Asian Journal of Oral and Maxillofacial Surgery最新文献

The various treatment modalities involved in the treatment of branchial fistula such as step ladder excision and use of strippers are well described in the literature.

We hereby report a case of complete branchial fistula and our modification in its management. By catheterizing the fistulous tract we were able to avoid extensive dissection, thus making the procedure relatively simple, less time consuming and ensuring a complete removal of the fistulous tract. This technique also overcomes the complication encountered with other surgical options such as injury to facial nerve and blood vessels of the neck.

Objective

To determine the effects of a gamma secretase inhibitor on the proliferation mediating cell-cycle regulators and invasive activity mediating matrix metalloproteinase (MMP) 9 expression in oral cancer cell lines.

Materials and methods

In the oral cancer cell lines SAS, HSC-3, and HSC-4, we investigated the expression of components and substrates of gamma secretase using the reverse transcription-polymerase chain reaction (RT-PCR). The proliferation of HSC-4 cells after treatment with a gamma secretase inhibitor was evaluated using a cell proliferation assay, and expressions of cell-cycle regulators were estimated using RT-PCR. The invasive activity of HSC-4 cells after treatment with the gamma secretase inhibitor was determined using a matrigel invasion assay, and MMP9 expression was measured employing RT-PCR.

Results

RT-PCR revealed the expression of components and substrates of gamma secretase in oral cancer cell lines SAS and HSC-4. HSC-4 cells treated with the gamma secretase inhibitor showed a reduction in proliferation, as well as a decrease in cyclin D1 and cyclin E expression and an increase of p27 (Kip1) expression. Moreover, a reduction of the invasive capacity and MMP9 expression were observed in these cells.

Conclusion

These results suggest that the inhibition of gamma secretase reduces cell proliferation mediating the expression of cell-cycle regulators and invasive activity mediating MMP9 expression, and that a gamma secretase inhibitor can be applied as a potential therapeutic agent in oral cancer.

We present a case of botryoid odontogenic cyst, affecting the anterior mandible in a 59-year-old Japanese female patient. The histochemical and immunohistochemical characteristics of the lesion are described. The nature of the cyst-lining epithelium was suggestive of an odontogenic origin as revealed by the expression of CK 10/13, CK14, and CK19, all of which have been reported to be present in the human enamel organ. An insignificant PCNA-immunoreaction was observed in the cyst-lining epithelium as compared with that of the odontogenic keratocyst. Furthermore, the appearance of diastase digestible, PAS-reactive material (consistent with glycogen) was evaluated that prefunctional cells of the dental lamina are a possible origin of the lesion.

Common disease of the salivary gland is sialolithiasis with or without sialadenitis. A young male presented with pain in the left sumandibular region mimicking sialolithiasis. Ultrasonography showed focal hypoechoic lesions with calcifications on both sides. CT and MRI confirmed the diagnosis of venous vascular malformation. Focal lesions like venous vascular malformation should be considered in differential diagnosis whenever focal calcifications are seen, as it could represent phleboliths. Doppler applications are mandatory in all focal lesions of salivary glands. In the management, ultrasound guided local sclerotherapy was used as primary treatment. This unusual presentation and management makes this case interesting.

Objective

We compared 3 bioabsorbable osteosynthesis plates of different shapes used for fixation after sagittal splitting ramus osteotomy in terms of stress on the plate and the bone segment connection area by 3-dimensional finite element stress analysis.

Materials and methods

Using a CT apparatus, images from the inferior border of the mandible up to the vertex were obtained, and a 3-dimensional model was produced. Based on this model, a model after bilateral sagittal splitting ramus osteotomy was produced, and subsequently, models of mono-cortical fixation of the proximal and distal bone segments using 3 plate types of different shapes (straight, L-shaped, and box-shaped plates) were fabricated. A load (20.79 kgf) was applied to the bilateral molar areas of the 3 models, and equivalent stress on the plate and the bone segment connection area and distal segment displacement were compared among the 3 models.

Results

The maximum equivalent stress (von Mises stress) on the plate was the lowest for the straight plate, followed in order by the box-shaped and L-shaped plates. In particular, in the L-shaped plate, marked stress concentration on the medial side of the bent portion was observed. The box-shaped plate showed the lowest maximum equivalent stress on the mandible and the smallest distal segment displacement.

Conclusion

The box-shaped plate has a greater fixation force than the straight or L-shaped plate due to low stress on the bone segment connection area, and may be a useful fixation method to counteract long-term stress on the mandible.

Introduction

The main reasons for the unsuccessful autotransplantation of teeth are the failure of initial healing and root resorption. The aim of this study was to elucidate the relationship between donor teeth factors and the prognosis of the transplants in which root resorption occurred.

Materials and methods

The study evaluated 110 patients with 117 transplants. The successful group included the cases which healed well, with only minor problems. The unsuccessful group included the cases with transplant-loss and progressive problems. The unsuccessful group and minor-trouble cases were judged with the type of problems; i.e. failure of initial healing, root resorption, and others. Root resorption was classified into 3 types; inflammation resorption, replacement resorption and cervical root resorption. The prognostic factors were evaluated to analyze the difference between rapidly progressing root resorption and the stable resorption.

Results

There were 20 unsuccessful transplants. In the unsuccessful group, rapidly progressing replacement root resorption was observed in 11 transplants. In the successful group, minor problems such as stable root resorption were found in 16 transplants. At least one of the atypical root shapes (divergent, curve, and hypertrophy), probing pocket depth of more than 4 mm, and/or extrusion were significantly more frequent in the replacement root resorption cases compared to cases with no significant findings. Probing pocket depth of more than 4 mm and/or extrusion, dental caries, history of restoration, root canal treatment were significantly more frequent in rapidly progressing replacement root resorption cases compared to stable root resorption cases.

Conclusions

Abnormal root shape, deep periodontal pocket, dental caries, restoration and root canal treatment of donor teeth are factors associated with progressive replacement root resorption after the autotransplantation of teeth.

Objectives

The aim of this study was to investigate the genetic association between recurrent aphthous stomatitis (RAS) and human leukocyte antigen (HLA) class 1 and class 2 alleles.

Materials and methods

Nucleotide sequence level typing of HLA-A, -B, -Cw, and -DRB1 alleles was performed on Japanese patients with RAS and their families. The subjects that participated in this study consisted of 25 families that had at least one patient suffering from RAS.

Results

One HLA-Cw allele, Cw*0303, and three HLA-DRB1 alleles, DRB1*0401, DRB1*0803 and DRB1*1101, showed a significant positive association with RAS. No HLA-A and HLA-B alleles showed significant association with RAS.

Conclusion

The present study strongly suggests the significant positive association of HLA alleles with RAS. No HLA-A and HLA-B alleles showed significant association with RAS. Thus, the present study indicates that HLA alleles, or closely linked loci, may be involved in the pathogenesis of RAS.

Reiter's syndrome, also known as reactive arthritis, is composed of the triad of arthritis, urethritis, and conjunctivitis. We herein report the rare case of a male patient with Reiter's syndrome and trismus caused by intravesical BCG immunotherapy. The patient experienced pain of the temporomandibular joint following immunotherapy, and it persisted for 5 months. He was instructed to undergo physiotherapy for mouth opening. After 7 months of treatment, he was able to open his mouth without inconvenience. The management of this case is presented and discussed.

Intraosseous vascular lesions of the maxillofacial region are rare, can be challenging for diagnosis considering various other jaw lesions. They are subdivided into hemangiomas and vascular malformations. Hemangiomas are usually located in soft tissues. Intraosseous hemangioma is a quite rare condition, comprising less than 1% of all intraosseous tumors. This article describes a case of central hemangioma of the mandible, angiography was used for diagnosis and treated with surgical excision. The newer technique, transmandibular curettage via proximal osteotomy without complete resection was used. This technique is less invasive but effective and helpful in preserving the normal anatomy and function.

This report is the case report of a 48-year-old woman who referred to our hospital complaining of a mass at the left maxillary tuberosity and slight trismus. CT and MRI imagings showed a tumor like image with bone absorption of the left maxillary tuberosity. Under general anesthesia, the lesion was excised. Histopathological examination showed low grade mucoepidermoid carcinoma. There is no sign of recurrence or metastasis of the tumor in 5 year after the surgery.