Surgical treatment of mandibular osteoradionecrosis: versatility of the scapular osteocutaneous flap.

Osteoradionecrosis of the mandible is a serious complication of radiotherapy for head and neck cancer and no single treatment has to date met with consistent success. A free scapular osteocutaneous flap was successfully transferred in nine patients with mandibular osteoradionecrosis who before this had not responded to conservative treatment. All but one of the patients had good bone union and there was no evidence of recurrence during a mean follow up period of four years and one month.

[Clinical experience of the Er: YAG laser for apicoectomy].

Recently, the Er: YAG laser has attracted attention because of its possibility of cutting hard tissue with extremely small thermal injuries. In this paper, eight cases (thirteen teeth) of apicoectomy using Er: YAG laser are reported. All procedures were performed without using air turbin or electric drill.

[Study on the positive rate of infectious diseases in in-patients at the department of oral surgery].

The positive rate of infectious diseases (syphilis, hepatitis B and C) in in-patients at the department of oral surgery was investigated for five years. Each positive rate of them was 2.4% for STS, (1.

[Survey on oral health of university students: examination on tooth conditions using panoramic X-ray films].

As an aid in instructions oral health care to university students, tooth conditions were examined using panoramic X-ray films. The materials were taken from 129 students of the University of Tokyo. The average age was 22 years 5 months.

Case reports of epulis treated by CO2 laser without anesthesia.

This study reports seven cases of epulis excised by the CO2 laser without anesthesia. The laser was used in a continuous wave mode at power setting of 2-4 W. All lesions were excised completely, and no patients felt pain during laser irradiation.

Modification of the Abbé flap for reconstruction of the vermilion tubercle and Cupid's bow in cleft lip patients.

Purpose: This article reports on the modification of the Abbé flap for correction of mild tightness of the corrected cleft lip deformity.

Patients And Methods: Twelve patients with a moderately tight lip deformity, from 16 to 35 years old, underwent this procedure. Nine had a unilateral deformity and 3 a bilateral deformity.

Use of cantilever iliac bone grafts for reconstruction of cleft lip-associated nasal deformities.

Purpose: The purpose of this study was to describe the clinical and radiographic observations on cantilever iliac bone grafts for reconstruction of cleft lip-associated nasal deformities.

Materials And Methods: Cantilever iliac bone grafts were performed on 14 patients with a severely deformed cleft lip-associated nose using the open rhinoplasty technique. An approximately 6-cm length of iliac bone was tightly inserted into a subperiosteal pocket over the nasal bones, and the nasal tip was elevated by the distal end of the graft.

Columella lengthening using a cartilage graft in the bilateral cleft lip-associated nose: choice of cartilage according to age.

Purpose: This article describes the technique of columellar lengthening using a cartilaginous strut in patients with a severely deformed bilateral cleft lip-associated nose.

Materials And Methods: When the upper lip is not deficient, and especially when resection of lip scar tissue is indicated, the Millard forked flap technique is recommended. Advancement of the prolabium into the columella for lengthening, combined with an Abbé flap for upper lip reconstruction, is indicated when a deficient upper lip is unable to provide adequate donor tissue.

Early correction of the nose in unilateral cleft lip patients using an open method: a 10-year review.

Purpose: To review a 10-year follow-up of cases with rhinoplasty for a cleft lip-associated nose deformity done during the preschool years.

Materials And Methods: Sixteen patients from 16 to 19 years of age were evaluated with two indices: the nasal index and the lobule portion of the columella index.

Results: Several years after surgery the results appeared to be reasonably satisfactory.

Correction of the cleft nasal deformity with an L-shaped iliac bone graft.

We describe our technique for correcting a cleft lip nasal deformity using L-shaped iliac bone grafts to achieve additional structural support and the desired nasal projection and profile. Augmenting the nasal bridge creates the illusion of a narrower nose. Further, the columellar portion of the L-shaped graft provides stabilization, eliminating the "see-saw" effect of the bridge graft on the fulcrum of the bony bridge, which can lead to a depressed tip and loss of the root indentation.

The histologic analysis of distraction osteogenesis of the mandible in rabbits.

The process of bone formation in mandibular lengthening by distraction was studied in 30 rabbits. The mandible was subjected to a corticotomy, held in a neutral position for 2 weeks, and then lengthened at 0.18 mm per 12 hours for 24 days using a unilateral external fixation device (Orthofix M-100).

[Clinico-statistical observation of patients referred from our hospital at the Department of Oral Surgery].

The patients referred from our hospital at the Department of Oral Surgery, University of Tokyo, during the two years from January 1990 to December 1991 were analyzed statistically. The results were as follows: 1. Our subjects were 1,152 patients (24.

[Clinico-statistical observation of emergency patients at the Department of Oral Surgery].

Emergency patients at the Department of Oral Surgery, University of Tokyo, during the three years from January 1990 to December 1992 were analyzed statistically. The results were as follows: 1. The total number of emergency patients was 209 and tended to increase with the advance in years.

[Questionnaire about dental health in new university students].

A questionnaire about dental health was given to 6846 new students in the University of Tokyo. The results were as follows: 1. 5.

Mandibular lengthening by gradual distraction: analysis using accurate skull replicas.

Bone lengthening in the upper and lower extremities by gradual distraction has become an accepted procedure. We have used an extraoral device to lengthen the mandible in four patients with unilateral mandibular hypoplasia. Using an accurate skull replica, the proposed corticotomy line, intended direction of lengthening, and appropriate position for the screws were determined.

Experience with U-shaped gluteal thigh flap for reconstruction of radionecrosis in the sacral region.

The gluteal thigh flap first reported by Hurwitz in 1980 can provide a large reliable flap for coverage of the sacrogluteal and perineal regions. This flap can be extended quite some way along its axial inferior gluteal vessels, but its width is limited to approximately 10 cm if direct approximation of the donor site defect is required. In this article, we report a U-shaped modification of the gluteal thigh flap for efficient use of the flap in covering a large defect in the sacrogluteal region.

Experimental study of prefabricated flaps using vein grafts.

Prefabrication of a flap may represent a new alternative, not limited by natural vascular territories, for creating donor sites. Experimental procedures in which an A-V shunt results in sufficient flap neovascularization have been reported. This study was undertaken to investigate how neovascularization from the recipient bed affects survival of this type of flap.

Experimental study on growth of epiphysial plate: free graft in rabbits.

The growth potential of a free graft of an epiphysial plate was investigated in rabbits. Two epiphysial plate grafts were harvested from each iliac crest. One was grafted to the head (onto bone) and the other to the ear (onto cartilage).

Prefabricated venous flaps: an experimental study in rabbits.

Prefabrication is a method for creating donor flaps by implantation of a nourishing pedicle prior to harvesting the flap. Based on the concept that implantation of a "flow-through" vein results in sufficient vascularisation to support a skin flap, we used a rabbit model to investigate the viability of prefabricated total venous perfusion (TVP) flaps. Prefabrication of an abdominal wall donor site was performed using the left epigastric vein in 25 male New Zealand white rabbits.

Upper extremity aneurysm in infants.

We report a 2-month-old female infant with a false aneurysm of the brachial artery and an 8-month-old male infant with a true aneurysm of a common digital artery. These traumatic aneurysms in the upper extremity are extremely rare in infants. In the former infant, reanastomosis of the brachial artery was performed.

Congenital alveolar adhesions.

We report an infant girl with congenital alveolar adhesions and a cleft palate. The mucosal bands were resected the day after birth. Stretching exercises of the mandible improved the range of movement at the temporomandibular joint.