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Summary.Bone resorption inhibitors,such as bisphosphonates and denosumab,are widely used to treat bone lesions caused by disorders of bone metabolism,multiple myeloma,and bone metastases from solid tumors,and the occurrence of antiresorptive agentrelated osteonecrosis of the jaw (ARONJ) is increasing.Currently,surgical treatment is recommended;however,case reports are sparse and there is no established global consensus on treatment.We report the case of a 75–year–old female patient with osteonecrosis of the mandible following bisphosphonate administration for the treatment of multiple myeloma,who was cured by conservative treatment alone.The patient had multiple myeloma and,therefore,had been receiving bisphosphonates for about 24 months prior to her first visit to Matsumoto Dental University Hospital.During periodontal treatment,the patient underwent extraction of the left mandibular wisdom tooth.About 6 months later,bone exposure was observed in the same area,and coexisting osteomyelitis of the jaw was diagnosed.Conservative treatment involving oral hygiene instructions,several doses of antibacterial agents,and frequent rinses was chosen for the bone exposure.About 6 months after the start of such treatment,the decayed bone had disappeared,and after 7 months,the mucosa had completely sealed.Disappearance of the findings of osteomyelitis was assessed by MRI.The infection tended to spread during the clinical course of the disease,but improved with conservative treatment alone,and the exposed area of bone has since epithelialized.We reaffirmed the importance of collaboration and sharing information on the medical history and medications between physicians and dentists while treating patients with primary diseases indicated for bisphosphonates.

Frailty is a cause of a nursing care status for the elderly people. Generally, elderly people get aged by various diseases such as Non–Communicable Diseases, stress, and lifestyle diseases overlap, and go through a period of frailty to necessary support, state of longterm care required stages. Therefore, efforts to stop weakness during the frailty period which can return to a healthy state, that is, to extend healthy life span is very important in future medical care.Social capital is characterized as a capital of a social organization that leads cooperative action to achieve the objectives of “social connection: network”, “norm”, “trust”, and has been reported a deep relationship with healthy life.Therefore, by examining the relationship between the health condition of the periodontal tissue, and the frailty and social capital, we focused on the influence on the healthy life from the health condition of the periodontal tissue. In other words, in this study, through the hypothesis that the health condition of periodontal tissue correlates with the frailty, and that individualsʼ social capital deteriorates due to frailty, it was aimed to elucidate whether the health condition of the periodontal tissue affects the healthy life span or not. A correlation tendency between the pre frailty state and the number of present teeth and the feeling of oral health of social capital was observed. When the pre frailty state worsened, the number of present teeth increased, and if the oral health condition at the questionnaire was bad, pre frailty state worsened. Further studies are needed to increase the number of cases in the future to determine whether oral condition due to periodontal disease is associated with frailty.

The incidence of mandibular fractures is the highest among facial bone fractures. Addi-tionally, most of mandibular fractures occur in the mandibular angle and condylar process. On the other hand, the incidence of fracture of coronoid process is extremely low. We experienced a case of mandibular fractures involving mandibular body, condylar process as well as the coronoid process in a man aged 3₉–years–old who had received strong direct external force to the mandible. Mandibular fractures usually occur in the condylar process and mandibular angle because direct external force is more likely to transmit to these re-gions. Based on the classification of mandibular fractures, the incidence of mandibularfractures involving coronoid process increases with an increased number of fractures lines that means complicated fracture. At the viewpoint of anatomical portion, direct external force dose not transmit to coronoid process; however, it is possible that direct external force may transmit coronoid process in the case of complicated fracture. In this case report, we considered the potential mechanism of fracture of coronoid process by using a three–dimensional finite element model of a human mandible stress distribution analysis.

Background Non-invasive biomarkers are required in clinical practice of glioblastoma (GBM). We have previously reported the liquid biopsy for differentiating glioblastoma, central nervous system primary lymphoma and healthy control. In this study, we analyzed the relationship between the preoperative serum expression of circulating small non-coding RNAs and the prognosis of GBM patients. Methods Preoperative blood samples of GBM, IDH-wildtype patients (N=26) were centrifuged and collected all small RNAs in serum. The expression of small non-coding RNAs were analyzed using a next-generation sequencing system. The small non-coding RNAs that could predict short-term survivals in GBM patients were selected by the stepwise analysis. A diagnostic model was created using the combination of these RNAs and evaluated with ROC curve. Results GBM patients treated with adjuvant therapy of temozolomide and radiotherapy were divided into two groups: (1) a short-term survival group (N=11) with a survival time less than 15 months and (2) a long-term survival group (N=15) with a survival time more than 15 months. In the short-term survival group, the preoperative serum expression levels of small RNA-X and small RNA-Y were high, and the expression levels of small RNA-Z and small RNA-W were low. Using these four small non-coding RNAs, a prognostic model was created. The model was able to predict the short-term survival group of GBM patients with a sensitivity of 90.9% and specificity of 93.3% (AUC: 0.969). Conclusion The prognostic model developed with preoperative small non-coding RNA in GBM patients may be useful for estimating the survival of GBM patients treated with adjuvant therapy of temozolomide and radiotherapy.

PURPOSE: To assess the mandibular cortical width (MCW) and morphology of the mandibular inferior cortex (MIC) on panoramic views from a large sample of males and females in various age groups by using an automated morphometric grading system for assisting osteoporosis screening. Furthermore, possible predictors and concrete cut-off values to identify the risk for osteoporosis were evaluated. MATERIALS AND METHODS: MCW, MIC, tooth loss (TL), and alveolar bone loss (ABL) were retrospectively evaluated in 700 panoramic images from dental patients in Hong Kong using commercially available software. To estimate possible predictors for identifying the risk of osteoporosis, age, TL, and ABL were evaluated with the receiver operating characteristic (ROC) curves for each gender separately. RESULTS: The age groups 60s (sixties), 70s and 80s showed statistically significant gender differences. For example, a smaller MCW and more MIC Class 3 were found in females. Furthermore, females exhibited a statistically significant increase in TL in the age groups 50 years and above. In males, age, TL or ABL did not correlate with MCW, whereas in females it statistically significantly did. Meanwhile, the correlation between ABL and MCW and MIC was weak for both genders. Concrete cut-off values to identify patients at risk of osteoporosis were 60.15 years and 3.5 missing teeth in females, and 72.55 years in males. CONCLUSION: Age and tooth loss were related to MCW and MIC in the population investigated. An age of ≥60 as well as more than 3.5 teeth lost seem to be indicators for a risk of osteoporosis in Chinese females based on panoramic views using artificial-intelligence-based software. ispartof: ORAL HEALTH & PREVENTIVE DENTISTRY vol:18 issue:4 pages:773-782 ispartof: location:Germany status: published

Objective: Glioblastoma (GBM) and Primary Central Nervous System Lymphoma (PCNSL) are common intracranial malignant tumors. The treatment of these tumors is quite different, accurate preoperative differentiation is the essential of clinical relevance.However, they sometimes present similar radiological[for full text, please go to the a.m. URL], 71. Jahrestagung der Deutschen Gesellschaft für Neurochirurgie (DGNC), 9. Joint Meeting mit der Japanischen Gesellschaft für Neurochirurgie

Relationships between environmental factors and fluctuations in landing of North Pacific giant octopus(Enteroctopus dofleini Wulker, 1910) at Minamikayabe town, Hakodate city, Japan, during 1985-2016 were analyzed using regression analysis. Annual landings ranged between 165 and 403 tons, with an average of 273 tons. The relationship between landings and temperature was significant in 9 of the 24 months examined; 7 of the 9 occurred in catches 3-4 years after the temperature was measured. Rainfall showed no significant relationship with catch amounts. The results of the regression analyses suggest that landings of E. dofleini were related to ocean temperature, especially to temperatures 3-4 years before the landings occurred, presumably during the early part of the life cycle of the landed octopuses.

We report a case of intramuscular lipoma of the left buccal region, along with a review of the relevant literature. Magnetic resonance imaging showed a spindle–shaped mass extending from the canine region to the anterior portion of the masseter muscle in the buccal–alveolar portion of the left mandible. The inner part was visualized as homogeneous high–signal intensity on both T1– and T2–weighted images, and a partial linear region with the same signal intensity as muscle was also observed. The removed tumor measured 35×40×15mm in size, and histopathological findings showed an intramuscular lipoma composed of adipose, muscle and connective tissues. Intramuscular lipomas account for 1.7%–2% of all lipomas, and they very rarely occur in the oral and maxillofacial region. Twenty–three cases with intramuscular lipomas in the oral and maxillofacial region, including our case, have been reported in Japan. The postoperative healing process is generally good. We followed–up our patient after explaining to him the importance of careful, long–term follow–up. It has been only 2 months, to date, since surgery but the outcome appears to be good.

Odontogenic keratocysts show a marked tendency toward proliferation or biological activity compared with jawbone cysts, being a disease highly recurrent after extirpation, which has been characterized as a cystic tumor. The WHO tissue classification of odontogenic cysts revised in 2005 states that, of previous odontogenic keratocysts, those whose epithelium histologically becomes parakeratotic are keratocystic odontogenic tumors. We encountered a keratocystic odontogenic tumor that had extensively progressed in the right maxillary sinus of a 17–year–old boy. In diagnostic imaging, an opaque image containing an impacted tooth was detected, which seemed to invade the right maxillary sinus. Then, the tumor in the right maxillary sinus was resected with a radical operation under systemic anesthesia. Histopathological tests showed that the tumor was coated with stratified squamous epithelium presenting with parakeratosis, with no inflammation found in the fibrous connective tissues under the epithelium. Consequently, a keratocystic odontogenic tumor was diagnosed. The postoperative course was favorable, with no recurrence as of 1 year and 8 months after the operation.

A case of iatrogenic sinusitis secondary to overfilling of a root canal filling material was reported. A 50–year old male was referred to our hospital with a symptom of nasal discharge. The cone–beam CT and panoramic x–ray images showed the soft–tissue density mass in right maxillary sinus and also the excess of root canal filling material from distobuccal root of right upper molar. After the administration of antibiotics and the root canal treatment, the excess material was surgically removed together with the amputation of the affected root, which resulted in the complete resolution of right maxillary sinusitis. The present case and the other related reports showed the risk of iatrogenic maxillary sinusitis even with a small fragment of overextended root canal filling materials. Dentists should be aware of this possibility for the ordinary root canal treatment.

Mandibular cortical erosion detected on dental panoramic radiographs is associated with increased risk of osteoporosis in older adults. Additionally, many reports have demonstrated an association between decreased number of teeth present and osteoporosis. However, whether mandibular cortical erosion is associated with a decreased number of teeth remains unclear. The purpose of this study, therefore, was to clarify the association between mandibular cortical erosion and number of teeth present in Japanese men and women aged 40 years and older. Among patients who visited our university hospital and underwent dental panoramic radiography for the diagnosis of dental diseases, 839 patients (293 men and 546 women) aged 40e89 years (mean [SD], 63.7 [10.6] years) participated in this study. Multiple regression analysis revealed that mildly to moderately eroded cortex (p ¼ 0.007) and severe eroded cortex (p < 0.001) were significantly associated with a decreased number of teeth present. Analysis of covariance adjusted for covariates revealed a significant association between mandibular cortical erosion category and number of teeth present (p < 0.001). Subjects with a severely eroded cortex had significantly fewer teeth present than those with a normal cortex (mean [SE], 20.7 [0.5] vs. 23.4 [0.3], p < 0.001) or mildly to moderately eroded cortex (22.2 [0.4], p ¼ 0.04). Subjects with a mildly to moderately eroded cortex had significantly fewer teeth present than those with a normal cortex (p ¼ 0.033). Our results suggest the significant association between mandibular cortical erosion and number of teeth present in Japanese men and women aged 40 years and older., 2016

The aim of this study was to develop a method for integrating morphological coordinates obtained with dental computer tomography (CT) and jaw movement coordinates acquired with a mandibular movement measuring device in order to enable multipoint analysis of anatomical condylar movements to be performed. The study subjects were two volunteers. One of the subjects displayed mandibular deviation and had a deformed condyle (on the deviated side), while the other subject exhibited normal occlusion and had healthy condyles. We placed three lead markers in front of each of the subjectsʼ ears and used them to integrate dental CT–derived morphological volume data and jaw movement data, both of which were obtained while the subjects were in the same seated position. Regarding the reproducibility of the reference point data, the positioning and orientation data obtained with the condylar movement measurement system exhibited maximum standard deviation values of 0.162 mm and 0.0₇4°, respectively, while the equivalent data acquired with the CT coordinate system displayed maximum standard deviation values of 0.068 mm and 0.00₇°, respectively. This suggested that reference point errors had little effect on our multipoint analysis of anatomical condylar movement and that the method used to transform the CT coordinates was highly precise. These results indicate that our method for integrating dental CT–derived coordinates with those acquired using a condylar movement measuring device leads to minimal errors in the positional/rotational data for the reference markers and hence, facilitates multipoint analyses of anatomical condylar movement.

Study background: Height loss and kyphosis are useful surrogate markers of osteoporotic vertebral fractures in the elderly. Loss of teeth in the elderly also is associated with osteoporosis. These imply the possibility that self-reported these indices may be associated with loss of teeth in the elderly. This study aimed to clarify the associations of self-reported height loss and kyphosis with number of teeth lost in Japanese elderly. Subjects and Methods: Among patients who visited dispensing pharmacies in Matsumoto, Japan, 307 patients (75 men and 232 women) aged 50–97 years participated in the study. They completed a structured questionnaire including covariates related to loss of teeth. Self-reported height loss and kyphosis were simply defined as three categories: no; mild-to-moderate; severe. Results: Analyses of covariance adjusted for covariates revealed that there were no significant differences in the numbers of teeth lost in total, or during the past 1 year among the three self-reported height loss categories. Significant differences were observed in the total numbers of teeth lost among the three self-reported kyphosis categories (p

Recently, the development of various antibiotics and increasing awareness of oral hygiene have reduced the incidence of serious cellulitis of the cheek, including dental infections. However, some cases invoive serious disease throughout the mediastinal area in elderly patients and those with underlying diseases. This time, we report a case of cellulitis of the cheek due to a bite to the buccal mucosa. The patient was a 10–year–old male. The patient visited hospital and complained of swelling of the left cheek. At the first examination, diffuse redness and swelling accompanied by spontaneous pain and tenderness from the left cheek to surrounding area of the left orbit as well as trismus and swollen lymph nodes in the left submaxillary were noted. A crateriform traumatic ulcer with a diameter of 2.₅ cm and induration likely due to a bite of the left buccal mucosa and accompanied by tenderness were found. CT revealed a high–density region of the buccal fat layer in the left buccal soft tissues as well as extensive and significant swelling and inflammatory reaction. The infusion of antibiotics, draining the abscess through an incision, and the drainage procedure resulted in effective healing of the cellulitis 6 days after admission. Traumatic ulcer and cellulitis may recur due to bite. In addition, for the prevention of adverse habits including teeth grinding and clenching, as well as mental factors due to mental tension and frustration, it is very important to not only undergo dental or oral surgical treatments, but also to consult a psychotherapist or psychiatrist.

We report a case of Garré osteomyelitis of the mandible involving a child. The patient was a 12–year–old girl with symptoms of swelling and pain of the left face. She presented to our hospital with asymmetrical swelling and tenderness and redness from the left cheek to the lower jaw, and tenderness of the left submandibular lymph nodes. Panoramic radiography revealed a well–demarcated radiolucent lesion that continued to the periodontal space of the second molar of the left mandible and was surrounded by a diffuse osteosclerotic area. In addition, cone beam CT images showed an onion peel–like periosteal reaction on the buccal side of the left mandible near this radiolucent lesion. A diagnosis of cellulitis of the left cheek and Garré osteomyelitis of the mandible was determined based on clinical and imaging findings. A cephem antibiotic (D.I.V.) and oral antibacterial drugs were started to improve inflammation. The symptoms promptly improved on the 4th day after the starr of treatment. It was reported that conservative therapy is appropriate treatment to repair tissues from the viewpoint of jaw development as well as the process of tooth formation in children. An early diagnosis based on specific findings like an onion peel appearance on imaging is required for effective treatment of osteomyelitis of the mandible in childhood.

Objectives The purpose of this study was to assess the association between the cortical shape of the mandible, as detected on panoramic radiographs, and trabecular bone structure, as assessed by cone-beam computed tomography (CBCT), in Japanese adults. Methods Panoramic radiographs and CBCT images of the mandibles of 50 subjects (18 men, 32 women), aged 45–86 years, were evaluated. An experienced oral and maxillofacial radiologist categorized the cortical shape of the mandible as detected on panoramic radiographs as normal, mildly to moderately eroded, and severely eroded cortices, respectively. All mandibles were scanned using CBCT. Four bone structure parameters of the basal portion of the mandible were calculated in three dimensions using an image-analysis system: total bone volume (mm3); cortical bone volume fraction (%); trabecular bone volume fraction (%); fractal dimension. One-way analysis of covariance with Bonferroni correction was employed to evaluate differences in the four bone parameters among the three cortical shape groups. Pearson’s correlation coefficient was calculated to examine correlations between age and cortical and trabecular bone volume fractions.Results Progression of cortical bone erosion was significantly associated with increased trabecular bone volume fraction (P\0.001) and increased fractal dimension(P = 0.01). Cortical bone volume fraction decreased significantly with age (P = 0.04). However, trabecular bone volume fraction tended to increase with age (P = 0.06). Conclusions The change in the trabecular bone structure of the mandible may differ from that of the general skeleton in Japanese adults., 2013

APSIPA ASC 2009: Asia-Pacific Signal and Information Processing Association, 2009 Annual Summit and Conference. 4-7 October 2009. Sapporo, Japan. Oral session: Intelligent Systems for Multimedia Signal Processing (6 October 2009)., The YCbCr. color space is suitable for image compression and adopted for JPEG and MPEG. The YCbCr color space is related with the HSI (hue, saturation, intensity) color space. The HSI color space is an ideal tool for developing image processing. In this paper, we propose a color image enhancement method, which is combined the intensity enhancement and the saturation enhancement, in the YCbCr color space. Even if the width and shape of (Cb,Cr) space is changed depending on the value of Y component, the proposed method is free from gamut problem. Furthermore, in the proposed method, the saturation enhancement degree can be altered to suit users' own preference.

Mandibular cortical erosion detected on dental panoramic radiographs (DPRs) may be useful for identifying women with osteoporosis, but little is known about the variation in diagnostic efficacy of observers worldwide. The purpose of this study was to measure the accuracy in identifying women at risk for osteoporosis in a worldwide group of observers using DPRs. We constructed a website that included background information about osteoporosis screening and instructions regarding the interpretation of mandibular cortical erosion. DPRs of 100 Japanese postmenopausal women aged 50 years or older who had completed skeletal bone mineral measurements by dual energy X-ray absorptiometry were digitized at 300 dpi. These were displayed on the website and used for the evaluation of diagnostic efficacy. Sixty observers aged 25 to 66 years recruited from 16 countries participated in this study. These observers classified cortical erosion into one of three groups (none, mild to moderate, and severe) on the website via the Internet, twice with an approximately 2-week interval. The diagnostic efficacy of the Osteoporosis Self-Assessment Tool (OST), a simple clinical decision rule based on age and weight, was also calculated and compared with that of cortical erosion. The overall mean sensitivity, specificity, positive predictive value (PPV), and negative predictive value (NPV) of the 60 observers in identifying women with osteoporosis by cortical erosion on DPRs were 82.5, 46.2, 46.7, and 84.0%, respectively. Those same values by the OST index were 82.9, 43.1, 43.9, and 82.4%, respectively. The intra-observer agreement in classifying cortical erosion on DPRs was sufficient (weighted kappa values > 0.6) in 36 (60%) observers. This was significantly increased in observers who specialized in oral radiology (P < 0.05). In the 36 observers with sufficient intra-observer agreement, the overall mean sensitivity, specificity, PPV, and NPV in identifying women with osteoporosis by any cortical erosion were 83.5, 48.7, 48.3, and 85.7%, respectively. The mean PPV and NPV were significantly higher in the 36 observers with sufficient intra-observer agreement than in the 24 observers with insufficient intra-observer agreement. Our results reconfirm the efficacy of cortical erosion findings in identifying postmenopausal women at risk for osteoporosis, among observers with sufficient intra-observer agreement. Information gathered from radiographic examination is at least as useful as that gathered from the OST index.

本論文の要旨は,平成7年11月の第15回日本口腔インプラント学会中国四国支部学術大会において発表した。本論文は,広島大学歯学部附属病院において行われた株式会社呉英製作所からの受託臨床研究における治験症例の観察結果をまとめたものである。