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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INTRODUCTION: Occlusal overload is considered to be one of the causes of late implant failure. However, it is unclear whether the magnitude of the patient's occlusal force is a risk factor for late implant failure. PURPOSE: This case-control study aimed to clarify the association between the cross-sectional area (CSA) of the masseter muscle and late implant failure. METHODS: This case-control study was limited to implant-supported fixed prostheses. We compared cases with at least one late implant failure (n = 25 patients) to controls (n = 82 patients) without implant failure. Patients were matched by age, sex, year of surgery, jaw and tooth type, and bone graft. Log-rank and Cox proportional hazard regression analyses were used to identify possible risk factors for late implant failure. RESULTS: The incidence of late implant failure was significantly associated with masseter muscle CSA ≥504.5 mm2 (hazard ratio: 4.43; 95% CI: 1.82-10.79; p < 0.01). CONCLUSION: Higher masseter muscle CSA increases the risk of late implant failure.

DOI： 10.1111/cid.13189

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BACKGROUND: Craniofacial disharmony in cases of jaw deformity associated with abnormal lateral deviation of the jaw mostly involves both the maxilla and mandible. However, it has been still difficult to capture the jaw deviation aspect in a 3-dimensional and quantitative techniques. In this study, we focused on 3-dimensional mandibular morphology and position of the condylar head in relation to the base of the skull in patients with mandibular prognathism, one of the most common jaw deformities. We used cluster analysis to quantify and classify deviation and clarified its characteristics. We also investigated the degree of correlation between those findings and menton (Me) deviation measured on frontal cephalograms, which is a conventional indicator of jaw deformity. RESULTS: Findings obtained from 100 patients (35 men, 65 women) were classified into the following three groups based on mandibular morphology and condylar position relative to the skull base. Then, reclassification using these parameters enabled classification of cluster analysis findings into seven groups based on abnormal jaw deviation characteristics. Comparison among these seven groups showed that the classification criteria were ramus height, mandibular body length, distance from the gonion to the apex of the coronoid process, and the lateral and vertical positions of the mandible. Weak correlation was also found between Me deviation on frontal cephalograms and each of the above parameters measured on 3D images. CONCLUSIONS: Focusing on mandibular morphology and condylar position relative to the skull base in patients with mandibular prognathism, we used cluster analysis to quantify and classify jaw deviation. The present results showed that the 3D characteristics of the mandible based on mandibular morphology and condylar position relative to the skull base can be classified into seven groups. Further, we clarified that Me deviation on frontal cephalograms, which has been used to date, is inadequate for capturing jaw deviation characteristics.

DOI： 10.1186/s40902-023-00372-y

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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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OBJECTIVE: We tested the hypothesis that histogram analysis parameters of standardized uptake values (SUVs) obtained preoperatively using 18F-fluorodeoxyglucose positron emission tomography (18F-FDG PET) are significantly influenced by differences in metabolic capacity due to the histologic grade of oral squamous cell carcinoma (OSCC). STUDY DESIGN: The study included 62 patients who were clinically diagnosed with OSCC and received surgical treatment after an 18F-FDG PET examination. Histogram analysis was performed using all voxels contained in the tumor area of each patient with an SUV ≥2.5. The histogram parameters calculated were the mean and standard deviation of SUVs, maximum SUV, metabolic tumor volume, skewness, and kurtosis. Statistical analyses were performed using a Mann-Whitney U test to calculate the significance of differences in these parameters between groups with well- and moderately- or poorly-differentiated tumors. Statistical significance was assumed at P < .05. RESULTS: Only a comparison of kurtosis in the histogram showed a significant difference between the well- and moderately/poorly-differentiated tumors (P = .0294). CONCLUSIONS: The distribution of metabolic capacity in oral squamous cell carcinoma tissues revealed on an 18F-FDG PET examination may help identify the histologic grade. This finding may provide valuable information for determining the subsequent treatment plan and predicting disease prognosis.

DOI： 10.1016/j.oooo.2022.03.005

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Language：Japanese   Publisher：新潟歯学会  

今回われわれは、関節隆起部の骨蜂巣内に炎症性変化が波及した変形性顎関節症の1例を報告する。症例は52歳の女性で、開口障害と左側顎関節部の疼痛を主訴に当院顎関節治療部を受診した。アプライアンス治療と薬物療法を受けたが疼痛が増悪したため当科を紹介で初診した。開口量は上下顎中切歯間距離で22mmであった。CT像では、左側下顎頭の関節面と関節隆起の後斜面が開閉口時に干渉し、同部の表面皮質骨には吸収像が認められた。MRIでは、左側顎関節円板は前方に転位して復位を認めず、T2強調像にて関節隆起部の骨蜂巣内に広がる高信号領域が認められた。パンピングマニュピレーションにて疼痛と開口障害は一時的に改善したが翌日には症状が再燃した。よって、顎関節開放手術にて、顎関節円板切除、関節隆起整形、高位下顎頭切除を行った。術後は早期より開口練習を行い、生じた咬合の偏位に関しては顎間ゴム牽引と補綴治療で対応した。術後のMRIでは、関節隆起内にみられた高信号は減少していた。術後に疼痛は消失して開口量は34mmを維持し、術後7年で転居のため転院となった。(著者抄録)

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

DOI： 10.1002/osi2.1122

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

The aims of this study were to perform a three-dimensional analysis of the craniofacial area, in particular, the temporal bone and to examine the morphological relationship between the temporal bone and asymmetry of the mandible in subjects with mandibular prognathism and facial asymmetry. Subjects were 50 adult orthognathic patients with facial asymmetry and mandibular prognathism. The initial computed tomographic data were reconstructed into three-dimensional and multiplanar reconstruction images. Linear and angular measurements of the temporal bone and the mandible were obtained. Then deviated and non-deviated sides were compared and the relationship between the temporal bone and mandibular morphology was investigated. The lengths of the mandibular body and ramus, the anteroposterior and vertical positions of the mandibular fossa, and the slant angle of the posterior surface of the petrous pyramid were significantly smaller (P < .05) on the deviated side than on the non-deviated side. Further, the left-right differences in the temporal bone were positively correlated with a deviation of the mandible and differences in the lengths of the mandibular body and ramus (P < .05). The results suggest that asymmetry of the temporal bone is closely related to mandibular asymmetry and might have an important role in the mechanism of facial asymmetry.

DOI： 10.1002/osi2.1111

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

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

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

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

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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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Masseter muscle hypertrophy is defined as the unilateral or bilateral expansion of the masseter muscle, and little is known about its etiology. Here we report a case of masseter muscle hypertrophy in a female patient in her 20 s who complained of facial asymmetry. Because of the hemifacial overgrowth of the right-side maxillofacial region from birth, she was thought to have congenital hemifacial hyperplasia. After orthodontic treatment and osteotomy, the patient underwent debulking of the right masseter muscle. Histologically, the surgical specimens exhibited thick masseter muscle fibers arranged irregularly. Masseter muscle cells exhibited diameters in the range of 20–60 μm.

DOI： 10.1016/j.ajoms.2019.08.005

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

DOI： 10.5794/jjoms.65.672

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

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

OBJECTIVE: Myofascial pain in temporomandibular joint disorders (TMDs) is evoked by various factors, including edematous change. We investigated whether the pain pattern is related to edematous change by using T2 mapping generated by magnetic resonance imaging to detect water content in the tissue. STUDY DESIGN: One hundred and five patients diagnosed with TMDs, with or without unilateral masseter muscle pain, were divided into 6 groups according to their pain experience: pain on compression (23 cases), pain on movement (13 cases), spontaneous pain (4 cases), pain on compression and movement (14 cases), pain on compression and spontaneous pain (2 cases), and no pain (49 cases). Differences in the mean T2 values of the masseter muscle between the group with pain on only one side (5 unilateral pain groups) or pain-free on both the right and left sides (pain-free group) were compared with paired t tests. Significant differences were assumed at P < .05. RESULTS: Significant differences in mean T2 values were found between the painful and pain-free sides in the group with pain on compression. CONCLUSIONS: The findings of edematous change in the masseter muscle of patients with pain on compression may affect treatment planning and lead to investigation of treatment options for myofascial pain in TMDs.

DOI： 10.1016/j.oooo.2018.06.003

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Dental cone-beam computed tomography (CBCT) received regulatory approval in Japan in 2000 and has been widely used since being approved for coverage by the National Health Insurance system in 2012. This imaging technique allows dental practitioners to observe and diagnose lesions in the dental hard tissue in three dimensions (3D). When performing routine radiography, the examination must be justified, and optimal protection should be provided according to the ALARA (as low as reasonably achievable) principles laid down by the International Commission on Radiological Protection. Dental CBCT should be performed in such a way that the radiation exposure is minimized and the benefits to the patient are maximized. There is a growing demand for widespread access to cutting-edge health care through Japan's universal health insurance system. However, at the same time, people want our limited human, material, and financial resources to be used efficiently while providing safe health care at the least possible cost to society. Japan's aging population is expected to reach a peak in 2025, when most of the baby boomer generation will be aged 75 years or older. Comprehensive health care networks are needed to overcome these challenges. Against this background, we hope that this text will contribute to the nation's oral health by encouraging efficient use of dental CBCT.

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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Synovial chondromatosis (SC) is a reactive joint disorder characterized by the development of metaplastic cartilaginous nodules floating within the joint space. We report a case of SC of the temporomandibular joint (TMJ) which had difficulty in diagnosis in a 40-year-old woman. The patient had TMJ pain with mandibular lateral deviation for two years. CT and MRI revealed well-defined and round-shaped bone resorption at the right mandibular fossa and an ovoid-shaped expansion of the superior articular cavity, which showed heterogeneous high signal intensity on T2-weighted MRI. Following a clinical diagnosis of benign TMJ tumor, the lesion was surgically removed. Histopathologically, it was diagnosed as SC in Milgram's stage 1, mainly involving the upper joint space. This is the first case report of SC in an early stage in which no cartilaginous nodules were generated but instead the mandibular fossa of the temporal bone was resorbed.

DOI： 10.1016/j.ajoms.2018.03.006

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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：CHURCHILL LIVINGSTONE  

The aim of this study was to determine the relationships among bone properties, bone metabolic markers, and types of jaw deformity. The subjects were 55 female patients with jaw deformities. Skeletal morphology was examined using lateral cephalograms, and the patients were divided into three groups according to the type of anteroposterior skeletal pattern. Serum osteocalcin, bone alkaline phosphatase, and tartrate-resistant acid phosphatase isoform 5b, as well as deoxypyridinoline in urine, were measured as bone metabolic markers Quantitative ultrasound (QUS) measurements were used to assess bone properties at the calcaneal bone. The bone volume and bone density of the condylar process were measured in 43 patients by computed tomography. There were no significant differences in bone metabolic markers and QUS parameters between the groups, although bone formation and resorption markers tended to be higher in patients with a protrusive mandible. On the other hand, patients with mandibular retrusion had a higher tendency to have small and dense condylar processes. In conclusion, the results suggest that growth depression or a degenerative change in the mandibular condyle is involved in the pathogenesis of mandibular retrusion, although risk factors for progressive condylar resorption were not determined.

DOI： 10.1016/j.ijom.2016.02.003

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

Most cases of hypophosphatasia (HPP) exhibit early loss of primary teeth. Results of microcomputed tomography (micro-CT) analysis of teeth with HPP have rarely been reported. The purpose of the present study was to describe the mineral density distribution and mapping of exfoliated teeth from an HPP patient using micro-CT. Four exfoliated teeth were obtained from a patient with HPP. Enamel and dentin mineral densities of exfoliated teeth were measured on micro-CT. The mean values of enamel and dentin mineral densities in mandibular primary central incisors with HPP were 1.61 and 0.98 g/cm3, respectively. The corresponding values in the mandibular primary lateral incisors were 1.60 and 0.98 g/cm3, respectively. Enamel hypoplasia was seen in the remaining teeth, both maxillary and mandibular primary canines and first and second molars. Micro-CT enables nondestructive, noninvasive evaluation and is useful for studying human hard tissues obtained from patients.

DOI： 10.1155/2016/4898456

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DOI： 10.1007/s11282-013-0153-1

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Language：Japanese   Publisher：新潟大学教育・学生支援機構  

新潟大学歯学部では,初年次教育として大学学習法を実施している.この授業は講義・演習での知識や技能をもとに,レポート作成とプレゼンテーションを行うもので,その学習活動を通して,間題解決能力,論理的思考力,表現力の開発をねらいとしている.今回,学習成果の直接評価に向けて,パフォーマンス評価を導入すべく,レポートからこれら能力を読み解くルーブリックづくりに取り組んだ.また,この経験からみえてきたパフォーマンス評価の難点とその対処について検討した.その結果,パフォーマンス評価により能力を把握できる可能性が示されたが,導入には教員の理解と協力,能力と関連した適切な評価観点の設定,評価の信頼性を高める工夫,評価と指導の一体化を考慮した授業デザインなど,いくつかの課題があることも明らかになった.The curriculum of Niigata University Faculty of Dentistry provides the &quot;Study Skills&quot; course as first year education. The ultimate goal of this course is to develop student abilities of problem solving, logical thinking and expression. For that purpose, each student is guided through the process of writing a report and presenting its content. To access the degree to which these abilities were achieved, we created a rubric and used it to evaluate the student reports. Based on the experience of this trial, we discussed problems for the introduction of performance assessment into the course. Although performance assessment has a high potential to grasp these abilities, there are some practical problems that may interfere with its introduction, such as &quot;how to involve the faculty in assessment&quot;, &quot;how to establish dimensions of the rubric that appropriately relate with the student abilities&quot;, &quot;how to increase the reliability of assessment&quot;, &quot;how to design the course to allow for a connection between assessment and instruction&quot;.

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

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

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Language：Japanese   Publisher：Japanese Society of Oral Oncology  

Myoepithelial carcinoma (MEC), a rare malignant salivary gland tumor, was first classified as a separate neoplasm by the World Health Organization (WHO) in 1991. The tumor represents less than 1% of all salivary gland neoplasms. MEC occurs most frequently in the parotid gland (75%), and approximately 10% in the submandibular gland, and there have been no previous reports of MEC arising from the sublingual gland. Herein, we report a case of MEC occurring in the sublingual gland.<br>A 67-year-old male came to our hospital in January of 2006, complaining of a swelling on the left side of the floor of the mouth. Clinical examination revealed a 30 × 20 × 10mm elastic, hard, non-tender, submucosal mass on the left side of the floor of the mouth. The mass had poor mobility, but no ulceration was seen on the surface of the mucosa.<br>Magnetic resonance imaging (MRI) showed an ovoid form mass with a bright mixture of hyper- and hypo-intense signals on T1-weighted images. No signs of mandibular bone invasion were detected. The resected specimen showed a lobulated shape and it extended from the sublingual gland into the surrounding tissues. Immunohistochemical analysis indicated that the tumor cells were positive for S-100 protein, SMA, pan-keratin, CK19, MUC-I, Calponin, and Vimentin. The pathological diagnosis was myoepithelial carcinoma of the sublingual gland. During the follow-up for 2 years and 9 months, there was no clinical or radiological evidence of loco-regional recurrence or distant metastasis.

DOI： 10.5843/jsot.24.113

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Other Link： http://search.jamas.or.jp/link/ui/2013021704

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

The aim of this study was to establish an objective method for quantitative evaluation of bone volume change after sinus augmentation. 11 sinuses in 9 patients were evaluated by computed tomography images taken before treatment (T0), and 3 months (T1) and at least 1 year (T2) after sinus augmentation. Based on the 3D digital subtraction technique, augmented bone images were extracted and bone volumes were calculated from voxel numbers of the extracted images. The mean augmented bone volumes at T1 and T2 were 2.46 cm(3) and 1.85 cm(3), respectively. These bone volume changes were statistically significant and the mean bone volume change +/- SE was -24.8% +/- 6.1%. Loss of augmented bone was observed in all except one of the patients. The correlation coefficient between bone volume change and elapsed time was -0.64, which was statistically significant and indicated that bone resorption progressed with elapse of time after sinus augmentation. The authors' method of analysis enabled visualization of augmented bone and objective assessment of bone volume change. Within the limited number of cases, the present investigation demonstrated a significant decrease in augmented bone volume between 3 and 23 months after surgery.

DOI： 10.1016/j.ijom.2012.01.020

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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：Japanese   Publisher：一般社団法人 日本顎関節学会  

Suppurative arthritis is a comparatively rare disease. We report a case of suppurative arthritis of the right temporomandibular joint with an abscess in the lateral pterygoid muscle. The patient was a 58-year-old man who complained of swelling of the right temporomandibular joint area and jaw opening pain. There was diffuse swelling and induration in the right temporomandibular joint area. Maximum interincisal opening was 18 mm and lateral open bite of about 2 mm on the right molar region was recognized in the occlusal position. Computed tomography and MRI showed bone resorption at the medial pole of the right mandibular condyle and abscess formation in the right temporomandibular joint capsule and lateral pterygoid muscle. Viscous yellowish-white pus was aspirated through a puncture needle from the abscess. &lt;i&gt;Peptostreptococcus micros&lt;/i&gt;, which was resident oral flora, was identified by bacteriological culture. Following treatment with antibiotics, swelling of the right temporomandibular joint area disappeared and maximum interincisal opening increased to 47 mm with a rightward mandibular deviation and joint noise. Since resident oral flora was the offending bacteria of the infection, it was thought that the odontogenic infection had spread to the mandibular condyle and the lateral pterygoid muscle.&lt;br&gt;

DOI： 10.11246/gakukansetsu.23.155

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Language：Japanese  

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Language：Japanese   Publisher：The Japanese Society for Temporomandibular Joint  

We present a case of acute suppurative arthritis of the temporomandibular joint (TMJ) due to repeated intra-articular injection of steroid. The patient was an 82-year-old woman who complained of swelling and pain of the right TMJ. At the first visit, an abscess around the TMJ was observed. CT findings revealed that the bone surface of the right TMJ was absorbed and rough, and the inside of the condylar head was sclerotic. Administration of intravenous antibiotics and drainage were performed. Progressive trismus and bony ankylosis of the TMJ were suspected 9 months after discharge. It is considered that the intra-articular injection of steroid should be performed carefully under strict infection control.<br>

DOI： 10.11246/gakukansetsu.23.1

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Other Link： http://search.jamas.or.jp/link/ui/2011200373

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

Infantile fibromatosis is a fibromatous lesion that arises in both soft and hard tissues, and occurs rarely in the head and neck region. A three-year-old boy was referred to our clinic because of painful swelling of the left submandibular region. CT scans and MRI revealed a localized perimandibular soft tissue mass, which suggested a malignant tumor, but we could not make a definitive pathological diagnosis from the needle biopsy specimens. The tumor was removed surgically while taking into consideration to avoid disturbing the maxillofacial cosmesis and functions. The pathological findings of the surgical specimen showed a tumor composed of spindle cells with no cellular atypia and mitosis, but showed invasion into the surrounding muscular tissue, and the final pathological diagnosis was infantile fibromatosis. There is no evidence of recurrence for five years postoperatively, but we have to close follow-up carefully because recurrence of the tumor after surgical resection was reported.

DOI： 10.5843/jsot.21.273

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

Objective. The purpose of this study is to evaluate the corrections of signal intensity of the temporomandibular joint (TMJ) disc caused by variations in sensitivity of the magnetic resonance imaging (MRI) surface coil, to compare the modified signal intensities of the posterior and anterior bands, and then to evaluate the relationship of the signal intensity difference to altered disc position and morphology in a group of TMJ patients. Study design. MRI was performed on 96 joints. All patients underwent imaging in axial, coronal, and sagittal planes using fast-spin echo sequences (FSE). The images were taken in the closed, partially opened, and maximum opened mouth positions in 2 sequences. Classifications were made according to the position and morphology of the disc. TMJs were divided into normal, anterior disc displacement with reduction (ADDwR), anterior disc displacement without reduction (ADDwoR), and partial anterior disc displacement with reduction (PDDwR). Disc morphology was subdivided as biconcave, lengthened, biconvex, thick posterior band, and others (defined as folded and rounded). The correction of the inhomogeneous sensitivity of the surface coil was done with the original software. The signal intensities (SI) of the posterior band and anterior band of TMJ discs were measured. The correlations among the groups of TMJs and disc morphologies and SI were statistically analyzed by using Bonferroni/Dunn multicomparison method test. Results. Of the total number of joints studied with the help of MRI, 37 were normal, 12 exhibited ADDwR, 32 ADDwoR, and 9 PDDwR. The corrected MR images indicated that SI of the posterior bands were higher than the anterior band of the discs. It can also be concluded that the SI of the posterior bands increased significantly in the following order: normal, PDDwR, ADDwR, and ADDwoR, while there is no statistical difference in the SI of the anterior band of the discs. In ADDwR and ADDwoR, thick posterior band is the most common shape. In normal TMJ, the biconcave shape is identified as the most frequently encountered shape. Conclusions. It was demonstrated that the SI of the posterior bands increase with the progress of internal derangement, and was found to be higher than that of the anterior band of the discs. It appears that disc degeneration starts from the posterior band of the disc. © 2006 Mosby, Inc. All rights reserved.

DOI： 10.1016/j.tripleo.2005.04.004

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Purpose: To present CT and MR images and compare CT and MRI features of oral and maxillofacial hemangioma and vascular malformation. Material and methods: The clinical materials consisted of nine vascular tumors from nine patients examined by both CT and MR scanners between November 1996 and March 2002. Both CT and MR images were retrospectively evaluated. The following features were evaluated: detectability of the lesion, border of the lesion, tumor margin, inner nature of the lesion, contrast between the lesion and surrounding tissues, degree of CT value or signal intensity of the lesion, enhancement of contrast medium, inner nature of the lesion after contrast medium injection, detectability of phleboliths and detectability of bone resorption. Results: In two patients, we could not detect lesions in any of the CT images because of artifacts from the teeth and/or dental restorations. In contrast, we could detect all lesions on T2-weighted MR images and contrast enhanced T1-weighted MR images. On T2-weighted images with the fat suppression technique, tumors tended to show higher contrast compared to surrounding tissues. Conclusion: T2-weighted images with the fat suppression technique and contrast enhanced T1-weighted images with the fat suppression technique were very useful for the detection of vascular lesions. Observation from optional directions (axial, coronal and sagittal images) seemed appropriate for delineating the extension of the tumor. Phleboliths detectability on CT images was superior to that on MR images. © 2004 Elsevier Ireland Ltd. All rights reserved.

DOI： 10.1016/j.ejrad.2004.09.011

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Nasoalveolar cyst is a rare nonodontogenic cyst arising in the nasoalar region of the face. In this case, a 39-year-old female had a nontender, fluctuant, soft, round, and bluish lesion in the right anterior gingiva of the right maxilla. Panoramic and magnetic resonance imaging examinatioins were performed. No abnormality was evident on the radiograph. The lesion was hypointense signal intensity on T1-weighted images and hyperintense on T2-weighted images. On sagittal T2-weighted images, a septum could be seen within the lesion. After injection of contrast medium and acquisition of T1-weighted images, enhancement was not observed in the lesion, but was evident at the periphery. The lesion did not enhance with contrast on T1-weighted images, but the periphery was enhanced. The lesion was surgically excised. Histopathologic examination showed the lesion to be a nasoalveolar cyst.

DOI： 10.1016/j.tripleo.2004.08.002

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Exercise can enhance the signal intensity (SI) of skeletal limb muscles on T2-weighted magnetic resonance imaging (MRI). The purpose here was to evaluate the effects of repetitive maximal clenching exercises involving the mandibular elevator muscles with T2-weighted MRI. Seven normal volunteers were imaged before and immediately after performing repetitive maximal clenching and at 3, 6, 9, 12, 15, 20 min after the exercise in a 1.5 T GE magnet with spin-echo sequences. SI in the masseter, medial pterygoid and temporalis increased significantly (p &lt
0.001) and the cross-sectional area (CSA) of masseter increased 10.11% on T2-weighted MRI after exercise. The increased SI and CSA declined approximately to the pre-exercise level in about 20 min after exercise. No SI and CSA changes were found in the inactive neck muscle and no SI changes in the mandibular bone marrow (p &gt
0.05). The findings suggest that the use of exercise-enhanced MRI might be helpful in the study of the function and dysfunction of muscles in the orofacial region. (C) 2000 Published by Elsevier Science Ltd.

DOI： 10.1016/S0003-9969(99)00078-3

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

It has been reported that the signal intensity of dense collagen fibers markedly increases in some tissues on MRI, when collagen fibers are oriented at about 55° against the static magnetic field. This angle is sometimes called the magic angle. The magic angle phenomenon is caused by magnetic dipolar-dipolar interaction between water protons. As this phenomenon has been reported to be related to the T2 relaxation rate only, the signal intensity may be influenced by the T2 relaxation rate at the spin echo (SE) sequence if other parameters are fixed. Information regarding the increasing ratio of signal intensity depending on the angle may be clinically important. A bovine tendon was rotated horizontally in a static magnetic field and images were obtained with SE or fast spin echo (FSE) sequences as follows: (a) SE (TR/TE=2000/15, 30, 45, 60), (b) SE (TR/TE=300, 500, 700/14), (c) FSE (TR/TE=3000/15, 105 eff., echo train length 14). By comparing the theoretical curves and data, it was con-firmed that the signal intensity was related to the second power of the local magnetic field strength. The increasing ratio of signal intensity of the bovine tendon at 55° (magic angle) compared with 0° was about 3 times (TE=30). The most influential TE was about 20-40 msec. The increasing ratio of signal intensity did not depend on TR change or the FSE technique.

DOI： 10.11242/dentalradiology1960.39.27

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DOI： 10.11501/3100698

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Language：Japanese   Publisher：特定非営利活動法人 日本歯科放射線学会  

DOI： 10.11242/dentalradiology1960.34.58

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Other Link： http://search.jamas.or.jp/link/ui/1994228214

Language：Japanese   Publisher：The Japan Prosthodontic Society  

Abnormalities of soft tissue of TMJ components are common in craniomandibular disorders. For the diagnosis of these abutormalities, MR imaging technique is useful. However, the relationship between MRI findings and signs and symptoms of craniomandibular disorders remains unclear. In this study, MRI findings and signs autd syntptoms of craniomandibular disorders were compared for 150 patients (300 TMJs) with craniounandibular disorders.

DOI： 10.2186/jjps.38.1066

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Other Link： http://search.jamas.or.jp/link/ui/1995148872

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

The aim of this study was to clarify the portion forming the contour of the mandibular head by temporomandibular joint (TMJ) frontal projection, and to clarify whether the shape of the mandibular head by TMJ frontal projection conformed to that by Yale's classification.<br>The projections evaluated in the present study were Grant-Lanting, modified Grant-Lanting, Clementschitsch, transmaxillary, Takaku, and Zimmer projections.<br>Lateral roentgenographic cephalography at maximal opening of the mouth was performed in the following two groups: 20 healthy volunteers with an inter-incisal opening more than 40mm, and 20 patients of cranio-mandibular disorders with an inter-incisal opening less than 35mm. The mean vertical angulation identical to the central X-ray beam of each TMJ frontal projection against the mandibular occlusal plane was obtained from those cephalograms.<br>The tangential point of the central X-ray beam in each TMJ frontal projection to the contour of the mandibular head was examined as the portion forming outline of the mandibular head in the lateral view of 58 mandibular heads of human dry skulls.<br>The shape of the mandibular head by TMJ frontal projection and that by Yale's classification were compared by using photographs of the same human dry skulls.<br>The results of the study were as follows:<br>1) The portion forming the contour of the mandibular head by frontal projection was within the posterior surface of the mandibular head, and the lower portion of the posterior surface was depicted as the mouth opened more widely.<br>2) The condylar contour by frontal projection showed the outline of the posterior surface of the mandibular head, and did not conform to the shape of the mandibular head by Yale's classification.

DOI： 10.11246/gakukansetsu1989.5.48

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Language：Japanese   Publisher：Japanese Society for Oral and Maxillofacial Radiology  

In order to make a guideline for efficient routine diagnostic imaging system for the temporoman-dibular joint (TMJ), a questionnaire was sent to every 29 oral radiology section of the dental colloge and university school of dentistry in Japan.<br>The part III dealt with radiographic terms for the osseous changes of the TMJ. The terms employed here were erosion, eburnation, sclerosis, marginal proliferation, osteophyte, deformity, loss of bone density, pseudocyst, concavity, flattening, facet, calcified body and loose body. The usage of those terms and the opinions about the relationship between those terms and the pathology by each respondents was analyzed.

DOI： 10.11242/dentalradiology1960.33.31

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Language：Japanese   Publisher：Japanese Society for Oral and Maxillofacial Radiology  

In order to make a guideline for appropriate routine diagnostic imaging system for the tempor-omandibular joint (TMJ), a questionnaire was sent to every 29 Oral radiology section of dental college and university school of dentistry in Japan.<br>In this article, the opinions of the respondents were analyzed concerning the following items:<br>1) observable and limited structures in the TMJ by each imaging method<br>2) significance of the imaging methods<br>3) ideal routine diagnostic imaging system.

DOI： 10.11242/dentalradiology1960.33.18

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Language：Japanese   Publisher：Japanese Society for Oral and Maxillofacial Radiology  

The purpose of this study is to visualize a mathematical human phantom with internal organs and absorbed dose distribution in the phantom as three-dimensional computer graphics (CG).<br>Each organs of modified GSF* mathematical phantom were displayed as a set of three-dimensional transparent color objects by the ray-tracing method.<br>Three-dimensional dose distribution data were calculated using Monte Carlo Method. After gray scale modification, the data were displayed with brightness for themselves or superimposed on the phantom image.<br>By our ray-tracing program, it took about three hours to obtain the image of the phantom head and its organs. It only took a few minutes, however, to re-display the image data on the hard disk. It was suggested that this display system was effective for education and checking algorithms of the Monte Carlo simulation.<br>*Gesellschaft für Strahlen and Umweltforschung

DOI： 10.11242/dentalradiology1960.32.61

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Language：Japanese   Publisher：特定非営利活動法人 日本歯科放射線学会  

DOI： 10.11242/dentalradiology1960.32.244

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Other Link： http://search.jamas.or.jp/link/ui/1994146775

Language：Japanese   Publisher：Japanese Society for Oral and Maxillofacial Radiology  

In order to make a guideline for appropriate routine diagnostic imaging system for the temporomandibular joint, a questionnaire was sent to every 29 oral radiology section of dental college and university school of dentistry in Japan. Sixty radiologists from 22 oral radiology sections (76%) replied to the questionnaire.<br>This three-part article will describe a present status, significance, and a future for each imaging method and diagnostic imaging system based on the opinions of the responders.<br>In part I, we analyzed the present status of frequency, technique and choice of each imaging method.

DOI： 10.11242/dentalradiology1960.32.223

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DOI： 10.11242/dentalradiology1960.31.87

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DOI： 10.11501/1729473

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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   Publisher：(公社)日本口腔外科学会  

症例は35歳女性で、16歳時に右側下顎の腫脹を主訴に受診した。CTにより線維性異形成症を疑い、生検は典型的な線維性異形成症の所見であった。成長期であることを考慮し、治療は行わず経過観察の方針となったが、外来通院が中断した。25歳時に発熱、右側下顎の腫脹、疼痛を訴えて受診した。CTで右側下顎部病変の増大を確認した。線維性異形成症の悪性転化も考慮して生検を施行し、線維性異形成症の診断であった。外科的切除は行わず経過観察の方針となったが、外来通院を自己中断した。35歳時に38℃台の持続する発熱と右側下顎に強い自発痛が出現した。CT所見では、右側下顎骨体部を中心に、右側下顎筋突起から左下4番に及ぶ病変を認めた。MRI所見では、右側筋突起先端から左側下顎臼歯部付近まで至る骨膨隆性病変を認めた。画像所見より線維性異形成症の悪性化を疑い、右下3番部より生検を行い、下顎骨単独病変と診断した。下顎区域切除術、両側顎下部郭清術ならびに血管柄付腓骨皮弁による下顎再建術を施行した。術後の経過は良好で、7年を経た現在も腫瘍の再発や転移はない。病理組織学的診断は低悪性骨中心性骨肉腫であった。

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Language：Japanese   Publisher：新潟大学  

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Other Link： http://hdl.handle.net/10191/19560

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Other Link： http://search.jamas.or.jp/link/ui/2008317042

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Other Link： http://search.jamas.or.jp/link/ui/2008317038

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Other Link： http://search.jamas.or.jp/link/ui/2008156706

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Other Link： http://search.jamas.or.jp/link/ui/2008156700

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Other Link： http://search.jamas.or.jp/link/ui/2007122222

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

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Objective: The purpose of this study is to determine the prevalence of radiographic presence of otomastoiditis while examining temporomandibular joint (TMJ) disorders in magnetic resonance images (MRI) in a series of 2270 temporomandibular joint magnetic resonance images and to examine the relationship between otomastoiditis and TMJ disorders. Materials and methods: 2270 temporomandibular joint magnetic resonance images and patients&#039; data were retrospectively investigated. Magnetic resonance images were obtained from the patients who referred to Osaka University Dental Hospital Outpatient Clinic with TMJ complaints for the last four years (from January 1998 to January 2003). The patients, who were diagnosed as otomastoiditis based on their temporomandibular joint magnetic resonance images, were sent to Osaka University Hospital Department of Otolaryngology for a medical consultation in order to have their pathologies certified following their MR process. Age and sex were recorded for all patients and for otomastoiditis cases; location of the disease, symptoms of patients and TMJ findings were noted as well. Results: Seven patients were diagnosed as acute otomastoiditis and one patient diagnosed as chronic active otitis media with cholesteatoma in the series of 2270 MR, which were representing a prevalence of 0.39%. Neurilemoma diagnosed in left mastoid process in one patient. The final diagnoses of all patients were made after medical consultation. Conclusion: While examining temporomandibular joint magnetic resonance images; it is not only important to examine just the TMJ structures, but also to look at the nearby anatomical features to check evidence for inflammatory disease. © 2004 Elsevier Ireland Ltd. All rights reserved.

DOI： 10.1016/j.ejrad.2004.11.001

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Language：Japanese   Publisher：Niigata University  

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Other Link： http://search.jamas.or.jp/link/ui/2005024099

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Language：Japanese   Publisher：The Japanese Society for Temporomandibular Joint  

Objective: To assess the effectiveness of magnetic resonance imaging (MRI) for the diagnosis of rheumatoid arthritis (RA) in the temporomandibular joint (TMJ), MRI was performed on RA patients with TMJ involvement.<BR>Methods: Six patients (all women) with TMJ involvement, of average age 49.8 years (range 24∼70), who had been serologically or clinically diagnosed with RA by orthopedists, were enrolled. Diagnostic imaging included plain radiography (panoramic radiography and lateral oblique transcranial projection), multisection tomography, and MRI, such as Proton density MRI, T1-weighted MRI and T2-weighted MRI. On each examination, bone changes of the TMJ and soft tissue in the TMJ were evaluated.<BR>Results: MRI showed that 9 of the 12 joints had bone changes, including erosion and osteophyte; disks were invisible in 5 joints; disks were superior to the condyle in 6 joints, and one disk had anterior disk displacement without reduction. On T2-weighted MR images, 5 joints had high signal intensity. Only one joint was suspected of having pannus.<BR>Conclusion: It was concluded that the effectiveness of visualizing bone changes of the TMJ by MRI was similar to that by conventional radiographic examination. MRI also visualized abnormal soft tissue in the TMJ. Thus, MRI might be a useful technique for evaluation in RA patients.

DOI： 10.11246/gakukansetsu1989.13.243

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Other Link： http://search.jamas.or.jp/link/ui/2002027506

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

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Language：Japanese   Publishing type：Article, review, commentary, editorial, etc. (trade magazine, newspaper, online media)   Publisher：産業開発機構  

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Other Link： http://search.jamas.or.jp/link/ui/1999091625

Language：English   Publisher：STOCKTON PRESS  

Objectives: To analyse the condylar movements of patients with temporomandibular disorders and investigate the mutual interaction between both temporomandibular joints (TMJs) by comparing bilateral simultaneous videofluorography with the disk position on MRI.
Methods: Fifty-two patients who had been diagnosed as having internal derangement in one or both TMJs on the base of the clinical symptoms underwent bilateral simultaneous videofluorography and MRI. The TMJs were classified from the MRI into three categories: superior disk position (SDP), reducing disk displacement (RDD) and nonreducing disk displacement (NDD), Condylar movements of the TMJs were analysed from the videofluorography and correlated with the MR diagnoses.
Results: The range of condylar movement of NDD joints was significantly shorter than that of SDP or RDD joints at maximum mouth opening (P&lt;0.001), but not at maximum protrusion and lateral protrusion. Based on the sagittal, condylar path during maximum mouth opening and closing, three patterns of condylar movement were identified: normal, deflected and short. Sixty-nine per cent of the normal pattern were SDP, 55% of the deflected RDD and 77% of the short NDD. The condylar movement of a NDD or RDD joint could influence the range and pattern of movement of the contralateral joint.
Conclusions: Analysis of condylar movement was helpful in assessing the state of the disk because they were closely related. The range and pattern of condylar movement of both TMJs were mutually interrelated. Patients with signs and symptoms of internal derangement should have both sides examined for an accurate and complete diagnosis.

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Publishing type：Rapid communication, short report, research note, etc. (scientific journal)   Publisher：Elsevier BV  

DOI： 10.1016/s1079-2104(97)90047-0

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Language：English   Publisher：STOCKTON PRESS  

Objectives: To describe the clinical and MRI findings in patients with disc displacement of the temporomandibular joint.
Methods: Eighty-eight joints in 51 patients referred for suspected TMJ disc displacement were examined by MRI. Two oral radiologists assessed the images. The clinical findings were obtained by retrospective review of the patients' records.
Results: Clicking was the most common clinical finding, present in 47 joints. Pain was reported for only 30 joints. Anterior disc displacement with reduction was found in 39 joints, anterior disc displacement without reduction in 31 joints, compound dislocations (anterolateral or anteromedial) in 13 joints and sideways displacement in 5 joints respectively. In about one-fourth of the joints, MRI revealed abnormal configuration of both disc and condyle. The osseous changes were subtle. Only 9% of the joints exhibited an osteophyte. Joint effusion in either the upper or the lower joint compartment was found in 19 joints. Out of 14 patients with joint effusion, six patients complained of pain from the TMJ region.
Conclusion: The most extensive soft and hard tissue changes were found in patients with anterior disc displacement without reduction. Pain was not a characteristic symptom for any type of disc displacement.

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Language：English   Publishing type：Research paper, summary (international conference)   Publisher：AMER ASSOC DENTAL RESEARCH  

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For patients with TMJ dysfunction, operators often change the condylar position by various methods. The aim of this study is to investigate how much the changes with time of condylar positions are related to the changes of clinical signs. The subjects were 584 joints of 127 patients with TMJ dysfunction to whom the serial lateral TMJ tomography was performed more than twice. In the most of cases where the condylar position had moved downward, inter-incisal distance had increased and TMJ noise had ameliorated. Furthermore, in many cases where the condylar position had moved forward, the amelioration of the TMJ pain was observed. It was considered that those ameliorations occurred because the positional relationship between the condylar head and the articular disk or posterior attachment had been improved. © 1993 The Japanese Society of Dental Radiology.

DOI： 10.1007/BF02349102

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Although magnetic resonance imaging (MRI) is the modality of choice for evaluation of TMJ disc position, it is sometimes difficult to determine when it is displaced or reduced. The MR images of 273 Patients with a clinical diagnosis of TMJ disorders were assessed for disc position and configuration. Most (90-97%) of the slightly anteriorly displaced discs were reduced to the normal position in the open-mouth position. However, the greater part (76%) of the distorted discs was completely displaced anteriorly and without reduction. Since no distorted discs were found in the normal disc position, we conclude that discs are distorted after displacement. © 1993.

DOI： 10.1259/dmfr.22.4.8181648

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Language：English   Publisher：MOSBY-YEAR BOOK INC  

One hundred thirty-one arthrographic examinations of temporomandibular joints were performed on 119 patients. The relationships between clinical symptoms, tomographic findings, and soft-tissue perforation were examined. Perforations of the articular disk or posterior attachment were revealed in 58 joints. Joints with crepitation showed a high frequency of perforation (20 of 22). Pain in the joint area and limitation of opening correlated to disk reduction. Perforations were observed in 12 of 21 joints with continuous pain. Osseous changes were detected in 89 joints. Joints with abnormal radiodensity (erosion, sclerosis) combined with abnormal shape (pocket erosion, osteophyte formation, deformity) showed a high frequency of perforation (41 of 45), which corresponded to 84% in this study. In those cases with osseous change or crepitation, positive predictive values of perforation were both 91%. These types of osseous change and their clinical significance might predict soft-tissue perforation with high accuracy before an arthrogram is performed.

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One hundred thirty-one arthrographic examinations of temporomandibular joints were performed on 119 patients. The relationships between clinical symptoms, tomographic findings, and soft-tissue perforation were examined. Perforations of the articular disk or posterior attachment were revealed in 58 joints. Joints with crepitation showed a high frequency of perforation (20 of 22). Pain in the joint area and limitation of opening correlated to disk reduction. Perforations were observed in 12 of 21 joints with continuous pain. Osseous changes were detected in 89 joints. Joints with abnormal radiodensity (erosion, sclerosis) combined with abnormal shape (pocket erosion, osteophyte formation, deformity) showed a high frequency of perforation (41 of 45), which corresponded to 84% in this study. In those cases with osseous change or crepitation, positive predictive values of perforation were both 91%. These types of osseous change and their clinical significance might predict soft-tissue perforation with high accuracy before an arthrogram is performed. © 1992 Mosby-Year Book, Inc. All rights reserved.

DOI： 10.1016/0030-4220(92)90390-C

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Event date： 2017.4

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