Myositis ossificans traumatica (MOT) is a disease in which muscular ossification develops following trauma. Almost all cases of MOT are found in skeletal muscle. The authors report in a 39-year-old man MOT involving several muscles in the head and neck, namely, bilateral masseter muscles, the left temporal muscle, the left lateral pterygoid muscle, and the left frontal muscle. Involvement of the lateral pterygoid muscle is especially rare.
Although cardiac arrhythmias are occasionally associated with dental extractions and dental anesthesia, atrioventricular block is rarely seen during dental procedures. We report a rare case of type I second-degree atrioventricular block (Wenckebach phenomenon) occurring after bilateral extraction of impacted mandibular third molars under general anesthesia in a 16-year-old Japanese girl. Under consultation with a cardiovascular physician, we carefully monitored the patient's vital signs postoperatively, including blood pressure, oxygen saturation, and electrocardiogram, using a bedside monitor. Her postoperative course was uneventful. A 12-lead electrocardiogram the following day revealed no abnormality. In this case, we hypothesize that extubation of the nasotracheal tube or oral/pharyngeal suction might have triggered a vagal reflex that caused type I second-degree atrioventricular block. Our experience indicates that standard cardiovascular monitoring should be used for patients undergoing dental treatment under general anesthesia, even for young, healthy patients, to prevent and detect cardiovascular emergencies.
Craniomaxillofacial surgery is difficult due to the complexity of the regional anatomy. Computerassisted surgery is a promising tool aiming to improve the safety and precision of such surgery. A computer-assisted surgical navigation approach for reconstruction of mandibular defects using a patient-specific titanium mesh tray and particulate cancellous bone and marrow (PCBM) harvested from bilateral anterior ilia is proposed. This case report involves a large multicystic ameloblastoma affecting the right mandible of a 31-year-old male patient. Following detailed clinical examination, radiological interpretation, and histopathological diagnosis, computer-assisted surgical simulation with a virtual 3-dimensional (3-D) model was designed using surgical planning software based on the pre-operative computed tomography data. Long-span segmental resection of the mandible was planned, and the defect was analyzed for reconstruction using a patient-specific reconstruction titanium mesh tray mediated with computer-aided design and manufacturing (CAD/CAM) techniques. During the actual surgery, the ultrasonic bone cutting instrument in the surgeon's hand was connected to the navigation system to touch an anatomical position on the patient. Therefore, osteotomies were performed finely and smoothly according to the navigation images of the cutting bone line by sequentially moving the instrument. Finally, a CAD/CAM-mediated titanium mesh tray condensed by PCBM was adapted to the remaining mandibular fragments. Six months postoperatively, the patient had a good mandibular configuration and facial contour. Integration * Corresponding author. S. Kondo et al. 86of different technologies, such as software planning and 3-D surgical simulation, combined with intraoperative navigation and CAD/CAM techniques, provides safe and precise mandibular reconstruction surgery.
Vascular endothelial growth factor (VEGF) is one of the most important angiogenic factors. VEGF165b was recently isolated as the anti-angiogenic VEGF splice variant. In the present study, we examined the association between VEGF165b expression and clinicopathological characteristics in order to determine how VEGF165b produced from oral squamous cell carcinoma (OSCC) affects the stromal cell biological activity. We examined the relationships between the expressions of both VEGF isoforms in normal human dermal fibroblasts (NHDFs) and OSCC cell lines (HSC2, 3, 4 and SAS). Our analyses indicated that both the mRNA and protein expression levels of VEGF165b in the HSC2 and SAS cells were higher than those in the NHDFs. VEGF165b did not promote cell growth or invasive capabilities, but it induced the cell adhesive capabilities to ECM. Although strong expression of the VEGF165 isoforms in tumor cells of OSCC tissues was observed, there was no significant difference in the VEGF165b expression level among the various degrees of malignancy. OSCC cells secrete VEGF165b into the stroma, and this factor may contribute to the process of anti-angiogenesis by inhibiting gelatinase-expressing cells and activating cell adhesive capabilities to ECM, such as that of fibroblasts surrounding tumor cells.
Occlusal management for cleft palate patients often lasts a long time, starting in the growth phase. Guidance of jaw development is required, because many factors, including lip and palate surgery, can cause undergrowth of the maxilla. We report herein the case of a patient who under went long-term monitoring of maxillofacial growth and development, occlusal control and surgical correction from childhood to adulthood, with favorable final outcomes. Maxillofacial growth and development and therapeutic effects are discussed. The patient was a woman with bilateral cleft lip and palate (incomplete on the left). Occlusal management was started at 4 years old. After the end of pubertal growth, she underwent upper right lateral incisor and lower bilateral premolar extraction at another hospital, as visiting our hospital was difficult. During retention, she showed progenia and openbite due to relapse. Skeletal mandibular protrusion due to maxillary undergrowth was diagnosed and surgical correction was performed by maxillary and mandibular osteotomies. The canine was placed in the right cleft defect, and occlusion was established non-prosthetically as a reduction of the dental arch, obtaining favorable results. To evaluate therapeutic effects, maxillofacial growth and development were evaluated longitudinally. Maxillary growth and development were based mostly on inferior components, and anterior growth was basically absent. Although occlusal management was started in early childhood, anterior maxillary growth guidance was not performed. Since maxillary growth is often marked in patients with cleft lip and palate showing normal overjet during the growth phase, improving overjet from the first examination is important.Key words bilateral cleft lip and palate, growth and development, orthodontic surgery.
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