Michio Shikimori

Adaptive and Remodeling Changes in the Fractured Mandibular Condyle After Open Reduction Using the Kirschner Pin

Six cases of fracture of the mandibular condyloid process in which there was osteosynthesis using the Kirschner pin were followed radiographically for more than 1 year. Tracings were made to analyze the remodeling process. The clinical course of all patients was satisfactory, without functional disturbance or asymmetries of the mandible.

Life-threatening sublingual hematoma in a severely hemophilic patient with factor VIII inhibitor

The management of a patient with Factor VIII inhibitor in whom a marked hematoma of the sublingual region developed is described. Administration of activated prothrombin complex concentrates and nasotracheal intubation with the fiberoptic laryngoscopy were used in the management of this patient.

The importance of local hemostatic procedures in dental extractions and oral mucosal bleeding of hemophiliac patients

Deficient coagulation factor replacement therapy is often indispensable for dental extractions and oral mucosal bleeding in hemophiliac patients. High concentrates are often infused in large amounts of volume, until complete hemostasis is achieved. Considering the various side effects of replacement therapy the volume infused should be reduced to a minimum. Several aspects associated with replacement therapy for the control of oral bleeding are studied. Our conclusion is that local hemostatic procedures are even more important than replacement therapy. The use of surgical packs and band retainers proved to be of benefit in this study.

Dental extraction in a patient with congenital deficiencies of factors V and VIII.

A case of combined congenital deficiencies of factors V and VIII is reported. The patients right mandibular first molar was extracted and a combination of local hemostatic treatment and the transfusion of fresh plasma resulted in healing of the socket without further postoperative bleeding.

Disseminated intravascular coagulation syndrome

This paper reports a patient with malignant fibrous histiocytoma of the maxilla who developed DIC during the 12-month observation of the hemostatic course, and a case of squamous cell cancer of the tongue associated with post-operative DIC. The triggers in these 2 cases were malignant tumor, infection, shock and operation. Heparin and aprotinin were administered in both cases. Hemostatic improvement was obtained in case 2, but neither cases were cured. The etiology, diagnosis and treatment of DIC are discussed.

Multiple extractions in a patient with factor VII deficiency.

Multiple extractions were carried out in a patient with factor VII deficiency treated with prothrombin complex concentrate. Hemostasis and healing were completely satisfactory. The side effects of prothrombin complex concentrate are discussed.

A Case of Marfan's Syndrome with Mandibular Prognathism

A case of mandibular prognathism with Marfans syndrome treated with sagittal splitting ramus osteotomy was presented.A 37 year-old man, complaining of difficulty of mouth opening was referred to our clinic. The patient was diagnosed as bilateral temporomandibular joints arthrosis with mandibular prognathism.Although occlusal treatment with bite splint was effective to some extent, intermittent trismus did not disappear, so bilateral sagittal splitting ramus osteotomy was performed to correct his dental malocclusion.Postoperative course was not eventful and his range of mouth opening increased to 35mm between incisal edges of maxillary and mandibular central incisor.

Four patients who had recurrence after primary radical treatment for gingival carcinoma of the mandible.

下顎歯肉癌で, 一次根治的手術後再発がみられた4症例につき臨床的および病理組織学的検討を行った。全例高分化型扁平上皮癌であった。症例1: 57歳, 女性。T2N1M0, StageIII。術後1年1か月で再発。好状況下で再治療により一次治療開始より10年8か月の現在経過良好。症例2: 46歳, 女性。T4N1M0, StageIV。腫瘍の著しい浸潤傾向があり, 術後4か月で耳下腺部に再発。腫瘍死。症例3: 59歳, 男性。T2N2cM0, StageIV。術後2年6か月で再発, しかし, その発見が遅れた。腫瘍死。症例4: 72歳, 女性。T2N0M0, StageII。術後3か月で再発。極めて浸潤性が強く, 経神経的進展もみられ腫瘍死。