Tetsuo Ishiki

Calcifying odontogenic cyst: A survey of 23 cases in the Japanese literature

The clinical, radiographic and histological characteristics of the calcifying odontogenic cyst were studied in 23 well-documented cases in the Japanese literature. The cysts occurred equally in males and females whose mean age was 21 years. The appeared as a painless swelling with cortical expansion and involved the maxilla three times more often than the mandible. There was no report of the lesion involving the soft tissues. Radiographically, the lesions were unilocular in most cases and contained aggregates or dispersed foci in the radiolucencies which were diagnosed as odontomes in 5 cases. Unerupted teeth and root resorption of the adjacent teeth were noted in approximately half of the cases. Except for one case, they were simply enucleated under a diagnosis of cyst or odontome and recurrence was encountered in no case. The excised specimens consisted of cystic sacs mostly containing calcified materials with or without tooth-like structures which were histologically diagnosed as odontomes in 10 cases. An intimate relationship between the cysts and the unerupted teeth was observed in 4 out of 10 cases. The pathogenesis of the lesion is discussed.

Chondrosarcoma of the mandible. Report of case and a survey of 23 cases in the Japanese literature.

A huge chondrosarcoma of the mandible (80 X 95 X 100 mm in size) with extension into the infratemporal fossa is described. The tumour was successfully treated by surgical removal and postoperative irradiation. A survey of the Japanese literature revealed 23 cases of chondrosarcoma with involvement of the mandible. The tumours occurred equally in males and females whose mean age was 38 years. The molar region was the site of predilection. The most common symptom was swelling and it was accompanied by pain in 7 cases and paraesthesia in 5 cases. Radiographically, the lesions were quite variable and with the exception of 3 cases in which information was not available, they consisted of a combination of irregular radiopacity and radiolucency in 9 cases, whereas the predominant feature was radiopacity in 6 cases and radiolucency in 4 cases. There was no radiographical abnormality in 2 cases. Root resorption of adjacent teeth was noted in 3 of 6 cases where information existed. Computed tomography was thought to be quite valuable in determining the nature and extent of the tumour. Although an elevation of serum alkaline phosphatase was observed in our case, results of laboratory tests were mostly of no diagnostic significance. Surgical removal was employed in 22 cases alone or in conjunction with irradiation and/or chemotherapy. Of 14 cases on whom information was available, local recurrence occurred in 6 cases in which radiotherapy was not given and distant metastasis in 2 of 10 cases on whom information was available. Of 20 patients on whom information was available on the postoperative course, 7 patients died 5 months to 6 years after the primary treatment.

Calcifying odontogenic cyst with complex odontoma

Abstract A calcifying odontogenic cyst associated with a complex odontoma is described. The presence of reduced enamel epithelium showing extensive proliferation accompanied by dentinoid and enameloid formation, and the morphologic connection of the lining epithelium of the cyst with the enamel epithelium, indicate that the possible origin of the cyst is the enamel epithelium of the odontoma.

Marsupialization as a possible diagnostic aid in cystic ameloblastoma. Case report.

Two cases of cystic ameloblastoma are described in which the diagnosis was established after marsupialization. Although the clinical and radiographic findings strongly suggested the diagnosis of ameloblastoma, the initial incisional biopsy specimens consisted of cystic walls lined with squamous epithelium which showed in both cases no evidence of ameloblastic proliferation. Marsupialization could be a diagnostic aid in these cases since relief of intracystic pressure may trigger regeneration of a solid mass of tumour in a monocystic ameloblastoma with cells possessing potentiality for spontaneous proliferation.

Central carcinoma of the jaw: A survey of 28 cases in the Japanese literature

A survey of the Japanese literature revealed 28 well-documented cases of central carcinoma of the jaws. There was no sex predominance and the mandible was the site of involvement in 26 cases. The most common initial symptom was local swelling, which was followed in order of frequency by spontaneous pain, paraesthesia of the lower lip, discomfort, loosening of teeth and trismus. On clinical examination, local swelling which was often accompanied by variable symptoms was an almost constant finding. Radiographic appearance varied from unilocular to worm-eaten type radiolucencies which were often surrounded by indistinct margins on close examination. Radical surgery, combined with irradiation and/or chemotherapy was the principal treatment in most cases, but there were 4 cases in which the lesions were simply excised under a tentative diagnosis of cyst; local recurrence was noted in 5 cases. Regional lymph node metastasis and lung metastasis were observed in 8 and 2 cases, respectively. No definite conclusion was drawn with regard to the prognosis because of the short follow-up period. Histologically, epidermoid carcinoma was most frequently seen, but odontogenic cyst was confirmed to be the site of origin in 3 cases only.

Non-Hodgkin's lymphoma of the gingiva: A case report

An unusual case of non-Hodgkins lymphoma with a progressive, necrotizing ulcer of the gingiva is reported. An establishment od diagnosis was difficult because of lack of malignancy in repeated biopsy specimens. Radiotherapy combined with administration of anti-tumor agents was effective in producing a rapid remission of the oral lesion, but multiple metastases appeared in the skin and the patient died 7 months after the onset of the initial symptoms. The tumor was regarded as being of gingival origin because of the absence of a primary focus in any other site of the body.

Treatment of “idiopathic midline destructive disease” by irradiation: A case report

An unusual case with an aggressive destructive granulomatous lesion of the maxilla is reported. Although the possibility of infection and neoplasm could be ruled out, a definite diagnosis could not be established even by repeated biopsies which showed the lesion to be a non-specific inflammatory process. Since Wegeners granulomatosis was most unlikely, the patient was treated by radiotherapy which caused rapid remission of the lesion with no sign of recurrence after 4 years. The clinical and histological findings as well as the responsiveness to the treatment were most indicative of idiopathic midline destructive disease. Effective management of lethal midline granuloma of unknown aetiology is discussed.

Effect of Low Power Laser in Bone Histomorphometry

There are some reports concerning the effect of low power laser upon bone regeneration(1, 2). And in dentistry, improved postsurgical wound healing after tooth extraction, alveoplasty, implantation and so on, has been examined on the clinical bases.

Necrotizing sialometaplasia of the palate: a case report and review of the literature.

Necrotizing sialometaplasiaは, 唾液腺の良性, 炎症性の疾患で, 腺組織の広範な壊死と扁平上皮化生を特徴とする。臨床的, 病理組織学的に扁平上皮癌や粘表皮癌に類似した所見を呈するため, 時に悪性腫瘍と誤診されることもある。しかし, 本症は数ケ月以内に自然治癒するとされており, 誤診による過剰な治療を防ぐために, 慎重な診断が必要である。症例: 21歳, 女性。主訴: 口蓋左側の腫脹と疼痛。口腔内診査にて口蓋左側に中央に潰瘍を伴った15×9mmの腫脹を認め, 臨床的に口蓋腺の炎症性疾患もしくは腫瘍と診断した。細胞診では, 異型細胞が認められ, 生検を行った。病理組織学的にNecrotizing sialometaplasiaの所見であり, 以後, 特に治療を行わずに治癒が確認された。