Publications by authors named "Kunio Yoshizawa"

52 Publications

Association between the point-rating system used for oral health and the prevalence of Gram-negative bacilli in hematological inpatients: A retrospective cohort study.

Medicine (Baltimore) 2021 Jun;100(22):e26111

Department of Oral and Maxillofacial Surgery, Division of Medicine, Interdisciplinary Graduate School, University of Yamanashi, 1110 Shimokato, Chuo, Yamanashi.

Abstract: Gram-negative bacteremia is a major cause of death among hematology inpatients who require heavy-dose chemotherapy and hematopoietic stem cell transplantation. Gram-negative bacillus (GNB) is more likely to be detected when the oral health is poor. However, there is a dearth of studies on the relationship between oral assessment and prevalence of GNB in hematology inpatients.This retrospective study aimed to evaluate the relationship between the original point-rating system for oral health examinations (point-oral exam) and the prevalence of GNB in hematology inpatients at the hematology ward of the Yamanashi University Hospital. GNB was detected by cultivating samples from the sputum and blood of each patient.A total of 129 subjects underwent a medical checkup and point-oral exam. The sputum and blood culture results of 55 patients were included in this study. The total points of patients positive for GNB (n = 25, 45.5%) were significantly higher than those who were negative for GNB (total score: median, 25th, 75th, percentile; 6 [4, 7] vs 2 [1, 4]; P = .00016). Based on the receiver operating characteristic analysis, a cutoff score of 5 proved to be most useful to detect GNB.An oral evaluation with a cutoff value of 5 or higher in the point-oral exam might indicate the need for a more thorough oral management to prevent the development of systemic infections from GNB.
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http://dx.doi.org/10.1097/MD.0000000000026111DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC8183721PMC
June 2021

Evaluation of condylar surface CT values related to condylar height reduction after orthognathic surgery.

J Craniomaxillofac Surg 2021 Jan 30. Epub 2021 Jan 30.

Department of Oral and Maxillofacial Surgery, Division of Medicine, Interdisciplinary Graduate School, University of Yamanashi, 1110 Shimokato, Chuo Yamanashi, 409-3893, Japan.

This study was performed to evaluate the relationship between condylar height reduction and changes in condylar surface computed tomography (CT) values in jaw deformity patients following orthognathic surgery. Mandibular advancement by sagittal split ramus osteotomy (SSRO) with Le Fort I osteotomy was performed in class II patients, and mandibular setback by SSRO with Le Fort I osteotomy was performed in class III patients. The maximum CT values (pixel values) at five points on the condylar surface and the condylar height, ramus height, condylar square, ramus angle, and gonial angle in the sagittal plane were measured preoperatively and 1 year postoperatively. Disc position was classified as anterior disc displacement (ADD) or other types by using magnetic resonance imaging (MRI). Ninety-two condyles of 46 female patients were prepared for this study. Their temporomandibular joints (TMJs) were divided into two groups based on class (46 joints in class II and 46 joints in class III) and two groups based on the findings (25 joints with ADD and 67 joints with other findings). ADD with and without reduction was observed in two joints in the class III group and in 23 joints in the class II group. The distribution of ADD incidence had not changed 1 year after surgery. Condylar height decreased 1 year after surgery in both class II patients (mandibular advancement) (p < 0.0001) and class III patients (mandibular setback) (p = 0.0306). Similarly, condylar height decreased 1 year after surgery both in patients who showed ADD (p = 0.0087) and those with other types (p = 0.0023). Significant postoperative increases at all angle sites on the condylar surface were found in the class II (p < 0.05) and ADD (p < 0.05) groups. This study showed that an enhanced condylar surface CT value might be one sign of condylar height reduction related to sequential condylar resorption, in combination with ADD.
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http://dx.doi.org/10.1016/j.jcms.2021.01.005DOI Listing
January 2021

Evaluation of recovery period in lower lip hypoesthesia after bilateral sagittal split osteotomy using trigeminal somatosensory evoked potential.

Oral Surg Oral Med Oral Pathol Oral Radiol 2021 Feb 13. Epub 2021 Feb 13.

Department of Oral and Maxillofacial Surgery, Division of Medicine, Graduate Faculty of Interdisciplinary Research University of Yamanashi, Chuo-shi, Yamanashi, Japan.

Background: Bilateral sagittal split osteotomy (BSSO) is one of the most frequently used treatments for jaw deformity worldwide. However, lower lip hypoesthesia is a postoperative complication of BSSO. Trigeminal somatosensory evoked potential can be used to evaluate neural pathway abnormalities by measuring latency. The purposes of this study were to measure latency before and after BSSO and to examine the relationship between latency and the duration of hypoesthesia recovery.

Study Design And Methods: This observational retrospective case-control study analyzed data recorded from 2013 to 2018. We divided the patient data into 5 groups according to recovery time. Using the latency obtained in trigeminal somatosensory evoked potential as the main outcome, we examined the relationship between hypoesthesia recovery time and latency.

Results: The group with unresolved postoperative hypoesthesia 6 months after surgery had significantly greater latency values extension than the group without postoperative hypoesthesia.

Conclusion: By measuring the degree of prolongation of latency before and after surgery, it is possible not only to indicate the presence of hypoesthesia but also to predict the hypoesthesia recovery period.
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http://dx.doi.org/10.1016/j.oooo.2021.02.007DOI Listing
February 2021

EHF suppresses cancer progression by inhibiting ETS1-mediated ZEB expression.

Oncogenesis 2021 Mar 12;10(3):26. Epub 2021 Mar 12.

Department of Biochemistry, Graduate School of Medicine, University of Yamanashi, Yamanashi, Japan.

ETS homologous factor (EHF) belongs to the epithelium-specific subfamily of the E26 transformation-specific (ETS) transcription factor family. Currently, little is known about EHF's function in cancer. We previously reported that ETS1 induces expression of the ZEB family proteins ZEB1/δEF1 and ZEB2/SIP1, which are key regulators of the epithelial-mesenchymal transition (EMT), by activating the ZEB1 promoters. We have found that EHF gene produces two transcript variants, namely a long form variant that includes exon 1 (EHF-LF) and a short form variant that excludes exon 1 (EHF-SF). Only EHF-SF abrogates ETS1-mediated activation of the ZEB1 promoter by promoting degradation of ETS1 proteins, thereby inhibiting the EMT phenotypes of cancer cells. Most importantly, we identified a novel point mutation within the conserved ETS domain of EHF, and found that EHF mutations abolish its original function while causing the EHF protein to act as a potential dominant negative, thereby enhancing metastasis in vivo. Therefore, we suggest that EHF acts as an anti-EMT factor by inhibiting the expression of ZEBs, and that EHF mutations exacerbate cancer progression.
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http://dx.doi.org/10.1038/s41389-021-00313-2DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7955083PMC
March 2021

Effect of low-intensity pulsed ultrasound on injured temporomandibular joints with or without articular disc removal in a rabbit model.

J Dent Sci 2021 Jan 4;16(1):287-295. Epub 2020 May 4.

Department of Oral and Maxillofacial Surgery, Division of Clinical Medicine, Graduate Faculty of Interdisciplinary Research, University of Yamanashi, 1110 Shimokato, Chuo, Yamanashi 409-3898, Japan.

Background/purpose: Dynamic stimulation can induce bone and cartilage growth. The purpose of this study was to examine the effect of low-intensity pulsed ultrasound (LIPUS) on injured temporomandibular joints (TMJs) in a rabbit model.

Materials And Methods: Twenty-four female Japanese white rabbits (age: 12-16 weeks, weight: 2.0-2.5 kg) were equally divided into 4 groups. In two groups, discectomy was performed with (the LD group) and without (the D group) subsequent LIPUS treatment. In the other groups, a sham operation was performed with (the LC group) and without (the C group) subsequent LIPUS treatment. Two animals in each group were sacrificed at each time point (2, 4, and 8 weeks postoperatively). Mandibular measurements were made using three-dimensional computed tomography. We performed histological and immunohistochemical examination of the articular disc, and the cartilage layer and bone at the 30- and 60-degree sites in each condyle.

Results: There were no statistically significant differences among the groups in terms of thickness of the disc or the fibrous articular zone, or the number of BMP-2 positive cells. In terms of mandibular length, there were differences among the groups after 4 (P = 0.0498) and 8 weeks (P = 0.0260). Specifically, there was a difference between the LC group and the C group after 4 weeks (P = 0.014) and 8 weeks (P = 0.029).

Conclusions: This study suggests that LIPUS has little effect on cartilage after TMJ injury. It may promote bone growth in a normal TMJ, although discectomy seems to reduce this effect.
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http://dx.doi.org/10.1016/j.jds.2020.04.002DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7770256PMC
January 2021

Change of lateral pterygoid muscle and temporomandibular disc position after bi-maxillary surgery in class II and III patients.

Oral Maxillofac Surg 2021 Mar 13;25(1):19-25. Epub 2020 Jul 13.

Department of Oral and Maxillofacial Surgery, Division of Medicine, Interdisciplinary Graduate School, University of Yamanashi, 1110, Shimokato, Chuoshi, 409-3821, Japan.

Objectives: The purpose of this study was to examine changes in lateral pterygoid muscle and temporomandibular joint (TMJ) disc position in classes II and III patients, before and after bi-maxillary surgery.

Materials And Methods: The subjects were comprised of 48 patients (96 sides), 23 of whom were diagnosed as class II and 25 as class III patients who underwent Le Fort I osteotomy and sagittal split ramus osteotomy (SSRO). The cross-sectional measurements of the lateral pterygoid muscles were measured at two levels of horizontal plane images (condyle and mandibular notch levels) by computed tomography (CT), before and 1 year after the operation. The relationship between these measurements regarding lateral pterygoid muscle and disc position by magnetic resonance image (MRI) was also examined statistically.

Results: Preoperatively, class II was significantly larger than class III in condylar angle at the upper level and in long diameter, square, condylar angle, and muscle angle at the lower level (P < 0.05). After 1 year, class II was significantly larger than class III in condylar angle, long diameter, and muscle angle at the upper level and in long diameter, short diameter, square, condylar angle, and muscle angle at the lower level (P < 0.05). TMJ disc position classification correlated significantly with condylar angle at the upper level and long diameter and condylar angle at the lower level (P < 0.0001).

Conclusion: This study suggested that there were differences in the cross-sectional measurements of the lateral pterygoid muscles between class II and class III patients, before and after bi-maxillary surgery.
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http://dx.doi.org/10.1007/s10006-020-00874-3DOI Listing
March 2021

Evaluation of border movement of the mandible before and after orthognathic surgery using a kinesiograph.

J Craniomaxillofac Surg 2020 May 2;48(5):477-482. Epub 2020 Mar 2.

Department of Oral and Maxillofacial Surgery (Head: Prof. Dr. K Ueki), Division of Medicine, Interdisciplinary Graduate School, University of Yamanashi, 1110 Shimokato, Chuo-shi, Yamanashi, 409-3898, Japan.

Purpose: The purpose of this study was to examine the changes in the mandibular border movement between class II and class III jaw deformity patients before and after orthognathic surgery, by using the same device.

Subjects: and Methods: Eighty one patients (28 in class II and 53 in class III) who underwent sagittal split ramus osteotomy (SSRO) with Le Fort I osteotomy using absorbable plate fixation and 27 controls with normal occlusion were enrolled. Mandibular border movement (observed using a kinesiograph) was recorded with a mandibular movement measure system (K7) before surgery, and at 6 months and 1 year after surgery. Time-course changes of 5 components of the mandibular border movement (MVO: Maximum vertical opening, CO to MAP: Maximum antero-posterior movement from centric occlusion, MLDL: maximum lateral deviation left, MLDR: maximum lateral deviation right, CO to MO: centric occlusion to maximum opening) were compared between classes II, III and controls statistically. The relationship between lateral cephalometric measurements and the components of mandibular border movement was also examined.

Results: There was a significant difference in CO to MAP (P = 0.0025) and CO to MO (P < 0.0001) between class II and class III in the time-course change. In class III, mean and standard deviation of MVO were 44.5 ± 6.7 mm before surgery and 39.8 ± 6.8 mm after 1 year. Mean and standard deviation of CO to MAP were 25.2 ± 6.8 mm before surgery and 21.5 ± 7.9 mm after 1 year. Mean and standard deviation of CO to MO were 53.4 ± 9.0 mm before surgery and 47.3 ± 8.4 mm after 1 year. In class II, mean and standard deviation of MVO were 38.8 ± 5.8 mm before surgery and 36.2 ± 7.4 mm after 1 year. Mean and standard deviation of CO to MAP were 18.0 ± 6.3 mm before surgery and 17.8 ± 7.4 mm after 1 year. Mean and standard deviation of CO to MO were 43.1 ± 7.5 mm before surgery and 39.6 ± 10.5 mm after 1 year. In MVO, CO to MAP and CO to MO, the values after 1 year did not significantly reach the pre-operative values in class III (P = 0.0001, P = 0.0007 and P < 0.0001), although there was no significant difference between pre-operation and after 1 year in class II. In CO to MO, class II (mean and standard deviation 39.6 ± 10.5 mm) and class III (mean and standard deviation 47.3 ± 8.4 mm) still remained smaller values than control (mean and standard deviation 52.7 ± 9.2 mm) after 1 year (P < 0.0001 and P = 0.0095).

Conclusion: This study suggests that bi-maxillary surgery can have more influence on the reduction in the range of mandibular border movement including vertical or antero-posterior motion than lateral deviation motion, in both groups. The difference in the time-course change in the mandibular border movement between the groups might depend more on the mandibular length than on the movement direction of the mandible by surgery such as advancement or setback.
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http://dx.doi.org/10.1016/j.jcms.2020.02.021DOI Listing
May 2020

Evaluation of intravenous prophylaxis antibiotics for third molar extraction under general anesthesia.

Odontology 2020 Oct 8;108(4):681-687. Epub 2020 Feb 8.

Division of Clinical Medicine, Department of Oral and Maxillofacial Surgery, Graduate Faculty of Interdisciplinary Research, University of Yamanashi, 1110 Shimokato, Chuo, Yamanashi, 409-3898, Japan.

Prophylactic antibiotic administration aims to maintain the postoperative wound environment. It is difficult to select appropriate prophylactic antibiotics to minimize the development of antibiotic resistant bacteria and the occurrence of complications. The purpose of this study was to compare the prophylactic effect of narrow spectrum antibiotics (cefazolin) with that of wide spectrum antibiotics (piperacillin) in preventing infection following third molar extraction. In addition, the effect of postoperative cefazolin administration was examined. This retrospective study included 350 patients who underwent third molar removal under general anesthesia. The patients were divided into three subgroups: preoperative cefazolin (N = 122), pre- and postoperative cefazolin (N = 101), and pre- and postoperative piperacillin (N = 127). The patients in the piperacillin group were administered the antibiotic preoperatively and postoperatively for 3 days. The patients in the preoperative cefazolin group were administered cefazolin preoperatively only. The patients in the pre- and postoperative cefazolin group were administered cefazolin preoperatively and postoperatively for 1 day. Surgical site infections (SSIs) were identified based on the Clavien-Dindo 30-day postoperative classification. There was a significant difference among the three groups of patients who had third molars classified as position C using the Pell and Gregory classification, according to the degree of impaction of the impacted third molar (P = 0.015). Our analysis showed that the number of SSI did not significantly differ between the three antibiotic treatment groups (P = 0.671). These results suggest that preoperative administration of cefazolin is as effective as postoperative administration of broad-spectrum antibiotics such as piperacillin.
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http://dx.doi.org/10.1007/s10266-020-00492-1DOI Listing
October 2020

Addiction of mesenchymal phenotypes on the FGF/FGFR axis in oral squamous cell carcinoma cells.

PLoS One 2019 4;14(11):e0217451. Epub 2019 Nov 4.

Department of Biochemistry, Interdisciplinary Graduate School of Medicine, University of Yamanashi, Chuo, Yamanashi, Japan.

The epithelial-mesenchymal transition (EMT) is a crucial morphological event that occurs during epithelial tumor progression. ZEB1/2 are EMT transcription factors that are positively correlated with EMT phenotypes and breast cancer aggressiveness. ZEB1/2 regulate the alternative splicing and hence isoform switching of fibroblast growth factor receptors (FGFRs) by repressing the epithelial splicing regulatory proteins, ESRP1 and ESRP2. Here, we show that the mesenchymal-like phenotypes of oral squamous cell carcinoma (OSCC) cells are dependent on autocrine FGF-FGFR signaling. Mesenchymal-like OSCC cells express low levels of ESRP1/2 and high levels of ZEB1/2, resulting in constitutive expression of the IIIc-isoform of FGFR, FGFR(IIIc). By contrast, epithelial-like OSCC cells showed opposite expression profiles for these proteins and constitutive expression of the IIIb-isoform of FGFR2, FGFR2(IIIb). Importantly, ERK1/2 was constitutively phosphorylated through FGFR1(IIIc), which was activated by factors secreted autonomously by mesenchymal-like OSCC cells and involved in sustained high-level expression of ZEB1. Antagonizing FGFR1 with either inhibitors or siRNAs considerably repressed ZEB1 expression and restored epithelial-like traits. Therefore, autocrine FGF-FGFR(IIIc) signaling appears to be responsible for sustaining ZEB1/2 at high levels and the EMT phenotype in OSCC cells.
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http://journals.plos.org/plosone/article?id=10.1371/journal.pone.0217451PLOS
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6827898PMC
March 2020

Stability of the chin after advancement genioplasty using absorbable plate and screws with template devices.

J Craniomaxillofac Surg 2019 Oct 29;47(10):1498-1503. Epub 2019 Jul 29.

Department of Oral and Maxillofacial Surgery, (Head: Prof. Dr. K Ueki), Division of Medicine, Interdisciplinary Graduate School, University of Yamanashi, 1110 Shimokato, Chuo-shi, Yamanashi, 409-3898, Japan.

Purpose: The purpose of this study was to compare the stability of the chin between absorbable plate and screws with a template device and titanium plate after advancement genioplasty in class II patients.

Patients And Methods: The subjects consisted of 22 Japanese class II patients who underwent genioplasty advancement in combination with bi-maxillary surgery. After genioplasty horizontal osteotomy, the template plate and screws were fixed at the central region of the chin temporarily. Then, two absorbable bi-cortical screws (uncalcined and unsintered hydroxyapatite and poly-l-lactic acid: uHA/PLLA) were used and fixed bilaterally. After removal of the template plate and screws, one absorbable plate and screws were added to fix the segment in the advancement genioplasty (n = 14). The remaining 8 patients underwent genioplasty advancement surgery with the conventional titanium plate. For all patients, lateral cephalograms were obtained pre- and immediately after surgery and at 1 year after surgery. Change in the Pogonion (Pog) and Menton (Me) points and the corresponding soft tissue points (PogS and MeS) were evaluated.

Results: Although there were no significant differences in the change from before to immediately after surgery between the absorbable and titanium groups, there were significant differences in the Pog (Y) (P = 0.0379) and PogS (Y) (P = 0.0379) from immediately after surgery to after 1 year between both groups.

Conclusion: This study shows that predicted advancement of the chin in the absorbable group could be achieved by using a template and screws, and likewise in the titanium group. However, this study suggested that vertical relapse to the inferior site or resorption at the antero-superior edge of the segment could occur in the absorbable group.
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http://dx.doi.org/10.1016/j.jcms.2019.07.027DOI Listing
October 2019

Bone healing after Le Fort I osteotomy with SSRO, using uHA/PLLA plates and screws, in class II and III patients.

J Craniomaxillofac Surg 2019 Sep 26;47(9):1338-1342. Epub 2019 Jun 26.

Department of Oral and Maxillofacial Surgery (Head: Prof. Dr K Ueki), Division of Medicine, Interdisciplinary Graduate School, University of Yamanashi, 1110 Shimokato, Chuo-shi, Yamanashi, 409-3898, Japan.

Purpose: The purpose of this study was to compare bone healing after Le Fort I osteotomy with sagittal split ramus osteotomy (SSRO) in class II and class III patients.

Patients And Methods: The subjects consisted of 46 Japanese class II and III patients. Le Fort I osteotomy was performed in combination with SSRO. They were divided into two groups (23 class II cases and 23 class III cases). Four absorbable plates (uncalcined and unsintered hydroxyapatite and poly-l-lactic acid - uHA/PLLA) and screws were used to fix the maxillary segment in all patients, in the same manner. Postoperative computed tomography (CT) was analyzed for all patients at 1 week and 1 year postoperatively. The anterior and lateral areas between the maxillary segments were measured using two-dimensional frontal and lateral views from the three-dimensional images reconstructed over a constant CT value.

Results: There were no significant differences in the area of bone defect healing between classes II and III at 1 year postoperatively, although there were significant differences between the two groups at 1 week postoperatively (p < 0.05). Furthermore, there were no significant differences in the areas of bone defect between 1 week and 1 year postoperatively, in both groups.

Conclusion: Using measurements based on CT value threshold within 1 year after Le Fort I osteotomy, this study suggests that the areas of bony defect in the region of the anterior and lateral walls of the maxilla do not always decrease in both classes II and III.
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http://dx.doi.org/10.1016/j.jcms.2019.06.006DOI Listing
September 2019

Changes in cross-sectional measurements of masseter, medial pterygoid muscles, ramus, condyle and occlusal force after bi-maxillary surgery.

J Craniomaxillofac Surg 2019 Mar 24;47(3):400-405. Epub 2018 Dec 24.

Department of Oral and Maxillofacial Surgery, (Head: Prof. Dr. K Ueki), Division of Medicine, Interdisciplinary Graduate School, University of Yamanashi, 1110 Shimokato, Chuo-shi, Yamanashi, 409-3898, Japan.

Purpose: The purpose of this study was to examine changes in masseter and medial pterygoid muscles, ramus, condyle and occlusal force after bi-maxillary surgery in class II and III patients.

Subjects And Methods: The subjects were 42 patients (84 sides) who underwent sagittal split ramus osteotomy with Le Fort I osteotomy (21 class II cases: mandibular advancement and 21 class III cases: mandibular setback). The cross-sectional measurements of the masseter and medial pterygoid muscles, ramus and condyle were measured in horizontal plane images by computed tomography (CT), before and 1 year after the operation. Occlusal force and contact area were also recorded before and 1 year after the operation.

Results: Preoperatively, class II was significantly larger than class III in masseter width (P = 0.0068), masseter area (P < 0.0001) and medial pterygoid length (P < 0.0001). However, class II was significantly smaller than class III in medial pterygoid width (P < 0.0001). After 1 year, class II was significantly smaller than class III in masseter length (P = 0.0017). Class II was still larger than class III in medial pterygoid area after 1 year (P = 0.0343). Class II was significantly larger than class III in condylar angle pre-operatively (P < 0.0001) and after 1 year (P = 0.0006). After 1 year, class II decreased significantly more than class III in condylar thickness (P = 0.0020), condylar width (P < 0.0001) and condylar area (P < 0.0001).

Conclusion: This study suggested that changes in the cross-sectional measurements of masseter and medial pterygoid muscles and the condyle differed between class II and class III patients, although occlusal force did not significantly change 1 year after surgery in both groups.
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http://dx.doi.org/10.1016/j.jcms.2018.11.036DOI Listing
March 2019

Adaptive change in temporomandibular joint tissue and mandibular morphology following surgically induced anterior disc displacement by bFGF injection in a rabbit model.

J Craniomaxillofac Surg 2019 Feb 5;47(2):320-327. Epub 2018 Dec 5.

Department of Oral and Maxillofacial Surgery (Head: Prof. Dr. K Ueki), Division of Medicine, Interdisciplinary Graduate School, University of Yamanashi, 1110 Shimokato, Chuo-shi, Yamanashi, 409-3898, Japan. Electronic address:

Purpose: The purpose of this study was to examine the effect of injecting basic fibroblast growth factor following surgical induced anterior disc displacement in temporomandibular joints (TMJ).

Materials And Methods: Adult male Japanese white rabbits (n = 16; 2.0-2.5 kg; 10 weeks old) were assigned to experimental and control groups. In the experimental group, anterior disc displacement was induced in the bilateral TMJ. Recombinant human basic fibroblast growth factor (rh bFGF) 0.1 μg/1 μL aqueous solution was injected into the left retro-discal connective tissue close to the disc (ADL group), and saline alone was injected into the same site on the right (ADR group). In the control group, a sham operation without disc position change was performed in the bilateral TMJ (CR group and CL group). Four animals from the experimental (ADR and ADL) and control (CR and CL) groups were sacrificed at 1 and 12 weeks postoperatively to evaluate the mandibular morphology and computed tomographic (CT) value of the condylar head, using 3 dimensional computed tomography. Furthermore, cartilage layers and disc tissue were examined histologically.

Results: Regarding CT value at the 0° site of the condylar surface, ADR showed the lowest value after 1 week (P = 0.0325). However, there were no significant differences among the 4 groups regarding CT values at the other degree sites after 1 and 12 weeks. Regarding mandibular length, ADR showed the lowest value after 12 weeks (P = 0.0079). In condylar width, ADR showed the lowest value after 1 week (P = 0.0097).

Conclusion: This study suggested that surgically induced anterior disc displacement could affect condylar morphology in the early stage, and could decrease mandibular length in the late stage. However, bFGF injection into the TMJ might prevent the degenerative change derived from anterior disc displacement and inhibition of sequential mandibular growth.
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http://dx.doi.org/10.1016/j.jcms.2018.11.034DOI Listing
February 2019

Evaluation of Space-Maintaining Sinus Membrane Using the Absorbable Screws in Sinus Lifting Bone Augmentation.

Implant Dent 2019 Feb;28(1):28-38

Professor, Division of Clinical Medicine, Department of Oral and Maxillofacial Surgery, Graduate Faculty of Interdisciplinary, University of Yamanashi, Yamanashi, Japan.

Purpose: We investigated whether it was possible to perform a sinus lift maintaining absorbable screw material with biological activity.

Materials And Methods: Thirty rabbits were used. The screws used in this study were unsintered hydroxyapatite/poly-L-lactic acid (uHA/PLLA) (uHA/PLLA group) and titanium alloy (Ti group). Some uHA/PLLA screws were treated with ultraviolet light (UV-uHA/PLLA group). Each group consisted of 10 rabbits, and 2 screws were implanted for 1 rabbit. The screws were implanted into the frontal bone. Rabbits were euthanized at 3 days, 1, 2, 3, and 4 weeks postoperatively and prepared for histological examination, BMP-2 cell staining, and micro-computed tomography (micro-CT) assessment.

Results: At 1, 2, and 3 weeks, the UV uHA/PLLA group had significantly more bone contact and new bone ratio on histological assessment than the other 2 groups. At 1, 2, 3, and 4 weeks, micro-CT assessment revealed significant differences between the UV uHA/PLLA group and the other 2 groups.

Conclusions: Sinus lift surgery using absorbable screw allowed bone formation. The UV-treated hydroxyapatite/poly-L-lactic acid (uHA/PLLA) was superior for sinus lift bone augmentation using a screw.
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http://dx.doi.org/10.1097/ID.0000000000000843DOI Listing
February 2019

Relationship between occlusal force and condylar morphology in class II and III after bi-maxillary osteotomy.

J Craniomaxillofac Surg 2018 Dec 22;46(12):2103-2107. Epub 2018 Oct 22.

Department of Oral and Maxillofacial Surgery (Head: Prof. Dr. K Ueki), Division of Medicine, Interdisciplinary Graduate School, University of Yamanashi, 1110 Shimokato, Chuo-shi, Yamanashi, 409-3898, Japan.

Purpose: The purpose of this study was to examine the relationship between occlusal force and condylar morphology in class II and III after sagittal split ramus osteotomy (SSRO) with Le Fort I osteotomy.

Materials And Methods: The subjects were 42 female patients who underwent bi-maxillary surgery, and were divided into 2 groups (21 class II and 21 class III cases). They were selected randomly from among patients that underwent surgery from 2012 to 2017. Condylar height, ramus height, ramus inclination and condylar square were assessed by computed tomography (CT), preoperatively and 1 year postoperatively. Occlusal contact area and occlusal force were measured pre- and 1, 3, 6 and 12 months post-operative.

Results: Condylar height and ramus height of the class II advancement cases decrease more significantly than those of class III. There were no significant differences in time-course changes of occlusal force and area between the class II and III. In the class II cases, occlusal force at 1 and 3 months was significantly lower than the preoperative value (P = 0.0009, P = 0.0002). On the other hand, in class III, occlusal force at 1, 3 and 6 months (P = 0.0038, P = 0.0031, P = 0.0283) was significantly lower than the preoperative value.

Conclusion: This study suggested that occlusal force of the class II advancement cases reached the pre-operative level earlier than that of the class III setback cases, even though condylar height decreased after surgery in the class II cases. However, a correlation between occlusal force change and condylar height reduction after surgery could not be found.
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http://dx.doi.org/10.1016/j.jcms.2018.10.010DOI Listing
December 2018

Mandibular bone healing after advancement or setback surgery using sagittal split ramus osteotomy.

J Craniomaxillofac Surg 2018 Sep 13;46(9):1500-1503. Epub 2018 Jun 13.

Department of Oral and Maxillofacial Surgery (Head: Prof. Dr. K Ueki), Division of Medicine, Interdisciplinary Graduate School, University of Yamanashi, 1110 Shimokato, Chuo-shi, Yamanashi, 409-3898, Japan.

Purpose: The purpose of this study was to compare mandibular bone healing after advancement or setback surgery using sagittal split ramus osteotomy (SSRO).

Subjects: and Methods. The subjects were 50 patients (100 sides) who underwent bi-maxillary surgery, and were divided into 2 groups (25 class II advancement cases and 25 class III setback cases). They were selected randomly from the patients who underwent surgery between 2012 and 2017. Ramus square, ramus length and ramus width were measured in the horizontal plane image of computed tomography (CT), before and immediately after the operation, and at 1 year after the operation.

Results: Ramus square in the class III cases significantly increased in 1 year after the operation (P < 0.0001), meanwhile there was no change after 1 year in the class II cases. Before the operation, there were no significant differences in the all measurements between classes II and III. However, for ramus width, class III was significantly larger than class II immediately after (P = 0.0014) and at 1 year after the operation (P = 0.0003).

Conclusion: This study suggested that post-operative change in ramus morphology was different between class II advancement surgery and class III setback surgery.
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http://dx.doi.org/10.1016/j.jcms.2018.06.010DOI Listing
September 2018

Time-course change in temporomandibular joint space after advancement and setback mandibular osteotomy with Le Fort I osteotomy.

J Craniomaxillofac Surg 2018 Apr 9;46(4):679-687. Epub 2018 Feb 9.

Department of Oral and Maxillofacial Surgery, (Head: Prof. Dr. K Ueki), Division of Medicine, Interdisciplinary Graduate School, University of Yamanashi, 1110 Shimokato, Chuo-shi, Yamanashi, 409-3898, Japan.

Purpose: The purpose of this study was to compare time-course changes in temporomandibular joint (TMJ) space between mandibular advancement surgery and setback surgery after sagittal split ramus osteotomy (SSRO) and Le Fort I osteotomy.

Subjects And Methods: The subjects were 46 patients (92 joints) who underwent bi-maxillary surgery. The TMJ disc position was assessed by magnetic resonance imaging (MRI) and the anterior, superior, posterior, medial and lateral joint spaces were assessed by computed tomography (CT), preoperatively and at 1 week and 1 year postoperative. The 92 joints were divided into 2 groups, namely class II (n = 46 joints), and class III (n = 46 joints) (an advanced group vs a setback group). Next, the 92 joints were divided into 2 groups comprising 36 joints with anterior disc displacement joint (ADD group) and 56 joints without (non-ADD group). Time-course changes in the measurements were compared statistically between the advanced and setback groups, and between the ADD and non-ADD groups.

Results: There were no significant differences between the advance group and setback group regarding time-course change in all the joint spaces. However, there were significant differences between the ADD group and non-ADD group regarding time-course change in the medial, anterior, superior and posterior joint spaces (P < 0.05).

Conclusion: This study suggested that ADD could affect the time-course change in TMJ space and condylar position after bi-maxillary osteotomy.
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http://dx.doi.org/10.1016/j.jcms.2018.02.001DOI Listing
April 2018

Comparison of temporomandibular joint and ramus morphology between class II and class III cases before and after bi-maxillary osteotomy.

J Craniomaxillofac Surg 2017 Dec 22;45(12):2002-2009. Epub 2017 Sep 22.

Department of Oral and Maxillofacial Surgery (Head: Prof. Dr. K Ueki), Division of Medicine, Interdisciplinary Graduate School, University of Yamanashi, 1110 Shimokato, Chuo-shi, Yamanashi, 409-3898, Japan. Electronic address:

Purpose: The purpose of this study was to compare changes in temporomandibular joint (TMJ) and ramus morphology between class II and III cases before and after sagittal split ramus osteotomy (SSRO) and Le Fort I osteotomy.

Materials And Methods: The subjects were 39 patients (78 sides) who underwent bi-maxillary surgery. They consisted of 2 groups (18 class II cases and 21 class III cases), and were selected randomly from among patients who underwent surgery between 2012 and 2016. The TMJ disc tissue and joint effusion were assessed by magnetic resonance imaging (MRI) and the TMJ space, condylar height, ramus height, ramus inclination and condylar square were assessed by computed tomography (CT), pre- and post-operatively.

Results: The number of joints with anterior disc displacement in class II was significantly higher than that in class III (p < 0.0001). However, there were no significant differences between the two classes regarding ratio of joint symptoms and ratio of joint effusion pre- and post-operatively. Class II was significantly better than class III regarding reduction ratio of condylar height (p < 0.0001) and square (p = 0.0005).

Conclusion: The study findings suggest that condylar morphology could change in both class II and III after bi-maxillary surgery. The findings of the numerical analysis also demonstrated that reduction of condylar volume occurred frequently in class II, although TMJ disc position classification did not change significantly, as previously reported.
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http://dx.doi.org/10.1016/j.jcms.2017.09.018DOI Listing
December 2017

Modified hybrid fixation using absorbable plate and screw for mandibular advancement surgery.

J Craniomaxillofac Surg 2017 Nov 10;45(11):1788-1793. Epub 2017 Aug 10.

Department of Oral and Maxillofacial Surgery(Head: Prof. Dr. K. Ueki), Division of Medicine, Interdisciplinary Graduate School, University of Yamanashi, 1110 Shimokato, Chuo-shi, Yamanashi, 409-3898, Japan.

Purpose: The purpose of this study was to examine the skeletal stability of mandibular advancement after sagittal split ramus osteotomy (SSRO) with modified hybrid fixation using absorbable plates and screws.

Materials And Methods: A total of 54 Japanese patients were enrolled in this study. Of them, 23 who were diagnosed with mandibular prognathism underwent setback surgery with bi-cortical plate fixation using absorbable plates and screws (setback group). Another 23 who were diagnosed with mandibular retrognathism underwent advancement surgery with modified hybrid fixation using absorbable plates (advance group), and 8 who were diagnosed with mandibular retrognathism underwent advancement surgery with titanium plates (titanium group). Skeletal stability and horizontal condylar angle were analyzed by axial, frontal, and lateral cephalograms preoperatively and at 1 month, 3 months and 1 year post-operatively. The findings were compared statistically.

Results: The advance group showed no significant difference compared with the titanium group. There were significant differences between the setback and advance groups regarding SNB, ANB, gonial angle, ramus inclination, occlusal plane, convexity and Me-Ag right in T1 naturally (P < 0.05). However, in T2, there were no significant differences between the groups for the other measurements, although there were significant differences in ANB, interincisal angle, occlusal plane and Me-Ag right (P < 0.05). In T3, a significant difference was seen only in Me-Ag right (P = 0.0145).

Conclusion: This study suggested that the use of an absorbable plate and screw was useful and reliable for mandibular advancement surgery as well as mandibular setback surgery, when the fixation method was devised successfully.
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http://dx.doi.org/10.1016/j.jcms.2017.08.006DOI Listing
November 2017

Change in lip closing force in Classes II and III malocclusion before and after sagittal split ramus osteotomy with Le Fort I osteotomy.

J Craniomaxillofac Surg 2017 Sep 8;45(9):1415-1418. Epub 2017 Jul 8.

Department of Oral and Maxillofacial Surgery, (Head: Prof. Dr. K Ueki), Division of Medicine, Interdisciplinary Graduate School, University of Yamanashi, 1110 Shimokato, Chuo-shi, Yamanashi, 409-3898, Japan.

Purpose: The purpose of this study was to examine lip closing force in Class II and III patients before and after orthognathic surgery.

Subject And Methods: The subjects were 45 patients (15 Class II women, 15 Class III men and 15 Class III women) diagnosed with jaw deformity who underwent sagittal split ramus osteotomy with Le Fort I osteotomy and 30 controls with normal skeleton and occlusion (15 men, 15 women). Maximum and minimum lip closing forces were measured using Lip De Cum before and after surgery, and compared statistically.

Results: In the Class II women, maximum and minimum lip closing forces did not change after surgery. However, maximum and minimum lip pressure increased significantly in the Class III men (P = 0.0116, P = 0.0295) and maximum lip closing force increased significantly in the Class III women (P = 0.0082). After 6 months, maximum lip closing force was significantly lower in both Classes II and III women than in the control women (P = 0.0002, P = 0.0045).

Conclusions: This study suggested that maximum postoperative lip pressure did not improve in the Class II women, although maximum lip closing force increased in the Class III men and women after sagittal split ramus osteotomy with Le Fort I osteotomy.
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http://dx.doi.org/10.1016/j.jcms.2017.06.026DOI Listing
September 2017

Bone regeneration enhancement by ultra-violet (UV) treatment for uHA/PLLA absorbable mesh.

J Craniomaxillofac Surg 2017 May 12;45(5):634-641. Epub 2017 Feb 12.

Department of Oral & Maxillofacial Surgery (Chief Professor: Koichiro Ueki), Division of Medicine, Interdisciplinary Graduate School of Medicine and Engineering, University of Yamanashi, 1110 Shimokato, Chuo, Yamanashi, Japan.

Purpose: The purpose of this study was to evaluate the effect of bone regeneration enhancement by ultra-violet (UV) treatment of an unsintered hydroxyapatite (u-HA)/poly-l-lactic acid (PLLA) mesh in rabbitnasal bone.

Materials And Methods: Thirty adult male Japanese white rabbits (12-16 weeks, 2.5-3.0 kg) were used in this study. After incising along the nasal bone, 6 × 6 × depth 1 mm two bone defects were made on both sides. In the UV group (n = 30), the defects were covered with uHA/PLLA mesh, treated by UV (wavelength 172 nm, tube wall illumination 13 mW/cm, period 8 min, intensity 6.26 J/cm) and screwed. In the control group (n = 30), untreated uHA/PLLA was applied in a similar manner. The rabbits were sacrificed at 1, 2, 3, 4 and 6 weeks postoperatively, and formalin-fixed specimens were frozen. The specimens were stained with haematoxylin and eosin. For immunohistochemical analysis, the specimens were treated with anti-alkaline phosphatase (ALP). Finally, bone ratio and ALP expression were evaluated microscopically.

Results: The UV group had a significantly higher number of ALP stained cells than the control group after 1, 2, and 3 weeks (P < 0.05). The bone ratio was also significantly higher in the UV group than in the control group after 1, 2, 3, and 4 weeks (P < 0.05).

Conclusion: This study suggests that bone regeneration can be enhanced by UV treatment using an uHA/PLLA mesh.
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http://dx.doi.org/10.1016/j.jcms.2017.02.001DOI Listing
May 2017

Condylar surface CT value in sagittal plane before and after sagittal split ramus osteotomy.

Oral Maxillofac Surg 2017 Jun 28;21(2):159-169. Epub 2017 Feb 28.

Department of Oral and Maxillofacial Surgery, Division of Medicine, Interdisciplinary Graduate School, University of Yamanashi, 1110 Shimokato Chuo, Yamanashi, 409-3893, Japan.

Purpose: The purpose of this study was to evaluate the relationship between computed tomography (CT) values of the condylar surface and temporomandibular joint (TMJ) disc position in the sagittal plane before and after sagittal split ramus osteotomy (SSRO) setback surgery, retrospectively.

Materials And Methods: The subjects were 75 patients (150 condyles) who underwent bilateral SSRO setback surgery. They were divided into two groups (42 symmetric patients and 33 asymmetric patients). Maximum CT values (pixel values) of five points of the condylar surface and condylar height, length, fossa height, fossa length, and ramus angle in the sagittal plane were measured preoperatively and 1 year postoperatively. Disc position was classified as anterior disc displacement, anterior type, fully covered type, and posterior type, both pre- and postoperatively, using magnetic resonance imaging (MRI).

Results: Postoperative value was significantly higher than preoperative one in CT value of 135° (P = 0.0199) and 180° (0.0363), in the non-deviation side in the asymmetry group. The anterior disc displacement group was significantly larger than those of some other areas pre- and postoperatively in the CT value of 0° point (P < 0.05).

Conclusions: This study suggested that CT value of the posterior site of the condylar surface could change in the non-deviation side in the asymmetry group after 1 year SSRO, and the condyle with anterior displacement showed high CT value at the anterior site of the condyle before and after surgery.
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http://dx.doi.org/10.1007/s10006-017-0612-7DOI Listing
June 2017

Evaluation of maxillary sinus after Le Fort I osteotomy using various fixation materials.

J Craniomaxillofac Surg 2017 Apr 31;45(4):552-557. Epub 2017 Jan 31.

Department of Oral and Maxillofacial Surgery (Head: Prof. Dr. K. Ueki), Division of Medicine, Interdisciplinary Graduate School, University of Yamanashi, 1110 Shimokato, Chuo-shi, Yamanashi, 409-3898, Japan.

Purpose: The purpose of this study was to evaluate maxillary sinus and predict the factors affecting the postoperative sinus condition after Le Fort I osteotomy using various fixation materials.

Materials And Methods: The study subjects consisted of 71 patients (21 male and 50 female, 142 sides) who underwent Le Fort I osteotomy with sagittal split ramus osteotomy. The maxillary sinus bony area and the inside air area were measured in the coronal plane across the mesial aspect of the first molar perpendicular to the Frankfurt horizontal plane of a computed tomography (CT) image preoperatively and at 1 week and 1 year after surgery. The rate of intact sinus area (the inside air area/the maxillary sinus bony area) was calculated. Subjects were divided into groups according to gender, preoperative diagnosis (Angle class II and III with and without asymmetry), plate fixation material (PLLA and uHA/PLLA), and use or non-use of bone alternative material (α-tricalcium phosphate). Statistic comparisons between groups were performed in each division. Furthermore, age, operation time, amount of blood loss, and direction and amount of movement were examined as the continuous variables to statistically predict the rate of intact sinus area after 1 week and 1 year.

Results: The rate of intact sinus area after 1 week was significantly correlated with age, amount of anterio-posterior movement, and preoperative rate of the intact sinus area (p < 0.0001). Rate of intact sinus area after 1 year was significantly low in the group that used the bone alternative material compared to the group that did not (p < 0.0282).

Conclusion: The study suggests that the bone alternative material might be a cause of inflammation in the sinus after 1 year. Moreover, attention needs to be paid to older age, backward movement of the maxillary segment, and preoperative sinusitis including hypertrophy of sinus membrane in Le Fort I osteotomy.
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http://dx.doi.org/10.1016/j.jcms.2017.01.027DOI Listing
April 2017

Effect on surface character and mechanical property of unsintered hydroxyapatite/poly-l-lactic acid (uHA/PLLA) material by UV treatment.

J Biomed Mater Res B Appl Biomater 2018 Jan 26;106(1):191-200. Epub 2016 Dec 26.

Department of Oral and Maxillofacial Surgery, Division of Clinical Medicine, Graduate Faculty of Interdisciplinary Research, University of Yamanashi, 1110 Shimokato, Chuo, Yamanashi, Japan.

Materials fabricated with unsintered hydroxyapatite/poly-l-lactic acid (uHA/PLLA) exhibit biological activity and biocompatibility, but are also hydrophobic. This hydrophobicity limits the ability of cells or tissues to adhere to the surface of the material and thereby prevents the materials from exhibiting effective biological activity. In this study, we examined the effects of ultraviolet (UV) treatment on the hydrophobicity of uHA/PLLA. We compared the contact angle, mechanical strength, cell attachment, and cell differentiation capacity between untreated uHA/PLLA and uHA/PLLA treated with UV light. The contact angle of UV-treated uHA/PLLA was significantly reduced compared with that of untreated uHA/PLLA. However, there were no differences in mechanical strength between untreated uHA/PLLA and UV-treated uHA/PLLA. Notably, the ability of cells to adhere to UV-treated uHA/PLLA was significantly increased compared with that of untreated uHA/PLLA. Similarly, there were significant differences between UV-treated uHA/PLLA and untreated uHA/PLLA in alkaline phosphatase assays. These findings demonstrated that UV irradiation of uHA/PLLA improved the surface hydrophilicity without changing the mechanical strength of the material; thus, UV treatment of uHA/PLLA may facilitate the use of this material in biomedical applications. © 2016 Wiley Periodicals, Inc. J Biomed Mater Res Part B: Appl Biomater, 106B: 191-200, 2018.
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http://dx.doi.org/10.1002/jbm.b.33833DOI Listing
January 2018

Comparison of skeletal stability after sagittal split ramus osteotomy among mono-cortical plate fixation, bi-cortical plate fixation, and hybrid fixation using absorbable plates and screws.

J Craniomaxillofac Surg 2017 Feb 19;45(2):178-182. Epub 2016 Nov 19.

Department of Oral and Maxillofacial Surgery (Head: Prof. Dr. K Ueki), Division of Medicine, Interdisciplinary Graduate School, University of Yamanashi, 1110 Shimokato, Chuo-shi, Yamanashi, 409-3898, Japan.

Purpose: The purpose of this study was to examine skeletal stability and plate breakage after sagittal split ramus osteotomy (SSRO) with the mono-cortical plate fixation, bi-cortical plate fixation, and hybrid fixation techniques using absorbable plates and screws.

Materials And Methods: A total of 76 Japanese patients diagnosed with mandibular prognathism with and without maxillary deformity were divided into 3 groups randomly. A total of 28 patients underwent SSRO with mono-cortical plate fixation, 23 underwent SSRO with bi-cortical plate fixation, and 25 underwent SSRO with hybrid fixation. Skeletal stability and horizontal condylar angle were analyzed by axial, frontal, and lateral cephalograms from before the operation to 1 year postoperatively. Breakage of the plate and screws was observed by 3-dimensional computed tomography (3DCT) immediately after surgery and after 1 year.

Results: Although there was a significant difference between the mono-cortical plate fixation group and hybrid fixation group regarding right MeAg in T1 (P = 0.0488) and occlusal plane in T1 (P = 0.0346), there were no significant differences between the groups for the other measurements in each time interval. In 2 cases, namely, 6 sides in the mono-cortical plate fixation group, breakage of the absorbable plate was found by 3DCT. However, there was no breakage in the bi-cortical plate fixation group and hybrid fixation group.

Conclusion: This study results suggested that there were no significant differences in the postoperative skeletal stability among the 3 groups, and bi-cortical fixation as well as hybrid fixation was a reliable and useful method to prevent plate breakage even if an absorbable material was used.
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http://dx.doi.org/10.1016/j.jcms.2016.11.007DOI Listing
February 2017

Comparison between various densities of pore titanium meshes and e-polytetrafluoroethylene (ePTFE) membrane regarding bone regeneration induced by low intensity pulsed ultrasound (LIPUS) in rabbit nasal bone.

J Craniomaxillofac Surg 2016 Sep 2;44(9):1152-61. Epub 2016 Jul 2.

Department of Oral and Maxillofacial Surgery (Head: Prof. Dr. K. Ueki), Division of Medicine, Interdisciplinary Graduate School of Medicine, University of Yamanashi, 1110 Shimokato, Chuo-shi, Yamanashi, 409-3898, Japan. Electronic address:

Purpose: The purpose of this study was to compare bone regenerative capability following use of polytetrafluoroethylene (ePTFE) membrane against that when various densities of pore titanium meshes are used with and without low intensity pulsed ultrasound (LIPUS).

Materials And Methods: Adult male white rabbits were divided into 8 groups. In 4 groups, after incising along the nasal bone, four 3 × 8 mm bone defects were made in both sides and covered by an ePTFE membrane (group E: n = 15), a high density pore titanium mesh (group H: n = 15), a low density pore titanium mesh (group L: n = 15), and no mesh (control) (group C: n = 15). Furthermore, LIPUS was irradiated after surgery in 4 groups (groups EL, HL, LL and CL, in each n = 15). The rabbits were sacrificed at 1, 2 and 8 weeks postoperative, and formalin-fixed specimens were embedded in acrylic resin. The specimens were stained with hematoxylin and eosin. For immunohistochemical analysis, the specimens were treated with bone morphogenetic protein (BMP)-2 antibody.

Results: Group H had significantly higher values than groups L, E, and C regarding bone area ratio and labeling index of BMP-2 positive cells (P < 0.05). Furthermore, Group HL also had significantly higher values than the other groups regarding bone area ratio and labeling index of BMP-2 positive cells at 1, 2 and 8 weeks postoperative (P < 0.05).

Conclusion: The results suggested that high density pore titanium mesh could induce new bone regeneration more than low density pore titanium mesh and ePTFE membrane. New bone formation may increase following LIPUS application.
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http://dx.doi.org/10.1016/j.jcms.2016.06.029DOI Listing
September 2016

Assessment of nasal septum after Le Fort I osteotomy with computer tomography.

J Craniomaxillofac Surg 2016 Sep 8;44(9):1187-93. Epub 2016 Jun 8.

Department of Oral & Maxillofacial Surgery (Chief: Prof. Koichiro Ueki, DDS, PhD), Division of Clinical Medicine, Graduate Faculty of Interdisciplinary Research, University of Yamanashi, 1110 Shimokato, Chuo, Yamanashi, 409-3898, Japan.

The purpose of this study was to evaluate the effects of Le Fort I osteotomy on nasal septum deviation and differences in left and right airway sizes, and to determine whether the nasal septum was affected by differences in the direction of movement. Forty patients underwent conventional Le Fort I osteotomy, and computed tomography (CT) was performed preoperatively, and 1 week and 1 year postoperatively. The nasal septum angle and airway area were measured at the anterior, middle, and posterior positions on the CT images Patients were divided into 2 groups depending on each difference in movement (impaction ≥5 mm or other; anterior movement or other; and impaction asymmetry or other). There were no significant differences in the nasal septum angle and the airway of all patients. Among the patient groups, there were no significant differences in the nasal septum angle and airway. We concluded that conventional LI osteotomy did not influence the nasal septum deviation or the left and right airway asymmetry. Differences in the method of moving the maxilla have not been shown to affect changes in the nasal septum.
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http://dx.doi.org/10.1016/j.jcms.2016.05.024DOI Listing
September 2016

A Case of Sublingual Ranula That Responded Successfully to Localized Injection Treatment with OK-432 after Healing from Drug Induced Hypersensitivity Syndrome.

Case Rep Dent 2016 6;2016:6939568. Epub 2016 Apr 6.

Department of Oral and Maxillofacial Surgery, Division of Medicine, Interdisciplinary Graduate School of Medical and Engineering, University of Yamanashi, 1110 Shimokato, Chuo, Yamanashi 409-3898, Japan.

A ranula is a mucus retention cyst or pseudocyst caused by leakage of mucus from the sublingual gland and generally occurs in the oral floor. In addition, drug induced hypersensitivity syndrome (DIHS) is a rare but well-recognized serious adverse effect characterized by fever, skin rashes, generalized lymphadenopathy, hepatitis, and hepatosplenomegaly and oral stomatitis. This paper presents the first case of successfully treated sublingual ranula with localized injection of OK-432 after healing from drug induced hypersensitivity syndrome, which has previously been unreported in the literature. We present the case of a 38-year-old Japanese woman with sublingual ranula that responded successfully to localized injection treatment with OK-432 after healing from drug induced hypersensitivity syndrome. She was affected with cutaneous myositis and interstitial lung disease when she was 26 years old. At the age 34 years, she received additional oral treatment of diaminodiphenyl-sulfone due to deterioration of the cutaneous myositis, which resulted in drug induced hypersensitivity syndrome (DIHS) with severe oral stomatitis. Local injection of OK-432 to the ranula may be a very safe and useful treatment method even if the patient has a history of drug allergy and has connective tissue disease such as cutaneous myositis.
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http://dx.doi.org/10.1155/2016/6939568DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC4837263PMC
May 2016

Loss of epidermal growth factor receptor expression in oral squamous cell carcinoma is associated with invasiveness and epithelial-mesenchymal transition.

Oncol Lett 2016 Jan 27;11(1):201-207. Epub 2015 Oct 27.

Department of Oral and Maxillofacial Surgery, Division of Cancer Medicine, Kanazawa University Graduate School of Medical Science, Kanazawa, Ishikawa 920-8640, Japan.

Inhibition of epidermal growth factor receptor (EGFR) signaling has emerged as a novel therapeutic strategy for the treatment of oral squamous cell carcinoma (OSCC). The EGFR-directed inhibitor cetuximab is currently the only approved targeted therapy for the treatment of OSCC. EGFR status may affect the patient response to cetuximab treatment. In the present study, via analysis of the immunomarker for EGFR, it was revealed that 58.3% of the total cases investigated stained positively for EGFR expression, and furthermore, that invasiveness was inversely correlated with EGFR expression. Expression levels of EGFR were quantified, and the correlation between EGFR expression and cetuximab sensitivity was investigated using three varying grades of invasive human OSCC line. EGFR expression in high-grade invasive cells was significantly downregulated compared with that of low-grade invasive cells. There was no significant antiproliferative effect in the high-grade invasive cells treated with various concentrations of cetuximab. The EMT-associated genes, N-cadherin, vimentin and Snail, were upregulated in the high-grade invasive cells. The low-grade invasive cells exhibited characteristics of typical epithelial cells, including the expression of E-cadherin and absence of the expression of N-cadherin, vimentin and Snail. Transforming growth factor-β induced low-grade invasive cells to undergo an epithelial-mesenchymal transition (EMT)-associated gene switch, which resulted in low levels of EGFR expression. The results of the present study suggested that loss of EGFR expression in OSCC was associated with EMT, and may have functional implications with regard to tumor invasiveness and the resistance to cetuximab treatment.
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http://dx.doi.org/10.3892/ol.2015.3833DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC4727181PMC
January 2016

Change in mandibular body height at the site of a fixation plate in the advance (lengthening) and setback (shortening) sides after sagittal split ramus osteotomy.

J Craniomaxillofac Surg 2016 Mar 17;44(3):279-84. Epub 2015 Dec 17.

Department of Oral and Maxillofacial Surgery, Division of Medicine, Interdisciplinary Graduate School of Medicine, University of Yamanashi, 1110 Shimokato, Chuo, Yamanashi 409-3893, Japan.

Purpose: The purpose of this study was to evaluate changes in mandibular body height at the site of a fixation plate in the advance (lengthening) and setback (shortening) sides after sagittal split ramus osteotomy (SSRO).

Subjects And Methods: The subjects were 49 patients (98 sides) who underwent bilateral SSRO surgery. The subjects were divided into 4 groups as follows, setback (shortening) sides in mandibular prognathism (Prog S group; n = 42), advancement (lengthening) sides in mandibular retrognathism (Retro L group; n = 24), setback (shortening) sides in mandibular asymmetry (Asym S group; n = 16) and advancement (lengthening) sides in mandibular asymmetry (Asym L group; n = 16). Postoperative computed tomography (CT) was analyzed for all patients pre-operatively, and at 1 week and 1 year postoperative. Mandibular body height at the site of the fixation plate, mandibular upper height above the plate and mandibular lower height under the plate were measured by 3-dimensional (3D) CT.

Results: There were no significant differences in mandibular height between the lengthening and shortening sides in mandibular prognathism, retrognathism and asymmetry in the time-course change. Upper mandibular height at the mid-point of the fixation plate after 1 year was significantly smaller than that after 1 week in all sides (P < 0.05).

Conclusion: This study suggested that slight bone resorption could occur at the upper site of a fixation plate after set back and advancement SSRO.
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http://dx.doi.org/10.1016/j.jcms.2015.11.019DOI Listing
March 2016