Fabrication and evaluation of carbonate apatite granule sponges using sh-derived collagen for advanced synthetic bone substitutes

Journal of Materials Science. Materials in Medicine


Application and evaluation of carbonate apatite granules for mandibular bone defect reconstruction after jawbone cyst enucleation-a retrospective case series

To evaluate the effectiveness of COAp granules in the mandibular bone defects by using computed tomography (CT) images. This study was retrospective case series of mandibular bone defect reconstruction using COAp granules. Six patients with jawbone cysts treated by simultaneous grafting COAp granules after cyst enucleation were enrolled. Patients without grafting COAp granules were excluded. Mandibular bone height including buccolingual bone height, the change of perpendicular distance between the buccolingual line to the alveolar ridge, and the three-dimensional volume of remaining COAp granules were analyzed using CT images obtained at 3, 6, 12, 18, and 24 months postoperatively. Postoperative CT images showed that cortical and cancellous bone-like structures were formed on the grafting area periphery and inside the defect, respectively, with gradual resorption of the COAp granules. Furthermore, there was no evidence of leaving bone defect even at the center of the lesion when the defect was successfully reconstructed by filling it with COAp granules. The percentage volume of remaining COAp granules to the volume at 3 months postoperatively were 76.1 ± 13.1%, 35.8 ± 22.5%, 25.0 ± 13.0%, and 9.9 ± 6.4% at 6, 12, 18, and 24 months postoperatively, and the volume reduction rate increased significantly within 12 months postoperatively. Grafting COAp granules after the enucleation of a jawbone cyst is a good reconstructive treatment option for postoperative prosthetic treatment because COAp granules are gradually replaced by new bone while preserving the contour of the mandibular bone. Not applicable.


Fabrication of a carbonate apatite granules sponge as a new bone substitute and its histological evaluation at rat calvarial bone defects

Journal of Oral and Maxillofacial Surgery, Medicine, and Pathology


Evaluation of dose constraint for contralateral neck in the unilateral neck volumetric-modulated arc radiotherapy

片側頸部を標的とした強度変調回転照射における線量制約の検討


術後に顎関節に疼痛を訴えた顎偏位を伴う骨格性上顎前突症例

術後に顎関節に疼痛を訴えた顎偏位を伴う骨格性上顎前突症例

The Journal of Chu-Shikoku Orthodontic Society

中·四国矯正歯科学会雑誌


Analysis of the sublingual artery using contrast-enhanced computed tomography

This in vivo study aimed to clarify the position of the sublingual artery (SLA) relative to the mandibular bone and to infer the potential risk for injury during dental implant surgery. Contrast-enhanced computed tomography images of the mouth of 50 edentulous patients (100 sides) treated at Tokushima University Hospital were reviewed. Curved planar reconstructed images perpendicular to the alveolar ridge were processed and classified into molar, premolar, canine, and incisor regions. The SLA and its branches were identified, and the distance from the mandible to the SLA was measured. The SLA was located close to the mandible (<2 mm) in the molar, premolar, canine, and incisor segments in 12.0% (95% confidence interval 5.6%-18.4%), 20.6% (12.6%-28.7%), 30.5% (21.3%-39.8%), and 41.8% (28.8%-54.9%) cases, respectively. The SLA was located within ±3 mm craniocaudally to the upper wall of the mandibular canal in the molar and premolar regions in 50% of cases and within ±5 mm craniocaudally to the mylohyoid ridge in the canine and incisor regions in the other cases, with no sex or age-related differences. The vertical distance from the alveolar ridge to the SLA was influenced by sex and age owing to alveolar resorption, indicating that the alveolar ridge is not a reliable reference for predicting SLA position. As the risk of SLA injury always exist during dental implant placement and there is no way to confirm the SLA pathways in a patient, clinicians must avoid injuring the sublingual soft tissue.

Clinical Implant Dentistry and Related Research


Pollen food allergy syndrome caused by Japanese radish: A case report

Pollen food allergy syndrome (PFAS) is a food allergy that manifests as hypersensitivity symptoms of the oropharyngeal mucosa on ingesting specific foods, and findings resemble herpetic gingivostomatitis. Few reports of PFAS caused by consuming radishes are found in the literature. A 31-year-old man presented to our department with stomatitis and pharyngeal pain. He had no history of allergies. Herpetic gingivostomatitis was suspected. He was admitted to the emergency room a few days later complaining of oral and epigastric pain. Symptoms were similar to those reported previously. He reported frequently consuming raw Japanese radish ( L.) which gave rise to his symptoms. Japanese radish was suspected as the allergen. The skin-prick test confirmed the diagnosis of PFAS. PFAS can be diagnosed easily once the food-causing symptoms are identified. Upon encountering widespread erosion in the oral cavity, it is essential to consider PFAS as the possible cause.


A case of fishbone in the tongue that migrated toward the hyoid bone

舌骨近傍に移動した舌内迷入魚骨の1例

Japanese Journal of Oral & Maxillofacial Surgery


Computed tomography-based morphological analysis for intraoral vertical ramus osteotomy in patients with mandibular prognathism


Comparison of bioresorbable bone substitutes, carbonate apatite and β-tricalcium phosphate, for alveolar bone augmentation with simultaneous implant placement.


Reconstruction of rabbit mandibular bone defects using carbonate apatite honeycomb blocks with an interconnected porous structure.

Carbonate apatite (COAp) granules are useful as a bone substitute because they can be remodeled to new natural bone in a manner that conforms to the bone remodeling process. However, reconstructing large bone defects using COAp granules is difficult because of their granular shape. Therefore, we fabricated COAp honeycomb blocks (HCBs) with continuous unidirectional pores. We aimed to elucidate the tissue response and availability of COAp HCBs in the reconstruction of rabbit mandibular bone defects after marginal mandibulectomy. The percentages of the remaining COAp area and calcified bone area (newly formed bone) were estimated from the histological images. COAp area was 49.1 ± 4.9%, 30.3 ± 3.5%, and 25.5 ± 8.8%, whereas newly formed bone area was 3.0 ± 0.6%, 24.3 ± 3.3%, and 34.7 ± 4.8% at 4, 8, and 12 weeks, respectively, after implantation. Thus, COAp HCBs were gradually resorbed and replaced by new bone. The newly formed bone penetrated most of the pores in the COAp HCBs at 12 weeks after implantation. By contrast, the granulation tissue scarcely invaded the COAp HCBs. Some osteoclasts invaded the wall of COAp HCBs, making resorption pits. Furthermore, many osteoblasts were found on the newly formed bone, indicating ongoing bone remodeling. Blood vessels were also formed inside most of the pores in the COAp HCBs. These findings suggest that COAp HCBs have good osteoconductivity and can be used for the reconstruction of large mandibular bone defects. The COAp HCB were gradually resorbed and replaced by newly formed bone.

Journal of Materials Science. Materials in Medicine


Survey of oral maxillofacial injury experiences and sports mouthguard use in wakeboarders

International Journal of Sports Dentistry


A Case of Ameloblastoma Removed Using a Three-dimensional Transparent Plastic Jaw Model Which Can Visualize Internal Jawbone Structures


miR 155 5p can be involved in acquisition of osseointegration on titanium surface

Dental implants made of titanium are commonly used. Although titanium implants succeed by osseointegration with bone, the detailed molecular mechanism of osseointegration is unclear. To clarify the involvement of microRNA (miRNA) in the acquisition of osseointegration on titanium, here we compared the miRNA expression profiles of mouse osteoblast-like cells (MC3T3-E1) cultured on titanium-, gold-, and stainless steel-coating glass dishes by microarray analysis. Three kinds of metals, namely titanium, gold, and stainless steel, were coated on the surface of the glass dishes by sputtering with similar roughness and shape of their surface. After MC3T3-E1 cells were cultured on the dishes without coating or coating with titanium, gold, or stainless steel for 6 h, total RNA was extracted, and miRNA expression was analyzed by microarray. To confirm the expression of the selected miRNA during osteogenic differentiation of MC3T3-E1 cells, real-time PCR analysis was performed. Furthermore, the effects of selected miRNA were examined by ectopic overexpression in MC3T3-E1 cells. The microarray analysis revealed that the expressions of miR-155-5p and miR-7023-3p were significantly increased in MC3T3-E1 cells cultured on titanium-coating glass dishes, compared to non-coating, gold-, and stainless steel-coating glass dishes. Interestingly, miR-155-5p was upregulated during osteogenic differentiation of MC3T3-E1 cells. Furthermore, overexpression of miR-155-5p enhanced the expression of Runx2 and Col1a1. In this study, miR-155-5p may be involved in the acquisition of osseointegration on titanium implant via upregulating osteogenic differentiation-related genes.

In Vitro Cellular & Developmental Biology. Animal


ピロカルピン塩酸塩を用いた口腔リンス法の有用性と安全性の検討

ピロカルピン塩酸塩を用いた口腔リンス法の有用性と安全性の検討


Prevalence of and risk factors for postoperative complications after lower third molar extraction: A multicenter prospective observational study in Japan

Lower third molar extraction is the most common surgical treatment among routine dental and oral surgical procedures. while the surgical procedures for lower third molar extraction are well established, the difficulty of tooth extraction and the frequency of postoperative complications differ depending on the patient's background. To establish a management protocol for the lower third molars, the prevalence of and risk factors for postoperative complications after lower third molar extraction were investigated in a large number of Japanese patients in a multicenter prospective study. During 6 consecutive months in 2020, 1826 lower third molar extractions were performed at the 20 participating institutions. The medical records of the patients were reviewed, and relevant data were extracted. The prevalence of and risk factors for postoperative complications were analyzed. The prevalence of postoperative complications after lower third molar extraction was 10.0%. Multivariate analysis indicated that age (≤32 vs >32, odds ratio [OR]: 1.428, 95% confidence interval [95% CI]: 1.040-1.962, P < .05), the radiographic anatomical relationship between the tooth roots and mandibular canal (overlapping of the roots and canal vs no close anatomical relationship between the roots and the superior border of the canal, OR: 2.078, 95% CI: 1.333-3.238, P < .01; overlapping of the roots and canal vs roots impinging on the superior border of the canal, OR: 1.599, 95% CI: 1.050-2.435, P < .05), and impaction depth according to the Pell and Gregory classification (position C vs position A, OR: 3.7622, 95% CI: 2.079-6.310, P < .001; position C vs position B, OR: 2.574, 95% CI: 1.574-4.210, P < .001) are significant independent risk factors for postoperative complications after lower third molar extraction. These results suggested that higher age and a deeply impacted tooth might be significant independent risk factors for postoperative complications after lower third molar extraction.


Osteoclast behaviors on the surface of deproteinized bovine bone mineral and carbonate apatite substitutes in vitro

Journal of Biomedical Materials Research. Part A


Radiomics analysis of [18F]-fluoro-2-deoxyglucose positron emission tomography for the prediction of cervical lymph node metastasis in tongue squamous cell carcinoma

This study aimed to create a predictive model for cervical lymph node metastasis (CLNM) in patients with tongue squamous cell carcinoma (SCC) based on radiomics features detected by [F]-fluoro-2-deoxyglucose (F-FDG) positron emission tomography (PET). A total of 40 patients with tongue SCC who underwent F-FDG PET imaging during their first medical examination were enrolled. During the follow-up period (mean 28 months), 20 patients had CLNM, including six with late CLNM, whereas the remaining 20 patients did not have CLNM. Radiomics features were extracted from F-FDG PET images of all patients irrespective of metal artifact, and clinicopathological factors were obtained from the medical records. Late CLNM was defined as the CLNM that occurred after major treatment. The least absolute shrinkage and selection operator (LASSO) model was used for radiomics feature selection and sequential data fitting. The receiver operating characteristic curve analysis was used to assess the predictive performance of the F-FDG PET-based model and clinicopathological factors model (CFM) for CLNM. Six radiomics features were selected from LASSO analysis. The average values of the area under the curve (AUC), accuracy, sensitivity, and specificity of radiomics analysis for predicting CLNM from F-FDG PET images were 0.79, 0.68, 0.65, and 0.70, respectively. In contrast, those of the CFM were 0.54, 0.60, 0.60, and 0.60, respectively. The F-FDG PET-based model showed significantly higher AUC than that of the CFM. The F-FDG PET-based model has better potential for diagnosing CLNM and predicting late CLNM in patients with tongue SCC than the CFM.


Alveolar ridge preservation in beagle dogs using carbonate apatite bone substitute


Association of PD L1 and ZEB 1 expression patterns with clinicopathological characteristics and prognosis in oral squamous cell carcinoma

Programmed cell death-1 (PD-1) and its ligand programmed cell death 1 ligand 1 (PD-L1) are immune checkpoint inhibitors that play an important role in the host immune avoidance mechanism of tumors. The relationship between PD-L1 expression and malignancy has been reported in various types of cancer, such as lung and gastric cancer. In addition, epithelial-mesenchymal transition (EMT) of cancer cells is deeply involved in the invasion and metastasis of cancer. It has been reported that zinc finger E-box binding homeobox 1 (ZEB-1), an EMT inducer, contributes to metastasis in pancreatic and colon cancer. The present study aimed to investigate the relationship between the expression patterns of two markers, PD-L1 and ZEB-1, and clinicopathological characteristics and prognosis of oral squamous cell carcinoma (OSCC). Biopsy or surgical excision specimens from 169 patients with OSCC were used in the present study. Immunohistochemical staining with monoclonal anti-PD-L1 antibody and anti-ZEB-1 antibody was conducted. Cases with >1% tumor cells positive for PD-L1 and those with >10% tumor cells positive for ZEB-1 were considered positive, respectively. The findings revealed that individual expression of PD-L1 and ZEB-1 in OSCC was not associated with tumor size, degree of differentiation or Yamamoto-Kohama invasion pattern classification. However, co-expression of PD-L1 and ZEB-1 was associated with higher cervical lymph node metastasis and a lower survival rate. In conclusion, the results of the present study indicated that co-expression of PD-L1 and ZEB-1 could serve as a potential marker for the prognosis of patients with OSCC.


Staged Sinus Floor Elevation Using Novel Low-Crystalline Carbonate Apatite Granules: Prospective Results after 3-Year Functional Loading.


Soluble Factor from Oral Cancer Cell Lines Inhibits Interferon-γ Production by OK-432 via CD40/CD40Ligand Pathway


Evaluation of anatomical references for locating the course of the posterior superior alveolar artery for dental implant surgery

This retrospective cohort study aimed to identify the best anatomical reference for predicting the posterior superior alveolar artery (PSAA) location. Computed tomographic images of 90 maxillary sinuses were evaluated. We studied five references, including the alveolar crest, maxillary sinus floor, zygomatoalveolar crest, hard palate and soft palate, and measured the distances between them and the PSAA. Variations in the distance were evaluated by the standard deviation and coefficient of variation (CV). The zygomatoalveolar crest was an unstable reference, owing to its high standard deviation and CV. The smallest CV was for the distance between the alveolar crest and PSAA, although the distance was smaller in edentulous jaws than dentulous jaws. The distance between the sinus floor and PSAA was larger in male and edentulous patients. The PSAA was detected in 40.0%, 44.4%, 54.4% and 56.7% of the sinus walls at the first and second premolar and the first and second molar positions, respectively. At these tooth positions, the respective heights above the hard palate were 11.2 ± 4.9, 8.2 ± 4.9, 6.2 ± 2.8 and 8.1 ± 2.9 mm. The hard palate was the most stable reference for predicting the location of the PSAA, irrespective of sex, age and dentition.

International Journal of Oral and Maxillofacial Surgery


A clinical study on malignant lymphomas arising in the oral region

口腔領域に発症した悪性リンパ腫の臨床的検討

We examined the clinical characteristics of 18 cases of malignant lymphomas arising in the oral region which were diagnosed at our department during the 11 years from 2008 to 2018. The patients consisted of 10 males and 8 females whose mean age was 70.2 years. The primary site was the upper gingiva in 10 cases (55.6%), and the initial symptoms were tumor mass and swelling in 15 cases (83.3%). Only 7 cases (38.9%) were clinically diagnosed as malignant lymphoma at first visit, but the other 11 cases were difficult to diagnose correctly. The various clinical symptoms such as mass formation and ulcer made differential diagnosis difficult, and a definitive diagnosis could not be obtained by only a single biopsy. Therefore, we examined whether blood test results might be used as an indicator of the diagnosis or not. Our results showed that LDH in 8 of 17 cases (47.1%) and sIL-2R in 11 of 16 cases (68.8%) were high values. Furthermore, we examined whether lymphocyte-monocyte ratio (LMR) helped the diagnosis or not. Thirteen of 17 cases (76.5%) showed a low value of LMR. There was a significant difference in LMR compared to non-malignant lymphoma patients. LMR in the blood tests was also considered to be a useful marker for the diagnosis.

2008年から2018年までの11年間に当科で口腔領域に発症した悪性リンパ腫の18例について臨床的特徴を調べた．患者は，平均年齢が70.2歳の男性10例，女性8例であった．原発部位の10例(55.6%)は上顎歯肉で，初期症状は15例(83.3%)で腫瘤と腫脹であった．7例(38.9%)が初診時に臨床的に悪性リンパ腫と診断されたが，その他の11例は正しく診断することが困難であった．腫瘤形成や潰瘍のような様々な臨床症状が診断を困難にしており，1回の生検では確定診断が得られなかった．そこで，血液検査値が診断の指標であるかどうかを検討した．われわれの結果は，17例中8例のLDH(47.1%)と16例中11例のsIL-2R(68.8%)が高い値を示していた．さらに，われわれはリンパ球/単球数比(LMR)が診断に役立つかどうかを調べた．LMRの値は，17例中13例(76.5%)が有意に低く，非ML患者と比較しても有意差を認めた．以上のことより，LMRの血液検査も診断の補助的なマーカーであると考えられた．

Journal of Japan Society for Oral Tumors


Actinomycotic osteomyelitis of the mandible with bone destruction: Two case reports with a review of the Japanese literatures


強度変調放射線治療に伴う放射線性顎骨壊死の頻度と危険因子の検討

強度変調放射線治療に伴う放射線性顎骨壊死の頻度と危険因子の検討


Inferior alveolar nerve paresthesia caused by the extrusion of calcium hydroxide-based paste into themandibular canal: A case report.

Journal of Oral and Maxillofacial Surgery, Medicine, and Pathology


Histological comparison of three apatitic bone substitutes with different carbonate contents in alveolar bone defects in a beagle mandible with simultaneous implant installation.

Since bone apatite is a carbonate apatite containing carbonate in an apatitic structure, carbonate content may be one of the factors governing the osteoconductivity of apatitic bone substitutes. The aim of this study was to evaluate the effects of carbonate content on the osteoconductivity of apatitic bone substitutes using three commercially available bone substitutes for the reconstruction of alveolar bone defects of a beagle mandible with simultaneous dental implant installation. NEOBONE, Bio-Oss, and Cytrans that contain 0.1, 5.5, and 12.0 mass% of carbonate, respectively, were used in this study. The amount of newly formed bone in the upper portion of the alveolar bone defect of the beagle's mandible was 0.7, 6.6, and 39.4% at 4 weeks after surgery and 4.7, 39.5, and 75.2% at 12 weeks after surgery for NEOBONE, Bio-Oss, and Cytrans, respectively. The results indicate that bone-to-implant contact ratio was the largest for Cytrans. Additionally, the continuity of the alveolar ridge was restored in the case of Cytrans, whereas the continuity of the alveolar ridge was not sufficient when using NEOBONE and Bio-Oss. Both Cytrans and Bio-Oss that have a relatively larger carbonate content in their apatitic structure was resorbed with time. We concluded that carbonate content is one of important factors governing the osteoconductivity of apatitic bone substitutes.

Journal of Biomedical Materials Research. Part B, Applied Biomaterials


A case of microcystic adnexal carcinoma arising in the upper gingiva

Microcystic adnexal carcinoma (MAC) is a rare malignant tumor of skin appendages. MAC grows slowly, but is locally aggressive. The metastatic potential is low, but the recurrence rates are very high owing to insufficient dissection. The most common location of MAC is the skin of the midface of middle-aged adults. There has been no report about MAC arising in the gingiva. We report here an extremely rare case of MAC of the upper gingiva in a 53-year-old woman. She presented to our hospital with a 6-year history of a gradually increasing gingival mass. Intraoral examination revealed a smooth, poorly circumscribed mass with white granules resembling Fordyce spots on her upper gingiva. There was no bone destruction or regional lymph node swelling. The histopathological diagnosis was a tumor of skin appendages. Tumor resection was performed. Postoperative pathological examination revealed that the tumor differentiated into hair follicles and the sweat-gland-like structures and deeply infiltrated into muscle, perineural spaces, and bone. Since the surgical margins were positive, additional resection was performed after preoperative mapping biopsy. Finally, the tumor was completely excised. No tumor recurrence or metastasis have been observed over 1 year.

Japanese Journal of Oral & Maxillofacial Surgery


Fabrication of porous carbonate apatite granules using microfiber and its histological evaluations in rabbit calvarial bone defects

Carbonate apatite (CO Ap) granules are known to show good osteoconductivity and replaced to new bone. On the other hand, it is well known that a porous structure allows bone tissue to penetrate its pores, and the optimal pore size for bone ingrowth is dependent on the composition and structure of the scaffold material. Therefore, the aim of this study was to fabricate various porous CO Ap granules through a two-step dissolution-precipitation reaction using CaSO as a precursor and 30-, 50-, 120-, and 205-μm diameter microfibers as porogen and to find the optimal pore size of CO Ap. Porous CO Ap granules were successfully fabricated with pore size 8.2-18.7% smaller than the size of the original fiber porogen. Two weeks after the reconstruction of rabbit calvarial bone defects using porous CO Ap granules, the largest amount of mature bone was seen to be formed inside the pores of CO Ap (120) [porous CO Ap granules made using 120-μm microfiber] followed by CO Ap (50) and CO Ap (30). At 4 and 8 weeks, no statistically significant difference was observed based on the pore size, even though largest amount of mature bone was formed in case of CO Ap (120). It is concluded, therefore, that the optimal pore size of the CO Ap is that of CO Ap (120), which is 85 μm.

Journal of Biomedical Materials Research. Part A


Application of low-crystalline carbonate apatite granules in 2-stage sinus floor augmentation: a prospective clinical trial and histomorphometric evaluation.

The purpose of this study was to elucidate the efficacy and safety of carbonate apatite (COAp) granules in 2-stage sinus floor augmentation through the radiographic and histomorphometric assessment of bone biopsy specimens. Two-stage sinus floor augmentation was performed on 13 patients with a total of 17 implants. Radiographic assessment using panoramic radiographs was performed immediately after augmentation and was also performed 2 additional times, at 7±2 months and 18±2 months post-augmentation, respectively. Bone biopsy specimens taken from planned implant placement sites underwent micro-computed tomography, after which histological sections were prepared. Postoperative healing of the sinus floor augmentation was uneventful in all cases. The mean preoperative residual bone height was 3.5±1.3 mm, and this was increased to 13.3±1.7 mm by augmentation with the COAp granules. The mean height of the augmented site had decreased to 10.7±1.9 mm by 7±2 months after augmentation; however, implants with lengths in the range of 6.5 to 11.5 mm could still be placed. The mean height of the augmented site had decreased to 9.6±1.4 mm by 18±2 months post-augmentation. No implant failure or complications were observed. Few inflammatory cells or foreign body giant cells were observed in the bone biopsy specimens. Although there were individual differences in the amount of new bone detected, new bone was observed to be in direct contact with the COAp granules in all cases, without an intermediate layer of fibrous tissue. The amounts of bone and residual COAp were 33.8%±15.1% and 15.3%±11.9%, respectively. In this first demonstration, low-crystalline COAp granules showed excellent biocompatibility, and bone biopsy showed them to be replaced with bone in humans. COAp granules are a useful and safe bone substitute for two-stage sinus floor augmentation. ICTRP Identifier: JPRN-UMIN000019281.

Journal of Periodontal & Implant Science


Fabrication of carbonate apatite honeycomb and its tissue response.

Carbonate apatite (CO Ap) block can be used as a bone substitute because it can be remodeled to new natural bone in a manner conforming with the bone remodeling process. Among the many porous structures available, honeycomb (HC) structure is advantageous for rapid replacement of CO Ap to bone. In this study, the feasibility to fabricate a CO Ap HC was studied, along with its initial tissue response in rabbit femur bone defect. First, a mixture of Ca(OH) and a wax-based binder was extruded from a HC mold. Then the fabricated HC was heated for binder removal and carbonation at 450°C in a mixed O -CO atmosphere, forming a CaCO HC. When the CaCO HC was immersed in 1 mol/L Na PO solution at 80°C for 7 days, its composition changed from CaCO to CO Ap, maintaining the structure of the original CaCO HC. Compressive strengths of the CaCO and CO Ap HCs were 65.2 ± 7.4 MPa and 88.7 ± 4.7 MPa, respectively. When the rabbit femur bone defect was reconstructed with the CO Ap HC, new bone penetrated the CO Ap HC completely. Osteoclasts and osteoblasts were found on the surface of the newly formed bone and osteocytes were also found in the newly formed bone, indicating ongoing bone remodeling. Furthermore, blood vessels were formed inside the pores of CO Ap HC. Therefore, CO Ap HC has good potential as an ideal bone substitute. © 2019 Wiley Periodicals, Inc. J Biomed Mater Res Part A: 107A: 1014-1020, 2019.


Effects of acidic calcium phosphate concentration on setting reaction and tissue response to β-tricalcium phosphate granular cement.

Beta-tricalcium phosphate granular cement (β-TCP GC), consisting of β-TCP granules and an acidic calcium phosphate (Ca-P) solution, shows promise in the reconstruction of bone defects as it sets to form interconnected porous structures, that is, β-TCP granules are bridged with dicalcium phosphate dihydrate (DCPD) crystals. In this study, the effects of acidic Ca-P solution concentration (0-600 mmol/L) on the setting reaction and tissue response to β-TCP GC were investigated. The β-TCP GC set upon mixing with its liquid phase, based on the formation of DCPD crystals, which bridged β-TCP granules to one another. Diametral tensile strength of the set β-TCP GC was relatively the same, at ∼0.6 MPa, when the Ca-P concentration was 20-600 mmol/L. Due to the setting ability, reconstruction of the rat's calvarial bone defect using β-TCP GC with 20, 200, and 600 mmol/L Ca-P solution was much easier compared to that with β-TCP granules without setting ability. Four weeks after the reconstruction, the amount of new bone was the same, ∼17% in both β-TCP GC and β-TCP granules groups. Cellular response to β-TCP granules and β-TCP GC using the 20 mmol/L acidic Ca-P solution was almost the same. However, β-TCP GC using the 200 and 600 mmol/L acidic Ca-P solution showed a more severe inflammatory reaction. It is concluded, therefore, that β-TCP GC, using the 20 mmol/L acidic Ca-P solution, is recommended as this concentration allows surgical techniques to be performed easily and provides good mechanical strength, and the similar cellular response to β-TCP granules. © 2019 Wiley Periodicals, Inc. J Biomed Mater Res Part B, 2019.


Maxillary Sinus Floor Augmentation Using Low-Crystalline Carbonate Apatite Granules With Simultaneous Implant Installation: First-in-Human Clinical Trial.

Carbonate apatite (COAp), an inorganic component of human bone, can be fabricated in chemically pure form from calcium carbonate block via a dissolution-precipitation reaction. A first-in-human clinical trial was conducted in which low-crystalline COAp granules were evaluated for safety and efficacy in sinus floor augmentation and simultaneous implant installation. Procedures were performed in 8 patients (9 implants) with 2 granule sizes: small (300 to 600 μm) and medium (600 to 1,000 μm). Panoramic radiographic assessment was performed immediately after augmentation, 7 ± 2 months after augmentation, 6 ± 2 months after prosthetic loading, and 12 ± 2 months after prosthetic loading. Postoperative healing was uniformly uneventful, with no abnormal bleeding, pain, or swelling, and all implants achieved successful osseointegration. The mean residual maxillary molar bone height was 5.2 ± 0.8 mm preoperatively and increased to 14.0 ± 1.9 mm after augmentation. Implants 9.0 to 11.5 mm in length were placed. The post-augmentation height decreased to 12.4 ± 1.3 mm at 7 ± 2 months; after prosthetic loading, it decreased to 11.9 ± 0.8 mm at 6 ± 2 months and 11.7 ± 0.6 mm at 12 ± 2 months. No abnormal bone resorption of the augmented areas was observed, and bone height supporting the implants was maintained. The overall implant survival rate was 100%, with no implant failures or complications during the first year. Low-crystalline COAp granules were useful and safe for sinus floor augmentation and simultaneous implant installation, providing a promising bone substitute for dental implant surgery.

Journal of Oral and Maxillofacial Surgery


新規骨補填材としての炭酸アパタイトの開発と骨再生医療に向けて

新規骨補填材としての炭酸アパタイトの開発と骨再生医療に向けて

Journal of the Japanese Academy of Maxillofacial Prosthetics


Fabrication and Evaluation of Carbonate Apatite-coated Calcium Carbonate Bone Substitutes for Bone Tissue Engineering

Carbonate apatite-coated calcium carbonate (CO Ap/CaCO ) was fabricated through a dissolution-precipitation reaction using CaCO granules as a precursor to accelerate bone replacement based on superior osteoconductivity of the CO Ap shell, along with Ca release from the CaCO core and quicker resorption of the CaCO core. In the present study, CaCO , 10% CO Ap/CaCO , 30% CO Ap/CaCO , and CO Ap granules were fabricated and examined histologically to evaluate their potential as bone substitutes. Larger contents of CaCO in the granules resulted in higher Ca release and promoted cell proliferation of murine preosteoblasts at 6 days compared with CO Ap. Interestingly, in a rabbit femur defect model, 10% CO Ap/CaCO induced significantly higher new bone formation and higher material resorption compared with CO Ap at 8 weeks. Nevertheless, CO Ap showed a superior osteoconductive potential compared with 10% CO Ap/CaCO at 8 weeks. All tested granules were most likely resorbed by cell mediation including multinucleated giant cell functions. Therefore, we conclude that CO Ap/CaCO has a positive potential for bone tissue engineering based on well-controlled calcium release, bone formation, and material resorption.

Journal of Tissue Engineering and Regenerative Medicine


Compositional and histological comparison of carbonate apatite fabricated by dissolutionprecipitation reaction and Bio-Oss®.

Carbonate apatite (COAp) is an inorganic component of bone. This study aimed to compare the composition and tissue response to of COAp (COAp-DP) fabricated by the dissolution-precipitation reaction using calcite as a precursor and Bio-Oss®, which is widely used in orthopedic and dental fields as a synthetic bone substitute. X-ray diffraction and Fourier transform infrared results showed that COAp-DP and Bio-Oss® were both B-type carbonate apatite with low crystallinity. The average sizes of COAp-DP and Bio-Oss® granules were 450 ± 58 and 667 ± 168μ m, respectively, and their carbonate contents were 12.1 ± 0.6 and 5.6 ± 0.1 wt%, respectively. COAp-DP had a larger amount of CO than Bio-Oss® but higher crystallinity than Bio-Oss®. When a bone defect made at the femur of rabbits was reconstructed with COAp-DP and Bio-Oss®, COAp-DP granules were partially replaced with bone, whereas Bio-Oss® remained at 8 weeks after implantation. COAp-DP granules elicited a significantly larger amount of new bone formation at the cortical bone portion than Bio-Oss® at 4 weeks after the implantation. The results obtained in the present study demonstrated that COAp-DP and Bio-Oss® showed different behavior even though they were both classified as COAp. The CO content in COAp played a more important role than the crystallinity of COAp for replacement to bone and high osteoconductivity.

Journal of Materials Science. Materials in Medicine


Expression of CD44,CD44v9ABCG2, CD24,Bmi-1 and ALDH1 in stage andoral spuamous cell carcinoma and their association with clinicopathological factors

Cancer stem cells (CSCs) exhibit self-replication, self-differentiation, drug resistance and immune evasion activities. In recent years CSCs have become increasingly important for the treatment of malignant tumors. CSCs express specific markers, including cluster of differentiation (CD)44, CD44 variant 9 (CD44v9), ATP-binding cassette sub-family G member 2 (ABCG2), CD24, B lymphoma Mo-MLV insertion region 1 homolog (BMI-1) and aldehyde dehydrogenase 1 (ALDH1). However, the prognostic value of their expression in patients with oral squamous cell carcinoma (OSCC) are not well known. The present study evaluated these markers in stage I and II patients with OSCC and examined the association between T classification, histological differentiation, classification of invasion mode, lymph node metastasis and disease-free survival rate. Tissue specimens were obtained from 70 patients with stage I or II OSCC following either surgery or biopsy. Immunohistochemistry was performed and positive staining was defiend as 10% positive cells. CD44 and CD44v9 expressions were strongly detected in all OSCC tissues compared with normal epithelial cells. A total of 22 (31.4%) cases expressed ABCG2 and there was a significant association between ABCG2 expression and invasion. A total of 41 cases (59.0%) expressed CD24 and there was a significant association between CD24 expression and invasion. A total of 33 cases (47.1%) expressed BMI-1 and there was a significant association between BMI-1 expression and the disease-free survival rate. A total of 18 cases (25.7%) expressed ALDH1. Although there was no association between ALDH1 expression and T classification, there were significant associations between ALDH1 expression and histological differentiation, invasion mode, metastasis and the disease-free survival rate. Multivariate analysis revealed that ALDH1 expression was the only prognostic factor for disease-free survival rate. The results of the present study suggest that the positivity of ALDH1 detected in patients with OSCC correlates with the number of cells undergoing epithelial mesenchymal transition and metastasis. These findings indicated that the expression of ALDH1 may be an effective prognostic marker indicating the survival of patients with stage I and II OSCC.


Effect of a novel orally bioavailable CXCR4 inhibitor, AMD070, on the metastasis of oral cancer cells.

We have previously demonstrated that the stromal cell-derived factor (SDF-1)/CXCR4 system is involved in the metastasis of head and neck cancer. Additionally, it has been revealed that the blockade of CXCR4 by subcutaneous daily injection with AMD3100, a CXCR4 antagonist, may be effective in preventing metastasis in CXCR4-related head and neck cancer. Recent investigations have suggested that AMD070, a novel orally bioavailable inhibitor of CXCR4, may be minimally invasive compared with AMD3100. In the present study, we examined the effect of AMD070 on metastasis induced by the SDF-1/CXCR4 axis in B88-SDF-1 oral cancer cells, which express high levels of SDF-1 and CXCR4. Although treatment with AMD070 did not affect the anchorage-dependent growth of B88-SDF-1 cells, it significantly suppressed the anchorage-independent growth. Moreover, the SDF-1/CXCR4-dependent migration and invasion of B88-SDF-1 cells was significantly inhibited following treatment with AMD070. Subsequently, we performed an experimental therapy using AMD070 to prevent the distant metastasis of B88-SDF-1 cells in vivo. Daily oral administration of AMD070 significantly inhibited the lung metastasis of B88-SDF-1 cells in nude mice. These results indicated that AMD070 could be useful as a novel orally bioavailable inhibitor of oral cancer metastasis.


Prevalence and imaging characteristics of nasopharyngeal and eustachian tube tonsilloliths in 2244 patients determined using computed tomography

Nasopharyngeal tonsilloliths (NT) and eustachian tube tonsilloliths (ET) are not as well-known to radiologists as palatine and lingual tonsilloliths. The aim of this investigation was to determine the prevalence and imaging characteristics of NT and ET using CT and panoramic radiographs. We retrospectively assessed the scans of 2244 patients who underwent consecutive CT and panoramic radiographs of the maxillofacial region. The prevalence, size, number, and position of NT and ET were analysed. NT and ET were detected in 14 (0.6%) and 6 (0.3%) of 2244 patients on CT, respectively, but they were undetectable on panoramic radiographs. No significant difference was found in the prevalence with respect to sex. Although there was also no significant difference in the prevalence among age groups, tonsilloliths were most commonly noted in patients over 40 years old; they appeared as small and round calcified bodies, ranging from 1 to 3 mm in diameter. All NT were found 0 to 3 mm beneath the nasopharyngeal mucosal surface. The prevalence of NT and ET on CT was lower than that of palatine and lingual tonsilloliths. However, since they are encountered more frequently than clinically significant calcifying diseases such as retropharyngeal calcific tendinitis, clinicians should be able to correctly diagnose NT and ET based on their anatomical features.


Lingual tonsillolith: prevalence and imaging characteristics evaluated on 2244 pairs of panoramic radiographs and CT images

Lingual tonsilloliths are not as well-known to radiologists than palatine tonsilloliths, although they might be common in clinical practice. The aim of this investigation was to clarify the prevalence and imaging characteristics of lingual tonsilloliths using panoramic radiographs and CT images. This study included 2244 patients without pathology at the base of tongue who had undergone panoramic radiography and CT of the maxillofacial region. The size, number and position of lingual tonsilloliths relative to the mandible and tongue were evaluated. Lingual tonsilloliths were observed in 33 (1.5%) and 108 (4.8%) of all patients on panoramic radiographs and CT images, respectively. The prevalence was higher in patients aged ≥40 years than in those aged < 40 years (χ, p < 0.01). They appeared as small, round- or rod-shaped calcified bodies, and they always located closely anterior (1-17 mm) to the anterior border of oropharyngeal airway on panoramic radiographs. Lingual tonsilloliths were superimposed over the surrounding soft tissue inferior to the body of the mandible, posteroinferior to the angle of the mandible and posterior to the mandible in 16 (48.5%), 15 (45.5%) and 1 (3.0%) individual, respectively. A significant correlation was observed between the detectability on panoramic radiographs and size (Spearman's r = 0.961, p < 0.01) of tonsilloliths, as revealed by CT images. Lingual tonsilloliths commonly appear on CT. They also appear on panoramic radiography and may superimpose the surrounding soft tissue of the mandible. Although lingual tonsilloliths may resemble other pathological calcifications including submandibular sialoliths and lingual osseous cholistoma, they can be differentiated by carefully observing panoramic radiographs. When clinicians detect calcified bodies near the base of tongue, lingual tonsilloliths should be included in the differential diagnoses.


Palonosetron Prevents Highly Emetogenic Chemotherapy-induced Nausea and Vomiting in Oral Cancer Patients

To evaluate the efficacy of palonosetron in preventing acute and delayed nausea and vomiting in patients receiving highly emetogenic chemotherapy (HEC) in oral cancer patients. Oral cancer patients receiving HEC were enrolled; among the 40 patients, 87 courses of chemotherapy were administered. On day 1, 0.75 mg palonosetron was intravenously administrated just before chemotherapy. The primary endpoint was the proportion of patients with a complete response (CR) and the secondary endpoint was the proportion of patients with complete control (CC) during the acute and delayed phase. During the acute phase, 86 of 87 courses (98.9%) had CR and 84 of 87 courses (96.6%) had CC. During the delayed phase, 84 of 87 courses (96.6%) had CR and 70 of 87 courses (80.5%) had CC. Palonosetron is effective at preventing HEC-induced chemotherapy-induced nausea and vomiting (CINV) in oral cancer chemotherapeutic regimens in the acute and delayed phases.


徳島県における口腔がん検診の現状

徳島県における口腔がん検診の現状

日本歯科人間ドック学会誌

日本歯科人間ドック学会誌


Single non-contact Nd: YAG laser irradiation treatment for venous malformations in the oral cavity

Journal of Oral and Maxillofacial Surgery, Medicine, and Pathology


Establishment and characterization of a clear cell odontogenic carcinoma cell line with EWSR1-ATF1 fusion gene.

To the best of our knowledge, this is the first report on the establishment of a CCOC cell line. CCOC-T cells serve as a useful in vitro model for understanding the pathogenesis and nature of MOT.


Effectiveness of Newly Developed Water-Equivalent Mouthpiece during External Beam Radiotherapy for Oral Cancer


Prevalence and imaging characteristics of palatine tonsilloliths evaluated on 2244 pairs of panoramic radiographs and CT images.

Palatine tonsilloliths incidentally detected on diagnostic imaging should be differentiated from pathologic calcifications to enable correct diagnosis and treatment. The aim of this study is to clarify the prevalence and imaging characteristics of palatine tonsilloliths on panoramic radiographs. We retrospectively reviewed 2244 individuals who underwent pairs of consecutive panoramic radiography and computed tomography (CT) of the head and neck region. The imaging characteristics of palatine tonsilloliths on panoramic radiography were compared with the findings from CT, which was considered the gold standard. Tonsilloliths were detected in 300 (13.4 %) and 914 (40.7 %) of the 2244 individuals on panoramic radiographs and CT, respectively. On panoramic radiographs, tonsilloliths were superimposed over the ramus of the mandible at the level coincident with and inferior to the soft palate in 176 (7.8 %) and 90 (4.0 %) individuals, respectively. Tonsilloliths were also superimposed over the surrounding soft tissue inferior to the body of the mandible, postero-inferior to the angle of the mandible, and posterior to the ramus of the mandible in 33 (1.5 %), 26 (1.2 %), and 28 (1.3 %) individuals, respectively. A significant correlation was observed between the detectability on panoramic radiographs and the size (Spearman r = 1.000) and number (Spearman r = 0.991) of tonsilloliths, as revealed by CT images. The present results suggest that tonsilloliths are commonly detected on panoramic radiographs. Furthermore, they can be superimposed on both the mandible and the surrounding soft tissue. Clinicians should include tonsilloliths among the differential diagnoses when calcified bodies are detected on panoramic radiographs.


A case of tophaceous pseudogout of the temporomandibular joint extending to the base of the skull

A case of tophaceous pseudogout (i.e., calcium pyrophosphate dihydrate (CPPD) crystal deposition disease) in the temporomandibular joint (TMJ), extending to the base of the skull, is reported. A 38-year-old man was referred to the hospital with mild pain in the right chin and tip of the tongue. Panoramic radiography showed a large calcified mass around the right TMJ. Computed tomography imaging revealed a large, granular, calcified mass surrounding the right condylar head and extending to the base of the skull. The mass was clinically and radiographically suspected to be a pseudogout lesion. A biopsy specimen was collected under general anaesthesia to confirm the diagnosis. On histology, the mass was found to contain deposits of numerous rod-shaped and rhomboid crystals, which suggested tophaceous pseudogout. The deposits were identified as CPPD crystal deposition, based on analysis by X-ray diffraction and Fourier transform infrared spectroscopy. These two crystallography methods were useful in confirming the diagnosis of CPPD crystal deposition disease in the TMJ.

International Journal of Oral and Maxillofacial Surgery


口腔がん患者の歯科疾患罹患状況

口腔がん患者の歯科疾患罹患状況

日本歯科人間ドック学会誌

日本歯科人間ドック学会誌


A Retrospective Clinical Evaluation of the Survival of Dental Implants in Combination with Sinus Floor Elevation at 3 Years

上顎洞底挙上術を併用したインプラントの3年経過後の臨床的評価

The purpose of this study was to evaluate the risk factors for the loss of implants with sinus floor elevation. We statistically carried out a clinical examination on 49 cases, 80 implants at 3 years after the fitting of implant-anchored fixed prostheses.
The results are summarized as follows:
1. Two implants failed in 80 implants, indicating survival rates of 97.5%.
2. There was no statistically significant difference between implant placement timing, initial bone height, sinus membrane thickness, type, diameter, primary stability of implants and graft materials used for sinus floor elevation.
3. The length of implant affected the survival of implants used for sinus floor elevation.

Journal of Japanese Society of Oral Implantology

日本口腔インプラント学会誌


Fabrication and Physical Evaluation of Gelatin-Coated Carbonate Apatite Foam

Carbonate apatite (CO3Ap) foam has gained much attention in recent years because of its ability to rapidly replace bone. However, its mechanical strength is extremely low for clinical use. In this study, to understand the potential of gelatin-reinforced CO3Ap foam for bone replacement, CO3Ap foam was reinforced with gelatin and the resulting physical characteristics were evaluated. The mechanical strength increased significantly with the gelatin reinforcement. The compressive strength of gelatin-free CO3Ap foam was 74 kPa whereas that of the gelatin-reinforced CO3Ap foam, fabricated using 30 mass % gelatin solution, was approximately 3 MPa. Heat treatment for crosslinking gelatin had little effect on the mechanical strength of the foam. The gelatin-reinforced foam did not maintain its shape when immersed in a saline solution as this promoted swelling of the gelatin; however, in the same conditions, the heat-treated gelatin-reinforced foam proved to be stable. It is concluded, therefore, that heat treatment is the key to the fabrication of stable gelatin-reinforced CO3Ap foam.


Intraoral Ultrasonography of Tongue Mass Lesions

To demonstrate the usefulness of intraoral ultrasonography (IOUS) for tongue mass lesions, we analyzed surgery cases excluding squamous-cell carcinoma and leukoplakia and compared IOUS and pathological findings. We used the hospital information system and Radiology Information System to evaluate the IOUS and pathological findings of patients who underwent surgeries for tongue masses in the past 11 years. Surgeries for the tongues were performed in 268 cases. Imaging examinations were carried out in 52 (19.4%) cases including 42 (15.7%) cases by IOUS. The pathological results of the surgeries were as follows: 36 cases were inflammatory lesions, 74 cases were tumours, 131 cases were hyperplasia, 8 cases were cystic lesions and 19 cases were other miscellaneous lesions. On the other hand, the number of patients who received IOUS in the same period was 87, and 42 of them had surgeries. In 32 out of the 42 (76.2%) cases, pre-operative IOUS features matched with pathological results. Most of the haemangiomas and lipomas could be diagnosed by IOUS alone. IOUS of the tongue revealed the nature of the lesions including the border, size, location, depth, the presence or absence of a capsule and the internal structure including vascularity of the mass. The ultrasonographic findings well reflected the histological findings. IOUS is a simple and useful technique that provides additional information beyond inspection, clarifying the internal structure, blood flow and relationships with the adjacent tissues. In this article, we indicated 11 representative cases (fibrous polyp, haemangioma, pyogenic granuloma, lipoma, liposarcoma, chondroma, lymphangioma, schwannoma, neurofibroma, pleomorphic adenoma and amyloidosis) to show the usefulness of IOUS.


Allergic contact dermatitis caused by titanium screws and dental implants

Titanium has been considered to be a non-allergenic material. However, several studies have reported cases of metal allergy caused by titanium-containing materials. We describe a 69-year-old male for whom significant pathologic findings around dental implants had never been observed. He exhibited allergic symptoms (eczema) after orthopedic surgery. The titanium screws used in the orthopedic surgery that he underwent were removed 1 year later, but the eczema remained. After removal of dental implants, the eczema disappeared completely. Titanium is used not only for medical applications such as plastic surgery and/or dental implants, but also for paints, white pigments, photocatalysts, and various types of everyday goods. Most of the usage of titanium is in the form of titanium dioxide. This rapid expansion of titanium-containing products has increased percutaneous and permucosal exposure of titanium to the population. In general, allergic risk of titanium material is smaller than that of other metal materials. However, we suggest that pre-implant patients should be asked about a history of hypersensitivity reactions to metals, and patch testing should be recommended to patients who have experienced such reactions.


Measurement of the zygomatic bone and pilot hole technique for safer insertion of zygomaticus implants

The zygomaticus implant was developed for patients with severe bone resorption of the posterior maxilla. These may eliminate or minimize the need for bone grafting. Although the zygomaticus implant has shown a remarkable success rate in this difficult-to-treat patient population, the method requires an advanced surgical technique and carries an increased risk of complications. There have been few anatomical studies on the zygomatic bone in relation to the insertion of zygomaticus implants. The height and thickness of the zygomatic bone for the insertion were measured in this study. The thickness at the 90° angle point, where the upper margin of the zygomatic arch and the temporal margin of the frontal process of the zygomatic bone intersect and where the apex of the implant penetrates, was found to be 1.8±0.4 mm; this gradually increased inferiorly and anteriorly. Thus, the penetration point of the apex of the zygomaticus implant should be located more inferoanterior to the 90° angle point, as the thickness in this region is thinner than the diameter of the implant. Based on the results of this study, a newer and safer insertion method for the zygomaticus implant using a drill guide is proposed.


インプラントの表面性状がオッセオインテグレーション喪失に及ぼす影響:滑面(機械加工面)と粗面(陽極酸化面)インプラント体の比較

日本口腔インプラント学会誌


インプラント体の表面性状の違いが周囲骨吸収に及ぼす影響:埋入後5年経過時の同一患者の隣接するインプラント体により比較

日本口腔インプラント学会誌


Effects of low crystalline carbonate apatite on proliferation and osteoblastic differentiation of human bone marrow cells

Carbonated apatite (CO3Ap) is the inorganic component of bone. We have proposed a new method for the fabrication of CO3Ap blocks based on a dissolution-precipitation method using a synthetic precursor. The aim of this study is to examine the effects of low crystalline CO3Ap on initial cell attachment, proliferation and osteoblastic differentiation of human bone marrow cells (hBMCs) using sintered hydroxyapatite and tissue culture plates as controls. Initial cell attachment and proliferation were assessed with a MTT assay. Expression of osteoblastic markers was examined by reverse transcription-polymerase chain reaction. XRD and FT-IR results showed formation of B-type carbonate apatite with lower crystallinity. No difference was observed for initial cell attachment between HAp and CO3Ap discs. hBMSC attached more significantly on tissue culture plate than on HAp and CO3Ap discs. The number of cells on HAp was higher than that on CO3Ap until day 7, after which the number of cells was similar. hBMSC proliferated more significantly on tissue culture plate than on HAp and CO3Ap discs. In contrast, hBMCs incubated on CO3Ap demonstrated much higher expression of osteoblastic markers of differentiation, such as type I collagen, alkaline phosphatase, osteopontin and osteocalcin, than hBMCs on HAp. On the tissue culture plate, they were not any change throughout the culture period. These results demonstrated that low crystalline CO3Ap exhibit higher osteoinductivity than HAp.

Journal of Materials Science. Materials in Medicine


Neuroendocrine tumor in the mandible: a case report with imaging and histopathologic findings

Neuroendocrine tumors (NETs) arise from neuroendocrine cells and are mostly observed in the gastrointestinal tract, pancreas, and lungs. NETs in the oral and maxillofacial region are extremely rare. We report a case of a 59-year-old woman with an NET in the mandible. The patient did not show any symptoms except for remarkable swelling and bleeding. The lesion appeared as a radiolucent honeycomb abnormality with bone destruction on panoramic radiography. The histopathologic diagnosis following a biopsy was NET. Contrast-enhanced computed tomography (CT), (18)F-fluorodeoxyglucose positron emission computed tomography ((18)F-FDG PET/CT), and adrenal scintigraphy-labeled meta-iodobenylguanidine were the modalities added to identify the primary site. Multiple lesions were confirmed in the gastrointestinal tract. Endoscopy was performed to identify the lesions, and several lesions were observed protruding from the mucous membranes. However, the endoscopy specimens did not yield an accurate diagnosis because adequate samples were not acquired. Blood and urine tests revealed no functional activity caused by the tumors. Although the origin was not histopathologically confirmed with endoscopy, this patient was situationally diagnosed with nonfunctional NET originating from the duodenum, as demonstrated by the metastases in the mandible.

Oral Surgery, Oral Medicine, Oral Pathology and Oral Radiology


Involvement of miR-518c-5p to Growth and Metastasis in Oral Cancer

We have previously demonstrated that a stromal cell-derived factor-1 (SDF-1; CXCL12)/CXCR4 system is involved in the establishment of metastasis in oral cancer. Recently, small non coding RNAs, microRNAs (miRNAs) have been shown to be involved in the metastatic process of several types of cancers. However, the miRNAs that contribute to metastases induced by the SDF-1/CXCR4 system in oral cancer are largely unknown. In this study, we examined the metastasis-related miRNAs induced by the SDF-1/CXCR4 system using B88-SDF-1 oral cancer cells, which exhibit functional CXCR4 and distant metastatic potential in vivo. Through miRNA microarray analysis, we identified the upregulation of miR-518c-5p in B88-SDF-1 cells, and confirmed the induction by real-time PCR analysis. Although an LNA-based miR-518c-5p inhibitor did not affect cell growth of B88-SDF-1 cells, it did significantly inhibit the migration of the cells. Next, we transfected a miR-518c expression vector into parental B88 cells and CAL27 oral cancer cells and isolated stable transfectants, B88-518c and CAL27-518c cells, respectively. The anchorage-dependent and -independent growth of miR-518c transfectants was significantly enhanced compared with the growth of mock cells. Moreover, we detected the enhanced migration of these cells. The LNA-based miR-518c-5p inhibitor significantly impaired the enhanced cell growth and migration of miR-518c transfectants, indicating that these phenomena were mainly dependent on the expression of miR-518c-5p. Next, we examined the function of miR-518c-5p in vivo. miR-518c transfectants or mock transfectants were inoculated into the masseter muscle or the blood vessels of nude mice. Tumor volume, lymph nodes metastasis, and lung metastasis were significantly increased in the mice inoculated with the miR-518c transfectants. These results indicated that miR-518c-5p regulates the growth and metastasis of oral cancer as a downstream target of the SDF-1/CXCR4 system.


Prevalence and Imaging Characteristics of Palatine Tonsilloloths Detected by CT in 2,873 Consecutive Patients


Three-dimensional sodium chloride (NaCI) model for simulated mandibular reconstruction surgery : a new environmentally friendly material

Mandibular reconstruction using a fibular graft is a difficult procedure that requires technical expertise to enable adequate occlusal function and restore an aesthetic appearance. Here we used three-dimensional (3D) sodium chloride (NaCl) models for simulated mandibular reconstruction surgery. This study aimed to reveal the accuracy of mandibular reconstruction with fibular grafts using this model. Mandibular reconstructions using 3D NaCl models were performed in 5 cases. The maxilla, mandible, and fibular models were developed using computed tomography (CT) data. We performed preoperative cutting and simulation surgery using this model. Angles between the body of the corpus and symphysis were measured from the axial view (n = 4). Angles between the ramus and the body of the corpus were measured from the lateral and axial views (n = 6). These angles were measured on simulated models and postoperative CT images were compared. Differences between the angles measured on the simulated models and postoperative CT images were 0-5° (mean, 1.9°). We were able to reproduce the neomandibles with precise osteotomies using the 3D NaCl models. We believe that simulated mandibular reconstruction surgery using this model might help reduce the number of intraoperative neomandibular segment adjustments.

The Journal of Medical Investigation : JMI


Antitumour effect of valproic acid against salivary gland cancer in vitro and in vivo

Salivary gland cancer (SGC) has a comparatively poor prognosis and is prone to frequent recurrence and metastases. Therefore, the development of more effective chemotherapy against SGC is desirable. The aim of the present study was to investigate the antitumour effects of valproic acid (VPA) against SGC in vitro and in vivo. Two human SGC cell lines (HSY and HSG cells) were used in the present study. The effects of VPA on the proliferation of SGC cells in vitro were assessed by MTT assay. Cancer cells treated with VPA were subjected to cell cycle analysis by flow cytometry. In addition, the expression levels of p21 and p27 were examined by real-time RT-PCR to identify the mechanisms of the antitumour effect of VPA on SGC. The effects of VPA on cancer growth in vivo were evaluated in a xenograft model. VPA inhibited the proliferation of SGC cells in a dose-dependent manner in vitro. Degenerated cancer cells were observed at high concentrations of VPA. In the cell cycle analysis, VPA induced cell-growth inhibition and G1 arrest of cell cycle progression in both cancer cell lines in a time- and dose-dependent manner. VPA markedly upregulated the mRNA expression levels of both p21 and p27 in both SGC cell lines in a time-dependent manner. In the xenograft model experiment, VPA treatment markedly inhibited the growth of salivary gland tumours when compared with the growth of the untreated controls. VPA may be a valuable drug in the development of better therapeutic regimens for SGC.


顎顔面領域における骨治癒に対する低出力超音波パルス照射の使用経験

顎顔面領域における骨治癒に対する低出力超音波パルス照射の使用経験


A Clinical Study on the Usefulness of Short Implants

ショートインプラントの有用性に関する臨床的検討

The purpose of this study was to determine whether clinical success can be achieved with Brånemark system short implants (Nobel Biocare) three years after the placement of implants.
One hundred and thirteen short implants (10 mm) were installed:42 implants with smooth surfaces and 71 implants with rough surfaces. Twenty-two implants were installed in the maxilla, and 91 implants in the mandible. All implants were submerged. A chi-square test was used to evaluate the significance of implant loss of short implants with implants longer than 10 mm.
There was no significant difference in the failure rates between short implants and implants longer than 10 mm. Among smooth surface implants, the failure rate of short implants was significantly higher than that of implants longer than 10 mm, but among rough surface implants, no significant difference in the failure rates was observed between short implants and implants longer than 10 mm. These results demonstrated that short implants with rough surfaces were as useful as implants longer than 10 mm.

Journal of Japanese Society of Oral Implantology

日本口腔インプラント学会誌


The Role of Metabotropic Glutamate Receptor 5 on the Stromal Cell-Derived Factor-1/CXCR4 System in Oral Cancer

We have demonstrated that blocking CXCR4 may be a potent anti-metastatic therapy for CXCR4-related oral cancer. However, as CXCR4 antagonists are currently in clinical use to induce the mobilization of hematopoietic stem cells, continuous administration as an inhibitor for the metastasis may lead to persistent leukocytosis. In this study, we investigated the novel therapeutic downstream target(s) of the SDF-1/CXCR4 system, using B88-SDF-1 cells, which have an autocrine SDF-1/CXCR4 system and exhibit distant metastatic potential in vivo. Microarray analysis revealed that 418 genes were upregulated in B88-SDF-1 cells. We identified a gene that is highly upregulated in B88-SDF-1 cells, metabotropic glutamate receptor 5 (mGluR5), which was downregulated following treatment with 1,1' -[1,4-Phenylenebis(methylene)]bis-1,4,8,11-tetraazacyclotetradecane octahydrochloride (AMD3100), a CXCR4 antagonist. The upregulation of mGluR5 mRNA in the SDF-1/CXCR4 system was predominately regulated by the Ras-extracellular signal-regulated kinase (ERK)1/2 pathway. Additionally, the growth of B88-SDF-1 cells was not affected by the mGluR5 agonist (S)-3,5-DHPG (DHPG) or the mGluR5 antagonists 2-Methyl-6-(phenylethynyl)pyridine (MPEP) and 3-((2-Methyl-1,3-thiazol-4-yl)ethynyl)pyridine (MTEP). However, we observed that DHPG promoted B88-SDF-1 cell migration, whereas both MPEP and MTEP inhibited B88-SDF-1 cell migration. To assess drug toxicity, the antagonists were intraperitoneally injected into immunocompetent mice for 4 weeks. Mice injected with MPEP (5 mg/kg) and MTEP (5 mg/kg) did not exhibit any side effects, such as hematotoxicity, allergic reactions or weight loss. The administration of antagonists significantly inhibited the metastasis of B88-SDF-1 cells to the lungs of nude mice. These results suggest that blocking mGluR5 with antagonists such as MPEP and MTEP could prevent metastasis in CXCR4-related oral cancer without causing side effects.


Effect of soluble factors derived from oral cancer cells on the production of interferon-γ from peripheral blood mononuclear cells following stimulation with OK-432

The streptococcal antitumor agent OK-432 is commonly used as an immunopotentiator for immunotherapy in various types of malignant tumors including oral cancer. It has been demonstrated that OK-432 elicits an antitumor effect by stimulating immunocompetent cells, thereby inducing multiple cytokines including interferon (IFN)-γ, interleukin (IL)-2 and IL-12. Serum concentrations of IFN-γ in patients with oral cancer were examined 24 h after administration of OK-432. Serum concentrations of IFN-γ in patients with advanced cancer were significantly lower than those in patients with early cancer. These results suggested that some soluble factors produced by cancer cells may inhibit IFN-γ production with OK-432. Thus, in the present study, an in vitro simulation model was established for the immune status of patients with oral cancer by adding conditioned medium (CM) derived from oral cancer cell lines into a culture of peripheral blood mononuclear cells (PBMCs) derived from a healthy volunteer. We investigated whether soluble factors derived from oral cancer cells affected IFN-γ production from PBMCs following stimulation with OK-432. PBMCs stimulated with OK-432 produced a large amount of IFN-γ; however, both IFN-γ production and cytotoxic activity from PBMCs induced by OK-432 were inhibited by the addition of CM in a dose-dependent manner. In order to examine these inhibitory effects against IFN-γ production, the contribution of inhibitory cytokines such as IL-4, IL-6, IL-10, transforming growth factor-β and vascular endothelial growth factor was investigated. However, neutralization of these inhibitory cytokines did not recover IFN-γ production inhibited by CM. These results indicated that unknown molecules may inhibit IFN-γ production from PBMCs following stimulation with OK-432.


Bortezomib-enhanced radiosensitization through the suppression of radiation-induced nuclear factor B activity in human oral cancer cells.

Oral cancer cells have a significantly augmented nuclear factor-κB (NF-κB) activity and the inhibition of this activity suppresses tumor growth. Bortezomib is a proteasome inhibitor and a drug used for molecular-targeted therapy (targets NF-κB). In this study, we investigated whether bortezomib would be effective as an inhibitor of proliferation and a radiosensitizer for the treatment of oral cancer. We demonstrate that bortezomib inhibits NF-κB activity and cell proliferation. The combined treatment with bortezomib and radiation (RT) suppressed NF-κB activity and cell growth in vitro and in vivo compared with RT treatment alone. To investigate the mechanisms by which bortezomib suppresses tumor growth, the expression of signaling molecules downstream of NF-κB were examined by ELISA. The combined treatment significantly inhibited the radiation-induced production of angiogenic factors and decreased the number of blood vessels in the tumor tissues. Although the expression of anti-apoptotic proteins was upregulated by RT, bortezomib downregulated the RT-induced expression of these proteins. Moreover, the expression of cleaved poly(ADP-ribose) polymerase in vitro and in vivo was enhanced by bortezomib, indicating that bortezomib inhibits tumor growth by inducing apoptosis. This study clearly demonstrates that bortezomib significantly inhibits tumor growth and that the combined treatment with bortezomib and RT results in a significant inhibition of tumor growth. The mechanisms underlying the inhibition of tumor growth by bortezomib include the suppression of angiogenesis and the induction of apoptosis. A novel molecular targeting therapy including bortezomib may be effective in the treatment of oral cancer by suppressing NF-κB activity.


Expression and function of CXCR4 in human salivary gland cancers

Salivary gland cancers (SGCs) frequently metastasize to cervical lymph nodes and distant organs. Currently, the mechanisms responsible for the metastatic behavior of SGC cells are not fully understood. We previously demonstrated that the stromal cell-derived factor-1 (SDF-1; also known as CXCL12)/CXCR4 system is involved in the establishment of metastasis in oral squamous cell carcinoma. In the present study, we investigated the role of CXCR4 in the metastatic behavior of SGCs. We examined the expression of CXCR4 mRNA and protein in human SGC cell lines by quantitative RT-PCR and western blotting, respectively. The expression of CXCR4 mRNA and protein were frequently upregulated in 5 out of 6 SGC cell lines. Functional CXCR4 expression was demonstrated by the ability of these SGC cell lines to migrate toward an SDF-1 gradient. SDF-1 rapidly activated extracellular signal-regulated kinase (ERK)1/2 in SGC cell lines. Immunohistochemical analysis revealed that CXCR4 protein expression was detected in either the nucleus or cytoplasm of cancer cells in 16 out of 20 tissues of adenoid cystic carcinoma (ACC) and in 4 out of 6 tissues of mucoepidermoid carcinoma, which are representative of SGC. Furthermore, ACC cell lines exhibited dramatic metastasis to the lung following intravenous inoculation, whereas AMD3100, a CXCR4 antagonist, significantly inhibited lung metastasis of the cells, ameliorated body weight loss and improved the survival rate of tumor-bearing nude mice. These results indicate that CXCR4 expression contributes to the metastatic potential of SGCs.


A case of giant cell epulis accompanied by bone formation in the premolar region of the mandible

下顎小臼歯部に発生した骨形成を伴う巨細胞エプーリスの1例

Giant cell epulis (peripheral giant cell granuloma) is a granuloma consisting of a large number of multinucleated giant cells. Its incidence is high in Europe and the United States, but is very low in Japan. Giant cell epulis accompanied by bone formation is extremely rare in Japan. We report a case of giant cell epulis accompanied by bone formation. A 46-year-old woman visited our hospital because of a mass in the left mandibular molar region. There was a well-demarcated, pedunculated mass in the left mandibular molar region. The mass was excised under the clinical diagnosis of epulis. Histopathologically, the resected specimen consisted of spindle cells resembling fibroblasts and many multinucleated giant cells. Moreover, newly synthesized bone was observed in the center of the mass. The pathological diagnosis was a giant cell granuloma. Two years six months after the operation, there has been no evidence of recurrence.

Japanese Journal of Oral & Maxillofacial Surgery


Cholesteryl group- and acryloyl group-bearing pullulan nanogel to deliver BMP2 and FGF18 for bone tissue engineering.

To create a drug delivery system that allows the controlled release of proteins, such as growth factors, over a long-term period, cholesteryl group- and acryloyl group-bearing pullulan (CHPOA) nanogels were aggregated to form fast-degradable hydrogels (CHPOA/hydrogels) by cross-linking with thiol-bearing polyethylene glycol. The gold standard of clinical bone reconstruction therapy with a physiologically active material is treatment with recombinant human bone morphogenetic protein 2 (BMP2); however, this approach has limitations, such as inflammation, poor cost-efficiency, and varying interindividual susceptibility. In this study, two distinct growth factors, BMP2 and recombinant human fibroblast growth factor 18 (FGF18), were applied to a critical-size skull bone defect for bone repair by the CHPOA/hydrogel system. The CHPOA-FGF18/hydrogel displayed identical results to the control CHPOA-PBS/hydrogel, and the CHPOA-BMP2/hydrogel treatment imperfectly induced bone repair. By contrast, the CHPOA-FGF18 + BMP2/hydrogel treatment strongly enhanced and stabilized the BMP2-dependent bone repair, inducing osteoprogenitor cell infiltration inside and around the hydrogel. This report indicates that the CHPOA/hydrogel system can successfully deliver two different proteins to the bone defect to induce effective bone repair. The combination of the CHPOA/hydrogel system with the growth factors FGF18 and BMP2 might be a step towards efficient bone tissue engineering.


Preoperative evaluation of patients with squamous cell carcinoma of the oral cavity: fluorine-18 fluorodeoxyglucose positron emission tomography/computed tomography and ultrasonography versus histopathology.

PET/CT and US are complementary tools to evaluate preoperative patients.

Oral Surgery, Oral Medicine, Oral Pathology and Oral Radiology


Antitumor efficacy of sequential treatment with docetaxel and 5-fluorouracil against human oral cancer cells

Docetaxel (DOC) and 5-fluorouracil (5-FU) are important anticancer agents widely used in the treatment of a variety of cancers including oral squamous cell carcinoma (OSCC). The purpose of this study was to determine the antitumor efficacy of the sequential administration of DOC and 5-FU against OSCC cells (B88 and CAL27 cells) in vitro and in vivo. In in vitro growth inhibition assays, sequential treatment with DOC followed by 5-FU was more effective in inhibiting cancer cell growth than 5-FU followed by DOC, single treatment with DOC or 5-FU, or combined treatment with DOC and 5-FU. Furthermore, DOC followed by 5-FU significantly inhibited tumor growth in vivo compared to 5-FU followed by DOC. To understand the mechanisms underlying the enhanced growth inhibitory effect of the administration sequence, DOC followed by 5-FU, we examined the expression of 5-FU metabolic enzymes such as thymidylate synthase (TS), dihydropyrimidine dehydrogenase (DPD) and orotate phosphoribosyl transferase (OPRT), which were known to regulate the antitumor effect of 5-FU, by real-time RT-PCR and western blot analysis. Downregulation of TS and DPD expression and upregulation of OPRT expression were induced by DOC treatment, suggesting that DOC enhanced the efficacy of 5-FU by altering the expression of its metabolic enzymes. These results indicate that sequential treatment with DOC followed by 5-FU could be a promising therapeutic strategy for oral cancer.


Effects of a concurrent chemoradiotherapy with S-1 for locally advanced oral cancer

.The Oral Cancer Study Group Of Chugoku-shikoku

A number of regimens composed of concurrent chemoradiotherapy (CCRT) have been attempted as radical or adjuvant therapies for locally advanced oral cancer. CCRT with S-1 is considered promising due to its efficacy and simplicity of application. Patients (n=16) with locally advanced squamous cell carcinoma of the oral cavity were enrolled. Chemotherapy consisted of oral administration of S-1 (65 mg/m(2)) for 14 consecutive days followed by a 1-week rest. Radiation treatment at a dose of 30 Gy in 15 fractions was administered concomitantly with S-1. A course schedule of 3 weeks of treatment was applied twice. The overall response rate was 87.5%. Median progression-free survival and median overall survival were 6.3 and 42.5 months, respectively. Although no grade 4 adverse events were observed, grade 3 adverse events, such as anemia (12.5%), stomatitis (25%) and anorexia (18.8%) were present. Thus, CCRT with S-1 is an effective modality that can be safely conducted with minimal burden on patients.


[Evaluation of Combination Chemotherapy with Oral S-1 Administration Followed by Docetaxel by Superselective Intra-Arterial Infusion for Patients with Oral Squamous Cell Carcinomas.]

口腔扁平上皮癌に対するS-1を併用したDocetaxel超選択的動注化学療法の臨床効果に関する研究

The purpose of this study was to evaluate the effectiveness and adverse events of combination chemotherapy with oral S-1 administration following docetaxel(DOC)treatment by superselective intra-arterial infusion as neo-adjuvant chemotherapy (NAC)for patients with oral squamous cell carcinoma. Thirteen patients were enrolled in this study(9 men and 4 women, with a mean age of 61. 0 years). All patients were given S-1 65mg/m / 2 per day for 14 days, and DOC 40-50mg/m2 by intraarterial infusion was administered. The locoregional response evaluated 3 weeks after administration was 100%, including a 69. 2% complete response. According to Oboshi and Shimosato's classification, histological evaluation of surgical specimens revealed that 3 cases were Grade IIa, 4 cases Grade IIb, 1 case Grade IVa, and 4 cases Grade IVc. The severe side effects were neutropenia and cerebral infarction. The present study suggests that combination chemotherapy with S-1 and DOC by superselective intra-arterial infusion would be an effective and safe regimen in NAC for oral squamous cell carcinomas.

Japanese Journal of Cancer and Chemotherapy


Blockade of CXCR4 in oral squamous cell carcinoma inhibits lymph node metastases.

We have previously demonstrated that a stromal cell-derived factor-1 (SDF-1; CXCL12)/CXCR4 system is involved in the establishment of lymph node metastasis in oral squamous cell carcinoma (OSCC). In this study, we investigated whether the blockade of CXCR4 inhibits lymph node metastasis in B88 OSCC cells. These cells harbour a functional CXCR4 and have the potential to metastasise to the lymph node in vivo. Following introduction of a vector that expresses short hairpin small interfering RNA (shRNA) against CXCR4, we isolated three clones (shCXCR4-16, -17 and -21) that showed decreased expression of CXCR4 mRNA. These clones also had reduced CXCR4 protein levels and showed impairments in calcium flux and cell migration in response to SDF-1. These cells were orthotopically inoculated into the masseter muscle of nude mice. Lymph node metastases, loss in body weight and tumour volumes were significantly inhibited in mice inoculated with shCXCR4-17 cells compared to mice inoculated with control cells. SDF-1-induced migration of B88 cells was significantly inhibited in vitro by the treatment with 1,1'-[1,4-phenylenebis(methylene)]bis-1,4,8,11-tetraazacyclotetradecane octahydrochloride (AMD3100), a CXCR4 antagonist. Subcutaneous administration of AMD3100 significantly inhibited the lymph node metastases of B88 cells when they were orthotopically inoculated into the masseter muscle of nude mice. Moreover, the enhanced production of interleukin (IL)-6 and IL-8 in response to SDF-1 was inhibited by shRNA against CXCR4 or by treatment with AMD3100. These results suggest that blockade of CXCR4 may be a potent anti-metastatic therapy against lymph node metastases in cases of CXCR4-related OSCC.


Osteoporosis influences the early period of the healing after distraction osteogenesis in a rat osteoporotic model.

Despite the clinical adoption of distraction osteogenesis (DO), studies examining the bone healing process at the distraction gap in osteoporotic bone are limited. We examined the effect of osteoporosis in the ovariectomized rat on DO.

Journal of Cranio-Maxillo-Facial Surgery


切除からインプラントを維持源としたエピテーゼまで一貫治療を行った上顎洞悪性線維性組織球腫の1例


Vesnarinone downregulates CXCR4 expression via upregulation of Krüppel-like factor 2 in oral cancer cells.

BACKGROUND: We have demonstrated that the stromal cell-derived factor-1 (SDF-1; CXCL12)/CXCR4 system is involved in the establishment of lymph node metastasis in oral squamous cell carcinoma (SCC). Chemotherapy is a powerful tool for the treatment of oral cancer, including oral SCC; however, the effects of chemotherapeutic agents on the expression of CXCR4 are unknown. In this study, we examined the expression of CXCR4 associated with the chemotherapeutic agents in oral cancer cells. RESULTS: The expression of CXCR4 was examined using 3 different chemotherapeutic agents; 5-fluorouracil, cisplatin, and vesnarinone (3,4-dihydro-6-[4-(3,4-dimethoxybenzoyl)-1-piperazinyl]-2-(1H)-quinolinone) in B88, a line of oral cancer cells that exhibits high levels of CXCR4 and lymph node metastatic potential. Of the 3 chemotherapeutic agents that we examined, only vesnarinone downregulated the expression of CXCR4 at the mRNA as well as the protein level. Vesnarinone significantly inhibited lymph node metastasis in tumor-bearing nude mice. Moreover, vesnarinone markedly inhibited 2.7-kb human CXCR4 promoter activity, and we identified the transcription factor, Krüppel-like factor 2 (KLF2), as a novel vesnarinone-responsive molecule, which was bound to the CXCR4 promoter at positions -300 to -167 relative to the transcription start site. The forced-expression of KLF2 led to the downregulation of CXCR4 mRNA and impaired CXCR4 promoter activity. The use of siRNA against KLF2 led to an upregulation of CXCR4 mRNA. CONCLUSION: These Results indicate that vesnarinone downregulates CXCR4 via the upregulation of KLF2 in oral cancer.


著しい骨吸収を伴う歯性上顎洞炎の1例

著しい骨吸収を伴う歯性上顎洞炎の1例


即時荷重インプラントに関する臨床的検討:3年経過時の臨床成績 .

即時荷重インプラントに関する臨床的検討:3年経過時の臨床成績 .

Journal of Japanese Society of Oral Implantology

日本口腔インプラント学会誌


共鳴振動周波数分析装置を用いた即時荷重インプラント安定性の経時的評価

共鳴振動周波数分析装置を用いた即時荷重インプラント安定性の経時的評価

日本顎顔面インプラント学会誌

日本顎顔面インプラント学会誌


Histological evaluation of apatite cement containing atelocollagen

Tissue response to apatite cement (AC) containing atelocollagen (AC (ate)) was evaluated using conventional AC (c-AC) as a control material. At one week, the only difference between AC (ate) and c-AC was found in the soft tissue response. With c-AC, a moderate inflammatory response was exhibited: small particles of c-AC were scattered in the cutaneous tissue and many foreign body giant cells were aggregated around the scattered c-AC, whereas AC (ate) showed only a slight inflammatory response with few foreign body giant cells. In terms of bone tissue response, difference between AC (ate) and c-AC was observed at four weeks. New bone formation was observed along the cement at the edge of the pre-existing cortical bone in both c-AC and AC (ate). However, in the case of AC (ate), more abundant and thicker new bone was formed along the cement in the bone marrow when compared with c-AC.


HAP-PLGA複合体による顎骨再生への応用に関する実験的研究

HAP-PLGA複合体による顎骨再生への応用に関する実験的研究

Japanese Journal of Oral & Maxillofacial Surgery


硫酸カリウム水溶液による急速加熱型クリストバライト埋没材の鋳型放置時間の短縮 --- -クラウン適合精度, 硬化膨張, 加熱膨張に及ぼす影響-

Journal of Nippon Academy of Dental Technology


頬部に生じた孤立性神経線維腫の1例

頬部に生じた孤立性神経線維腫の1例

Neurofibroma is a benign tumor originating from Schwann cells, perineural fibroblasts, or both. It is commonly associated with neurofibromatosis (von Recklinghausen's disease), while solitary neurofibroma rarely occurs in the oral region. We report a rare case of solitary neurofibroma arising in the cheek. The patient was a 47-year-old woman who had no symptoms, except for a painless swelling in the right side of the cheek. We found neither cafe-au-lait spots nor tumors on the skin of her body. Intraoral examination revealed a solitary, mobile, welldelimited, elastic soft mass 25 mm in diameter in the cheek. CT scan revealed an enhanced tumor mass in the cheek. The tumor was surgically removed. Histopathologically, it was composed of proliferating spindle cells and collagen-like fibers. Immunohistochemical studies showed positive staining of tumor cells with S-100 protein. The histopathological diagnosis was neurofibroma. About 12 months after the operation, there is no evidence of recurrence.


Evaluation of the position, mobility, and morphology of the disc by MRI before and after four different treatments for temporomandibular joint disorders.

The purpose of this study was to evaluate changes in disc position, mobility, and morphology in patients with temporomandibular joint disorders (TMD) in response to four different treatments, splint therapy, pumping manipulation, arthrocentesis, and arthroscopic surgery, using magnetic resonance imaging (MRI). Eighty-five joints (85 patients) with unilateral internal derangement or osteoarthritis that were successfully treated were included in this study. The patients were divided into four groups as follows: splint therapy group, pumping manipulation group, arthrocentesis group, and arthroscopic surgery group. Changes in the disc position, mobility, and morphology before and after treatment were compared among the four groups using MRI. All discs showed anterior disc displacement (ADD) without reduction before treatment. Only 10% of the joints became ADD with reduction after treatment, and the other joints remained ADD without reduction in spite of treatment. Discs treated by arthroscopic surgery were located more anteriorly compared with pre-treatment. In pre-treatment MRI, the rate of stuck disc increased as the stage of the treatment advanced. In post-treatment MRI, all temporomandibular joints (TMJs) had mobile discs. The disc deformity advanced after arthrocentesis and arthroscopic surgery. Even though clinical signs and symptoms were alleviated by treatment, most discs remained ADD without reduction on MRI in spite of treatment. This suggests that the four treatments do not necessarily improve the position and deformity of the disc, and that arthroscopic surgery advances the deformity and anterior displacement of the disc. Disc mobility is important for improving clinical signs and symptoms.


Serial contrast-enhanced MRI of the dondyle and posterior disk attachment for assessing temporomandibular joint disorders


Isolation and characterization of synovial cells from the human temporomandibular joint.

The synovial tissues with temporomandibular disorders (TMDs) often show chronic inflammatory changes and the synovial cells participate in the pathogenic processes of TMDs. The synovial membrane is composed of a synovial lining layer and a connective sublining layer. The synovial lining layer is made up of two kinds of cells: macrophage-like type A and fibroblastic type B cells. The aim of this study was to isolate and characterize synovial cells from the human temporomandibular joint (TMJ).


硫酸カリウム水溶液による急速加熱型クリストバライト埋没材の鋳型放置時間の短縮 クラウン適合精度，硬化膨張，加熱膨張に及ぼす影響


下顎枝矢状分割術を施行した外科的矯正治療前後における顎関節MRI所見の変化

下顎枝矢状分割術を施行した外科的矯正治療前後における顎関節MRI所見の変化

Journal of the Japanese Society for the Temporomandibular Joint


[Evaluation of a combination chemotherapy with docetaxel and nedaplatin for patients with oral squamous cell carcinomas].

口腔扁平上皮癌に対するDocetaxelとNedaplatin併用療法の臨床的検討

The purpose of this study was to evaluate the effectiveness and safety of combination chemotherapy with docetaxel (TXT) and nedaplatin (CDGP) for patients with oral squamous cell carcinomas. Eight patients were enrolled in this study (4 men and 4 women, with a mean age of 61.7 years). TXT and CDGP were administered at a dose of 60 mg/m(2) and 70 mg/m(2) by drip infusion for 120 minutes, respectively. Three patients received one more administration 4 weeks after the first one. The locoregional response was evaluated 4 weeks after the final administration of TXT and CDGP. As a result, the locoregional response rate after 1 course was 62.5% including 25.0% of complete response (CR). The response rate after 2 courses was 100.0% with 66.7% of CR. According to Oboshi and Shimosato's classification, histological evaluation of surgical specimens revealed that four cases were Grade IIa, two cases Grade IIb, and two cases Grade IV. The severe adverse events were neutropenia and leukopenia, which were effectively managed with granulocyte colony-stimulating factor (G-CSF). No other severe side effects were recognized. The present study suggested that the combination chemotherapy with TXT and CDGP would be an effective and safe regimen in neo-adjuvant chemotherapy for oral squamous cell carcinomas.

Japanese Journal of Cancer and Chemotherapy


Comparison of Resonance Frequency Analyzer and Tooth Mobility Measurement Device for the Evaluation of Dental Implant Stability

インプラントの安定性評価における共鳴振動周波数分析装置と歯牙動揺度測定装置の比較

Journal of Japanese Society of Oral Implantology

日本口腔インプラント学会誌


Usefulness of the autologous transfusion in the orthognathic surgery

上顎骨切り術(Le Fort I型骨切り術)における貯血式自己血輸血の有用性に関する検討

Journal of Japanese Society of Autologous Blood Transfusion


顎義歯支持におけるインプラント体の配置に関する研究:ストレート型埋入モデルとアーチ型埋入モデルとの比較


高齢者の下顎に発生した顎骨中心性神経鞘腫の1例

高齢者の下顎に発生した顎骨中心性神経鞘腫の1例

Journal of The Japanese Stomatological Society


チタンメッシュトレーと腸骨骨髄海綿骨細片移植による下顎骨再建後のインプラント義歯の機能評価

日本口腔インプラント学会誌


即時荷重インプラントに関する臨床的検討: 臨床術式と1年経過時の臨床成績

即時荷重インプラントに関する臨床的検討: 臨床術式と1年経過時の臨床成績

日本口腔インプラント学会誌


硫酸カリウム水溶液による急速加熱型クリストバライト埋没材の鋳型放置時間短縮の試み

Journal of Nippon Academy of Dental Technology


新しい外鼻矯正装置付口蓋床の作製法と臨床応用

新しい外鼻矯正装置付口蓋床の作製法と臨床応用


Proliferation and Differentiation of Cultured MC3T3-E1 Osteoblasts on Surface-layer Modified Hydroxyapatite Ceramic with Acid and Heat Treatments

Effects of functionally gradient calcium phosphate consisting of hydroxyapatite (HAP) and alpha-tricalcium phosphate (alpha-TCP) on proliferation and differentiation of osteoblasts were evaluated using MC3T3-E1 cells. There were no significant differences in the proliferation of MC3T3-E1 cells among HAP-alpha-TCP functionally gradient calcium phosphate, pure HAP, and cell culture plastic wells. mRNA expressions of type I collagen, alkaline phosphate, and osteocalcine were evaluated as indexes of initial; mid-stage, and late-stage osteoblastic differentiation. Basically, HAP-alpha-TCP functionally gradient calcium phosphate and pure HAP enhanced the expressions of the three markers when compared with that of cell culture plastic wells. For type I collagen and alkaline phosphate expressions, HAP-alpha-TCP functionally gradient calcium phosphate showed the same expression level as pure HAP. For osteocalcine expression, HAP-alpha-TCP functionally gradient calcium phosphate showed a higher level than pure HAP. We concluded, therefore, HAP-alpha-TCP functionally gradient calcium phosphate has good potential to be a bone filler material with high osteoconductivity.


Strengthening of calcium phosphate cement by compounding calcium carbonate whiskers

The purpose of this study was to investigate how aragonite (calcium carbonate) whiskers influenced the strengthening and carbonating of alpha-tricalcium phosphate (alpha-TCP) based calcium phosphate cement. Aragonite whiskers of 0.95 microm width with an aspect ratio of 6.6 were prepared. The cement powder, alpha-TCP containing 0-50 mass% aragonite whisker, was mixed with 0.6 mol/L NaH2PO4 solution and incubated at 37 degrees C and 100% relative humidity. Diametral tensile strength (DTS) value increased significantly when appropriate amount of aragonaite whiskers was added. For example, DTS value of set cement containing 20 mass% aragonite whisker was 5.8 +/- 0.5 MPa, whereas DTS value of set cement containing no whiskers was 1.3 +/- 0.2 MPa after 1-week incubation. SEM observation revealed that the shape of the whiskers and the densification of the structure could have contributed to the strengthening of the set cement. Moreover, FTIR spectra implied that a bone-like carbonated apatite was precipitated in the cement. The results obtained in the present study revealed that the shape as well as any slight dissolution of aragonite whiskers could contribute to improving the properties of a-TCP based calcium phosphate cement.


上顎骨切り術(Le Fort I型骨切り術)における貯血式自己血輸血の有用性に関する検討


常温重合型粘弾性レジンを用いた小型鼻口腔瘻栓塞子

常温重合型粘弾性レジンを用いた小型鼻口腔瘻栓塞子

Journal fo Japanese Cleft Palate Association


Effect of Surface Topography on Ssseointegration Establishment of Dental Implant --- Comparison between Smooth and Rough Surfaces

インプラントの表面性状がオッセオインテグレーション獲得に及ぼす影響 --- 滑面と粗面(陽極酸化面)フィクスチャーの比較

日本口腔インプラント学会誌


Esthetic and Functional Repairment of Malunion afterMultiple Maxillofacial Bone Fracture Using Orthognathic Surgery and Bone Graft;Report of a Case

顔面多発骨折の変形治療に対し顎矯正手術および骨移植術により形態·機能を改善した1例

Japanese Society of Oral and Maxillofacial Traumatology


舌体部へのピアス迷入の1例

舌体部へのピアス迷入の1例

Body piercing is becoming more popular. Increasing popularity of tongue piercing has led to a rise in infectious complications and secondary metal allergy. We report a rare case of a deeply impacted metal barbelltype pierced ornament into the tongue.<BR>A 19-year-old man was referred to our hospital by a general practitioner bacause of discomfort of the tongue and difficulty in eating. The patient had a slight swelling of the tongue. Physical examination revealed a hard mass in the body of the tongue. Mandibular occlusal radiographs showed a radiopaque body measuring about 3×3mm in the center of the tongue. The clinical diagnosis was a foreign body in the tongue. The foreign body was removed surgically under local anesthesia. We performed element analysis of the removed foreign body. The patient's progress has been good, without functional disorders of the tongue.

Japanese Journal of Oral & Maxillofacial Surgery


Effects of various sterilization methods on the setting and mechanical properties of apatite cement

Sterilization capability is a necessary requirement for any material that is to be used in a medical application. Therefore, it is necessary for apatite cement (AC) to be sterilized. Because there is little information on the sterilization methods of AC, the aims of this investigation were to evaluate the effects of various sterilization methods, including steam, dry heat, ethylene oxide (EtO) gas, and gamma irradiation sterilizations, on the setting and mechanical properties of AC. In the case of steam sterilization, because AC powder aggregated before setting-time measurements, the setting time could not be measured. When the powder was sterilized by dry heat or EtO gas, the setting time was prolonged significantly and the wet diametral tensile strength (DTS) value decreased significantly. Therefore, sterilizations with steam, dry heat, or EtO gas were suggested to be inappropriate methods for AC. Accordingly, the following experiments focused on gamma sterilization. The setting time of AC was retarded with an increase in gamma irradiation dose. The wet DTS value decreased with the increase in gamma irradiation dose. There was no compositional change due to the gamma irradiation. The following tests were carried out in order to examine the effect of the gamma irradiation on the setting reaction of AC in detail. Tetracalcium phosphate [TTCP: Ca(4)(PO(4))(2)O] and dicalcium phosphate anhydrous (DCPA: CaHPO(4)) were separately irradiated, and the cements were produced with the use of irradiated powder and nonirradiated powder. Although the wet DTS value of AC produced from irradiated TTCP and nonirradiated DCPA decreased with increasing gamma irradiation dose, there was no significant difference. In contrast, the wet DTS value of AC produced from irradiated DCPA and nonirradiated TTCP significantly decreased with the increase in gamma irradiation dose. In conclusion, although the detailed mechanism of the delayed setting time and decreased DTS value was not clarified by the present study, it was found that gamma irradiation affected DCPA more than TTCP.

Journal of Biomedical Materials Research. Part B, Applied Biomaterials


Effects of neutral sodium hydrogen phosphate on the setting property and hemostatic ability of hydroxyapatite putty as a local hemostatic agent for bone

Hydroxyapatite (HAP) putty has been reported to have good hemostatic ability and excellent biocompatibility. Although the setting reaction of HAP putty and resulting transformation to HAP is the reason for this excellent biocompatibility, it also limits the handling period. In this study, the relationship between the setting reaction of HAP putty and its hemostatic ability was investigated, where neutral sodium hydrogen phosphate concentration and post-preparation time were used as indexes. A higher concentration of neutral sodium hydrogen phosphate was found to result in decreased hemostatic ability. The hemostatic ability of HAP putty decreased with time after its preparation; thus it was important to use HAP putty within 10 min after its preparation. The adhesive strength of HAP putty to bone increased with time. Therefore reliable hemostasis can be expected with HAP putty. Although the limited handling time is a drawback, HAP putty is thought to have a good potential as a hemostatic agent-it is highly reliable, and has a high hemostatic ability with excellent biocompatibility.


Effects of apatite cements on proliferation and differentiation of human osteoblasts in vitro

Although apatite cement (AC) and sintered hydroxyapatite (s-HAP) are known to show good osteoconductivity, it is not clear whether or not the degree of their osteoconductivity is the same. In addition, it has not been clarified whether or not it is dependent on the type of AC; conventional AC (c-AC), fast-setting AC (fs-AC) or anti-washout AC (aw-AC). The aim of this study was to investigate the effects of ACs on cultured human osteoblasts, as they may provide a useful index of osteoconductivity. Human osteoblasts were cultured on the surfaces of ACs and s-HAP, and were evaluated with respect to cell attachment, proliferation, and differentiation. We found that ACs and s-HAP showed similar cell attachment. No significant difference between ACs and s-HAP was found with respect to the proliferation of osteoblasts. In contrast, we found that the differentiation of osteoblasts was enhanced on the surface of ACs compared with that of s-HAP. However, there was no difference among the types of AC. We therefore concluded that AC may show better osteoconductivity than s-HAP, and that osteoconductivity of AC may be similar, regardless of the type of AC.


Fracture associated with hydrogen absorption of sustained tensile-loaded titanium in acid and neutral fluoride solutions

The fracture of commercial pure titanium in acid and neutral fluoride solutions has been examined by a sustained tensile-loading test and hydrogen thermal desorption analysis. It was found that the fracture of titanium occurred in neutral 2.0% NaF solution as well as in 2.0% acidulated phosphate fluoride (APF) solution. The time to fracture decreased with increasing applied stress in both 2.0% APF and 2.0% NaF solutions. In the case of the same applied stress, the time to fracture in the 2.0% APF solution was shorter than that in the 2.0% NaF solution. General corrosion was exhibited on the side surface of the tested specimens. The formation of sodium titanium fluoride was observed on the surface of the immersed specimens in the 2.0% APF solution. Hydrogen desorption of the tested specimen in the 2.0% APF solution was observed with a peak at approximately 600 degrees C. The amount of absorbed hydrogen was >300 mass ppm in the 2.0% APF solution under an applied stress for 24 h. The results of the present study imply that applying stress to titanium by immersing in fluoride solutions leads to the degradation of its mechanical properties.

Journal of Biomedical Materials Research. Part A


薬物療法を行った顎関節症患者の臨床的検討

薬物療法を行った顎関節症患者の臨床的検討

Journal of the Japanese Society for the Temporomandibular Joint