore, the development of software combining metal artifact reduction methods with automatic contouring methods is necessary to reducing interobserver variability and contouring workload.

DOI： 10.3390/tomography9010009

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

The layered structures of facial muscles and their topographical relationship with facial fasciae are still not fully understood. This study aimed to clarify the layered structures of facial muscles and fasciae in the temporal-malar-mandible-neck region. Thirty-four human cadavers were examined during gross anatomy courses at Niigata University (2017-2020). The face was composed of 3-layered (deep, middle, and superficial) fasciae and 4-layered facial muscles (first superficial, second superficial, third, and fourth muscle layers) according to the attachment of muscles and their topographical relationship with the fasciae. The deep fascia covered the temporal and masseter muscles. The parotid gland and facial nerves were enveloped in the middle fascia. The superficial fascia was continuous with the second superficial muscle layer. The connection between fourth and superficial muscles was at the malar and buccal areas, where the platysma blended with the masseter and the plural muscles blended with the buccinator. Our findings suggest that cooperation between the 4-layered structure of the facial muscles surrounding the apertures of the eyes and mouth and the superficial fascia enables humans to produce complex facial expressions. Furthermore, the spread of inflammation in the face may be owing to the layered facial muscles and fasciae, as these layered structures separate tissues into multiple compartments.

DOI： 10.1097/SCS.0000000000008700

PubMed

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

BACKGROUND: Suprahyoid muscles behavior during the tongue lifting movement has not yet been elucidated. OBJECTIVE: The purpose of this study was to investigate the potential of elastography imaging to examine developmental oral dysfunction in children and oral hypofunction in older adults using sonography. METHODS: Tongue pressure was measured using a manometer with a probe. The tongue pressure was measured with simultaneously scanning the geniohyoid muscle (GHM) and the anterior belly of the digastric muscle (DGM) using sonographic elastography. Sagittal images of the GHM and coronal images of the DGM were used for the strain ratio measurement. The strain ratio of the muscles was measured three times for each subject with the tongue pressure values of 0–30 kPa. RESULTS: The strain ratio of the GHM were higher than those of the DGM at tongue pressure of 10, 20 and 30 kPa. The strain ratio of the GHM increased as the tongue pressure increased in all participants. In contrast, the strain ratio of the DGM tended to slowly decrease as tongue pressure increased in female participants. CONCLUSION: Sonographic elastography is useful for visual and quantitative evaluation of elastic properties in suprahyoid muscles during tongue lifting movements.

DOI： 10.3233/bme-221414

PubMed

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

OBJECTIVE: To identify factors affecting condylar bone changes following surgical-orthodontic treatment. METHODS: A total of 200 patients with dentofacial deformities were classified into skeletal Classes I, II, and skeletal Class III groups consisting of 61 and 139 subjects, respectively. Temporomandibular joints (TMJs) were evaluated using clinical findings and computed tomography images before treatment, immediately before surgery, and 6 months after surgery. RESULTS: Condylar bone changes occurred at a significantly higher rate after surgery in both groups. Factors related to condylar bone changes following surgical-orthodontic treatment included skeletal Class I or II, disc displacement, and condylar bone changes before treatment. There were three cases with condylar bone changes after surgery that were diagnosed with condylar resorption and skeletal Class II and anterior disc displacement before surgery. CONCLUSION: Condylar resorption could occur when the load on the condyle increases after orthognathic surgery and exceeds the permissible limit.

DOI： 10.1080/08869634.2022.2118263

PubMed

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

DOI： 10.1016/j.ajoms.2022.02.007

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Publishing type：Research paper (scientific journal)   Publisher：Wiley  

DOI： 10.1002/osi2.1155

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Other Link： https://onlinelibrary.wiley.com/doi/full-xml/10.1002/osi2.1155

Language：Japanese   Publisher：(一社)日本顎関節学会  

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Language：Japanese   Publisher：(NPO)日本口腔科学会  

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Language：Japanese   Publisher：(NPO)日本口腔科学会  

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

DOI： 10.11242/dentalradiology.61.41

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Language：Japanese   Publisher：(一社)日本口腔ケア学会  

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

DOI： 10.1002/osi2.1129

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

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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Language：Japanese   Publisher：新潟歯学会  

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Language：Japanese   Publisher：(公社)日本矯正歯科学会  

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

BACKGROUND: There is no available data on the occurrence rate of a converged alveolar canal, the detailed three-dimensional (3D) courses of alveolar canals/grooves (ACGs), or the contribution of each superior alveolar nerve to each area in the maxilla. This study aimed to clarify the 3D courses of ACGs, the relationship between ACGs and superior alveolar nerves, and the contribution of posterior superior alveolar nerves (PSANs) using computed tomography (CT) with histological analysis. METHODS: During the gross anatomy course at Niigata University, we investigated nine human cadavers. RESULTS: All anterior and posterior ACGs converged into the common alveolar canal, which contained blood vessels and several nerve bundles surrounded by perineurium, located at the nasal floor near the pyriform aperture. Histometrical analysis clarified that 16.3% of the nerve bundles in this canal were derived from PSANs, and 67% of the bundles were dispersed while they coursed down to the nasal floor. There seems to be no relationship between the density of nerve bundles in the canal and the number of remaining anterior teeth. CONCLUSIONS: Data obtained from observing the detailed 3D courses of anterior and posterior ACGs, and their relationship with superior alveolar nerves, suggest that PSANs partially contribute to the nociception of the anterior teeth.

DOI： 10.1016/j.aanat.2021.151784

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

BACKGROUND: Spindle cell squamous cell carcinoma is an uncommon variant of squamous cell carcinoma; its diagnosis is sometimes challenging because it histopathologically resembles neoplastic or reactive spindle cell lesions of mesenchymal origins. Here, we report a rare case of spindle cell squamous cell carcinoma exhibiting prominent neutrophil phagocytosis. CASE PRESENTATION: A 69-year-old Japanese man presented with pain and a polypoid mass on the lower left gingiva. He had received chemoradiotherapy for squamous cell carcinoma of the buccal mucosa 15 years prior to this consultation. In addition, he was treated for mandibular osteonecrosis 6 years after chemoradiotherapy without evidence of cancer recurrence. A biopsy revealed atypical spindle or pleomorphic cells scattered in the edematous and fibrin-rich stroma; however, no malignant squamous components were apparent. These atypical cells frequently contained neutrophils within their cytoplasm that formed cell-in-cell figures. Immunohistochemically, the atypical cells were negative for cytokeratins, epithelial membrane antigen, and E-cadherin, but positive for p63, vimentin, and p53. Although these findings suggested spindle cell squamous cell carcinoma, it was difficult to reach a definitive diagnosis. Based on a clinical diagnosis of a malignant tumor, the patient underwent a hemimandibulectomy. The surgically resected specimen had a typical spindle cell squamous cell carcinoma histology consisting of biphasic spindle cells and conventional squamous cell carcinoma components. Moreover, the surgical specimen also exhibited spindle tumor cells that frequently included neutrophils, around which intense staining for lysosomal-associated membrane protein 1 and cathepsin B was observed. This suggested that the cell-in-cell figures represent active neutrophil phagocytosis by tumor cells, and not emperipolesis. CONCLUSION: The presence of neutrophil phagocytosis may be a potent indicator of malignancy.

DOI： 10.1186/s13256-021-03066-z

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Language：Japanese   Publisher：(NPO)日本口腔科学会  

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

The clinical features of xerostomia induced by immune checkpoint inhibitors (ICI) are similar to those of Sjögren's syndrome (SS), whereas the immunohistological and serological features are known to differ from those of SS. However, the radiologic imaging features of salivary glands are not yet well known. We report a case of a 56-year-old male patient diagnosed with ICI-induced xerostomia. The patient underwent various imaging examinations to investigate the condition of the salivary glands, which indicated the following: (1) less specific findings on contrast-enhanced computed tomography, (2) mixed with intermediate and low signal intensity on both T1-weighted and fat-suppressed T2-weighted magnetic resonance imaging and poor "salt and pepper" appearance on magnetic resonance sialography, and (3) multiple ovoid hypoechoic areas with hyperechoic bands without acute sialadenitis on ultrasound. These radiologic imaging findings suggested remarkable lymphocyte infiltration, which could be a characteristic of ICI-induced xerostomia.

DOI： 10.1007/s11282-020-00480-9

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Language：Japanese   Publisher：(公社)日本歯科医師会  

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

OBJECTIVES: Other iatrogenic immunodeficiency-associated lymphoproliferative disorders (OI-LPD) have been reported as one of the adverse effects of immunosuppressive therapy. The aim of this study was to describe the clinicopathologic and immunohistochemical features of OI-LPD in the oral cavity. STUDY DESIGN: Immunohistochemistry was performed to describe the immunohistochemical features in our 4 cases. The results were analyzed along with 62 cases of oral OI-LPD in the English and Japanese literature to define clinical and pathologic characteristic features. RESULTS: In our immunohistochemical analysis, Epstein-Barr virus (EBV)-positive OI-LPD showed a higher percentage of mouse double minute 2-positive cells than EBV-negative samples. A literature survey revealed that OI-LPD (including the present cases) arises primarily in the gingiva, followed by the tongue, and usually occurs with a male-to-female ratio of 1:1.9. The rate of EBV positivity was 93.8%. Further, 31 of 66 patients had osteonecrosis of the jaw and 24 of 31 patients had taken multiple immunosuppressive drugs in combination. CONCLUSIONS: We can therefore conclude that the overexpression of mouse double minute 2 in OI-LPD is associated with EBV infection, and the combination of multiple immunosuppressive drugs may be a risk factor for osteonecrosis of the jaw.

DOI： 10.1016/j.oooo.2021.05.015

PubMed

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Language：English   Publishing type：Research paper (international conference proceedings)   Publisher：Springer Science and Business Media LLC  

DOI： 10.1007/s00520-021-06285-8

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Other Link： https://link.springer.com/article/10.1007/s00520-021-06285-8/fulltext.html

Publishing type：Research paper (scientific journal)   Publisher：Springer Science and Business Media LLC  

<title>Abstract</title><sec>
<title>Objectives</title>
This study aimed to clarify the accuracy of intraoral ultrasonography (US), computed tomography (CT), and magnetic resonance imaging (MRI) in preoperative image depth of invasion (DOI) measurement of T1/T2 tongue cancer through comparison with histopathological measurements.


</sec><sec>
<title>Methods</title>
Imaging of the primary lesions was performed at our hospital; the lesions were classified into T1 and T2 based on the 8th edition of the AJCC/UICC, and surgery performed. There was histopathological confirmation of lesions as squamous cell carcinoma in 48 patients with tongue cancer. T3 and T4 cases, cases in which preoperative chemotherapy and radiation therapy were performed, and cases where biopsy was performed before imaging were excluded. The radiological DOI in US, CT, and MRI and the histopathological DOI as base were comparatively investigated and statistical analyses were performed by Bland–Altman analysis and Spearman's rank correlation coefficient.


</sec><sec>
<title>Results</title>
Bland–Altman analysis showed that the US radiological DOI was overestimated by an average of 0.2 mm compared to the histopathological DOI, while CT and MRI radiological DOI were overestimated by an average of 2–3 mm. The comparison of CT and MRI revealed that the difference between the MRI and histopathological DOI, as well as the 95% limit of agreement, were smaller than those of the CT radiological DOI.


</sec><sec>
<title>Conclusions</title>
US is the most accurate preoperative diagnostic tool for T1 and T2 squamous cell carcinoma; CT and MRI tend to have an overestimation of about 2–3 mm and so caution is required.


</sec>

DOI： 10.1007/s11282-021-00533-7

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Other Link： https://link.springer.com/article/10.1007/s11282-021-00533-7/fulltext.html

Language：Japanese   Publisher：(NPO)日本歯科放射線学会  

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Language：Japanese   Publisher：(NPO)日本歯科放射線学会  

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Publishing type：Research paper (scientific journal)   Publisher：Wiley  

DOI： 10.1002/osi2.1111

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Other Link： https://onlinelibrary.wiley.com/doi/full-xml/10.1002/osi2.1111

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

DOI： 10.1002/osi2.1110

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Other Link： https://onlinelibrary.wiley.com/doi/full-xml/10.1002/osi2.1110

Language：Japanese   Publisher：(一社)日本口腔ケア学会  

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Language：Japanese   Publisher：(NPO)日本歯科放射線学会  

口腔内超音波検査により小唾液腺の口腔内超音波正常像について検討した。口腔乾燥感を含め口腔内に自覚症状のない健常な成人20名(女性13名、男性7名、平均29.4歳)を対象とした。超音波診断装置には、本体としてHIVISION Preirusを、超音波プローブには日常臨床で口腔内超音波走査に使用しているホッケースティック型術中用小型リニアプローブEUP-O54Jを使用した。口唇腺は上下唇とも口腔粘膜直下に一〜二層になって分布が確認された。また、腺葉群の大きさはそれぞれ後方の口角付近の方が大きく、厚みに相当する短径は上唇で平均1.5mm、下唇で2.2mmであった。さらに、血流表示画像において腺葉群内部の血流の確認が可能であり、マイクロスコピーコイルを用いたMRIに近い画像所見を得ることが可能であったと判断された。

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Other Link： https://search.jamas.or.jp/index.php?module=Default&action=Link&pub_year=2021&ichushi_jid=J00567&link_issn=&doc_id=20210406250001&doc_link_id=10.11242%2Fdentalradiology.60.35&url=https%3A%2F%2Fdoi.org%2F10.11242%2Fdentalradiology.60.35&type=J-STAGE&icon=https%3A%2F%2Fjk04.jamas.or.jp%2Ficon%2F00007_3.gif

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

The aim of this study was to compare the estimated public medical care cost of measures to address metallic dental restorations (MDRs) for head and neck radiotherapy using high-energy mega-voltage X-rays. This was considered a first step to clarify which MDR measure was more cost-effective. We estimated the medical care cost of radiotherapy for two representative MDR measures: (i) with MDR removal or (ii) without MDR removal (non-MDR removal) using magnetic resonance imaging and a spacer. A total of 5520 patients received head and neck radiation therapy in 2018. The mean number of MDRs per person was 4.1 dental crowns and 1.3 dental bridges. The mean cost per person was estimated to be 121 720 yen for MDR removal and 54 940 yen for non-MDR removal. Therefore, the difference in total public medical care cost between MDR removal and non-MDR removal was estimated to be 303 268 800 yen. Our results suggested that non-MDR removal would be more cost-effective than MDR removal for head and neck radiotherapy. In the future, a national survey and cost-effectiveness analysis via a multicenter study are necessary; these investigations should include various outcomes such as the rate of local control, status of oral mucositis, frequency of hospital visits and efforts of the medical professionals.

DOI： 10.1093/jrr/rrab003

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

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Language：Japanese   Publisher：Japanese Stomatological Society  

DOI： 10.11277/stomatology.70.279

CiNii Article

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Language：Japanese   Publisher：新潟歯学会  

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Language：Japanese   Publisher：新潟歯学会  

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

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Language：Japanese   Publisher：新潟歯学会  

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Language：Japanese   Publisher：(一社)日本口腔腫瘍学会  

かかりつけ歯科医院での長期メインテナンス中、下顎埋伏智歯の歯冠部に関連して生じたと考えられる高齢者の原発性骨内癌を経験したので報告する。症例は74歳の男性、右側下唇の知覚異常と右側下顎臼歯部の咬合痛を主訴に当科紹介初診となった。右側下顎第二大臼歯は挺出し、動揺度2、頬側歯肉に軽度の腫脹を認めたが排膿はなかった。パノラマX線写真で右側下顎智歯は骨性に逆生埋伏しており、単純CTで埋伏智歯の歯冠部に連続した境界不明瞭で辺縁不整な35×25mm大の腫瘤性病変を認めた。生検にて扁平上皮癌(原発性骨内癌疑い)の診断を得て、顎下部郭清術、下顎骨区域切除術、金属プレートによる顎骨再建術を行った。一般的に原発性骨内癌は嚢胞様病変から悪性転化するとされるが、本症例は当科初診の8ヵ月前に紹介元で撮影されたパノラマX線写真では異常所見は観察されず、明白な嚢胞様変化を辿ることなく悪性転化し、急速に増大したと推察された。症状のない下顎埋伏智歯は経過観察されることが多いが、発育性嚢胞や歯周炎などのリスクが低いと判断される高齢者の下顎埋伏智歯においても、多様な変化の可能性も念頭に置いた経過観察が肝要である。(著者抄録)

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Language：Japanese   Publisher：新潟歯学会  

線維性異形成症(FD)は正常な骨組織が線維性結合組織で置換され増殖することを特徴とする非腫瘍性骨病変である。骨格成長後にはFDの増殖が静止するとされているが、成人期でも増大をきたすことがある。今回、上顎骨FDの減量手術後再増大をきたし、再び減量手術が必要となった症例を経験したので報告する。患者は42歳の男性。25歳の時に上顎骨FDの減量手術を施行されるも受診が途絶え、再増大による顔面非対称をきたしたため17年後に当科初診となった。顔面非対称改善と病変増大による機能障害の予防のため、右側上顎骨頬側と口蓋側の2回に分けて減量手術を行った。削除量の目安としてCT画像から3次元実体モデルを利用してサージカルガイドを制作し、術中の対称性確認と手術時間の短縮を行った。術後3年経過した現在、明らかな再増大はない。今回もあくまで減量手術であり、病巣の残遺に伴う病態変化の可能性についての患者教育とともに長期の経過管理が重要と考えられた。(著者抄録)

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Language：Japanese   Publisher：(NPO)日本口腔科学会  

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Language：Japanese   Publisher：(NPO)日本口腔科学会  

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Language：Japanese   Publisher：(NPO)日本口腔科学会  

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Language：Japanese   Publisher：(NPO)日本口腔科学会  

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

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Publishing type：Research paper (scientific journal)  

© 2020 Asian AOMS(+) ASOMP(+) JSOP(+) JSOMS(+) JSOM(+) and JAMI We describe a case of low-grade myofibroblastic sarcoma (LGMS) on the dorsum of the tongue. A 41-year-old Japanese man noticed that a mass on the dorsal surface of the tongue had been present for 8 months. Computed tomography showed a homogeneously enhancing mass measuring 16 × 14 mm in the midline of the tongue. Magnetic resonance imaging showed a homogeneously enhancing mass with an almost clear margin on post-contrast T1-weighted imaging. The lesion was homogeneous with high signal intensity on T2-weighted imaging. The patient underwent excisional biopsy. Histologically, the tumor had an indistinct margin and was composed of spindle-shaped cells arranged in cellular fascicles. The cell nuclei showed signs of mild atypia. Positive staining for desmin and less strong staining for α-smooth muscle actin revealed that the tumor cells were myofibroblasts or smooth muscle cells. The tumor cells were negative for h-caldesmon. The MIB-1 labeling index of the tumor was 4.9 %. Thus, based on the histopathological, immunohistochemical and imaging findings, the tumor was finally diagnosed as LGMS. We reviewed the literature on the immunohistochemistry of LGMS. We suggest that immunohistochemistry is helpful in the differential diagnosis of LGMS.

DOI： 10.1016/j.ajoms.2020.07.011

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BACKGROUND: Lip closing functions have never been evaluated from the viewpoint of elastic properties. OBJECTIVES: The purpose of the present study was to investigate the behavior of the lower orbicularis oris muscle during a button-pull exercise to measure lip closing force and quantitatively evaluate its elastic properties using sonographic elastography. METHODS: Appropriate compression loads for elastography were randomly measured on one of three types of acoustic couplers on three examiners. Compression tests were performed on three types of acoustic couplers within the appropriate compression load. Using the acoustic coupler with the lowest elastic modulus, the strain ratio of the lower orbicularis oris muscle during lip closing was measured, and elastography was performed on six males under tension loads of 0-8 N. RESULTS: The intraclass correlation coefficient (1, 3) for the tension load of 0 N was 0.81. Elastography showed that the strain ratio values increased significantly (p < 0.05) as the tension load increased. CONCLUSIONS: Combining the data obtained from lip closing test devices and sonographic elastography enabled the muscle performance to be evaluated objectively and accurately.

DOI： 10.3233/BME-201101

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

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Language：Japanese   Publisher：(一社)日本顎関節学会  

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Language：Japanese   Publisher：(一社)日本顎関節学会  

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Language：Japanese   Publisher：(NPO)日本口腔科学会  

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Objectives: The present study was performed to investigate the mineral density distribution in enamel and dentin for both permanent and primary teeth and to establish the standard density per tooth type using micro-computed tomography (CT). Methods: Fifty-seven extracted human teeth (37 permanent, 20 primary) were evaluated in the present study. The enamel and dentin mineral densities in the extracted teeth were measured using micro-CT. Cubic regression curves were used to determine the mineral density distribution in the enamel and dentin for each tooth type. Results: The mean values, distributions, and regression equations of the mineral densities were obtained. The mean mineral density values for permanent enamel and dentin were significantly higher than those for their primary counterparts for each tooth type. Conclusions: In the present study, we demonstrated the distribution of mineral density in sound enamel and dentin and attempted to determine the standard mineral density for each tooth type using micro-CT. The mineral density distributions found in this study contribute to our understanding of the mechanical properties of enamel and dentin. A positive correlation suggests that the systemic bone mineral density could be predicted based on the analysis of exfoliated teeth, such as in patients with hypophosphatasia. The present results may be useful in establishing a numerical standard for the mechanism involved in root fracture and for early detection of root fracture risk.

DOI： 10.1007/s11282-018-0315-2

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Language：Japanese   Publisher：新潟歯学会  

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Language：Japanese   Publisher：(公社)日本矯正歯科学会  

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DOI： 10.1016/j.ajoms.2018.03.006

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Language：Japanese   Publisher：医歯薬出版(株)  

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Language：Japanese   Publisher：(NPO)日本口腔科学会  

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Language：Japanese   Publisher：(NPO)日本歯科放射線学会  

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Language：Japanese   Publisher：(NPO)日本歯科放射線学会  

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Language：Japanese   Publisher：(NPO)日本歯科放射線学会  

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DOI： 10.1007/s11282-018-0314-3

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© 2018 Asian AOMS(+) ASOMP(+) JSOP(+) JSOMS(+) JSOM(+) and JAMI Methotrexate (MTX) is a commonly used medicine treating rheumatoid arthritis (RA), and occasional patients receiving MTX are known to have lymphoproliferative disorders (MTX–LPDs). MTX–LPDs involving widely the maxillofacial region have been rarely documented, though those limited in the oral cavity are not so rare. We herein report a 63-year-old Japanese woman with RA, who had received MTX and developed maxillofacial lesions with lymph-node swelling as MTX–LPD. She had subcutaneous masses around her nasolabial sulcus in addition to a submucosal mass of the right side of the palate, which were similarly and homogeneously enhanced with contrastive media together with cervical, inguinal, and axillary lymph nodes in computed tomography. In biopsy, the palatal mass showed a nodular proliferation of CD20-positive large atypical lymphocytes without Epstein-Barr viral infection signals replacing the mucous gland, which resembled that seen in diffuse large B-cell lymphoma. Under the diagnosis of MTX–LPD, MTX was discontinued for four months, and those mass lesions and the swollen lymph nodes simultaneously disappeared. These findings suggest that observation after MTX withdrawal should be tried in the treatment of patients with MTX–LPD arising in the background of RA, even if the clinicopathological findings are suggestive of malignant lymphoma. This is a report describing comprehensive clinicopathological data of an oromaxillofacial MTX–LPD case with simultaneous lymphadenopathy.

DOI： 10.1016/j.ajoms.2018.07.010

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DOI： 10.1016/j.oooo.2018.06.003

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Language：Japanese   Publisher：新潟歯学会  

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Language：English   Publishing type：Research paper (international conference proceedings)   Publisher：OXFORD UNIV PRESS  

DOI： 10.1093/annonc/mdx583

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DOI： 10.1016/j.jpor.2017.01.003

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

DOI： 10.5794/jjoms.63.358

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Language：Japanese   Publisher：(NPO)日本歯科放射線学会  

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Language：Japanese   Publisher：(NPO)日本歯科放射線学会  

閉塞性睡眠時無呼吸症候群(OSAS)の診断・治療歴のない正常人8名(男性5名、女性3名、28〜54歳)を対象とした。下顎骨の前方移動と舌骨の頭側移動について、2台の超音波診断装置とそれぞれに専用のホッケースティック型術中用小型探触子を用いて仰臥位にて同時動態観察を行った。舌骨移動量の平均値は最大9.0mm、最小2.0mmで、変動係数は最大19.5%、最小5.2%であった。反応率の平均値は最大0.87、最小0.28で、変動係数は最大16.1%、最小4.6%であった。反応率の変動係数は舌骨移動量のそれよりも小さい値を示し、個人の代表値として舌骨移動量よりも反応率が有用であることが示唆された。いずれの値も性別や年齢との関係は認めなかった。身長や体重、BMIとの間にも有意な相関は認めなかった。日を置いて2度計測した2名は、いずれもこれらの検査で反応率に有意差は認めなかった。

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Other Link： https://search.jamas.or.jp/index.php?module=Default&action=Link&pub_year=2017&ichushi_jid=J00567&link_issn=&doc_id=20170529220002&doc_link_id=%2Fcg7dentr%2F2016%2F005602%2F003%2F0064-0069%26dl%3D0&url=http%3A%2F%2Fwww.medicalonline.jp%2Fjamas.php%3FGoodsID%3D%2Fcg7dentr%2F2016%2F005602%2F003%2F0064-0069%26dl%3D0&type=MedicalOnline&icon=https%3A%2F%2Fjk04.jamas.or.jp%2Ficon%2F00004_2.gif

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DOI： 10.1007/s11282-016-0269-1

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Language：Japanese   Publishing type：Research paper (scientific journal)   Publisher：新潟歯学会  

われわれは、側頭部蜂窩織炎後に残遺した瘢痕による開口障害の1例を報告する。顎顔面口腔領域における炎症性開口障害は、消炎に伴い自ずと改善されることがほとんどであるが、ごくまれに炎症が長期に及び開口障害が持続することがある。患者は62歳の男性で、側頭部蜂窩織炎の消炎後に開口障害が改善せず、当院を受診した。開口障害の治療として、まず保存的に開口訓練を数ヵ月間行ったが、改善が得られなかった。保存療法での改善が認められない場合、外科療法を考慮するが、その明確な適応基準はない。本例の臨床的特徴として、end feelの硬い開口障害で、側頭筋腱・腱膜過形成症と同様に前方運動や側方運動などの下顎頭の滑走が認められた。画像診断では、MRI画像にて、側頭筋、咬筋に沿って頭蓋底から筋突起におよぶ瘢痕が帯状に形成されており、顎関節部には異常所見はなかった。瘢痕および筋突起の切除により術中開口量は十分に回復し、術後早期からの開口練習により症状は改善した。(著者抄録)

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Language：English   Publishing type：Research paper (scientific journal)   Publisher：OXFORD UNIV PRESS  

The changes in dose distribution caused by backscatter radiation from a common commercial dental alloy (Au-Ag- Pd dental alloy; DA) were investigated to identify the optimal material and thicknesses of a dental device (DD) for effective prevention of mucositis. To this end, 1 cm(3) of DA was irradiated with a 6-MV X-ray beam (100 MU) in a field size of 10 x 10 cm(2) using a Novalis TX linear accelerator. Ethylene vinyl acetate copolymer, polyolefin elastomer, and polyethylene terephthalate (PET) were selected as DD materials. The depth dose along the central axis was determined with respect to the presence/absence of DA and DDs at thicknesses of 110 mm using a parallel-plate ionization chamber. The dose in the absence of DDs showed the lowest value at a distance of 5 mm from the DA surface and gradually increased with distance between the measurement point and the DA surface for distances of &gt;= 5 mm. Except for PET, no significant difference between the DA dose curves for the presence and absence of DDs was observed. In the dose curve, PET showed a slightly higher dose for DA with DD than for DA without DD for thicknesses of &gt;= 4 mm. The findings herein suggest that the optimal DD material for preventing local dose enhancement of the mucosa caused by DA backscatter radiation should have a relatively low atomic number and physical density and that optimal DD thickness should be chosen considering backscatter radiation and percentage depth dose.

DOI： 10.1093/jrr/rrw092

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Language：Japanese  

DOI： 10.5927/jjjd.26.214

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Language：Japanese   Publisher：(NPO)日本歯科放射線学会  

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

Objectives This study evaluated the effects of combined topical sodium fluoride and casein phosphopeptide-amorphous calcium phosphate (CPP-ACP) paste application on root surface conditions in cancer patients undergoing head and neck radiotherapy.Patients and methods Nineteen patients undergoing conventional external radiotherapy in head and neck cancer were enrolled and divided into CPP-ACP (topical sodium fluoride/daily CPP-ACP paste application) and Non-CPP-ACP (topical fluoride application alone) groups. Chronological root surface texture changes were prospectively investigated for 1 year.Results The mean radiation dose of the parotid gland did not differ significantly between the CPP-ACP and Non-CPP-ACP groups. From baseline to 6 and 6-12 months, the CPP-ACP group had significantly better root surface textures than those in the Non-CPP-ACP group (p = 0.001 and p < 0.001, respectively). The hard surface numbers in the CPP-ACP group increased from 347 to 350 in 12 months. The respective soft lesion incidence rates from baseline to 6, 6-12, and baseline to 12 months were significantly lower in the CPP-ACP group than those in the Non-CPP-ACP group (per patient: p = 0.038, p = 0.038, and p = 0.029; per root surface: p = 0.026, p < 0.001, and p < 0.001).Conclusions The present results suggest that dental management with a combination of topical sodium fluoride and CPP-ACP paste application can control root surface caries more effectively than topical sodium fluoride alone in patients undergoing head and neck radiotherapy.

DOI： 10.1007/s11282-015-0218-4

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DOI： 10.1002/ar.23327

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DOI： 10.1155/2016/4898456

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DOI： 10.1016/j.ajoms.2016.05.006

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Language：Japanese   Publisher：日本実験力学会  

Micro computed tomography (Micro CT) is an imaging technique widely used for visualizing the internal structure of objects using the x-ray attenuation method. As it enables non-destructive, noninvasive evaluation and three-dimensional analysis, it is useful for various studies of human hard tissues. Most hypophosphatasia cases exhibit early loss of primary teeth, however findings of Micro CT analysis of them have not been reported. The purpose of the present study was to describe the mineral density distribution of exfoliated teeth with hypophosphatasia using Micro CT. Each two exfoliated teeth of mandibular primary central incisors gained from 2 hypophosphatasia patients were investigated for enamel and dentin mineral densities. Mineral density distribution revealed that the case 1 were lower than the homonymous teeth case 2 in the region of enamel edge in enamel and dentinoenamel junction in dentin. These results suggested that hypophosphatasia patients had the variety of hypomineralization in the primary dentition. The investigations using Micro CT is useful for various studies of human hard tissues gained from patients since it enables non-destructive, noninvasive evaluation.

DOI： 10.11395/jjsem.16.122

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Language：Japanese   Publisher：新潟歯学会  

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Language：Japanese   Publisher：(NPO)日本口腔科学会  

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Language：Japanese   Publisher：(株)第一歯科出版  

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Language：Japanese   Publisher：(NPO)日本口腔科学会  

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Language：Japanese   Publisher：(NPO)日本歯科放射線学会  

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Language：Japanese   Publisher：(一社)日本口腔ケア学会  

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Language：Japanese   Publisher：(一社)日本口腔ケア学会  

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DOI： 10.1016/j.prp.2014.06.028

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DOI： 10.1016/j.oooo.2013.08.032

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Language：Japanese  

DOI： 10.5794/jjoms.60.348

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Language：Japanese   Publisher：(株)デンタルダイヤモンド社  

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

We present a preliminary case report on the application of computed tomography perfusion (CTP) with a single-compartment kinetic model for early detection of subsequent lymph node metastasis in gingival carcinoma. A 47-year-old female patient with squamous cell carcinoma of the right lower molar gingiva (cT1N0M0) was reviewed. At 4 months after the initial treatment, a subsequent lymph node metastasis was suspected on monthly follow-up ultrasonography. She provided written informed consent prior to participating in the study, which had been approved by the institutional review board at our institution. After a standard head and neck contrast-enhanced CT examination, CTP images were acquired with a coverage of 32 mm (64 x 0.5-mm thickness) and a total acquisition time of 45 s, initiated at 5 s after intravenous infusion of 40 ml of 370 mg I/ml non-ionic iodine contrast agent at a rate of 4 ml/s. Post-processing of the CTP data was performed with dedicated software based on a single-compartment kinetic model (Ziosoft Inc., Tokyo, Japan). The SC flow parameter represented the blood flow per unit volume of tissue, in milliliters per minute per milliliter (i.e., min(-1)). The mean SC flow value was 1.144 min(-1) in a totally replaced metastatic node and 0.985 min(-1) in a partially replaced node, compared with 0.787 min(-1) in the contralateral benign node. In conclusion, CTP with a single-compartment kinetic model is considered to be one of the useful methods for detection of a small non-necrotic subsequently developing metastatic cervical lymph node.

DOI： 10.1007/s11282-013-0153-1

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Language：Japanese   Publishing type：Research paper (scientific journal)   Publisher：The Japanese Society of Oral Diagnosis / Oral Medicine  

We investigated the relationship between oral care and candida species in 16 patients (14 men and 2 women) undergoing radiotherapy for head and neck cancer. They also received oral care by specialized dental staff. Candida species were detected in 12 patients (75% of all patients): <i>C. albicance</i> was detected in 8 cases (50%) and non-<i>C. albicance</i> was detected in 4 cases (25%). Advanced oral mucositis of more than grade 3 was seen in 13 patients, and candida species were detected in 11 cases.<br>Oral care in consideration of candida species is important because <i>C. albicance</i> and non-<i>C. albicance</i> were frequently detected in patients undergoing radiotherapy for head and neck cancer even though their oral condition was well maintained.

DOI： 10.15214/jsodom.27.1

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Other Link： http://search.jamas.or.jp/link/ui/2014220823

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

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DOI： 10.1016/j.humpath.2013.08.011

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

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Language：English   Publishing type：Research paper (scientific journal)   Publisher：Springer-Verlag Tokyo  

We present a preliminary case report on the application of computed tomography perfusion (CTP) with a single-compartment kinetic model for early detection of subsequent lymph node metastasis in gingival carcinoma. A 47-year-old female patient with squamous cell carcinoma of the right lower molar gingiva (cT1N0M0) was reviewed. At 4 months after the initial treatment, a subsequent lymph node metastasis was suspected on monthly follow-up ultrasonography. She provided written informed consent prior to participating in the study, which had been approved by the institutional review board at our institution. After a standard head and neck contrast-enhanced CT examination, CTP images were acquired with a coverage of 32 mm (64 x 0.5-mm thickness) and a total acquisition time of 45 s, initiated at 5 s after intravenous infusion of 40 ml of 370 mg I/ml non-ionic iodine contrast agent at a rate of 4 ml/s. Post-processing of the CTP data was performed with dedicated software based on a single-compartment kinetic model (Ziosoft Inc., Tokyo, Japan). The SC flow parameter represented the blood flow per unit volume of tissue, in milliliters per minute per milliliter (i.e., min-1). The mean SC flow value was 1.144 min-1 in a totally replaced metastatic node and 0.985 min -1 in a partially replaced node, compared with 0.787 min-1 in the contralateral benign node. In conclusion, CTP with a single-compartment kinetic model is considered to be one of the useful methods for detection of a small non-necrotic subsequently developing metastatic cervical lymph node. © Japanese Society for Oral and Maxillofacial Radiology and Springer 2013.

DOI： 10.1007/s11282-013-0153-1

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

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

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

The synovitis, acne, pustulosis, hyperostosis, and osteitis (SAPHO) syndrome consists of a combination of inflammatory bone disorders and dermatologic pathology. Bone lesions as a form of diffuse sclerosing osteomyelitis in the mandible occur in the posterior body and ramus. Bone lesions rarely spread to the temporomandibular joint (TMJ) where ankylosis may result. Herein we present an unusual case of SAPHO syndrome with TMJ involvement in which severe destruction of the TMJ occurred. We observed an extension of the invasive soft tissue lesion into the infratemporal fossa from the TMJ with complete resorption of the condyle. In contrast to other previously reported cases, in our case the condyle was strongly suspected as the primary site of the bone lesion with subsequent extension to the ramus and infratemporal fossa. The destructive nature and related symptoms resembled a malignant tumor. © 2013 Elsevier Inc. All rights reserved.

DOI： 10.1016/j.oooo.2013.03.011

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

DOI： 10.11277/stomatology.62.215

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A case of solitary central neurofibroma of the mandible arising in a 70-year-old man is reported. The patient had a radiolucent lesion, measuring 16. mm in diameter, with central radiopaque freckles in the right incisor-canine region of the mandible, which was discovered incidentally during routine dental check-up. The lesion was persisted for 10 years without any symptoms or complication. It was clinically diagnosed as benign tumor and surgically removed under general anesthesia. Histologically, the removed tumor was relatively well demarcated and composed of a sparse proliferation of elongated spindle-shaped cells with wavy nuclei in loosely textured connective tissue stroma, which was associated with bone formation. Clinicopathological features of central neurofibroma of the jaw bone are reviewed from the literature. This is the first report of central neurofibroma arising in the anterior part of the mandible. © 2012 Asian AOMS, ASOMP, JSOP, JSOMS, JSOM, and JAMI.

DOI： 10.1016/j.ajoms.2012.12.002

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Objective: The aim of this study was to evaluate the usefulness of hypothetical monoenergetic images after dual-energy computed tomography (DECT) for assessment of the bone encircling dental implant bodies. Study design: Seventy-two axial images of implantation sites clipped out from image data scanned using DECT in dual-energy mode were used. Subjective assessment on reduction of dark-band-like artifacts (R-DBAs) and diagnosability of adjacent bone condition (D-ABC) in 3 sets of DECT images - a fused image set (DE120) and 2 sets of hypothetical monoenergetic images (ME100, ME190) - was performed and the results were statistically analyzed. Results: With regards to R-DBAs and D-ABC, significant differences among DE120, ME100, and ME190 were observed. The ME100 and ME190 images revealed more artifact reduction and diagnosability than those of DE120. Conclusions: DECT imaging followed by hypothetical monoenergetic image construction can cause R-DBAs and increase D-ABC and may be potentially used for the evaluation of postoperative changes in the bone encircling implant bodies. © 2013 Elsevier Inc. All rights reserved.

DOI： 10.1016/j.oooo.2013.03.014

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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. © 2012 John Wiley &amp
Sons A/S.

DOI： 10.1111/odi.12022

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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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OBJECTIVES: Bleeding in the floor of the mouth during implant surgery is attributed to arterial injuries in the sublingual space: clinicians may injure the submental and sublingual arteries, which originate from the facial and lingual arteries, respectively. This study aimed to clarify the three-dimensional courses of submental and sublingual arteries and their topographic relation to the mandible. MATERIALS AND METHODS: During the gross anatomy course at the Faculty of Dentistry and Graduate School, Niigata University (2009-2011), we investigated the relationship between the courses of submental and sublingual arteries and their dividing patterns of the mylohyoid muscle, sublingual gland, and mandible using 27 human cadavers. RESULTS: The courses of submental and sublingual arteries were divided into four patterns: (1) the sublingual space was supplied by the sublingual artery (type I: 63%), (2) it was supplied by both the sublingual and submental arteries (type II: 5.6%), (3) it was supplied by the submental artery without the sublingual artery (type III: 29.6%), and (4) type III without the deep lingual artery originated from the lingual artery (type IV: 1.8%). In type II, III, and IV, the submental artery perforates the mylohyoid muscle or takes a roundabout route to travel near the surface of the mandible. The percentage occurrence of arteries traveling between the sublingual gland and mandible in type II, III, and IV (55%) is higher than that in type I (8.8%). CONCLUSION: Susceptibility of the submental artery in type II, III, and IV to injury during implant surgery is suggested.

DOI： 10.1111/j.1600-0501.2011.02348.x

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DOI： 10.1111/j.1600-0501.2011.02348.x

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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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Objectives: Masticatory muscle pain is one of the typical symptoms of temporomandibular joint disorders (TMD). T2 mapping (distribution of T2 values) is a notable MRI technique for evaluating water contents in tissues. We investigated the clinical significance of T2 mapping for the evaluation of masticator muscle conditions by comparing the difference in the T2 values between the painful and pain-free sides of the masseter muscle in patients with TMD. Methods: Seventy-three patients clinically diagnosed with TMD were enrolled in this study. We divided the patients into two groups: a unilateral pain group (patients with unilateral masseter muscle pain) and a painless group (patients without muscle pain). There were 29 patients in the unilateral pain group and 44 patients in the painless group. We compared the difference in the mean T2 values between the painful and pain-free sides of the masseter muscle in the unilateral pain group and between the right and left sides in the painless group. Results: The mean T2 values of the masseter muscle on the painful side were significantly higher than those on the pain-free side in the unilateral muscle pain group (p &lt
0.01). In the painless group, there was no significant difference in the mean T2 values between the right and left sides. Conclusions: It is suggested that T2 mapping is a promising method for evaluating masseter muscle pain caused by edematous change related to TMD through monitoring of the T2 values. © 2012 Japanese Society for Oral and Maxillofacial Radiology and Springer Japan.

DOI： 10.1007/s11282-012-0108-y

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To investigate the possibility of predicting salivation ability using pulsed Doppler ultrasonography.Thirty healthy volunteers were enrolled in this study. The blood flow velocity in the submandibular gland before and during acid stimulation was recorded by pulsed Doppler ultrasonography. The changes in the maximum blood flow velocity (V (max)) and minimum blood flow velocity (V (min)) were analyzed and compared with the salivation abilities.Strong linear correlations between before and during acid stimulation were observed in the amount of salivation (R = 0.879, p < 0.05) and the V (max) (R = 0.938, p < 0.05). The mean change rate in the stimulated V (max) was 1.58 (range 1.10-4.58), and the mean (range) change rates in the V (max) after 1, 3, and 5 min of acid stimulation were 0.96 (0.47-1.47), 0.97 (0.79-1.40), and 0.98 (0.70-1.23), respectively. No strong linear correlation was observed between the amount of salivation and the blood flow velocity.Although it is known that an increase in the amount of salivation is closely related to an increase in the blood flow velocity in the salivary glands, our findings did not show a linear correlation between the amount of salivation and the blood flow velocity.

DOI： 10.1007/s11282-012-0102-4

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Language：English   Publishing type：Research paper (scientific journal)   Publisher：Societatea Romana de Stomatologie  

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

Ghost cell odontogenic carcinoma (GCOC) is a rare malignant variant of odontogenic tumor with ghost cells; only 29 cases are documented. Our patient was a 68-year-old man with a painless, well-defined, radiolucent swelling of the mandibular gingiva in the right incisor-to-molar region. It was diagnosed as a benign calcifying cystic odontogenic tumor (CCOT) on fenestration biopsy. Eighteen years later, he returned with swelling in the same area. The lesion was excised, diagnosed as GCOC, and considered a secondary malignant manifestation of the benign CCOT. No adjuvant chemotherapy or radiotherapy was administered, and his postoperative course was uneventful for 48 months, with no recurrence or distant metastasis. Among the 30 reported cases of GCOC, the mean age at diagnosis was 40.3 years, 22 (73%) involved the maxilla. Twelve (40%) were secondary malignant manifestations of benign CCOTs or dentinogenic ghost cell tumors. Five patients died of recurrence or distant metastasis. (Oral Surg Oral Med Oral Pathol Oral Radiol 2012;114:e35-e40)

DOI： 10.1016/j.oooo.2012.01.018

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The diagnosis of orofacial pain associated with temporomandibular disorders after repeated temporomandibular joint (TMJ) surgeries can be quite difficult. This case report describes a 52-year-old woman who had previously undergone five TMJ surgeries and developed divergent pain caused by a trigger point in the left preauricular area. Computed tomography and magnetic resonance imaging could not be used to identify a lesion because of metallic artifacts from a TMJ prosthesis. However, sonography indicated the location of the suspected lesion. Moreover, a neurological examination performed with local anesthesia was clinically effective in ruling out other diagnoses of orofacial pain. Ultimately, a histopathological examination of a biopsy specimen from the painful site confirmed the lesion to be a traumatic neuroma. This case report suggests the value of including traumatic neuroma in the differential diagnosis of patients with a history of previous TMJ surgery who present with orofacial pain in the region of the TMJ.

DOI： 10.1179/crn.2012.028

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Language：Japanese   Publishing type：Research paper (scientific journal)   Publisher：Japanese Society of Oral and Maxillofacial Surgeons  

Polymorphous low-grade adenocarcinoma （PLGA） is a rare malignant salivary gland tumor arising most commonly in the palate. We report a case of PLGA in a 72-year-old woman. The patient had a protrusive tumor, measuring 18 × 18 mm, in the left retromolar region. Radiographically, it was located in the submucosa with smooth and shallow resorption of the mandibular bone cortex. A biopsy suggested a benign salivary gland tumor, although a definitive diagnosis was not obtained. The tumor was surgically removed under general anesthesia. It was easily removed from the surface of the mandibular bone. Histopathological examination of the surgical specimen showed a relatively well-demarcated solid epithelial tumor with focal lack of a fibrous capsule. Tumor cells showed a monotonously basaloid appearance characterized by various architectural patterns, including solid, tubular, trabecular, and cribriform ones. Immunohistochemically, the tumor cells were positive for keratin 7, vimentin, and S-100 protein, which indicated myoepithelial characteristics. It was finally diagnosed as PLGA. The postoperative course has been uneventful as of 2 years after surgery.

DOI： 10.5794/jjoms.58.262

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Language：English   Publishing type：Research paper (scientific journal)   Publisher：BRITISH INST RADIOLOGY  

We performed CT lymphography on an 81-year-old female patient with a histologically confirmed squamous cell carcinoma of the tongue with no clinical or radiological evidence of cervical lymph node involvement. The lateral lingual lymph node was identified as a sentinel node, which is the first lymph node to receive drainage from a primary tumour. CT lymphography also showed draining lymphatics passing through the sublingual space, the medial side of the submandibular gland and near the hyoid bone and connected with the middle internal jugular node. Although metastasis to the lateral lingual lymph node is known as one of the crucial events in determining survival outcome in cancer of the tongue and floor of the mouth, very few reports are available on the imaging of the lateral lingual lymph node metastasis. This is the first report regarding the lateral lingual lymph node identified as a sentinel node demonstrated on CT lymphography. Dentomaxillofacial Radiology (2012) 41, 254-258. doi: 10.1259/dmfr/61883763

DOI： 10.1259/dmfr/61883763

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

The diagnosis of orofacial pain associated with temporomandibular disorders after repeated temporomandibular joint (TMJ) surgeries can be quite difficult. This case report describes a 52-year-old woman who had previously undergone five TMJ surgeries and developed divergent pain caused by a trigger point in the left preauricular area. Computed tomography and magnetic resonance imaging could not be used to identify a lesion because of metallic artifacts from a TMJ prosthesis. However, sonography indicated the location of the suspected lesion. Moreover, a neurological examination performed with local anesthesia was clinically effective in ruling out other diagnoses of orofacial pain. Ultimately, a histopathological examination of a biopsy specimen from the painful site confirmed the lesion to be a traumatic neuroma. This case report suggests the value of including traumatic neuroma in the differential diagnosis of patients with a history of previous TMJ surgery who present with orofacial pain in the region of the TMJ. © 2012 by CHROMA, Inc.

DOI： 10.1179/crn.2012.028

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Objectives: The aims of this study were to confirm the course of the anterior superior alveolar nerve (ASAN) canal in maxillary bone on CT images and to clarify the components of its contents to provide new evidence for neurovascularization of the anterior jaw bones. Methods: The heads and two jaw bone specimens (maxillae) of three formalin-perfused cadavers were examined. The ASAN canal course was verified on cone-beam computed tomography (CBCT) images of the heads. Subsequently, the canal structures branching from the inferior orbital canal were dissected macroanatomically and compared with the CBCT images. Microanatomically, the ASAN canal was visualized in two bone specimens from the infraorbital region using micro-computed tomography (micro-CT). To verify the micro-CT findings, each specimen was sectioned for comparison with the histological observations. Results: The gross anatomy revealed close correspondence between the course of the ASAN canal on CBCT images and that of the neurovascular bundle dissected from the canal structures branching from the inferior orbital canal. Microscopically, it was verified on micro-CT images that the ASAN canal contained neurovascular bundles including nerve bundles, arteries, and veins. Conclusions: We confirmed that the canal-like structure in the anterior maxillary bone on CT images is the ASAN canal. It should be noted that the ASAN canal is filled with neurovascular structures. The present findings may provide useful information for clinicians assessing potential risks prior to anterior jaw bone surgical procedures. © 2011 Japanese Society for Oral and Maxillofacial Radiology and Springer.

DOI： 10.1007/s11282-011-0067-8

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

Objectives The aims of this study were to confirm the course of the anterior superior alveolar nerve (ASAN) canal in maxillary bone on CT images and to clarify the components of its contents to provide new evidence for neurovascularization of the anterior jaw bones.
Methods The heads and two jaw bone specimens (maxillae) of three formalin-perfused cadavers were examined. The ASAN canal course was verified on cone-beam computed tomography (CBCT) images of the heads. Subsequently, the canal structures branching from the inferior orbital canal were dissected macroanatomically and compared with the CBCT images. Microanatomically, the ASAN canal was visualized in two bone specimens from the infraorbital region using micro-computed tomography (micro-CT). To verify the micro-CT findings, each specimen was sectioned for comparison with the histological observations.
Results The gross anatomy revealed close correspondence between the course of the ASAN canal on CBCT images and that of the neurovascular bundle dissected from the canal structures branching from the inferior orbital canal. Microscopically, it was verified on micro-CT images that the ASAN canal contained neurovascular bundles including nerve bundles, arteries, and veins.
Conclusions We confirmed that the canal-like structure in the anterior maxillary bone on CT images is the ASAN canal. It should be noted that the ASAN canal is filled with neurovascular structures. The present findings may provide useful information for clinicians assessing potential risks prior to anterior jaw bone surgical procedures.

DOI： 10.1007/s11282-011-0067-8

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Language：Japanese   Publisher：(一社)日本顎関節学会  

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

The authors report a case of adenoid cystic carcinoma (ACC) complicated with sialolithiasis of the submandibular gland. The patient was a 43-year-old female with a history of papillotubular carcinoma of the breast almost at the same time. She had noticed a swelling in her sublingual area for 10 years, which was later diagnosed by her dentist to be due to a sialolith in the left submandibular gland. After several years of observation, the patient was referred to have her left submandibular gland, containing the stone, surgically removed with a diagnosis of atrophic sialadenitis. Histopathologically, the submandibular gland was extensively replaced with fibrous granulation tissue, in which there were small but invasive foci of ACC. The present case indicates that ACC could arise in the background of chronic sialadenitis. It is suggested that long-standing sialadenitis cases should be carefully examined to exclude suspicion of malignancy before surgery.

DOI： 10.1016/j.ijom.2010.11.009

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Language：English   Publishing type：Research paper (scientific journal)   Publisher：BRITISH INST RADIOLOGY  

In this article we report a case of desmoplastic ameloblastoma in which chronological changes in the early development can be observed on dental radiographs. The tumour grew very slowly and did not appear to have a strong potential for local extension like typical ameloblastomas. Radiological findings of our case suggest the tumour arose from the periodontal membrane. However, it was not possible to obtain conclusive histopathological evidence. Dentomaxillofacial Radiology (2011) 40, 126-129. doi: 10.1259/dmfr/55423624

DOI： 10.1259/dmfr/55423624

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Language：English   Publishing type：Research paper (scientific journal)   Publisher：ELSEVIER IRELAND LTD  

Purpose: There are no entire maxillary finite element analysis models available, as a base of reference for the dimensions of conventional segment finite element analysis models. The objectives of this study were: (1) to construct a maxillary model derived from a human skull and to investigate the strain distribution around a posterior implant embedded in it; (2) to investigate the usability of conventional segment maxillary models.
Methods: CT DICOM data of a human dried skull maxilla was imported into the Mesh Generation Tools (ANSYS AI environment) and a computer-generated implant-abutment unit was bicortically embedded into it. In this Large model, Von Mises strains under axial and buccolingual loads were then calculated by a finite element program. Moreover, two simplified maxillary segments (Simplified models) were computer-generated and their Von Mises strains were similarly calculated.
Results: Although absolute values differed markedly, strain distribution patterns in the cortical bone were similar to those in the Simplified models: high Von Mises strains in the cortical bone concentrated in the sinus floor around the implant apex under axial load, and in the alveolar crest around the implant neck under buccolingual load.
Conclusions: The simplified and segmented three-dimensional finite element models of the human maxilla showed the same locations of the highest equivalent strains as the full maxilla model created from CT DICOM data. If absolute strain values are not of interest, the Simplified models could be used in strain analyses of simulated posterior maxilla for diagnostic suggestions in implant placement. (C) 2010 Japan Prosthodontic Society. Published by Elsevier Ireland. All rights reserved.

DOI： 10.1016/j.jpor.2010.07.002

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Language：Japanese   Publisher：(一社)日本口腔ケア学会  

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Language：Japanese   Publisher：特定非営利活動法人 日本顎変形症学会  

Regarding diagnostic imaging for surgical correction of jaw deformities, a three-dimensional evaluation of upper-airway structures composing the airway wall morphology is considered to be essential for predicting post-operational changes in the volume and shape of the airway. The aims of this study were as follows: (1) to propose useful measuring methods for estimating the morphology of the pharyngeal airway, (2) to identify which morphologic factor has the greatest influence on the volume of the pharyngeal airway, and (3) to investigate the relationship between the maxillofacial morphology and pharyngeal airway shape.&lt;br&gt;Pre-operative CT images of seventy-nine patients with jaw deformity aged from 15 to 20 years who were candidates for surgical orthodontic treatment were used in this study. The airway was measured from the nasopharyngeal level to tongue-base level, and the average cross-sectional area was calculated from the volume and length of the airway. To obtain the area, antero-posterior diameter, and width measurements, cross-sections at four levels were selected in the upper airway; i.e., nasopharyngeal level, hard-palate level, oropharyngeal level, and tongue-base level. In order to evaluate the correlation between maxillofacial and pharyngeal morphology, cephalometric analysis was carried out using lateral cephalograms. The subjects were divided into two groups based on skeletal deformities of Class II and Class III from the results of cephalometric analysis, and the differences in pharyngeal morphology between the two groups were investigated statistically. The significance level was set at P &lt; 0.05. The average volume and average cross-sectional area of the pharyngeal airway was 15.71 &amp;plusmn; 5.36 cm&lt;sup&gt;3&lt;/sup&gt; and 2.23 &amp;plusmn; 0.74 cm&lt;sup&gt;2&lt;/sup&gt; respectively. Our results revealed that the area at the oropharyngeal level mostly contributed to the size of the pharyngeal airway. It was demonstrated that the area and anteroposterior length at the palatal level in the skeletal Class II group were significantly smaller than those in the skeletal Class III group. Even though no statistical significance was found between the two groups, the width of the airway in the hard-palate level and antero-posterior length in the oropharyngeal level showed a possible statistical correlation with some cephalometric measurement values, indicating that there could be some relationship between airway and maxillofacial morphology.

DOI： 10.5927/jjjd.21.215

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Language：Japanese   Publishing type：Research paper (scientific journal)   Publisher：Japanese Society of Oral Oncology  

目的：舌扁平上皮癌症例における口底部の介在リンパ節への後発転移の画像所見について検討を行う。<br>対象と方法：1997年から2007年までの間に，口底部の介在リンパ節への後発転移と考えられる腫瘤性病変が出現した舌扁平上皮癌5症例を検討対象とした。いずれも1か月に1回の綿密な超音波診断による経過観察で検出されたものであり，CTとMRI検査が引き続き施行された。われわれは，転移巣が舌下隙後方で顎下腺内側に出現した場合に，外側舌リンパ節と同様の介在リンパ節への転移と考え，傍顎下腺リンパ節転移と呼称することとした。<br>結果：術前画像と頸部郭清で得られた病理標本との照合の結果，2例は外側舌リンパ節転移，2例は傍顎下腺リンパ節転移，1例はそれらの両方と推測された。同期間に口底部の介在リンパ節に転移を来たした症例は潜在的転移が認められた2例を含めて7例であり，頸部リンパ節転移が証明された舌扁平上皮癌43例の16.3%に及んだ。<br>結論：傍顎下腺リンパ節は，外側舌リンパ節とともに舌から上内頸静脈リンパ節にいたる経路の介在リンパ節の役割を有すると考えられた。N0舌扁平上皮癌の経過観察において，外側舌リンパ節と傍顎下腺リンパ節への後発転移を画像で検出するには，正確な解剖学的知識と注意深い観察が必要と考えられる。

DOI： 10.5843/jsot.22.25

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Other Link： http://search.jamas.or.jp/link/ui/2010145564

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DOI： 10.1179/crn.2009.037

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

Purpose: To assess the clinical significance of a portable ultrasound system for the diagnosis of lymph node metastasis in patients with oral cancer, we investigated the diagnostic accuracy of sonography as compared with histopathological results.Materials and methods: From January 2007 through July 2008, 26 consecutive patients with oral cancer who underwent neck dissection were studied. A total of 268 sonographically detected lymph nodes were histopathologically evaluated for metastasis, and a side-by-side comparison of lymph nodes between preoperative sonography and histopathology was performed. The portable ultrasound equipment we used was a GE LOGIQ-e with a 5-13 MHz linear transducer. On sonography, a metastatic lymph node was defined as a lymph node with a minimal axial diameter of more than 8 mm that lacked an echogenic hilum, had a heterogeneous internal structure that reflected central necrosis, or both.Results: Of the 268 nodes, 45 nodes were metastatic, and the remaining 223 were non-metastatic on histopathological examination. When the lymph nodes were compared between preoperative sonography and histopathological specimens on a side-by-side basis, the sensitivity, specificity, and accuracy for the detection of metastasis were 64.4 %, 98.7 %, and 92.9 %, respectively.Conclusion: Although the sensitivity was slightly low, our results suggested that the portable ultrasound system was useful for the detection of cervical lymph node metastasis in patients with oral cancer, particularly during postoperative follow-up.

DOI： 10.5794/jjoms.55.408

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Language：Japanese  

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DOI： 10.1016/j.cca.2009.03.018

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

Purpose: To evaluate the significance of our dental management protocol by observing the chronological change of dental health of head and neck radiotherapy patients. Patients and Methods: Fifty-two head and neck radiotherapy patients who had received dental management to prevent and/or alleviate their oral complications were enrolled in this study. They were followed for three or more years after radiotherapy. We divided them into three groups according to the timing of the start of dental management
Pre, Mid and Post. The chronological changes of dental status (DMFT and the number of tooth extractions) and osteoradionecrosis were investigated for three to five years. Results: The increase in the DMFT index of the Pre and Mid groups was reduced to less than 2 by introducing our dental management protocol. On the contrary, the number of unavoidable tooth extractions following radiotherapy was the least in the Pre group. The incidence rates of osteoradionecrosis of the mandible in the Pre, Mid and Post groups were 6.5%, 18.0% and 20.0% respectively. Conclusion: Our dental management protocol was proved to be effective in maintaining dental health and helpful in controlling osteoradionecrosis following head and neck radiotherapy. For a more effective outcome, we advocate that dental management should commence before the start of head and neck radiotherapy. © 2009, Japan Society for Head and Neck Cancer. All rights reserved.

DOI： 10.5981/jjhnc.35.266

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Language：Japanese   Publisher：新潟歯学会  

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DOI： 10.11277/stomatology1952.57.371

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Other Link： http://search.jamas.or.jp/link/ui/2009062022

Language：English   Publishing type：Research paper (scientific journal)   Publisher：BRITISH INST RADIOLOGY  

We report Bill unusual case of adenoid cystic carcinoma (ACC) arising in the sublingual gland and extending into the submandibular duct. Our article mainly describes the MR findings. The margin of the mass was well-defined and the mass was divided into two parts - anterior and posterior. The anterior part of the mass showed isointense to surrounding muscle on T-1 weighted images and hyperintense on fat-saturated T-2 weighted images. The posterior part of the mass showed hyperintense both on T-1 weighted and fat-saturated T-2 weighted images. The findings indicated that the cystic space of the posterior part was filled with tumour mass which extended from the anterior part. ACC of the sublingual gland extending into the submandibular duct is rare and the MR findings have not been previously described in the literature.

DOI： 10.1259/dmfr/31299961

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OBJECTIVE: Oral health status is a risk factor for postradiation bone complications (also known as osteoradionecrosis [ORN]), and oral health care is an important element in the prevention of this condition. Some authors recommend extracting teeth with a questionable prognosis and either gross mobility or periodontal disease. However, the criteria for making such decisions remain to be elucidated. In addition, the specific details of the association between oral health status and ORN have not yet been clearly demonstrated. The purpose of this study was to clarify the relationship between oral health status and the development of ORN. STUDY DESIGN: Thirty-nine head and neck cancer patients whose radiation fields included both the teeth and the mandible were followed for > or = 3 years after radiotherapy. Among these patients, 6 suffered from ORN (ORN group), and the other 33 did not experience the condition (non-ORN group). We analyzed the patient factors, radiation factors, and oral health factors related to the complication. RESULTS: The onset of ORN occurred from 18 months to 51 months after radiotherapy. The radiation dose in the oral cavity and the oral health status before radiotherapy were not significant risk factors for ORN. However, the oral health status at 1 year or 2 years after radiotherapy was significantly associated with the development of ORN. The oral health conditions that increased the risk of ORN were > 5 mm periodontal pocket depth, > 40% dental plaque score, > 60% alveolar bone loss level, and a grade 3 radiographic periodontal status. CONCLUSION: This is the first report to show the changes in the oral health status before and after radiotherapy regarding the development of ORN. The results support the periodontal status that almost all clinicians agree on as indications for preradiation teeth extraction (namely, periodontal pockets of > 5 mm) to prevent ORN. Good oral health status, especially after radiotherapy, is very important in the prevention of ORN, and we recommend periodical dental management and care by well trained dentists and dental hygienists to avoid the condition.

DOI： 10.1016/j.tripleo.2007.10.011

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DOI： 10.1016/j.tripleo.2007.10.011

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Language：Japanese   Publisher：新潟歯学会  

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Other Link： https://search.jamas.or.jp/default/link?pub_year=2008&ichushi_jid=J00999&link_issn=&doc_id=20080811360013&doc_link_id=%2Fdj2ngtdt%2F2008%2F003801%2F018%2F0047-0047%26dl%3D2&url=https%3A%2F%2Fwww.medicalonline.jp%2Fjamas.php%3FGoodsID%3D%2Fdj2ngtdt%2F2008%2F003801%2F018%2F0047-0047%26dl%3D2&type=MedicalOnline&icon=https%3A%2F%2Fjk04.jamas.or.jp%2Ficon%2F00004_5.gif

Language：English   Publishing type：Research paper (scientific journal)   Publisher：BRITISH INST RADIOLOGY  

Objectives: The aim of this study is to discuss the pathological course of chronic osteomyelitis of the mandible by investigating a correlation between CT and histopathological findings and to argue the usefulness of CT examination in the evaluation of mandibular chronic osteomyelitis.
Methods: CT images obtained between 1997 and 2004 of 62 lesions in 60 patients with chronic osteomyelitis involving the mandible were reviewed retrospectively. CT images obtained at initial examination or pre-operative evaluation were reviewed and CT findings of affected bone were classified into three patterns: bone-defect pattern, frosted-glass pattern and compact-bone pattern. In 7 of 62 lesions, CT images and histopathological specimens were selected to obtain a side-by-side comparison in order to clarify what histopathological features reflect those three patterns of CT findings. Additionally, the correlations among the three patterns in the course of mandibular chronic osteomyelitis were also assessed.
Results: The areas of bone-defect pattern, frosted-glass pattern and compact-bone pattern observed on CT images were revealed to indicate fibre-rich granulation tissue, new formation of bony trabeculae and thickening of bony trabeculae on histopathological findings, respectively.
Conclusions: It was considered that these three patterns are significant in the evaluation of the process of the course of chronic osteomyelitis. We advocate that CT is useful to grasp the complex pathological conditions of chronic mandibular osteomyelitis.

DOI： 10.1259/dmfr/38320433

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The EUB-8500 with the newly-developed “real-time tissue elastography” technology enables the tissue elasticity to be displayed. Real-time tissue elastography may thus be useful for characterizing pathological tissue in cervical lymph node metastases in oral cancer. Therefore, we studied its clinical usefulness in diagnosing cervical lymph node metastases in oral cancer using an ultrasound diagnostic system equipped with the real-time tissue elastographic function. Twenty-six lymph nodes in 15 patients with oral cancer were enrolled in this study. Based on the Tsukuba Elastography Score, we classified real-time tissue elastographic images of lymph nodes in five patterns. The patterns of images were compared with the histopathological diagnosis obtained by surgery. Furthermore, we considered lymph nodes as non-metastatic when no metastatic findings were observed within a follow-up period of one year or more. Metastatic lymph nodes showed pattern 3, 4 or 5. Non-metastatic lymph nodes showed pattern 1 or 2. The differences of tissue elasticity between metastatic lymph nodes and non-metastatic lymph nodes were clearly identified. If the patterns above category 3 were assumed as metastases, the precision of diagnosis was as follows: sensitivity of 92%, specificity of 86%, accuracy of 88%, PPV (positive predictive value) of 85% and NPV (negative predictive value) of 92%. Additionally, metastatic lymph nodes with a minimum axial diameter of 0.5 cm could be precisely detected using elastography. Real-time tissue elastography is a promising method which allows characterization and differentiation of benign and malignant lymph nodes with a high sensitivity, specificity and accuracy, offering complementary information to conventional ultrasonographic imaging. © 2008, Japan Society for Head and Neck Cancer. All rights reserved.

DOI： 10.5981/jjhnc.34.518

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Language：English   Publishing type：Research paper (scientific journal)   Publisher：Scientific Communications International Ltd  

Custom-made artificial bone produced by the figurative lithographic method based on 3-dimensional computed tomography data is now available as a compatible and reliable implant. We describe a patient with hemifacial microsomia who was treated with custom-made artificial bone, made from hydroxyapatite, for facial symmetry. Using the implant was less invasive surgically and shortened the operating time. A full-scale model and template were created using the binder jet method and 3-dimensional computed tomography images reformatted with single-helical scan data. These technologies were useful for producing the custom-made implant and explaining the procedure to the patient perioperatively. A symmetrical profile of the patient's face has been maintained without any resorption of the implant and graft bed for 3 years. The hydroxyapatite custom-made implant was effective for facial rehabilitation in the treatment of mandibular asymmetry due to hemifacial microsomia. © 2008 Asian Association of Oral and Maxillofacial Surgeons.

DOI： 10.1016/S0915-6992(08)80028-3

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DOI： 10.5927/jjjd1991.17.29

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Language：English   Publishing type：Research paper (scientific journal)   Publisher：BRITISH INST RADIOLOGY  

Objectives: We investigated condylar bone changes in 1032 joints from 516 subjects in order to clarify the incidence and type of bone changes in the temporomandibular joint (TMJ), and alteration of the change during follow-up, in patients with temporomandibular disorders (TMD).
Methods: We classified condylar bone change into five types on multiplanar reformatted (MPR) images of helical CT: N, no bone change; F, flattening; E, erosion with or without roughening; D, deformity; S, deformity accompanied by erosion with or without roughening. In 51 of 516 subjects, follow-up CT examination was performed and transition of condylar bone change was observed.
Results: Condylar bone change was seen in 617 (63.7%) of 1032 joints and in 70 (68.6%) of 102 follow-up joints. The number of joints of Types D and S increased at follow-up, but those of Types N, F and E decreased.
Conclusion: In this study, the main direction of transition of condylar bone change in joints with TMD was absorptive bone change to absorptive with sclerotic (proliferative) bone change and further to sclerotic (proliferative) bone change. Our classification of condylar bone change was thought to be convenient for the evaluation of bone change in TMD.

DOI： 10.1259/dmfr/28078357

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Language：Japanese   Publisher：新潟歯学会  

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DOI： 10.11242/dentalradiology.47.53

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Language：Japanese   Publishing type：Research paper (scientific journal)   Publisher：Niigata University  

The purpose of this study was to evaluate the relationship between three-dimensional ratio of mandibular deviation and volume of masseter muscle in the jaw deformity patients with mandibular deviation by the use of volume rendering technic. Subjects comprised 17 patients diagnosed as skeletal mandibular prognathism with deviation. Volume rendering technic facilitated extraction of masseter muscle from the three-dimensional image with CT, and enabled us to perform volume measurement of masseter muscle precisely. There was no significant correlation between three-dimensional ratio of mandibular deviation and volume difference of masseter muscle in deviated and the opposite side(r = - 0.35). In addition, volume of masseter muscles in the deviated side might not necessarily be larger than that in the contralateral side. This finding suggests that morphological difference of masseter muscles in between deviated side and the opposite side is not necessarily observed in the jaw deformity patients with facial asymmetry.

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

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DOI： 10.5927/jjjd1991.16.12

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

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DOI： 10.5927/jjjd1991.15.87

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Language：English   Publishing type：Research paper (scientific journal)   Publisher：BRITISH INST RADIOLOGY  

Objectives: Head and neck radiologists should be familiar with typical post-therapeutic changes on enhanced CT after neck dissection because CT is widely used for the follow-up study in order to detect recurrent turnours at an early stage. The purpose of this study was to reveal post-therapeutic anatomical alterations and non-neoplastic processes demonstrated on enhanced CT.
Methods: Radical neck dissections were performed in 39 necks and modified radical neck dissections were performed in 8 necks. Post-operative radiotherapy was performed on 21 patients. Follow-up CT, studies were made within a period of 24 months.
Results: On enhanced CT, the densities of soft tissues replacing the resected structures were homogeneous in 44 necks and showed no contrast enhancement in 39 necks. During the 24 months after treatment, most of the soft tissues did not increase in size and the attenuation of the soft tissue remained unchanged. In 44 of 47 necks, lymphoedema (LE) was observed around the carotid artery at an early stage, and it converged into the space between internal carotid artery and external carotid artery gradually. In patients without post-operative radiotherapy, LE was observed around the carotid artery in 17 of 23 necks at 3 months after neck dissection and disappeared rapidly thereafter. In patients with post-operative radiotherapy, LE increased until 3 months after radiotherapy and decreased slowly thereafter.
Conclusions: This is the first report of enhanced CT evaluation of LE around the carotid artery after neck dissection probably exacerbated by irradiation. Clinicians should be aware of LE around the carotid artery in patients with post-operative radiotherapy because of the possible risk of neck cellulitis at least 1 year after treatment.

DOI： 10.1259/dmfr/31581800

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Language：Japanese   Publisher：新潟歯学会  

過去の報告を踏まえ,主として顎関節症に対する遠隔診断支援システムの構築を計画した.今回,予備的調査を行い,診断支援の必要性と適切な情報交換の方法について検討し,歯科領域での遠隔診断支援について運用可能な形式を検討した.新潟県歯科医師会全会員1310名にアンケートを郵送した.診断支援は,口腔外科,顎関節症,隣接医学,歯科放射線,口腔病理など口腔外科に関連した分野の希望が多かった.診断支援の際に利用を希望する通信方法は,電子メールの希望者が多かった.診査・診断機器では顎機能検査機器の利用者は少なかった.顎関節症患者は個人開業医よりも病院歯科に集まる傾向が明らかになった.診断支援の必要性については,必要性を認めている回答が多かった

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

This study investigated the association of craniofacial and glenoid fossa shapes and temporomandibular joint (TMJ) pathology in 39 orthodontic patients with signs and symptoms of TMJ disorders, using helical CT scans. Cephalometric measurements showed that 21 subjects with bilateral condylar bone change (BBC) had significantly smaller SNB angles, ramus heights and S-Ar/N-Ba ratios, as well as larger mandibular plane angles and lower anterior facial height than the 18 subjects with no condylar bone change (NBC). The average posterior slope of the left and right articular eminence in their central and lateral sections was significantly steeper in NBC than in BBC. Condylar bone change might, therefore, not only be related to the morphology of the mandible, but also of the glenoid fossa and cranial base. This appears to reflect adaptive changes in the condyle, articular eminence and cranial base in response to changes in loading. Copyright © 2005 by CHROMA, Inc.

DOI： 10.1179/crn.2005.036

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

This study was done to try to clarify the relationship between double contours and craniofacial morphology. The study sample included 56 pre-orthodontic patients with signs and symptoms of temporomandibular joint (TMJ) disorders. A comparison of craniofacial structures was done on 32 subjects with bilateral condylar bone change (BBC group: 28 female and 4 male) and 24 subjects with no condylar bone change (NBC group: 21 female and 3 male). The BBC showed significantly greater antegonial and ramus notch depths, as well as significantly more retruded mandibles, shorter ramus heights, and larger mandibular plane angles than the NBC. BBC subjects with bilateral double contours showed significantly more retruded mandibles, larger antegonial notch depth, and shorter lengths from the Sella to the Articulare than BBC subjects with no double contours. The study showed that important relationships exist between the presence of double contours and mandibular morphology and TMJ position. Copyright © 2005 by CHROMA, Inc.

DOI： 10.1179/crn.2005.020

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

This study showed significant differences in sagittal condylar and incisal path angles during mandibular protrusive excursion, as well as flattening of the condylar path related to the existence and type of condylar bone change. Twenty-eight (28) patients with signs and symptoms of TMJ disorders were studied, using a six-degrees-of-freedom measuring device and helical CT. Sagittal incisal and condylar path angles at two mm and three mm condylar path lengths (CPL) were significantly shorter in the bilateral condylar bone change (BBC), compared to the no bone change (NBC) group. Also, NBC incremental sagittal condylar path angles from three to five mm CPL and NBC condylar path curvature at five mm CPL were both significantly larger than in BBC. Comparing types of bone change, incremental sagittal condylar path angles from three to five mm CPL was significantly less in osteophyte than in NBC or erosion groups. Condylar path curvature at five mm CPL was also significantly less in osteophyte than in NBC. Copyright © 2005 by CHROMA, Inc.

DOI： 10.1179/crn.2005.026

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The purpose of this study was to investigate the condylar displacement from intercuspal position (IP) to reference position (RP), using a jaw movement measuring system with 6 d.f. and helical computed tomography (CT). The 19 patients included in the present study were divided into a group with bilateral condylar bone change (10 subjects, including the sub-groups with flattening and osteophyte formation) and a group with no condylar bone change (9 subjects). The results showed that the bone change group had significantly more superior, posterior and absolute horizontal IP to RP slides than the no bone change group. There was also a significant difference in the amount of anteroposterior and supero-inferior condylar IP-RP displacements related to the type of condylar bone change within the bone change group. The osteophyte sub-group showed the largest posterior displacement, and the flattening sub-group showed the largest superior displacement. These results suggested that this large IP-RP difference in the bone change group might be related to their temporomandibular joint (TMJ) pathology, and it might therefore be useful to keep this difference in mind as one of the clinical indices suggesting the presence of TMJ osteoarthritis (OA).

DOI： 10.1111/j.1365-2842.2004.01285.x

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The purpose of the present study was to investigate the relationship between the inclination of the articular eminence and temporomandibular joint (TMJ) pathology in orthognathic surgery patients with signs and symptoms of TMJ disorders. Twenty-one female orthognathic surgery patients with signs and symptoms of TMJ disorders were examined using pre-treatment helical computed tomography scans. The slope of the eminence in the medial, central and lateral sections of the subjects with osteophyte formation was significantly less than in the subjects with no bone change, and the medial section of the subjects with osteophyte formation was also significantly less steep than in the subjects with erosion. The central and lateral sections in the subjects with anterior disc displacement with reduction were significantly steeper than in subjects with anterior disc displacement without reduction. These results suggest that eminence flattening might occur during changes from erosion to osteophyte formation and from anterior disc displacement with reduction to anterior disc displacement without reduction. This appears to represent adaptation of the condyle, articular disc and articular eminence to changes in loading.

DOI： 10.1111/j.1365-2842.2004.01255.x

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

Temporomandibular joint (TMJ) osteoarthritis (OA) is a potential cause of craniofacial deformity. If TMJ OA appears during orthodontic treatment, the mandible usually rotates posteriorly, resulting in an unsatisfactory profile, especially in patients with pre-treatment mandibular retrusion. Although it is important to confirm the kind of TMJ pathosis at the start of orthodontic treatment, the relationship between TMJ OA, condylar remodelling and changes in craniofacial morphology remains unclear because of a lack of longitudinal studies. Elucidating this relationship might allow better prediction of post-treatment craniofacial morphology. In the present case reports, helical computed tomography and cephalometry were used to analyse relationships between the pattern and location of condylar remodelling and the changes in craniofacial morphology in three patients with TMJ OA.

DOI： 10.1046/j.1365-2842.2003.01246.x

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In order to distinguish benign from malignant nodules within the dissected neck area in patients with oral cancer during the follow-up period, we retrospectively evaluated the frequency and characteristic findings of fusiform-shaped nodules along the internal carotid artery observed by follow-up sonography. From 1997 to 2003, 52 patients with oral cancer, who underwent radical neck dissections, were enrolled in this study. The study cohort consisted of 33 males and 19 females ranging in age from 29 to 84 years (mean, 62.0 years). After neck dissection, every patient was examined repeatedly with sonography during the follow-up period at an interval of one month. CT and/or MRI were performed when clinically required. Any patient with recurrent neck mass was excluded from this study. In the 52 patients, fusiform-shaped nodules were observed in 10 patients (19%) by the follow-up sonography. The nodules were homogenously hypoechoic and the margin was well-demarcated except for the upper end. A hyperechoic core was clearly observed in every nodule, which showed a fatty density on post-contrast CT. On post-contrast MRI, the nodules enhanced markedly and the core showed hypointensity on fat saturated images. In conclusion, it was suggested that the fusiform-shaped nodules observed by follow-up sonography within the dissected neck area might be the superior cervical ganglion of sympathetic trunk. However, further studies are needed to disclose the true character of the nodules. © 2004, Japan Society for Head and Neck Cancer. All rights reserved.

DOI： 10.5981/jjhnc.30.630

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DOI： 10.1016/j.ooe.2004.06.002

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Language：English   Publishing type：Research paper (scientific journal)   Publisher：Japanese Society for Oral Pathology  

A case of a dentigerous cyst associated with a malformed supernumerary tooth is reported, and the clinicopathological characteristics of dentigerous cysts with abnormal dentition are reviewed from the literature and our hospital records. A 7-year-old boy had a painless and radiolucent lesion in his right molar region of the mandible. Radiographic examinations revealed that a well-defined cystic lesion, measuring 20 mm in diameter and containing a toothlike calcified structure, was located between the first and second molar tooth germs. Histopathologically, the cyst wall was composed of fibrous granulation tissue with a squamous epithelial lining. The calcified structure was a reversely concaved tooth crown which protruded into the cystic lumen with its enamel layer at the inner surface. The cyst lining epithelium was continuous with the reduced enamel epithelium covering the malformed tooth. A review of the literature and a case survey in our hospital showed that about 10% of dentigerous cysts were associated with supernumerary teeth which were mostly located in the median region of the maxilla, but that those in the mandibular molar region were extremely rare.

DOI： 10.3353/omp.8.55

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Other Link： http://search.jamas.or.jp/link/ui/2004123238

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

DOI： 10.5927/jjjd1991.13.12

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We report a case of odontogenic keratocyst with a respiratory epithelial lining and a malformed impacted tooth in the maxilla of a 39-year-old Japanese female who suffered from swelling symptoms for half a year. CT examinations revealed an air-filled cystic lesion with an impacted tooth crown in the maxillary bone which expanded to the nasal cavity as well as to the maxillary sinus. Histopathologically, the surgically removed cyst wall consisted of fibrous granulation tissue with a lining of parakeratinized squamous epithelium as well as ciliated pseudostratified epithelium and with retention of desquamated keratin materials in the lumen. The impacted tooth was malformed lacking a root portion. We discuss the frequency of respiratory epithelium in odontogenic keratocysts.

DOI： 10.1034/j.1600-0714.2003.00149.x

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Language：English   Publishing type：Research paper (scientific journal)   Publisher：AMER SOC NEURORADIOLOGY  

We present the non-contrast-enhanced CT finding of high attenuation within metastatic regional lymph nodes in two patients with stage I or II tongue carcinoma during a follow-up period. The attenuation values of these lesions were approximately 70 HU or more. One patient had a level I node, and the other had a level II node. Contrast-enhanced CT failed to reveal these hyperattenuated areas within the nodes. Histopathologic examination revealed that these hyperattenuated areas were strongly correlated with the area of marked keratinization of metastatic foci. If contrast-enhanced CT had been the only imaging technique used, these lesions might have been overlooked. The clinician should be aware of the characteristic findings of non-contrast-enhanced, as well as contrast-enhanced, CT when investigating lymph node metastases at an early stage in patients with stage I or II tongue carcinoma during the follow-up period.

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Language：English   Publishing type：Research paper (scientific journal)   Publisher：MOSBY, INC  

Objective. We sought to assess the reliability of repeated sonography in the detection of cervical lymph node metastases at the earliest stage during a follow-up period in patients with stage I or stage II carcinoma of the tongue.
Study design. Eighteen consecutive patients with stage I or II squamous cell carcinoma of the tongue were included. When possible, every patient was examined with sonography approximately every 2 weeks during the follow-up period.
Results. With repeated sonography on 18 patients, 7 metastatic nodes of 7 patients (39%) meeting our criteria were found. With the use of computed tomography, we diagnosed 10 nodes (including the 7 nodes observed with sonography) in these 7 patients as metastatic. A histopathologic examination revealed that 12 nodes in the same 7 patients had metastatic foci. For sonography, the sensitivity per node was 58%, whereas that of computed tomography was 83%.
Conclusions. Follow-up sonography enabled the detection of all patients who had subsequent subclinical lymph node metastases. However, the sensitivity of sonography in the detection of smaller metastatic nodes was lower than that of computed tomography.

DOI： 10.1016/S1079-2104(03)00259-2

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Language：English   Publishing type：Research paper (scientific journal)   Publisher：BRITISH INST RADIOLOGY  

Objectives: The aim of this study is to investigate the relationship between the thickness of the roof of the glenoid fossa in the temporomandibular joint (TMJ) and the existence and types of condylar bone change.
Material and methods: Helical CT was used to measure the thickness of the roof of the glenoid fossa at its thinnest part in 37 orthodontic patients with temporomandibular disorders. Condylar bone changes were classified into four types: no bone change (24 joints); flattening (19 joints); osteophyte formation (13 joints); and erosion (18 joints).
Results: The roof of the glenoid fossa was significantly thicker in joints with bone change than in joints with no bone change (Mann-Whitney U-test, P &lt; 0.05). There was also a significant difference in relation to the type of condylar bone change: the thickness of the roof of the glenoid fossa in the erosion group was significantly greater than in the no bone change (P &lt; 0.01), flattening (P &lt; 0.05) and osteophyte formation (P &lt; 0.05) groups (Kruskal-Wallis and Games-Howell tests).
Conclusion: Compensative bone formation in the roof of the glenoid fossa might help to withstand the increased stress in the TMJ accompanying condylar bone change, especially erosion.

DOI： 10.1259/dmfr/15476586

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Language：English   Publishing type：Research paper (scientific journal)   Publisher：BRITISH INST RADIOLOGY  

Objectives: The aim of this study was to investigate the reliability of quantitative evaluation of bone trabeculae by helical CT.
Methods: Ten specimens of human cadaver mandibular condyles were examined using both micro-CT and helical CT, and volume rendered three-dimensional (3D) images were obtained from the CT data. Micro-CT was used as the reference standard. From the micro-CT data images, bone trabeculae in each condyle were extracted by image processing and their volumes were calculated automatically. From the helical CT data images, the cortical bone was manually removed and bone trabeculae in each condyle were extracted using opacity curve and colour mapping thresholds. The optimal cut-off CT value that resulted in a similar volume of bone trabeculae obtained from helical CT and micro-CT data was investigated.
Results: The optimal cut-off CT value to assess the volume of bone trabeculae accurately on 3D images obtained with helical CT data was found to be 200 Hounsfield units.
Conclusions: This study suggests that quantitative evaluation of bone trabeculae using helical CT might be a valid and useful method.

DOI： 10.1259/dmfr/28959099

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

This study was conducted to investigate the relationship between posterior mandibular excursion movement and temporomandibular joint osteoarthritis (TMJ OA) in 25 orthodontic patients with Angle Class I and Class II, using a six degrees-of-freedom measuring device and helical computed tomography. There were significant differences found in three-dimensional length, antero-posterior, absolute latero-medial and supero-inferior incisal, and condylar intercuspal position (IP)-retruded contact position (RCP) slides between bilateral, unilateral, and no condylar bone change groups. With respect to the types of condylar bone change, there were significant differences found in three-dimensional length, antero-posterior, and absolute latero-medial condylar IP-RCP slides between flattening, erosion and osteophyte groups. These results suggest that large three-dimensional, not only incisai but also condylar, IP-RCP slides might be related to the uni-/bilaterality and kind of TMJ pathosis, which might make such slides useful as clinical indices of TMJ OA. Copyright © 2003 by CHROMA, Inc.

DOI： 10.1080/08869634.2003.11746257

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

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Skeletal stability and temporomandibular joint (TMJ) signs and symptoms were analyzed in 23 patients in whom mandibular protrusion and mandibular deviation had been corrected using bilateral sagittal split ramus osteotomy (BSSRO group, n = 10) and unilateral SSRO and intraoral vertical ramus osteotomy (USSRO+IVRO group, n = 13). Miniplate fixation was used in SSRO but no fixation was used in IVRO. The ratio of condylar bony change was 30.4% (7/23) and all condylar bony changes were seen on the deviated side. All preoperative signs and symptoms of TMJ disorders (4/13 patients in the USSRO+IVRO group and 2/10 patients in the BSSRO group) disappeared after surgery. Comparing the USSRO+IVRO group and the BSSRO group, in patients without condylar bony change, the mandible in both groups was stable anteriorly and horizontally after surgery, even though there was a larger horizontal mandibular movement in the USSRO+IVRO group during surgery. Comparing patients with condylar bony change versus no condylar bony change in the USSRO+IVRO group, postoperative horizontal mandibular displacement was significantly larger in the condylar bony change group than in the no condylar bony change group. These results support the idea that USSRO+IVRO can be useful in correcting mandibular deviation as well as improving signs and symptoms of TMJ disorders. However, it also seems important to be aware of the possibility of horizontal mandibular relapse in patients with condylar bony change.

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Language：Japanese   Publishing type：Research paper (scientific journal)   Publisher：THE JAPANESE SOCIETY FOR JAW DEFORMITIES  

In this study, changes in temporomandibular joint symptoms and mandibular stability after orthognathic surgery in patients with mandibular retrognathism were investigated. Eight patients were examined clinically for pain, sound, movement and limitation of TMJ and by computed tomography (CT) and lateral cephalograms. TMJ signs and symptoms disappeared in two of the symptomatic patients after surgery, whereas two of the asymptomatic patients developed TMJ signs and symptoms postoperatively. The incidences of TMJ signs and symptoms before treatment and a year after surgery were both 3/8 (27.5%). The position of the disk and the condylar morphology were evaluated with CT. Six patients had disk displacements before treatment and seven patients a year after surgery. Erosions and/or deformities of the condyles were observed in six patients before treatment and all (eight) patients a year after surgery. The diagnosis in five patients was progressive condylar resorption because the ramus vertical hights decreased more than 4mm and/or counterclockwise rotation of the proximal segment was observed on the cephalograms, and remarkable resorption was also identified on postoperative CT. There was no association between signs and symptoms of TMJ and CT findings. The mean anterior movement of the mandible at surgery was 10.1mm at pogonion, and the mean horizontal relapse was 4.1mm. Large horizontal relapses were recognized in cases with progressive condylar resorption.<BR>In conclusion, patients with large mandibular advancement and counterclockwise rotation at surgery and condylar erosive bone change at preoperative examination appear to be at risk for progressive condylar resorption, but the mechanism is obscure.

DOI： 10.5927/jjjd1991.12.9

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Case report of a histologically validated malignant melanoma affecting the mandibular molar gingiva in a 31-year-old woman. Tumour was evaluated by magnetic resonance (MR) imaging at 1.5-T, spin-echo 3 mm slice thickness with T1-weighted and fat-saturated T1-weighted images. The fat-saturated T1-weighted images demonstrated the lesion more clearly than conventional T1-weighted images.

DOI： 10.1038/sj.dmfr.4600679

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We report a rare case of periosteal osteosarcoma of the mandible in a 15-year-old girl. Extension of the tumour into the bone marrow by way of the periodontal ligament is demonstrated.

DOI： 10.1038/sj.dmfr.4600664

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Language：English   Publishing type：Research paper (scientific journal)   Publisher：Japanese Soc. for Oral and Maxillofacial Radiology  

In order to assess the usefulness of repeated sonography in detecting cervical lymph node metastases at the earliest stage during a follow-up period in patients with stage I/II carcinoma, 20 consecutive patients with stage I/II squamous cell carcinoma of the tongue were studied. Each patient was examined repeatedly with sonography during the follow-up period. Nine metastatic nodes in 9 of the 20 patients (45%) met our criteria, and were detected by repeated sonography. Histopathological examination revealed that 14 nodes had metastatic foci. Although the sensitivity, per node, of sonography was originally only 64%, follow-up sonography detected all of the subclinical subsequent lymph node metastases among the patients in this study. In conclusion, repeated sonography was useful in the detection of lymph node metastases during follow-up care of patients with stage I/II tongue carcinoma, provided that the follow-up examination was performed at maximum interval of one month, if possible, sonography should be performed in such cases at two-week intervals for at least one and a half year.

DOI： 10.1007/BF02493266

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Language：English   Publishing type：Research paper (scientific journal)   Publisher：Japanese Soc. for Oral and Maxillofacial Radiology  

The aim of this study was to assess the prevalence of erosive osseous changes of the articular eminence in the temporomandibular joint without internal derangement. Sixty joints of 30 consecutive patients with mandibular prognathism were evaluated with both MR imaging and helical CT. On MPR images obtained with helical CT, erosive osseous changes of the articular eminence were observed in 18 joints (30%) of 13 patients. None of the joints studied demonstrated an osseous change in the mandibular condyle. MR imaging failed to detect erosive osseous changes of the articular eminence in all of the joints studied. In conclusion, MPR images obtained with helical CT were of value to detect erosive osseous changes of the articular eminence.

DOI： 10.1007/BF02493267

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DOI： 10.5843/jsot.13.75

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Language：Japanese   Publishing type：Research paper (scientific journal)   Publisher：(NPO)日本歯科放射線学会  

1996〜2001年に治療したN0舌扁平上皮癌10例を対象とし,USにて検出した後発転移リンパ節を,CTデータによるvolume rendering法で作成した三次元表示画像で明示した.CT・USとも偽陰性のリンパ節は3個であった.USで転移が検出された10個のリンパ節は全てvolume rendering画像上で明示できた.又,周囲との解剖学的構造との位置関係を立体的に認識することが容易であった.オパシテイカーブについては,リンパ節の局在部位を検出するにはslope状のカーブが適し,リンパ節の辺縁を明確化するにはwedge状のカーブが適していた.wedge状のカーブでは,周囲の解剖構造の透過性を調整することにより,よりリンパ節の輪郭が明瞭になる傾向が認められた.一方リンパ節内部の中心壊死を明確に描出することは困難であった.転移リンパ節の診断精度を向上させることは無かった

DOI： 10.11242/dentalradiology1960.41.240

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Other Link： https://search.jamas.or.jp/index.php?module=Default&action=Link&pub_year=2001&ichushi_jid=J00567&link_issn=&doc_id=20020130140003&doc_link_id=%2Fcg7dentr%2F2001%2F004104%2F003%2F0240-0244%26dl%3D0&url=http%3A%2F%2Fwww.medicalonline.jp%2Fjamas.php%3FGoodsID%3D%2Fcg7dentr%2F2001%2F004104%2F003%2F0240-0244%26dl%3D0&type=MedicalOnline&icon=https%3A%2F%2Fjk04.jamas.or.jp%2Ficon%2F00004_2.gif

Language：Japanese   Publishing type：Research paper (scientific journal)   Publisher：Japanese Society for Oral and Maxillofacial Radiology  

<b>Purpose</b> To discuss the relationship between radiation bone injuries and a splitting of the cortical bone in the radiation field.<br><b>Patients and methods</b> Between January 1993 and September 1998, 53 patients with head and neck cancer received radiotherapy. The study cohort consisted of 23 patients who were followed with computed tomographic scans more than one year after radiotherapy. We evaluated clinical and computed tomographic features. Computed tomographic scanning was performed with a section thickness of 3 or 4mm. Bone images were obtained with identical window width (4000 Haunsfield units) and window level (1000 Haunsfield units). Splitting of the cortical bone was defined as disappearance of bone density in the cortical bone, showing a linear shape running parallel to the surface of the cortex.<br><b>Results</b> Splitting appeared in 9 sites in 8 patients. All patients fulfilled UICC criteria for classifying oral cancer. Most of the patients received external irradiation with a total radiation dose of 50 or 60Gy. In all cases, splitting was found in the mandibular cortex at the site of muscle attachment, that was included in the radiation field. Appearance of bone changes in chronological order were periosteal reaction, splitting and bone necrosis.<br><b>Conclusion</b> We speculate that splitting results from injuries to bone structure cells caused by blood flow disturbance after surgery and radiotherapy. It is suggested that such splitting can be a predictor of osteoradionecrosis.

DOI： 10.11242/dentalradiology1960.41.101

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DOI： 10.1007/BF02493266

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Language：Japanese   Publisher：新潟歯学会  

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Language：Japanese   Publisher：日口蓋誌  

This study evaluated bone bridge formation after bone grafting using X-ray computed tomography, in complete unilateral cleft lip and palate patients. Subjects were 14 patients (5 females and 9 males), and all patients received two-stage palatoplasty combined with a Hotz plate, followed by bone grafting using autogenous particulate cancellous bone and marrow harvested from the iliac crest. X-ray computed tomography was performed before and after bone grafting (mean,3.6 months after), and an axial image was used. Then, both the shapes of cleft defects before bone grafting, and bone bridge formation after bone grafting, were classified into three types on basal and alveolar bone side level.&lt;BR&gt;Results were as follows:&lt;BR&gt;1) The cleft defect shape was classified into 5 types.1; on the basal and alveolar bone side, the anterior bone defect was larger than posterior (6 cases).2; on the basal bone side, the anterior was larger than the posterior but on the alveolar side, the anterior and posterior were the same (3 cases).3; on the basal bone side, the anterior and posterior were the same, but on the alveolar side, the anterior was larger than the posterior (2 cases).4; on the basal bone side, the anterior was larger than the posterior, but on alveolar side, the posterior was larger than the anterior (2 cases).5; on the basal and alveolar bone side, the anterior and posterior were the same (1 case).&lt;BR&gt;2) Except for two cases, satisfactory bone bridge formation was found.&lt;BR&gt;3) The mean age of bone grafting was 10 years and 3 months (range,7 to 15 years).&lt;BR&gt;4) Before bone grafting, the cleft side canine had, in 4 cases, already erupted, while in the other 10 cases it had not. Root formation of the cleft side canine ranged between 1/3 to complete.&lt;BR&gt;5) Two cases showed poor bone bridge formation on the basal bone side, and they were characterized by anterior bone defects that were larger than the posterior on the basal bone side, and widths of the basal bone defects that were larger than 20mm.&lt;BR&gt;In conclusion,&lt;BR&gt;1) Satisfactory bone bridge formation was gained at a high rate with two-stage palatoplasty combined with a Hotz plate.&lt;BR&gt;2) The width of a bone defect has strong influence on bone bridge formation.

DOI： 10.11224/cleftpalate1976.26.1_114

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Imaging studies have reported on the relationship between temporomandibular joint (TMJ) degeneration and facial deformity. These studies have suggested that mandibular growth is affected by TMJ degeneration, resulting in altered skeletal structure as mandibular retrustion. However, there are very few longitudinal case reports on TMJ osteoarthrosis (OA). Progressive open bite occurred in an adolescent patient with TMJ OA. Cephalometric analysis showed a downward and backward rotated mandible, and a labial inclination of the upper incisor. Magnetic resonance imaging showed internal derangement without reduction and erosion in the right and the left condyles. Although the cause of open bite is unclear in this case, tongue thrusting, and internal derangements in the temporomandibular joint were suspected as causes of the open bite. © 2001 British Orthodontic Society.

DOI： 10.1093/ortho/28.1.19

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Objectives: To study whether primary tumor thickness of stage I/II tongue carcinoma provides information about subsequent lymph node metastasis. Methods: Twenty consecutive patients with T1N0M0 or T2N0M0 tongue carcinoma were studied. Primary tumor thickness was measured with post-contrast helical computed tomography or intra-oral sonography. Cervical lymph nodes were evaluated periodically with sonography at intervals of 2-4 weeks. Sensitivity, specificity and accuracy for subsequent metastasis was calculated. Results: Positive sonographic findings appeared in nine nodes of nine patients during this follow-up period. Eleven patients underwent neck dissections, and nine had histopathologically positive nodes. Nine patients had no sonographic findings of metastasis during a minimum follow-up period of 20 months. Primary tumor thickness varied from 3-16 mm. Using 5 mm as a cut-off thickness, the sensitivity, specificity and accuracy for subsequent lymph node metastasis were 64, 100 and 75% respectively. Conclusions: Patients with stage I/II tongue carcinoma which is more than 5 mm thick are more likely to develop lymph node metastasis.

DOI： 10.1038/sj.dmfr.4600615

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BACKGROUND AND PURPOSE: In order to clarify the incidence and evolution of disk displacement in the temporomandibular joint (TMJ) in children, we performed a longitudinal analysis in 18 subjects. Some investigators have suggested that sonography can provide information about the articular disk position of the TMJ. The purpose of this study was to determine the diagnostic accuracy of sonography for revealing internal derangement of the TMJ in elementary school children compared with our standard of reference, MR imaging and helical CT. METHODS: Eighteen children were examined using both sonography and MR imaging or helical CT or both. The sonographically revealed distance between the articular capsule and the lateral surface of the mandibular condyle was measured and compared with that obtained by MR or helical CT scanning. RESULTS: Compared with our MR/CT standard of reference, sonography revealed a sensitivity of 83%, a specificity of 96%, and an accuracy of 92% for identifying disk displacement (defined as a distance of 4 mm or more between the articular capsule and the lateral surface of the mandibular condyle). CONCLUSION: Although sonography's sensitivity, specificity, and accuracy for the diagnosis of disk displacement were slightly inferior to those of MR or helical CT, we assert it is a useful imaging method for longitudinal investigations of a large group of elementary school children. Internal derangement of the TMJ should be suspected if sonography reveals a distance between the articular capsule and the lateral surface of the mandibular condyle of 4 mm or more.

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Language：English   Publishing type：Research paper (scientific journal)   Publisher：Mosby Inc.  

Objective. The purpose of this study was to investigate the relationship between self-reported parafunctional habits and condylar bony change and disk displacement in orthognathic surgery patients with signs and symptoms of temporomandibular joint disorders. Study design. This is a cross-sectional retrospective study of pretreatment helical computed tomography scans and question-naires of 94 female orthognathic surgery patients. Results. Condylar bony change, unilaterally or bilaterally, was found in 56.4% of the subjects, or 43.6% of the joints. Disk displacement, unilaterally or bilaterally, was seen in 59.6% of the subjects, or 45.7% of the joints. Bruxism and clenching was significantly associated with condylar bony change and disk displacement. Subjects with 3 or more parafunctional habits showed a significantly higher rate of bilateral condylar bony change. Conclusion. Our results suggest that bruxism and clenching might be related to deterioration of the temporomandibular joint and that the greater the number of parafunctional habits a subject has, the higher the risk of condylar bony change.

DOI： 10.1067/moe.2001.117558

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Language：English   Publishing type：Research paper (scientific journal)   Publisher：Mosby Inc.  

Objective. We sought to investigate the relationship between condylar bony change and disk displacement with respect to the signs and symptoms of temporomandibular joint (TMJ) disorders in patients undergoing orthognathic surgery. Study design. We performed a cross-sectional retrospective study of the pretreatment helical computed tomography scans of 129 orthognathic surgery patients. Results. Condylar bony change, unilaterally or bilaterally, was found in 35.7% of the subjects and 24.4% of the joints. Disk displacement, unilaterally or bilaterally, was seen in 41.4% of the subjects and 29.5% of the joints. The type of craniofacial deformity was significantly associated with condylar bony change and disk displacement. No association of clinical symptoms with respect to craniofacial deformity, condylar bony change, or disk displacement was found except in the case of TMJ sounds. Conclusion. The results suggested that craniofacial deformity might be related to TMJ disorders, but the only clinical symptom associated with types of craniofacial deformity was TMJ sounds.

DOI： 10.1067/moe.2001.112153

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Language：Japanese   Publishing type：Research paper (scientific journal)   Publisher：Japanese Society for Oral and Maxillofacial Radiology  

The purpose of this study was to investigate the age distribution of the minimal diameter of non-metastatic jugulodigastric lymph nodes seen on ultrasonography to establish a reliable criterion to differentiate metastatic from non-metastatic lymph nodes. Between October 1998 and November 1999, 386 patients with obstructive sleep apnea syndrome were examined using neck ultrasonography to evaluate atherosclerosis of the common carotid artery and the minimal diameter of jugulodigastric lymph nodes were measured simultaneously. The study cohort consisted of 100 Japanese males extracted at random ranging in age from 31 years to 79 years (average: 54.3 years). Patients with any oral malignancies were excluded. The minimal diameter of the node was 8.8 mm on average in patients in the fourth decade, 8.1 mm in the fifth decade, 7.2 mm in the sixth decade, 7.0 mm in the seventh decade, 7.0 mm in the eighth decade, respectively. A significant difference was observed between the fourth decade and the sixth decade or older using post hoc test (p<0.05): If the cut-off point of the minimal diameter should be 8 mm, the specificity was 45% in patients in the fourth decade, 70% in the fifth decade, 85% in the sixth decade, 85% in the seventh decade, 85% in the eighth decade, respectively. In conclusion, the minimal diameter of 8 or 9 mm in the jugulodigastric lymph nodes, which is the currently accepted criterion for metastatic lymph nodes on ultrasonography, might be almost adequate as the cut-off point. Additionally, we recommend that the cut-off point should be lmm larger in patients in the fourth decade than in patients in the sixth decade or older.

DOI： 10.11242/dentalradiology1960.40.33

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Language：Japanese   Publishing type：Research paper (scientific journal)   Publisher：The Japanese Society for Temporomandibular Joint  

Purpose: To clarify the peculiar sagittal MR findings that may indicate a cause of articular pain in opened-mouth position. Study design: MR images of 50 temporomandibular joints of 50 patients with non-reducible anteriorly displaced disk were analyzed with a special reference to "thrusting sign". "Thrusting sign" was defined as the condition in which the roughened surface of the mandibular condyle thrusts upon the thickened posterior disk attachment.<br>Results: "Thrusting sign" was observed in 20 of 27 joints in patients with articular pain in opened-mouth position. A statistically significant correlation was observed between articular pain and "thrusting sign".<br>Conclusions: "Thrusting sign" on sagittal MRI could be one of the most valuable findings closely related to articular pain in opened-mouth position.

DOI： 10.11246/gakukansetsu1989.12.223

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Other Link： http://search.jamas.or.jp/link/ui/2001027653

Language：Japanese   Publishing type：Research paper (scientific journal)   Publisher：The Japanese Society for Temporomandibular Joint  

Although the relationship between osteoarthritis of temporomandibular joint and craniofacial morphology has recently been reported, clinical correspondence may be late because of the variety of clinical features in osteoarthritis. The present study was performed to investigate the clinical guidelines for osteoarthritis in patients with jaw deformity, from the relationship between the TMJ pathology and tapping movement which is clinically used as occlusal criterion. Experimental data was obtained from forty-eight patients with jaw deformity (mean age: 20.5 years) using helical computed tomography, magnetic resonance image and a system for recording tapping movements with 6 degrees of freedom.<br>Deformity and erosion were frequently seen in subjects with bilateral condylar bony change group (bilateral group) and deformity was the common feature in subjects with unilateral condylar bony change group (unilateral group). Anterior disk displacement without reduction (ADNR) was the most common feature in the unilateral and bilateral groups.<br>By comparing the types of condylar bony change, the incisal and condylar points in the bilateral group were significantly more unstable during tapping than the group without condylar bony change. By comparing the types of disk displacement, the incisal point during tapping was more unstable in subjects with bilateral ADNR or ADNR and anterior disk displacement with reduction (ADWR), and the condylar point during tapping was more unstable in joints with ADNR and ADWR displacing condylar bony changes than joints with normal disk position. No difference of incisal and condylar points was found when anteroposterior craniofacial morphology was used as the criterion of comparison.<br>It was suggested that instability of incisal and condylar points during tapping might be related to the pathology of the temporomandibular joint in orthognathic patients.

DOI： 10.11246/gakukansetsu1989.12.88

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Other Link： http://search.jamas.or.jp/link/ui/2000236269

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

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

A case of ranula in a neonate is reported. A 2-month-old infant was found to have a small swelling in the floor of the mouth at birth. Initial examination revealed a fluctuant, translucent swelling with protrusion from the mouth. The lesion arose in the left side of the mouth floor. A computed tomographic examination confirmed the presence of a cystic lesion, un associated with the sublingual gland. The clinical diagnosis was a sublingual ranula. Although marsupialization was performed three times, the swelling recurred and returned to its original size soon after treatment. Three months later, extirpation of the cyst and the sublingual gland was performed. The postoperative course was uncomplicated, with no signs of recurrence for 6 months. The histological diagnosis was mucous retension cyst. To prevent recurrence, extirpation of the sublingual gland was effective, even in an infant.

DOI： 10.5794/jjoms.46.536

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Other Link： http://search.jamas.or.jp/link/ui/2001052352

Language：English   Publishing type：Research paper (scientific journal)   Publisher：Japanese Soc. for Oral and Maxillofacial Radiology  

Objectives: To investigate the status of the articular disc of the temporomandibular joint (TMJ) in patients with skeletal Class III malocclusion by means of magnetic resonance (MR) imaging. Methods: The position of the articular disc of the TMJ in closed- and opened-mouth positions was investigated in 50 adult patients with untreated skeletal Class III malocclusion by means of proton-density weighted MR imaging. Results: Of 100 joints of 50 patients, the lack of positional change of the articular disc relative to the mandibular condyle in both closed- and opened-mouth positions was observed in 62 joints. Conclusions: Although the cause of the lack of positional change of the disc relative to the condyle was unclear, this peculiar relationship of the disc and the condyle might possibly be associated with the function of the temporomandibular joint in skeletal Class III malocclusion.

DOI： 10.1007/BF02490158

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Purpose: To evaluate the effect of oral hygiene care of patients with oral cancer on alleviating acute radiation mucositis. Materials and methods: Eighteen patients receiving postoperative radiotherapy for tongue and oral floor cancer were evaluated. Radiotherapy was given in 2 Gy per fraction, 5 times a week for a total dose of 50 Gy in most patients. Radiation fields included the tongue and oral floor. During radiotherapy, 8 patients were treated by dento-maxillofacial radiologists with special concern on oral hygiene (oral hygiene group) and the remaining 10 patients were treated with routine dental care (standard medication group). Mucositis were evaluated using JCOG grade and EORTC/RTOG score by radiotherapists or dento-maxillofacial radiologists at 10 Gy intervals. Oral hygiene plans comprised motivation to maintain oral hygiene and establishing the habits of oral self care 4 times per day. Once a week, oral hygiene and oral cleaning of patients were checked by dento-maxillofacial radiologists. Oral self care included mechanical tooth brushing and a chemical mouthwash. Results: No patients with grade 3 and score 4 mucositis were noted in the oral hygiene group. Severe mucositis occurred less frequently in the oral hygiene group than in the standard medication group. Interruption of radiotherapy due to severe mucositis did not occur in the oral hygiene group. On the other hand, interruption of radiotherapy occurred in four patients in the standard medication group, and in three it was due to severe oral pain. Conclusions: Our results suggested that our method of oral hygiene was more effective for alleviating acute radiation mucositis than other methods so far reported. In addition, our method is considered to be useful in preventing rampant dental caries and severe periodontitis due to the xerostomia induced by radiotherapy. © 2000, Japanese Society for Therapeutic Radiology and Oncology. All rights reserved.

DOI： 10.11182/jastro1989.12.229

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This study was designed to assess the relationship between condylar bony change and mandibular deviation in the orthodontic patient. Seventy-one patients were examined with helical computed tomography and magnetic resonance imaging to assess the condylar bony change and:or disk displacement prior to acceptance for orthodontic treatment. They were grouped into no condylar bony change (NBC) and unilateral condylar bony change (UBC). Frontal and lateral cephalograms and panoramic radiographs were also utilized to evaluate craniofacial morphology, and condylar and ramal heights. The results revealed that TMJ sounds occurred more in the UBC than the NBC group at all ages
but, TMJ pain and difficulty of mouth opening did not show remarkable differences. Erosion, a characteristic feature in age 9-13 years in UBC, occurred with normal disk position or disk displacement without reduction. Flattening exhibited normal disk position in age 9-13 years but was accompanied with disk displacement in age 14-18 years and 19 years and above. Osteophyte formation was highly associated with disk displacement without reduction in all age groups. Moreover, the UBC group's mandible was deviated to the ipsilateral side with significantly shorter condylar height on the affected side. In all age groups of UBC, the difference of condylar height was highly correlated with anterior maxilla, occlusal and gonial planes and with mandibular deviation. All aforementioned results suggest that unilateral condylar bony change can occur with normal disk position or ahead of disk displacement in the young patients. It seems that unilateral condylar bony changes can cause not only mandibular deviation but can also affect the cant of maxillary basal bone, mandibular plane angle and lower dentition. © Munksgaard 2000.

DOI： 10.1034/j.1600-0544.2000.30305.x

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

Our objective was to find out the incidence of signs and symptoms of temporomandibular joint(TMJ) and disc displacement in patients with mandibular prognathism, Fifty-one patients were examined clinically and by axial computed tomography(CT). The incidence of TMJ signs and symptoms was 6/25(24%) in patients with simple mandibular prognathism and 12/26(46%) in patients with mandibular prognathism and asymmetry: No discs were displaced in patients with simple mandibular prognathism, but 15(58%) of the patients with mandibular prognathism and asymmetry had displaced discs. There was no association between signs and symptoms of TMJ and disc displacement, Patients with mild protrusion and severe asymmetry of the mandible had a high incidence of disc displacement, which interestingly was on the deviated side in 14 of the 15 patients affected. We conclude that skeletal morphology may hare a role in the development of TMJ disorders but the mechanism is obscure.

DOI： 10.1054/bjom.1999.0016

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Language：Japanese   Publisher：新潟歯学会  

他医院での切開処置後に急速な増大を示し,臨床的に悪性腫瘍が疑われ,診断に苦慮した硬口蓋神経鞘腫の1例を経験した.初診時,右側硬口蓋に27×21mm,周囲粘膜色の半球状の腫脹と,その中央の切開部から17×14×7mmの赤色で有茎性の腫瘤が認められ,腫瘤表層の細胞診はPAPIVであった.初診後も腫瘤は徐々に増大し,上顎悪性腫瘍を疑って,腫瘤増大部から生検を施行したが,病理診断は肉芽組織であった.そこで,より深部から再度生検し,神経鞘腫の確定診断を得,全麻下にて腫瘍摘出術を行った

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Language：English   Publishing type：Research paper (scientific journal)   Publisher：W.B. Saunders  

Purpose: The purpose of this article was to evaluate the initial volume of alveolar clefts and the bone bridges formed in patients who had undergone secondary bone grafting. Patients and Methods: Fifteen cleft patients were studied. Computed tomography (CT) scans were made at 2-mm slice sections immediately before operation and at 3 months and 1 year postoperatively. The volume of the alveolar clefts and bone bridges was calculated from stored images by using an image scanner and a personal computer. Results: The mean cleft volume of the patients was 1.1 ± 0.3 cm3. The corresponding volume of the bone bridges 3 months and 1 year postoperatively were 1.2 ± 0.6 cm3 and 1.1 ± 0.5 cm3, respectively. The value at 1 year was significantly decreased compared with that at 3 months. Conclusions: Adequate bone bridging was maintained for 1 year. However, it is suggested that the grafted site should be restored with a functioning tooth or a dental implant to place it under physiologic stress, because the volume of the bone bridges tends to decrease from 3 months to 1 year.

DOI： 10.1016/S0278-2391(99)90488-3

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

We describe the first reported case of an intracortical hemangioma of the mandible in a 13-year-old Japanese girl. Panoramic radiography and CT demonstrated a small osteolytic lesion which had expanded and thinned the cortex at the inferior border of the left mandible. The lesion enhanced on post-contrast T1-weighted MRI. The diagnosis was confirmed by histopathology following block excision. Intracortical hemangioma should be considered in the differential diagnosis of radiolucent lesions of the mandible.

DOI： 10.1038/sj.dmfr.4600422

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Language：English   Publishing type：Research paper (scientific journal)   Publisher：Mosby Inc.  

Objective. The purpose of this study was to establish the diagnostic reliability of anterior displacement of the articular disk in the temporomandibular joint on helical computed tomography. Study design. Ninety-four consecutive patients were examined through use of both computed tomography and magnetic resonance imaging. On axial computed tomography, anterior disk displacement was defined as the presence of an area of soft tissue density that was semilunar in shape and located in front of the mandibular condyle. Results. With magnetic resonance imaging taken as the diagnostic gold standard in evaluation of articular disk position, the sensitivity, specificity, and accuracy for computed tomography were 91%, 100%, and 97%, respectively, in the closed mouth position and 96%, 99%, and 98%, respectively, in the open mouth position. Conclusions. The detectability on axial helical computed tomography of anterior displacement of the articular disk in the temporomandibular joint in the open mouth position was almost equal to that on magnetic resonance imaging. It is recommended that the open mouth position be added when helical computed tomography is used to evaluate patients with temporomandibular joint disease. Copyright © 1999 by Mosby, Inc.

DOI： 10.1016/S1079-2104(99)70202-7

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

Several kinds of knee motion simulator systems have been developed for the accurate analysis of knee biomechanics. Knee motion simulators, however, are not recognized For their practical use because of difficulties in design and control. Tn this study, a wire-driven knee simulator which generates physiological knee motion has been developed. Physiological three-dimensional tibia motion against the femur can be generated by the simulator. Many clinical studies have been performed to analyze the length displacement pattern of the anterior cruciate ligament (ACL) and the posterior cruciate ligament (PCL). We assume that the physiological knee motion can be realized if the length displacement patterns of the ACL and PCL against the knee flexion angle are the same as the experimental data obtained from the literature. A fuzzy neural control policy, one of the most effective intelligent control policies, has been applied for control of the simulator. Applying the fuzzy neural control policy, human knowledge and experience can be reflected and adaptive/learning ability can be incorporated in the controller. On-line learning of the fuzzy neural controller is carried our to minimize a fuzzy controlled evaluation function using the back-propagation learning algorithm. The effectiveness of the proposed simulator has been evaluated by experiments using a model bone.

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In each of 3 patients referred for computed tomographic examinations of the temporomandibular joint, a gas collection was observed in the inferior space of the joint. The gas was-observed on the posterosuperior surface of the mandibular condyle in the open mouth position in each patient. Each of 2 patients had saucer-shaped bone resorption of the mandibular condyle adjacent to the gas; 1 patient had no remarkable bone abnormality. A history of temporomandibular joint puncture or facial trauma was denied by all 3 patients.

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Language：Japanese   Publishing type：Research paper (scientific journal)   Publisher：Japanese Society of Oral Oncology  

Three cases with tongue carcinoma, in which subclinical metastasis was detected by repeated ultrasonographic (US) examination of the neck lymph nodes performed at one-month interval, were reported. A hyperechoic area in the middle internal jugular lymph node was proved to correspond to a metastatic focus with marked keratinization histologically. In all three cases, metastatic lymphadenopathy could not be suspected on CT examination. It was suggested that repeated US examination is very useful to detect subclinical metastatic lymph nodes earlier, and it was recommended to perform it at least one-month intervals and if possible every two weeks.

DOI： 10.5843/jsot.10.282

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DOI： 10.5794/jjoms.43.809

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Other Link： http://search.jamas.or.jp/link/ui/1998024817

Language：Japanese   Publishing type：Thesis (other)  

In order to establish a possible role of axial CT in the diagnosis of articular disc dislocation of the temporomandibular joint, axial X-CT of 300 symptomatic patients were reviewed, and compared with MRI in 33 patients.<br />
Axial X-CT was taken parallel to RBL using 2mm-thickness slice in mouth closing, mandibular protrusive and mouth opening positions.<br />
On axial X-CT of mouth closing position, a soft tissue semilunar in shape was shown in front of the mandibular head in 413 (68.8%) of 600 joints.<br />
Of these 413 joints, the density of the soft tissue was hyperdense in 135 joints (32.7%) and isodense in remaining 278 joints (67.3%) compared with the lateral pterygoid muscle on the same side.<br />
Of 413 joints in mouth opening position, the soft tissue disappeared in 125 joints (30.3%) and it was still observed in front of the mandibular head in remaining 288 joints (69.7%) .<br />
Of 66 joints of 33 patients anterior displacement of the articular disc was found on sagittal MRI images in 38 joints, of which in 35 (92.1%) the displaced disc was detected as a soft tissue on axial X-CT.<br />
Of 40 joints of 20 patients medial sideways displacement of the articular disc was seen on coronal MR images in 3 joi

DOI： 10.11242/dentalradiology1960.35.55

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Bone changes in the mandibular head and mandibular fossa in 33 patients with TMJ disorders were studied with axial computed tomography in relation to clinical findings to clarify possible factors leading to bone changes in this phenomenon. Bone changes of the mandibular head were observed in 45 (68%) of the 66 TMJs. The mandibular head was juxtaposed to the mandibular fossa in 13 (29%) of the 45 joints in centric occlusion and in 29 joints (64%) in the anterior position on CT, whereas the mandibular head with no pathological bone change was juxtaposed to the mandibular fossa in none of the 21 joints in centric occlusion and in only 1 joint (5%) in the anterior position. In the two groups of patients with and without juxtaposition of the mandibular head and mandibular fossa with bone changes, the incidence of the initial symptoms such as pain. crepitus, and difficulty in opening the mouth was increased compared with the symptoms at presentation. However, the former group had severer symptoms than the latter group. These findings suggest that bony degeneration of the TMJ is accelerated by juxtaposition of the head and fossa.

DOI： 10.5794/jjoms.40.1207

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Language：English   Publishing type：Research paper (scientific journal)   Publisher：Springer-Verlag  

Nine carcinomas of the buccal mucosa treated by interstitial radiotherapy are reported. Histopathologically, 8 were squamous cell carcinomas and one was a muco-epidermoid carcinoma. Six patients were male and three were female. Five patients were more than 60 years old. Seven tumors (77%) were stage III or stage IV according to the UICC classification (1987). All cases were followed for more than 20 months. Only two patients died and seven patients are alive at the last follow up. The cumulative 3-year survival rate was 77%. Although this study was very limited in number, it was concluded that carcinomas of the buccal mucosa without bone involvement is not difficult to control if interstitial radiotherapy is appropriately utilized for the primary lesion. © 1993 The Japanese Society of Dental Radiology.

DOI： 10.1007/BF02349097

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Language：English   Publisher：(一社)日本生理学会  

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Language：Japanese   Publisher：(一社)日本小児口腔外科学会  

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

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

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

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J-GLOBAL

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

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Language：Japanese   Publisher：(NPO)日本口腔科学会  

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Language：Japanese   Publisher：(NPO)日本口腔科学会  

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

症例は17歳女性で、8歳頃に発熱した際に左側下顎角部の腫脹を認め、解熱後も残存していたが放置していた。14歳ごろから徐々に増大を自覚しており当科を紹介受診した。画像所見から脂肪腫または類皮嚢胞と診断し、全身麻酔下で経皮的に病変の摘出術を施行した。病変は耳下腺下極の内側に入り込んでおり、周囲耳下腺組織からの剥離は一部でやや困難であったが一塊として摘出した。術後6年6ヵ月間経過観察を行っていたが、再発所見を認めないため経過観察を終了とした。病理組織学的所見では大小2個の嚢胞腔を認め、いずれの嚢胞も内腔面は皮膚表皮様の基底線の平坦な重層扁平上皮で被覆されており、線維性組織から成る難胞壁はおおむね薄く、二つの嚢胞間部は肥厚していた。奇形様嚢胞との病理組織学的診断を下した。

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Language：Japanese  

J-GLOBAL

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Language：Japanese  

J-GLOBAL

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J-GLOBAL

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Language：Japanese  

J-GLOBAL

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Language：Japanese  

J-GLOBAL

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J-GLOBAL

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Language：Japanese  

J-GLOBAL

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J-GLOBAL

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

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

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Language：Japanese  

J-GLOBAL

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Language：Japanese  

J-GLOBAL

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Language：Japanese   Publisher：新潟歯学会  

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Language：Japanese   Publisher：新潟歯学会  

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Language：Japanese   Publisher：(一社)日本小児口腔外科学会  

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Language：Japanese   Publisher：(一社)日本顎関節学会  

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Language：Japanese   Publisher：(NPO)日本口腔科学会  

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

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

偏位を伴う骨格性下顎前突症と診断し、両側下顎枝矢状分割法による下顎単独後退術を施行し、術前後で下顎正中部の側方移動を伴いかつ下顎後退量に左右差を認めた15例(男性4名、女性11名、平均21歳2ヵ月)を対象とした。術前におけるoverjetの平均は-3.7±1.9mmであった。偏位側と非偏位側における後方移動量は各5.0+2.6mm(平均値と標準偏差)と6.9+2.0mmで、左右平均後方移動量は5.9+2.2mmであった。後方移動量の左右差は1.9+1.4mm、L1とPogの後方移動量は、各6.2+2.2mm、5.6+3.0mm、下顎正中部の平均側方移動量は2.4+1.1mmであった。各症例のL1における後方移動量と下顎左右後退量の平均値との間、Pogにおける後方移動量と下顎左右後退量の平均値の関係、下顎後退量の左右差と下顎正中部側方移動量間に有意な相関関係を認めた。回帰係数および切片についてT値を算出し、それぞれ4.26、5.46と有意であった。

DOI： 10.5927/jjjd.27.1

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Language：Japanese  

CiNii Article

CiNii Books

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Language：Japanese   Publishing type：Research paper, summary (national, other academic conference)  

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Language：Japanese  

J-GLOBAL

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Language：Japanese   Publisher：(NPO)日本口腔科学会  

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Language：Japanese   Publisher：(NPO)日本口腔科学会  

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

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

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

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Language：Japanese   Publisher：(NPO)日本歯科放射線学会  

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Language：Japanese   Publisher：(NPO)日本口腔科学会  

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Language：Japanese  

J-GLOBAL

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J-GLOBAL

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Language：Japanese   Publisher：新潟歯学会  

J-GLOBAL

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Language：Japanese   Publisher：新潟歯学会  

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Language：Japanese   Publisher：(一社)日本顎関節学会  

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Language：Japanese   Publisher：日本骨形態計測学会  

【目的】外科的矯正治療の矯正学的診断における主たる資料は、顔面規格写真、口腔内写真、歯列模型、正面・側面頭部エックス線規格写真、CTなどで、特にCTによる3次元分析が近年多用されるようになった。しかしながら、3次元分析を行うにあたっての計測点の設定、および再現性については未だ十分な検討がなされていない。本研究では、多断面再構成(multiplanner reconstruction:MPR)画像上で顎顔面形態の把握に有用と思われる計測点の3次元的な定義を行い、それぞれの抽出と再現性を評価した。【資料と方法】新潟大学医歯学総合病院・矯正歯科診療室に来院した顎変形症患者60名のうち、先天異常を認めずアーチファクトのない成人7名(男性3名、女性4名)のCT画像データを用いた。計測点の抽出にはDICOMビューアーソフトExavision Lite(Ziosoft、東京)を使用し、フランクフルト平面(FH平面)を基準平面とし直交MPR画像を表示後、44の計測点(X、Y、Z座標から成る計132の座標値)を2名の矯正歯科医がそれぞれ2回ずつ計測した。計測者内、計測者間における計測値の有意差は分散分析(ANOVA)を用いて評価し、誤差の程度については計測誤差のSDで評価した。【結果】計測者内では1回目と2回目の計測値に有意差は認められなかった。計測者間で有意差を認めた座標は132座標中39座標で、そのうちX座標は10座標、Y座標は15座標、X座標は14座標であった。計測者内誤差のSDは±0.70mm、計測者間誤差のSDは±0.84mmであった。【考察】3次元座標上で、設定困難かつ再現性が低かった計測点は、下顎枝後縁点(Ar)、Go、大口蓋孔であったが、計測値のSDはボクセルサイズと比較して小さかったことから、再現性は高く顎顔面形態の把握に有用であったと考えられた。また、FH平面を基準とし計測することにより、撮影時の頭位の変化に影響されることなくMPR画像上で再現性の高い計測点の抽出が可能であった。(著者抄録)

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Language：Japanese   Publisher：(一社)日本口蓋裂学会  

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Language：Japanese   Publisher：新潟医学会  

CiNii Article

CiNii Books

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Other Link： http://search.jamas.or.jp/link/ui/2013376198

Language：Japanese   Publisher：新潟医学会  

CiNii Article

CiNii Books

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Other Link： http://search.jamas.or.jp/link/ui/2013376196

Language：Japanese   Publisher：(一社)日本口腔ケア学会  

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Language：Japanese  

J-GLOBAL

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Language：Japanese   Publisher：新潟歯学会  

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Language：Japanese  

J-GLOBAL

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Language：Japanese   Publisher：(一社)日本顎関節学会  

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Language：Japanese   Publisher：(一社)日本顎関節学会  

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

DOI： 10.5927/jjjd.22.99

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Language：Japanese   Publisher：(一社)日本形成外科学会  

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Language：Japanese   Publisher：新潟歯学会  

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

顎矯正手術における超音波診断法(US)と単純CT画像を用いた顎動脈の走行位置評価の有用性について検討した。顎変形症患者15例30側を対象とした。頬骨弓と下顎切痕により形成される側頭下窩の音響窓からのUSによる顎動脈の描出のされ方は、明瞭24側、不明瞭6側であった。顎動脈の描出のされ方が明瞭であった24側において、閉口時と開口時とで音響窓皮膚面から顎動脈までの距離に大きな違いはなく、開口時に下顎切痕から顎動脈までの距離を観察することは困難であった。USの画像情報をもとに単純CT画像上で顎動脈の走行位置を検討し、全症例で顎動脈の走行位置が推測可能であった。顎動脈と外側翼突筋との位置関係については、Lateral typeが26側、Medial typeが4側であった。US走査時間はいずれの症例も15分を超えることはなく、患者に精神的および肉体的負担が生じなかった。

DOI： 10.5927/jjjd.21.232

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Language：Japanese   Publisher：新潟歯学会  

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Language：Japanese   Publisher：(公社)日本矯正歯科学会  

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

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

顎変形症患者における顎関節症状の発現率について症型ごとに調査するとともに、矯正治療開始前に撮像したCT画像による顎関節円板転位の有無と下顎頭形態の異常から、顎関節症状と顎顔面形態との関連について検討した。術前矯正治療開始前の顎変形症患者304例を対象とした。顎関節円板転位の発現率は女性に有意に多く発現した。顎関節臨床症状の発現率は、顎変形症全体で29.3%で、下顎非対称が有意に高い値を示した。顎関節円板転位の発現率は、顎変形症全体で28.3%で、下顎後退症が有意に高い値を示した。下顎頭形態異常の発現率は、顎変形症全体で20.1%で、下顎後退症、下顎非対称、上顎後退症が有意に高い値を示した。非対称群では、対称群と比較して顎関節円板転位と下顎頭形態異常の発現率が有意に高い値を示した。下顎の後退ならびに下顎の側方偏位が顎関節円板転位、下顎頭形態異常に関連があることが示唆された。

DOI： 10.5794/jjoms.57.441

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Language：Japanese   Publisher：(一社)日本顎関節学会  

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

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Language：Japanese   Publisher：新潟医学会  

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