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ABSTRACT: This study was designed to evaluate detailed philtral morphology involving sex and racial differences and to clarify the objective parameters related to subjective judgments regarding the clarity of the philtrum. Fifty-five Japanese and 20 Mexican normal subjects aged 24 to 40 years were recruited, and three-dimensional facial data were acquired using a noncontacting optical surface scanner. The visual classification of the philtral column morphology in Japanese adults using facial photographs revealed that the predominant philtral column shape was different by sex. The three-dimensional anthropometric data showed significant sex differences, which were reflected in the more pronounced visual impression of the philtrum in men. A comparative study between Japanese and Mexican women also revealed certain racial differences. Furthermore, both the philtral depth and central angle of Cupid's bow were extracted as explanatory variables related to the subjective judgments for the clarity of the philtrum. These results suggest that the comprehensive evaluation of philtral morphologic features by three-dimensional analysis is a useful means of identifying the ideal parameters in philtral construction in cleft surgery.
The Journal of craniofacial surgery 09/2011; 22(5):1606-11. · 0.81 Impact Factor
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ABSTRACT: In patients in whom a tracheal tube cannot be inserted through the nostrils due to multiple facial trauma or hypoplasty of the nose, submental orotracheal intubation (SOI) is performed to avoid tracheostomy. We report a new modification for SOI to minimize the risk of apnea. A 20-year-old man was scheduled for sagittal split ramus osteotomy. As the patient had severe hypoplasia of the nose, SOI was planned. Following orotracheal intubation with a spiral tube (first tube), a submental tunnel was surgically created. A second tube that had been confirmed, in advance, to snugly fit into the proximal end of the first tube was passed into the submental tunnel via a polypropylene cylinder and connected between the first tube and the breathing circuit. After careful withdrawal of the second tube through the submental tunnel, the first tube was directly connected to the breathing circuit after removal of the second tube. Although this technique requires additional time, apnea time is minimal even in patients in whom withdrawal of the tracheal tube through the submental tunnel takes time, because the second tube forms a link between the first tube and the breathing circuit, making it possible to ventilate the patient throughout the procedure.
Journal of Anesthesia 07/2011; 25(5):781-3. · 0.83 Impact Factor
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ABSTRACT: This study was undertaken to analyse in detail the morphological features of the philtral dimple and the developmental changes of philtral morphology, including a comparison with patients with a cleft lip.
Fifty-five normal Japanese adults, seventy-five children and fifteen patients with complete unilateral cleft lip were referred for analysis.
3D facial data were acquired with a non-contacting laser scanner. We calculated the desired linear and angular components, defining the features of the philtrum with analysing software.
The philtral dimple was morphologically expressed by the two different deepest points in the horizontal and sagittal sectional view, respectively. These decreased with age and did not show any correlation. In contrast, philtral measurements on the X-Y coordinates increased during the course of development. Most of the linear and angular variables in the patients with the cleft lip had exhibited greater values than the normal subjects, reflecting the deformed philtral morphology.
To obtain an optimally natural philtral construction accompanied by a symmetrical lip in cleft surgery, it is critical to take into consideration both the geometric features of the philtral depth and age-appropriate morphological features of the philtrum as objective criteria.
Journal of cranio-maxillo-facial surgery: official publication of the European Association for Cranio-Maxillo-Facial Surgery 06/2011; 40(3):215-22. · 1.25 Impact Factor
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British Journal of Oral and Maxillofacial Surgery 10/2010; 49(8):670-1. · 1.95 Impact Factor
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ABSTRACT: Maxillary anterior segmental distraction osteogenesis (MASDO) is an effective surgical orthodontic treatment for the retruded maxilla in cleft lip and palate because of its benefit of the conservation of velopharyngeal function. Some reports showed MASDO using various devices, but they do not allow the rotational movement of the distracted anterior segment. In this article, we showed MASDO using hybrid distracters (DynaForm System: Stryker Osteosymthesis, Leibinger Micro Implants, Kalamazoo, MI), which allow the advance of the distracted segment with rotational movement.
The hybrid distractor with 4 metal arms is secured beyond both alveolar osteotomy lines on each side. These 2 distractors permit rotational movement of the segment by controlling the amount of advancement on each side.
For 6 patients with cleft lip and palate, MASDO using hybrid distractors was performed and the anterior segment moved at planned positions without any complications except lip discomfort, which disappeared after removal of the distractor.
MASDO, using an institutionally diagnosed hybrid distractor can successfully achieve the necessary rotational movements of the anterior maxillary segment owing to its design, which incorporates some mechanical flexibility.
Oral surgery, oral medicine, oral pathology, oral radiology, and endodontics 04/2010; 110(3):292-300. · 1.50 Impact Factor
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ABSTRACT: Myeloid cell leukemia-1 (Mcl-1), a member of the B-cell lymphoma-2 (Bcl-2) family, has been reported to be a critical survival factor in hematopoietic cells, yet little data exists for a role of Mcl-1 in human oral squamous cell carcinoma (SCC). A high level expression of Mcl-1 was observed in tumor cells of human primary SCC, lymph node metastasis tissues, and SCC cell lines. We manipulated expression of Mcl-1 protein in SCC cells by small interfering RNA (siRNA) for Mcl-1 and observed that Mcl-1 siRNA inhibited the growth of SCCs accompanied with apoptosis. Combination therapy of Mcl-1 siRNA and anti-tumor drug drastically inhibited the cell growth in comparison to that in each single treatment. In addition, phosphorylation of focal adhesion kinase (FAK) was decreased by treatment with Mcl-1 siRNA, resulting in decreases in phosphorylation of MEK1/2 and MAPK. The cell growth inhibition caused by knockdown of Mcl-1 was suggested to be mainly a result of suppression of proliferation via the inhibition of intracellular FAK/MAPK signaling pathways. These results imply a potentially important and novel role of the inhibition of Mcl-1 function by the use of specific siRNA in the treatment of SCC.
Journal of Pharmacological Sciences 08/2009; 110(3):344-53. · 2.08 Impact Factor
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ABSTRACT: The optimal method of management of clinical N0 neck in squamous cell carcinoma of the oral cavity remains controversial. We used decision analysis to determine the current optimal strategy in comparison with observation of the neck and elective neck dissection. A total of 165 previously untreated patients with N0 classification were investigated. Probabilities of each recurrence were calculated and probabilities of being cured in each event were substituted with the 5-year overall survival calculation with Kaplan-Meier method. A sensitivity analysis was performed to determine the optimal threshold for treatment of the N0 neck. The threshold of N0 neck was calculated using the formula with putting the three probabilities of being cured. In this study the threshold was estimated at 44.4%. N0 neck of squamous cell carcinoma of the oral cavity should be observed if the probability of occult metastasis is less than 44.4%. Proper calculation of three probabilities of being cured in each institution will make a decision of the optimal method of clinical N0 neck by using the threshold formula.
Oral Oncology 06/2009; 45(10):908-11. · 2.86 Impact Factor
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ABSTRACT: Intraductal papilloma is a rare benign salivary gland tumor. This lesion is commonly observed in the duct of the minor salivary gland, predominantly in lip and buccal mucosa, but the case in the sublingual region is quite rare. This report shows a first case of intraductal papilloma developed in minor salivary gland of sublingual region. A 47-year-old Japanese male was referred to our hospital with painless submucosal nodule in the right sublingual region beside Wharton's duct orifice. The excised specimen was histologically diagnosed as intraductal papilloma of minor salivary gland, according to the microscopic finding of the papillary growth of ductal epithelium into the ductal space with fibrovascular core. Immunohistochemical study showed the tumor cells originated from ductal luminal cells because of positive Cytokeratin 18 and 7 staining in both types of cells.
Oral surgery, oral medicine, oral pathology, oral radiology, and endodontics 06/2009; 107(5):e34-7. · 1.50 Impact Factor
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ABSTRACT: The purpose of this study was to examine morphological changes of the mandibular region using frontal cephalograms following bilateral sagittal split osteotomy (BSSO) for mandibular setback. Furthermore, we compared the stability between screw and plate fixation.
Pre and postoperative frontal cephalograms were taken of 26 patients. Parameters, Angle "A" which is formed by constructed lines along the mandibular ramus, and mandibular width at the angle were calculated. The subjects were analyzed according to the types of bony fixation, whether by screws or plates.
Angle "A" and mandibular angular width of total numbers did not widely change at early period following operation. Late postoperatively, mandibular width of total numbers decreased in conjunction with increasing Angle "A". When comparing the parameters between screw and plate groups, the plate group showed a decrease of Angle "A" as an early change. Late postoperatively, the plate group showed an increase of Angle "A" and a decrease of mandibular width, while the screw group had smaller changes.
We demonstrate postoperative inclination of mandibular lower ramus towards the facial midline. We suggest that the types of rigid fixation have an influence on frontal skeletal morphology, namely that screw fixation has higher stability.
Journal of cranio-maxillo-facial surgery: official publication of the European Association for Cranio-Maxillo-Facial Surgery 06/2009; 37(7):412-6. · 1.25 Impact Factor
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ABSTRACT: A novel computer-assisted 3-D simulation for osteotomy and CAD/CAM fabrication of surgical splints consider the relative inter-bone interference and space after bone translation were developed. CT image of a patient for osteotomy was operated and simulation of surgery for deformation, segmentation, displacement of the bone was processed effectively by virtual reality haptic device PHANTOM. CAD of a bite splint before surgery and after bone displacement was done in the process of simulation. CAM of resin bite splints was done by precise Rapid Prototyping CAM machine. All fabricated splint were sufficiently functioned to determine the position of jaws.
Studies in health technology and informatics 02/2009; 142:331-6.
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ABSTRACT: Vertical alveolar augmentation by distraction osteogenesis has become a standard pretreatment of dental implants due to the main benefit of lack of donor site complications, and many reports have shown its benefit with various types of alveolar distractors. However, autogenous bone transplantation and/or guided bone regeneration techniques are still the standard treatment for correcting a narrow alveolar ridge because of few commercially available distractors for alveolar widening. In this article, we treated a case by a mesh-plate type of alveolar widening distractor for a narrow posterior mandibular alveolar ridge after extirpation of a large jaw cyst.
Oral surgery, oral medicine, oral pathology, oral radiology, and endodontics 10/2008; 106(5):e1-7. · 1.50 Impact Factor
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ABSTRACT: In this report, we show a case of the extensive nasopalatine duct cyst showing remarkable nasolabial protrusion. CT and MR examinations showed remarkable expansion of the extraosseous part of the lesion toward anterior and lateral sides, and this finding is considered to show the rather aggressive nature of this common cystic lesion after penetration of the maxillary cortex.
Oral surgery, oral medicine, oral pathology, oral radiology, and endodontics 10/2008; 106(4):e46-50. · 1.50 Impact Factor
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The Journal of trauma 09/2008; 66(4):E46-9. · 2.48 Impact Factor
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ABSTRACT: Maxillary distraction osteogenesis using intraoral distractors is now one of the standard treatments of maxillary retrusion. This report shows 2 cases of breakage of this internal maxillary distractor in patients with cleft lip and palate; one was observed during the distraction period and the other was during the retention period. The first case required a rotational movement of the distraction segment, and this movement caused the laterally dislocation of the posterior part of the distractor, where the distractor suffered some mechanical forces by mouth opening. In the latter case, breakage of distractor was observed on the radiographs taken 3 months after distraction and this complication may have been caused by mechanical force by occlusion and mastication. Both breakages were found at the joint of the anchorage plate and the extension rod, which has some flexibility for adjusting the plate to the bone surface. Therefore, surgeons should pay special attention for this mechanical weak area in this distractor not only during the advancement period, but also during the retention period and should avoid unnecessary frequent bending for adopting the bone surface, which directly weakens the joint.
Oral surgery, oral medicine, oral pathology, oral radiology, and endodontics 08/2008; 106(1):e1-7. · 1.50 Impact Factor
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ABSTRACT: To evaluate the incidence of blood exposure during outpatient oral surgery from splattering caused by use of high-speed rotary instruments at the Referral and Teaching Center, University Dental Hospital.
Twenty-five consecutive patients who had impacted mandibular third molars were selected. The attending surgeon wore an operation gown and visor mask, and carried out the tooth extraction with the regular procedure. We counted the number of bloodstains found on the operation gown and visor mask, and confirmed the presence of diluted and invisible bloodstains using a leucomalachite green presumptive test, which was able to detect dilutions up to 1:4,000.
There were 469 separate bloodstains on the gown and visor mask of oral surgeons, which came from 19 (76%) of 25 patients during impacted mandibular third molar surgery. Presumptive tests for invisible bloodstains resulted in 1,206 positive reactions, 2.57-fold greater than the visible stains, from 88% of the cases. All of the surgeons were right-handed and the common areas of staining were the right forearm, face, and thorax regions.
Dental procedures with high-speed instruments exposed surgeons to possible blood-borne infections by splashing in nearly 90% of the cases. Greater than 50% of the stains were invisible to the naked eye. Based on our results, strict compliance with barrier precautions, including routine use of an operation gown and visor mask, is recommended whenever oral surgery is carried out with high-speed rotary instruments.
Journal of oral and maxillofacial surgery: official journal of the American Association of Oral and Maxillofacial Surgeons 05/2008; 66(4):704-10. · 1.58 Impact Factor
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ABSTRACT: Surgical-assisted rapid palatal expansion includes various treatment procedures for solving transverse maxillary deficiencies, especially in cases with a matured palatal suture. Recent introduction of the concept of distraction osteogenesis has contributed to generalize this useful treatment and to develop some bone-borne devices that will not cause the problems found in cases treated by tooth-supported palatal expander. This report shows a conventional bone-borne distractor using commercially available orthodontic palatal expansion screws.
The distractor consists of 2 parts: one is a commercially available orthodontic palatal expansion screw (Hyrax type, Fan style) and another is a screw-ring, which is one of the attached parts of the mandibular distraction system. The bone screws are inserted transmucosally to the palatal bone via the screw-rings.
The palatal distractor can be applied to varied palatal shapes and can expand the palate without any trouble.
This conventional palatal distractor may contribute to generalize the transpalatal maxillary distraction osteogenesis for cases with maxillary teeth problems.
Oral surgery, oral medicine, oral pathology, oral radiology, and endodontics 03/2008; 105(2):e8-11. · 1.50 Impact Factor
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ABSTRACT: In this study, we found that a certain motor branch of glossopharyngeal (IX) motor nerves stably exhibits not only inspiratory activity but also expiratory activity with pons removal in neonatal rat brainstem-spinal cord preparations in vitro. Because this finding indicates that IX expiratory activity is masked by an inhibitory mechanism operating in the pons, we sought to determine the candidate neurons that exert an inhibitory effect on IX expiratory activity. IX expiratory activity was observed when only the pons was perfused with noradrenaline (NA) or clonidine (alpha2 adrenergic receptor agonist), but not when NA and yohimbine (alpha2 adrenergic receptor antagonist) were perfused together. IX expiratory activity was also observed following the removal of the dorsal pons but not the ventral pons. The local administration of clonidine into the bilateral locus coeruleus (LC) evoked burst discharges during the expiratory phase in the IX motor rootlet. These results suggest that neurons in the LC that possess an alpha2 adrenergic receptor on the membrane surface exert a tonic inhibitory effect on IX expiratory activity in neonatal rat brainstem-spinal cord preparations.
Neuroscience Research 02/2008; 60(1):2-9. · 2.25 Impact Factor
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Plastic and reconstructive surgery 09/2007; 120(2):508-16. · 2.74 Impact Factor
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ABSTRACT: Congenital granular cell lesion (CGCL) is well known to appear as the congenital epulis, predominantly on the median maxillary alveolar ridge. This lesion rarely occurs on the tongue, and only 7 cases, including 4 cases with simultaneous occurrence on the alveolar ridge, have been reported in the English literature. In this report, we report a case of congenital granular cell lesion seen on the tongue. The patient was a 7-day-old Japanese girl who presented with a polypoid mass on the anterior ventral surface near the tip of the tongue. The lesion was excised at 4 months, and its histological examination revealed large granular cells. Immunochemical staining by S-100 was negative, and it was diagnosed as congenital granular cell lesion.
Oral surgery, oral medicine, oral pathology, oral radiology, and endodontics 08/2007; 104(1):e45-8. · 1.50 Impact Factor
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Journal of Oral and Maxillofacial Surgery 05/2007; 65(4):813-7. · 1.64 Impact Factor
