Authorship：Corresponding author   Language：English   Publishing type：Research paper (scientific journal)  

OBJECTIVE: This study aimed to verify whether tooth extraction before the administration of bone-modifying agents (BMA) was effective in preventing the onset of medication-related osteonecrosis of the jaw (MRONJ). MATERIALS AND METHODS: This retrospective study included patients with a history of receiving BMA for cancer treatment. The patients were classified into three groups based on the timing of tooth extraction: no tooth extraction before the onset of MRONJ, tooth extraction before the administration of BMA, and tooth extraction after the administration of BMA. The incidence of MRONJ was compared between the groups. Fisher's exact test and Bonferroni correction were used to test for differences in proportions between the three groups. RESULTS: The total number of subjects was 123. Twenty-four patients (19.5%) developed MRONJ. The incidence rates were 12.3% (10/81), 17.9% (5/28), and 64.3% (9/14) in the non-extraction group, the extraction before BMA administration group, and the extraction after BMA administration group, respectively, showing statistically significant differences between the extraction after BMA administration group and the non-extraction groups and between the extraction after BMA administration group and the extraction before BMA administration group (p < 0.001, p = 0.0049). On the other hand, there was no statistically significant difference in incidence between the non-extraction and the extraction before BMA administration group (p = 0.5274). CONCLUSIONS: Tooth extraction before the administration of BMA is effective in preventing the onset of MRONJ in patients receiving BMA for cancer treatment. Prevention of MRONJ development in patients receiving BMA for cancer treatment contributes to the maintenance of patients' quality of life.

DOI： 10.1007/s10006-024-01221-6

PubMed

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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)日本口腔内科学会  

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Language：Japanese  

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Authorship：Lead author,　Corresponding author   Language：English   Publishing type：Research paper (scientific journal)   Publisher：Elsevier BV  

OBJECTIVE: This study aimed to compare the use of a powered instrument (PI) and ultrasonic curettage device (ULCD) with intraoperative blood loss (IOBL), drain volume (DV), calculated blood loss (CBL), and hidden blood loss (HBL) in orthognathic surgery. METHODS: We included 163 patients who underwent bimaxillary surgery in our department. CBL was calculated from the preoperative and postoperative hemoglobin levels using the "hemoglobin balance method." CBL is an indicator of the amount of perioperative blood loss. HBL was calculated by subtracting IOBL and DV from CBL. RESULTS: The PI group consisted of 61 patients (17 males and 44 females, age: 24.9 ± 9.5 years), and the ULCD group consisted of 102 patients (40 males and 62 females, age: 23.1 ± 7.8 years). In the PI group, the median IOBL, DV, CBL, and HBL were 540.0 (interquartile range [IQR] 380.0-670.0), 113.0 (IQR 77.0-147.0), 1000.0 (IQR 751.4-1248.6), and 285.8 (IQR 151.0-476.4) ml, respectively. In the ULCD group, the median IOBL, DV, CBL, and HBL were 327.5 (IQR 200.0-455.0), 105.5 (IQR 75.3-136.0), 759.5 (IQR 594.9-944.2), and 294.2 (IQR 120.8-456.9) ml, respectively. IOBL and CBL were significantly reduced with ULCD use, but no significant differences were observed in DV and HBL. CONCLUSIONS: This study showed that IOBL decreased with ULCD use, resulting in a decrease in CBL. Conversely, bleeding parameters (DV and HBL), which reflect the amount of bleeding that occurs after wound closure, did not show a decrease with ULCD use.

DOI： 10.1016/j.heliyon.2022.e12639

PubMed

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

DOI： 10.1016/j.ajoms.2022.08.005

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

OBJECTIVE: In orthognathic surgery, it is important to carefully manage peri-operative nutrition because maxillomandibular fixation and problems such as swelling and pain after surgery may make it difficult to eat normally and may prevent adequate nutrition. This study investigated the changes in nutritional status of patients with jaw deformities due to orthognathic surgery. STUDY DESIGN: The subjects were 155 jaw deformity patients, who underwent orthognathic surgery. The nutritional status was evaluated using anthropometry immediately before and 10 days after surgery and clinical laboratory results and the controlling nutritional status (CONUT) score before surgery and immediately, 1 week and >6 months after surgery. We investigated the relationship among the nutritional status, surgical procedures, and dietary intake in patients who underwent orthognathic surgery. RESULTS: The surgical procedure time and amount of bleeding were significantly greater as the surgical procedure became more complex. All of the laboratory values and CONUT scores were significantly decreased immediately after surgery and then increased over time, recovering to the same level as before surgery except for serum albumin at >6 months after surgery. CONCLUSIONS: Nutritional management is considered as one of the key factors for the better and faster recovery after the orthognathic surgery.

DOI： 10.1016/j.oooo.2022.07.007

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Authorship：Lead author,　Corresponding author   Language：Japanese   Publisher：(一社)日本口腔ケア学会  

当院(大学病院)で過去に実施した医科歯科連携実態調査で歯科への診療依頼の多かった呼吸器・感染症内科との医療連携の実態について、2018年1月〜2020年12月に当院呼吸器・感染症内科からの診療依頼患者154例(男性98例、女性56例、平均年齢67.3歳)を対象に、骨修飾薬(Bone modefying agent:BMA)の有害事象としての薬剤関連顎骨壊死(Medication related Osteonecrosis of the jaw:MRONJ)に焦点を当て調査した。その結果、依頼目的はBMA関連での診療依頼が110例(71.4%)で、そのうち癌治療に関連する症例は54例(癌治療患者群)、非癌治療が56例(非癌治療患者群)であった。BMA関連での診療依頼があった110例中、BMAが投与されたのは70例で、そのうち7例(癌治療患者群6例、非癌治療患者群1例)をMRONJと判定した。MRONJ発症率は、非癌治療患者群の3.0%(1/31)に対し、癌治療患者群では15.4%(6/39)であった。

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

DOI： 10.5794/jjoms.67.590

J-GLOBAL

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

Objective: The aim of this study was to compare the characteristics of 3D facial images obtained by multi-detector computed tomography (MDCT) and stereophotogrammetry and to determine whether both methods can be integrated with accurate analysis in the same coordinate system for treatment planning and postoperative assessment in orthognathic surgery. Methods: The subjects were 20 patients with jaw deformities. All of the patients underwent MDCT and stereophotogrammetry examinations for the assessment of maxillofacial morphologies before treatment. Standard triangulated language (STL) data of 3D facial surface images obtained by using MDCT and stereophotogrammetry were superimposed with four landmarks and the forehead and nasion area by a best-fit algorithm. The differences in Z coordinate values (mm) at ten measurement points and in six measurment volumes (cm3) between images obtained by using MDCT and stereophotogrammetry were calculated. Differences in Z coordinate values at the central measurement points were within 1 mm, but differences at the lateral measurement points, especially lower points, were significantly large. The volumes using MDCT were smaller than those using stereophotogrammetry, especially at lateral regions. Mean differences at the central measurement volumes were within 1 cm3, but mean differences at the lateral measurement volumes, ranging from 1.6 cm3 to 3.5 cm3, were comparatively large. In conclusion, the method presented for 3D superposition of images obtained from different modalities may be useful for treatment planning and postoperative evaluation of orthognathic surgery.

DOI： 10.1016/j.ajoms.2021.08.016

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

DOI： 10.1016/j.adoms.2021.100166

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

DOI： 10.1016/j.adoms.2021.100081

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Authorship：Lead author,　Corresponding author   Language：Japanese   Publisher：新潟歯学会  

新潟大学医歯学総合病院医療連携口腔管理チームは、2020年4月から医療連携口腔管理治療部として活動を行っている。今回、活動実態の把握と今後の課題を明らかにすることを目的に実態調査を行ったのでその結果を報告する。対象は2013年1月〜2020年6月の期間に当チームおよび当治療部を受診した患者とした。診療録および診療台帳を基に患者数、依頼目的、原疾患の診療科などを後方視的に調査・検討した。調査期間における新患数は4,077人で、その数は経年的に増加していた。依頼目的は感染予防が最も多く、年々増加していた。粘膜炎対応、顎骨壊死予防・対応は増加ののち、一定数で推移していた。原疾患の診療科は耳鼻咽喉・頭頸部外科が最も多く、ついで、腎・膠原病内科、呼吸器感染症内科、腫瘍内科、血液内科であった。新患数は年々増加していたが、周術期等口腔機能管理での介入が求められる全症例への介入には至っていなかった。今後は、介入対象の拡大に向け、より効率的な診療体制と病院内での協力体制の構築、地域医療機関との連携が必要であると考える。(著者抄録)

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Authorship：Lead author,　Corresponding author   Language：Japanese   Publisher：(NPO)日本口腔科学会  

近年、歯科用レーザーの使用に起因する皮下および縦隔気腫の報告が増加している。この論文では、CO2レーザー照射によって引き起こされた縦隔気腫の症例を報告する。患者は76歳の男性、歯科医院で右上顎歯4の歯肉瘻孔に対しCO2レーザーを照射された。治療中、右頬と右眼瞼周囲の急激な腫脹を認めた。同日、顔面から頸部に及ぶ腫脹を認め、他院口腔外科を経由し当院に紹介された。CT検査で、右側頭部から両側頸部にかけての皮下気腫と大動脈弓にまで及ぶ縦隔気腫が明らかになった。患者は入院し、抗菌薬投与を受けた。気腫は7日目までにほぼ消失し、8日目に退院した。CO2レーザー照射によって縦隔気腫が引き起こされる可能性を認識し、適切に治療する方法を知る必要がある。(著者抄録)

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Authorship：Lead author,　Corresponding author   Language：Japanese  

DOI： 10.5927/jjjd.28.296

J-GLOBAL

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Authorship：Lead author   Language：Japanese  

DOI： 10.5794/jjoms.64.255

J-GLOBAL

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Authorship：Lead author   Language：Japanese   Publisher：Japanese Society of Oral and Maxillofacial Surgeons  

<p>Extranodal marginal zone lymphoma of the mucosa-associated lymphoid tissue (MALT lymphoma) often occurs in the stomach. Although rare, MALT lymphoma can also occur in the oral cavity. MALT lymphoma is a low-grade lymphoma that can gradually transform into diffuse giant B cell lymphoma. Therefore, local therapy must be administered for localized lesions. A few cases of MALT lymphoma of the palate have been reported, but treatment strategies remain to be established. We report a case of MALT lymphoma in a 74-year-old woman who was successfully treated with radiotherapy and the molecular-targeted drug rituximab. The patient was examined at our department for a tumor extending from the left soft palate to the hard palate. The 20 × 20 mm lesion was painless and slightly elevated with a smooth surface. A pathological diagnosis of MALT lymphoma was established on biopsy. Treatment comprised 39.6 Gy of radiation followed by 8 courses of the molecular-targeted drug rituximab. The tumor showed a complete response, and there were no serious treatment-related adverse events. The patient has remained recurrence-free for 4 years.</p>

DOI： 10.5794/jjoms.62.336

CiNii Article

CiNii Books

J-GLOBAL

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Language：Japanese  

DOI： 10.11277/stomatology.65.270

J-GLOBAL

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Language：Japanese  

CiNii Article

CiNii Books

J-GLOBAL

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

The maxillofacial area is prone to the lodging of foreign objects in tissue, which are often difficult to remove. We describe a patient in whom foreign objects that were lodged deep in facial tissue were removed by using an optical navigational guidance system. An 84-year-old man presented with wounds on his face after falling through a glass door. Computed tomography images showed multiple radiopaque markers in the pterygopalatine fossa and temporal region. An optical navigation system was used to locate the foreign objects, and the glass pieces that were embedded in the skin and deeper tissues were extracted by using a guided navigation system with the patient under general anesthesia. Thus, foreign objects lodged in the maxillofacial area were successfully removed by using a guided navigation system in a minimally invasive manner.

DOI： 10.5794/jjoms.60.214

CiNii Article

CiNii Books

J-GLOBAL

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N-methyl-d-aspartate (NMDA) has been demonstrated to induce rhythmic activity in various neurons, including hypoglossal motoneurons (XIIms) and converts them to conditional pacemakers. Using whole-cell patch clamp recording in a slice preparation from neonatal rats, we confirmed that some XIIms act as conditional pacemakers, with TTX-insensitivity and a burst period that is voltage-dependent during NMDA application. Other XIIms in this study only fired tonically with NMDA application. Effects of medullary structures on conditional pacemaker XIIms were assessed using lesioned preparations. As a result, NMDA-induced rhythm (NIR) in the XIIm was observed with ventral lesions (excluding inspiratory neurons) and with dorsal lesions (excluding the swallowing center located in the nucleus of the solitary tract). The NIR was also observed with lateral lesions, but with a significantly decreased burst period. These data suggest that NMDA receptor activation selects a subset of XIIms and changes them to pacemakers whose properties can be altered by their excitability. The data also demonstrate that structures fundamental to the NIR are located within the area near the XII nucleus, indicating that the NIR is distinct from inspiratory and swallowing activities. The lateral medulla is considered to be a source of modulation of the excitability of XIIms. © 2013 Elsevier Ireland Ltd and the Japan Neuroscience Society.

DOI： 10.1016/j.neures.2013.03.007

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

Endoscopic-assisted surgery has gained widespread popularity as a minimally invasive procedure, particularly in the field of maxillofacial surgery. Because the surgical field around the mandibular angle is extremely narrow, the surrounding tissues may get caught in sharp rotary cutting instruments. In piezosurgery, bone tissues are selectively cut. This technique has various applications because minimal damage is caused by the rotary cutting instruments when they briefly come in contact with soft tissues. We report the case of a 33-year-old man who underwent resection of an osteoma in the region of the mandibular angle region via an intraoral approach. During surgery, the complete surgical field was within the view of the endoscope, thereby enabling the surgeon to easily resection the osteoma with the piezosurgery device. Considering that piezosurgery limits the extent of surgical invasion, this is an excellent low-risk technique that can be used in the field of maxillofacial surgery. (Oral Surg Oral Med Oral Pathol Oral Radiol 2013;115:e16-e20)

DOI： 10.1016/j.oooo.2011.09.032

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

Oral and maxillofacial surgery, which involves several sharp instruments and fixation materials, is consistently at a high risk for cross-contamination due to perforated gloves, but it is unclear how often such perforations occur. This study aimed to address this issue. The frequency of the perforation of surgical gloves (n = 1436) in 150 oral and maxillofacial surgeries including orthognathic surgery (n = 45) was assessed by the hydroinsufflation technique. Orthognathic surgery had the highest perforation rate in at least 1 glove in 1 operation (91.1%), followed by cleft lip and palate surgery (55.0%), excision of oral soft tumour (54.5%) and dental implantation (50.0%). The perforation rate in scrub nurses was 63.4%, followed by 44.4% in surgeons and first assistants, and 16.3% in second assistants. The odds ratio for the perforation rate in orthognathic surgery versus other surgeries was 16.0 (95% confidence interval: 5.3-48.0). The protection rate offered by double gloving in orthognathic surgery was 95.2%. These results suggest that, regardless of the surgical duration and blood loss in all fields of surgery, orthognathic surgery must be categorized in the highest risk group for glove perforation, following gynaecological and open lung surgery, due to the involvement of sharp objects.

DOI： 10.1016/j.ijom.2012.02.010

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Authorship：Lead author   Language：Japanese  

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