Septic arthritis of the temporomandibular joint (TMJ) is a rare disease that is characterized by preauricular pain, edema, malocclusion, trismus and abscess formation in the TMJ region. An 85-year-old male visited our...Septic arthritis of the temporomandibular joint (TMJ) is a rare disease that is characterized by preauricular pain, edema, malocclusion, trismus and abscess formation in the TMJ region. An 85-year-old male visited our hospital with the complaint of left-sided TMJ swelling, pain and trismus. Septic arthritis of the left TMJ was diagnosed on the basis of considerable elevation of CRP (Creactive proteins) and CT imaging findings. The patient was treated with oral Faropenem at 450 mg daily, but CRP increased three days after the initial visit. He was hospitalized and treated with intravenous administration of cefazolin at 2 g and clindamycin at 1.2 g daily for six days. Propionibacterium species and Veillonella species grew in a culture of the joint aspirate, but there was no apparent source of infection. After acute infectious symptoms had passed, the patient was treated with oral amoxicillin at 750 mg daily for eight weeks and was instructed to do jaw opening exercise. The patient was discharged on the 11th hospital day. After three weeks of the hospital discharge, the patient healed completely. To avoid serious complications, clinicians should include septic arthritis of the TMJ in the differential diagnosis of preauricular pain, trismus and swelling.展开更多
Objectives: The aim of this study was to identify independent prognostic predictors of the efficacy of oral appliance (OA) therapy for obstructive sleep apnea syndrome (OSAS). Materials and methods: The subjects consi...Objectives: The aim of this study was to identify independent prognostic predictors of the efficacy of oral appliance (OA) therapy for obstructive sleep apnea syndrome (OSAS). Materials and methods: The subjects consisted of 89 patients (77 males and 12 females) in whom OSAS had been treated with an OA. The mean age of the subjects was 52.4 years (range: 20 to 78 years) and mean body mass index (BMI) was 23.9 kg/m2 (range: 17.3 to 32.2 kg/m2). Lateral cephalograms were taken and 15 angle, 15 distance and 5 area measurements were calculated by means of a computerized program. Overnight polysomnography (PSG) was performed before treatment and several months after titration of OA therapy. OA therapy was considered effective if the apnea-hypopnea index several months after titration was under 15 events/h and was reduced to at least 50% of that before treatment. The examined data such as patient age, sex, BMI, data from cephalometric analyses, Epworth sleepiness scale, and data for pretreatment PSG were analyzed statistically, and multivariate logistic regression analysis was performed to clarify predictive variables for treatment outcome. Results: LFH (OR = 0.350;p = 0.035) and McN-A (OR = 0.276;p = 0.057) were selected as independent predictors from the explanatory variables. The predictive accuracy of the calculated logistic regression model was 74.2%. Conclusion: This results show that OA therapy for OSAS is more effective in patients with large anteroposterior diameter of the maxilla and large lower facial height.展开更多
Objective: The enhancement of multiple functions, including osteogenesis, angiogenesis, and cell recruitment, is required for efficient bone regeneration therapy. Recently, special attention has been focused on the mi...Objective: The enhancement of multiple functions, including osteogenesis, angiogenesis, and cell recruitment, is required for efficient bone regeneration therapy. Recently, special attention has been focused on the microenvironment of stem cells to facilitate bone regeneration. Herein, we examined the effects of various combinations of hypoxic conditions and osteogenic induction on rat mesenchymal cells, to develop a specific protocol for enhancing the multiple cellular functions beneficial to bone regeneration. Methods: Rat mesenchymal cells, isolated from bone marrow, adipose tissue, and periodontal ligament, were examined. The cells were cultured under varied conditions of O2 tension (hypoxia) and duration and timing of hypoxic exposure, with or without osteogenic induction. Consequently, four different protocols were examined by measuring the gene expression levels of Runx2, Vegfa, and Cxcl12, indicating a capability for osteogenesis, angiogenesis, and cell recruitment, respectively. Finally, the mineralization ability of the rat mesenchymal cells was assessed by quantitating their calcified nodule formation. Results: The simultaneous application of hypoxic exposure and osteogenic induction promoted Vegfa expression in all types of cells, but suppressed Runx2. In contrast, hypoxic preconditioning, followed by osteogenic induction, did not increase the expression of these genes;in fact, Vegfa expression decreased significantly. Among the various protocols, 0.5% O2 exposure for 12 h after osteogenic induction exhibited the largest fold changes of gene expression level, especially of Vegfa. Hypoxic post-conditioning enhanced the formation of calcified nodules in periodontal ligament-derived cells. Conclusion: Short-term hypoxic exposure after osteogenic induction could be used to improve the efficiency of mesenchymal cells for bone regeneration.展开更多
Platelet-rich plasma (PRP) has been used as a therapeutic tool to promote wound healing, in orthopedics, dermatology, oral surgery, etc. However, the mechanisms underlying the wound healing effects of PRP remain uncle...Platelet-rich plasma (PRP) has been used as a therapeutic tool to promote wound healing, in orthopedics, dermatology, oral surgery, etc. However, the mechanisms underlying the wound healing effects of PRP remain unclear. The purpose of this study was to evaluate the effectiveness of applying PRP, particularly in the management of tooth extraction sockets. Three upper molars of Fischer rats were extracted, and blood was drawn from the hearts of other rats to prepare PRP. The PRP was activated and applied to the bone defects of the experimental group, and nothing was applied to the bone defects of the control group. On day 3, fibrin network and granulation tissue, which are abundant in blood capillaries, were seen under the PRP layer in the experimental group. On the other hand, only inflammatory cells and a fibrin network were observed in the bone defects of the control group. On day 7, granulation tissue was seen in the bone defects in both the control group and experimental group, although excavation of granulation tissue was noted in the control group. The results demonstrated the presence of a rich fibrin network and early inflammatory reactions in the experimental group, which may lead to rise of thick, vessel-rich granulation tissue. The application of PRP may stimulate wound healing in tooth extraction bone defects, and PRP may confer some beneficial effects on the outcomes.展开更多
This paper is to evaluate postoperative function which has undergone reconstruction with vascularized or pedicled flaps for the treatment of oral carcinomas. The subjects consisted of 22 cases of 17 male and 5 female ...This paper is to evaluate postoperative function which has undergone reconstruction with vascularized or pedicled flaps for the treatment of oral carcinomas. The subjects consisted of 22 cases of 17 male and 5 female patients, and their mean age was 55 years. The sites of reconstruction were the tongue in 12 cases, mandible in 10 cases. The reconstruction was performed using deltopectoral (DP) flaps in 6 cases, pectoralis major musculo cutaneous (PMMC) flaps in 3 cases, DP flap + PMMC flap in one case, forearm (FA) flaps in 8 cases and peroneal (P) flaps with fibula in 4 cases. Postoperative masticatory, speech, swallowing functions and facial appearance were evaluated by Multi-factorial analysis. All functional results seem to be related to the type of resection. By multi-factorial analysis, the type of mandibular resection, flap area, and anterior resection were related to the masticatory or speech function in tongue resection. In mandibular resection, masticatory function was subjected to age;speech function was subjected to type of mandibular resection and plate reconstruction. The facial appearance was subjected to flap area. These results suggested that postoperative function was not related to only one factor, but using the classification of each defect site as one of the factor of multi-factorial analysis was useful.展开更多
Pigmentation of the oral mucosa is relatively common and has a wide variety of etiologies. Although most pigmented lesions of the oral mucosa are associated with deposition of melanin and accidental displacement of a ...Pigmentation of the oral mucosa is relatively common and has a wide variety of etiologies. Although most pigmented lesions of the oral mucosa are associated with deposition of melanin and accidental displacement of a dental alloy, accurate differential diagnosis of a pigmented lesion is important, especially in the case of malignant melanoma. We report two cases of oral mucosal pigmentation associated with accidental displacement of a dental alloy in which malignant melanoma was suspected. Excisional biopsy was carried out in these cases with the incision line set at approximately 5 mm from the lesions. Histopathologically, brownish foreign substances were observed in the lamina propria. Metal quantitative analyses of the extracted specimens were carried out by electron probe microanalysis (EPMA). The metal components and the mass concentration revealed that the metals were derived from a dental casting silver alloy in Case 1 and from a gold-silver palladium alloy in Case 2. Although exogenous pigmentation originating from a dental alloy is not rare, differential diagnosis of oral pigmented lesions is sometimes very difficult. In such cases, histopathological examination may be necessary for the diagnosis to exclude melanocytic lesions and EPMA may be effective to identify the causative dental alloy.展开更多
文摘Septic arthritis of the temporomandibular joint (TMJ) is a rare disease that is characterized by preauricular pain, edema, malocclusion, trismus and abscess formation in the TMJ region. An 85-year-old male visited our hospital with the complaint of left-sided TMJ swelling, pain and trismus. Septic arthritis of the left TMJ was diagnosed on the basis of considerable elevation of CRP (Creactive proteins) and CT imaging findings. The patient was treated with oral Faropenem at 450 mg daily, but CRP increased three days after the initial visit. He was hospitalized and treated with intravenous administration of cefazolin at 2 g and clindamycin at 1.2 g daily for six days. Propionibacterium species and Veillonella species grew in a culture of the joint aspirate, but there was no apparent source of infection. After acute infectious symptoms had passed, the patient was treated with oral amoxicillin at 750 mg daily for eight weeks and was instructed to do jaw opening exercise. The patient was discharged on the 11th hospital day. After three weeks of the hospital discharge, the patient healed completely. To avoid serious complications, clinicians should include septic arthritis of the TMJ in the differential diagnosis of preauricular pain, trismus and swelling.
文摘Objectives: The aim of this study was to identify independent prognostic predictors of the efficacy of oral appliance (OA) therapy for obstructive sleep apnea syndrome (OSAS). Materials and methods: The subjects consisted of 89 patients (77 males and 12 females) in whom OSAS had been treated with an OA. The mean age of the subjects was 52.4 years (range: 20 to 78 years) and mean body mass index (BMI) was 23.9 kg/m2 (range: 17.3 to 32.2 kg/m2). Lateral cephalograms were taken and 15 angle, 15 distance and 5 area measurements were calculated by means of a computerized program. Overnight polysomnography (PSG) was performed before treatment and several months after titration of OA therapy. OA therapy was considered effective if the apnea-hypopnea index several months after titration was under 15 events/h and was reduced to at least 50% of that before treatment. The examined data such as patient age, sex, BMI, data from cephalometric analyses, Epworth sleepiness scale, and data for pretreatment PSG were analyzed statistically, and multivariate logistic regression analysis was performed to clarify predictive variables for treatment outcome. Results: LFH (OR = 0.350;p = 0.035) and McN-A (OR = 0.276;p = 0.057) were selected as independent predictors from the explanatory variables. The predictive accuracy of the calculated logistic regression model was 74.2%. Conclusion: This results show that OA therapy for OSAS is more effective in patients with large anteroposterior diameter of the maxilla and large lower facial height.
文摘Objective: The enhancement of multiple functions, including osteogenesis, angiogenesis, and cell recruitment, is required for efficient bone regeneration therapy. Recently, special attention has been focused on the microenvironment of stem cells to facilitate bone regeneration. Herein, we examined the effects of various combinations of hypoxic conditions and osteogenic induction on rat mesenchymal cells, to develop a specific protocol for enhancing the multiple cellular functions beneficial to bone regeneration. Methods: Rat mesenchymal cells, isolated from bone marrow, adipose tissue, and periodontal ligament, were examined. The cells were cultured under varied conditions of O2 tension (hypoxia) and duration and timing of hypoxic exposure, with or without osteogenic induction. Consequently, four different protocols were examined by measuring the gene expression levels of Runx2, Vegfa, and Cxcl12, indicating a capability for osteogenesis, angiogenesis, and cell recruitment, respectively. Finally, the mineralization ability of the rat mesenchymal cells was assessed by quantitating their calcified nodule formation. Results: The simultaneous application of hypoxic exposure and osteogenic induction promoted Vegfa expression in all types of cells, but suppressed Runx2. In contrast, hypoxic preconditioning, followed by osteogenic induction, did not increase the expression of these genes;in fact, Vegfa expression decreased significantly. Among the various protocols, 0.5% O2 exposure for 12 h after osteogenic induction exhibited the largest fold changes of gene expression level, especially of Vegfa. Hypoxic post-conditioning enhanced the formation of calcified nodules in periodontal ligament-derived cells. Conclusion: Short-term hypoxic exposure after osteogenic induction could be used to improve the efficiency of mesenchymal cells for bone regeneration.
文摘Platelet-rich plasma (PRP) has been used as a therapeutic tool to promote wound healing, in orthopedics, dermatology, oral surgery, etc. However, the mechanisms underlying the wound healing effects of PRP remain unclear. The purpose of this study was to evaluate the effectiveness of applying PRP, particularly in the management of tooth extraction sockets. Three upper molars of Fischer rats were extracted, and blood was drawn from the hearts of other rats to prepare PRP. The PRP was activated and applied to the bone defects of the experimental group, and nothing was applied to the bone defects of the control group. On day 3, fibrin network and granulation tissue, which are abundant in blood capillaries, were seen under the PRP layer in the experimental group. On the other hand, only inflammatory cells and a fibrin network were observed in the bone defects of the control group. On day 7, granulation tissue was seen in the bone defects in both the control group and experimental group, although excavation of granulation tissue was noted in the control group. The results demonstrated the presence of a rich fibrin network and early inflammatory reactions in the experimental group, which may lead to rise of thick, vessel-rich granulation tissue. The application of PRP may stimulate wound healing in tooth extraction bone defects, and PRP may confer some beneficial effects on the outcomes.
文摘This paper is to evaluate postoperative function which has undergone reconstruction with vascularized or pedicled flaps for the treatment of oral carcinomas. The subjects consisted of 22 cases of 17 male and 5 female patients, and their mean age was 55 years. The sites of reconstruction were the tongue in 12 cases, mandible in 10 cases. The reconstruction was performed using deltopectoral (DP) flaps in 6 cases, pectoralis major musculo cutaneous (PMMC) flaps in 3 cases, DP flap + PMMC flap in one case, forearm (FA) flaps in 8 cases and peroneal (P) flaps with fibula in 4 cases. Postoperative masticatory, speech, swallowing functions and facial appearance were evaluated by Multi-factorial analysis. All functional results seem to be related to the type of resection. By multi-factorial analysis, the type of mandibular resection, flap area, and anterior resection were related to the masticatory or speech function in tongue resection. In mandibular resection, masticatory function was subjected to age;speech function was subjected to type of mandibular resection and plate reconstruction. The facial appearance was subjected to flap area. These results suggested that postoperative function was not related to only one factor, but using the classification of each defect site as one of the factor of multi-factorial analysis was useful.
文摘Pigmentation of the oral mucosa is relatively common and has a wide variety of etiologies. Although most pigmented lesions of the oral mucosa are associated with deposition of melanin and accidental displacement of a dental alloy, accurate differential diagnosis of a pigmented lesion is important, especially in the case of malignant melanoma. We report two cases of oral mucosal pigmentation associated with accidental displacement of a dental alloy in which malignant melanoma was suspected. Excisional biopsy was carried out in these cases with the incision line set at approximately 5 mm from the lesions. Histopathologically, brownish foreign substances were observed in the lamina propria. Metal quantitative analyses of the extracted specimens were carried out by electron probe microanalysis (EPMA). The metal components and the mass concentration revealed that the metals were derived from a dental casting silver alloy in Case 1 and from a gold-silver palladium alloy in Case 2. Although exogenous pigmentation originating from a dental alloy is not rare, differential diagnosis of oral pigmented lesions is sometimes very difficult. In such cases, histopathological examination may be necessary for the diagnosis to exclude melanocytic lesions and EPMA may be effective to identify the causative dental alloy.
