Takanori Ohya

Massive osteolysis of the maxillofacial bones

Abstract Two cases of massive osteolysis were encountered, one affecting the mandible and the other the maxilla and mandible. Only 13 cases have been reported so far in the existing literature for massive osteolysis of the mandible. It is indeed a rare disease. Our two cases were surgically treated and were clinically and histopathologically assessed.

Sicca symptom in a patient with hemochromatosis: minor salivary gland biopsy for differential diagnosis.

This paper reports a case of hemochromatosis with sicca symptom. The patient was a 59-year-old female who had been received a series of intravenous iron injections and blood transfusions because of anemia owing to side-effects of a chemotherapeutic agent. She complained of dry mouth and dry eyes in addition to symptoms of hemochromatosis. The histological appearance of the labial salivary gland, with heavy deposition of iron in acinar and duct epithelial cells and absence of focal lymphoid cell infiltration, did not support a diagnosis of Sjögrens syndrome but suggested functional damage of the salivary glands related to iron. The patient was given desferrioxamine, and clinical symptoms improved; re-examined labial salivary gland biopsy showed no iron deposition in any parenchymal cells after the treatment.

A rare case of simultaneous malignant tumors: Osteosarcoma of the mandible and lung cancer

Abstract This paper presents a rare case of simultaneous malignant tumors of the mandible and lung in a 32-year-old woman.

Primary malignant melanomas of the oral mucosa

7 patients with primary malignant melanoma of the oral mucosa treated during the past 15 years by extensive resection, and simultaneous neck dissection in 3 of them, are reported. 4 patients died. However, most of the patients stayed alive relatively long postoperatively.

Secondary reconstruction of the alveolar process after correction of mandibular discontinuity defects

Mandibular defects in six patients were immediately reconstructed with pure titanium reconstruction plates and autogenous iliac bone blocks. However, an alveolar process adequate for functional fitting of a denture did not form. More than 6 months after the reconstruction, correction of the ridge deficiency was attempted using autogenous particulate iliac cancellous bone and marrow combined with hydroxylapatite particles. By this secondary reconstruction, a functional well-fitting denture could be constructed for all six patients. After more than 2 years no evidence of resorption or infection has occurred.

Long-term restoration of masticatory function with fixed mandibular implants in cases of oral cancer.

The results of the present study show that the fixed mandibular implant system enables patients who have operations to treat oral cancer to use a stabilized denture continuously over an extended period of time.

Investigation of Postoperative Stability of Mandibular Asymmetry Cases

The purpose of the present study was to investigate postoperative stability of asymmetric mandible. We performed a cephalometric radiographic evaluation of postoperative stability on 11 patients who had undergone sagittal splitting ramus osteotomy of asymmetric jaw deformities at our clinic from 1989 to 1991.The results were as follows:1. Measurements of areas of right and left mandible by cephalometric radiograms, particulary those in the lower portion, were very useful to evaluate the postoperative change of mandibular asymmetry. The ratio of left area/right area in the lower portion of the mandible was turned to nearly 50/50 at one year after operation in 7 patients.2. Four of 7 patients, who had a difference of over 7mm in setback between right and left of the mandible and had a horizontal movement of over 6mm at the center of both lower central incisors, exhibited less postoperative horizontal stability.3. Only two of 9 patients, who were given preoperative orthodontic therapy, showed postoperative instability of the mandible.4. The correlation between postoperative horizontal instability and posteroanterior instability of the mandible was not definitely confirmed.

Combined treatment for two advanced carcinomas of the buccal mucosa with local hyperthermia.

頬粘膜進展癌の2例に対し温熱療法を組み入れた集学治療を施行し, 良好な経過を辿っているので報告する。症例1: 61歳, 男性。高分化型扁平上皮癌 (T3N2bM0) で, 治療はPM療法5クール (PEP1回2.5mg計72.5mg, MMC1回10mg計50mg) , 60Co36Gy, 温熱療法を頬部に5回, 頸部に6回, OK-432を総量44.5KE投与し, 左側全頸部郭清, 腫瘍切除, D―P皮弁による頬部全層欠損の即時再建術を施行した。症例2: 69歳男性, 高分化型扁平上皮癌 (T4N2bM0) 。右側浅側頭動脈を用いてCDDP150mg, PEP70mg, 5-FU1回125mg計2000mgを動静注し, 60Co照射を頬部, 頸部にそれぞれ40.5Gy, 60.5Gy併用した。さらに温熱療法を頸部に9回併用し, OK-432を術前に総計40.4KE投与した。1988年6月7日, 右側全頸部郭清, 腫瘍切除, 植皮術を施行した。初診より4年と2年7か月経過した現在、再発・転移なく経過良好である。2例とも重大な合併症も無く, 予定の化学療法, 放射線療法が施行でき, 根治的手術が可能であったことが良好に経過している要因と考えられた。

A prosthodontic approach to the surgical treatment of the epulis fissuratum

Simple excision of the epulis fissuratum results in loss of sulcus dept hand scar formation, hence the peripheral seal of full denture are obstructed. In order to avoid these condition, lyophilized porcine skin or dermis were used to excised surface for wound dressing, and treatment dentures were inserted one week after the operation which act as a splint maintaining sulcus depth. Furthermore, occlusal correction, which included to restore an optimal vertical dimension of occlusion of the old dentures, and correction of the extent of the tissue coverage by the old denture base were accomplished by modifying the old (treatment) dentures.Consequently, it seems that loss of sulcus depth and scar formation were reduced. The ridge relation was improved, and this improvement faciliated the eventual registration of the jaw relation.In broad lesion, it is difficult to correct the extent of tissue coverage by the resin bordermolding materials. Therefore, the extent of tissue coverage of old dentures without lesion by the impression technique before operation, and refitting the excised surface by instant chairside reline technique after the operation, it may be useful for the resolution of this difficulty.