Oral and Maxillofacial Surgery

1. Clinicopathological Study of Oral Cancers
2. Treatment for Advanced Oral Cancers
3. Reconstruction after Mandiblectomy
4. Treatment for Facial Bone Fractures

Key words:

local recurrence of oral cancer, regional lymph node metastasis, treatment for advanced cancer, mandibular reconstruction using BMP and PLLA plate, Treatment of facial bone fractures, miniplate, Herbert screw, condylar fracture

1. Clinicopathological Study of Oral Cancers

   To prevent local recurrence after primary tumor excision, it should be histologically confirmed that tumor cells are not persistent on the surgical margins. We reported a practical and rational method for examination of the surgical margins (modified MOHS method). However, discontinued skip lesions beyond surgical margins are able to form a recurrent tumor. A three-dimensional image reconstruction of serial sections, which were made from surgical specimens, disclosed the existence of skip lesions, and they were often found in a tumor showing a diffused, widespread invasion of small tumor nests and /or in a DNA aneuploid tumor. This result suggests that additional postoperative therapy seems to be necessary to prevent local recurrence in such a case.
   Early detection of lymph nodes metastasis improves prognosis of a patient. A fine needle aspiration cytology of cervical lymph nodes combined with an image analysis, were useful to diagnose early positive lymph nodes. Furthermore, ways to know the probability of occult metastasis were studied, and a higher S phase fraction value of tumor cell nuclei and an increase of tumor vascularization had a significant relationship to lymph node metastasis.

2. Treatment for Advanced Oral Cancers

   In locoregionally advanced carcinoma of the oral cavity, a tumor excision usually leaves functional disturbances, even if reconstruction of the excised tissues is performed. In our department, patients with advanced cancers are treated with chemotherapy, in which an antitumor drug can be delivered with high concentration into a tumor, in combination with radiotherapy. This method has a good antitumor effect and relatively minimal toxicity. Our experience suggests that this treatment method can maintain QOL of patients.

3. Reconstruction after Mandiblectomy

   We are trying to reconstruct the defect of the mandible in dogs using recombinant human bone morphogenetic protein-2 and an absorbable PLLA plate. This reconstruction method could make bone transplantation and use of a metal reconstruction plate unnecessary in the future.

4. Treatment for Facial Bone Fractures

   Our department was the first to introduce miniplate osteosynthesis for facial bone fractures in Japan (1980). This method is applied to various fields and it is now accepted as an excellent osteosynthesis method. Other new methods of treatment for mandibular fractures have been developed by our department, i.e. Herbert screw osteosynthesis and non-operative treatment with no intermaxillary fixation for condylar fractures.

1. Terasaki T, Akiyama T & Ikemura K (1996): Study on joint of fractured mandible by using bolts. Report of Kyushu-Kougyou Univ.(Engineering) 68: 1-7

2. Ikemura K, Fujie Y & Ohya R (1993): Histologic evaluation of tumor persistence at the surgical margins in oral cancer: An evaluation of all surgical margins using paraffin-embedded sections and its usefulness and limitations. J UOEH 15(4): 277-286

3. Ohya R & Ikemura K (1992): Flow cytometric analysis of DNA content in cancer of the oral mucosa, with special reference to clinico- histological factors. Oral and Maxillo-Facial Surgery, Proceedings of the 16th Congress of IAMFS March 31-April 3, 1991, Oita, Japan: 238-239

4. Ikemura K & Nakayoshi H (1992): Miniplate osteosynthesis for facial bone fractures: Application to cases necessitated more rigid fixation. Oral and Maxillo-Facial Surgery, Proceedings of the 16th Congress of IAMFS March 31-April 3, 1991, Oita, Japan: 309-311

5. Ikemura K & Ohya R (1990): The accuracy and usefulness of frozen-section diagnosis. Head & Neck 12(4): 298-302

6. Ikemura K, Hidaka H, Etoh T & Kabata K (1988): Osteosynthesis in facial bone fractures using miniplates: Clinical and experimental studies. J Oral Maxillofac Surg 46(1): 10-14

7. Yonetsu K & Ikemura K (1987): Ultrasonographic study of the relation of metastatic nodes to the carotid artery. Head & Neck Surg 9(5): 279-283

8. Ikemura K (1985): Treatment of condylar fractures associated with other mandibular fractures. J Oral Maxillofac Surg 43(10): 810- 813

9. Ikemura K, Kouno Y, Shibata H & Yamasaki K (1984): Biomechanical study on monocortical osteosynthesis for the fracture of the mandible. Int J Oral Surg 13(4): 307-312

10. Ikemura K, Kouno Y & Shibata H (1982): Treatment for fractures of the zygomatic complex: Frontozygomatic osteosynthesis with a miniature screwed plate. J UOEH 4(2): 157-163

Diseases of the teeth and periodontal tissues

Infections of the jaws

Cleft lip and palate

Maxillofacial trauma

Benign and malignant tumors of the oral cavity and jaw

Cystic diseases of the oral cavity and jaw

Diseases of the oral mucosa

Temporomandibular disorders

Diseases of the salivary glands

Occupational dental diseases

1. Name and academic degree: Kunio Ikemura, Professor, DDS, Ph.D.

2. Key words : oral cancer, mandibular reconstruction, maxillofacial trauma

3. Published papers:
   1. Ikemura K, Fujie Y & Ohya R (1993): Histologic evaluation of tumor persistence at the surgical margins in oral cancer: An evaluation of all surgical margins using paraffin-embedded sections and its usefulness and limitations. J UOEH 15(4): 277-286

   2. Ikemura K & Nakayoshi H (1992): Miniplate osteosynthesis for facial bone fractures: Application to cases necessitated more rigid fixation. Oral and Maxillo-Facial Surgery, Proceedings of the 16th Congress of IAMFS March 31-April 3, 1991, Oita, Japan: 309-311

   3. Ikemura K & Ohya R (1990): The accuracy and usefulness of frozen-section diagnosis. Head & Neck 12(4): 298-302

   4. Ikemura K, Hidaka H, Etoh T & Kabata K (1988): Osteosynthesis in facial bone fractures using miniplates: Clinical and experimental studies. J Oral Maxillofac Surg 46(1): 10-14

   5. Yonetsu K & Ikemura K (1987): Ultrasonographic study of the relation of metastatic nodes to the carotid artery. Head & Neck Surg 9(5): 279-283

   6. Ikemura K (1985): Treatment of condylar fractures associated with other mandibular fractures. J Oral Maxillofac Surg 43(10): 810- 813

   7. Ikemura K, Horie A, Tashiro H & Nandate M (1985): Simultaneous occurrence of a calcifying odontogenic cyst and its malignant transformation. Cancer 56(12): 2861-2864

   8. Ikemura K, Kouno Y, Shibata H & Yamasaki K (1984): Biomechanical study on monocortical osteosynthesis for the fracture of the mandible. Int J Oral Surg 13(4): 307-312

   9. Ikemura K, Kouno Y & Shibata H (1982): Treatment for fractures of the zygomatic complex: Frontozygomatic osteosynthesis with a miniature screwed plate. J UOEH 4(2): 157-163

   10. Pape HD und Ikemura K (1979): Erhebung zur prophylaktischen Entfernung der Weisheitszahnkeime. Dtsch zahnärztl Z 34(2): 213-215

4. Academic society affiliation:
   

   Japanese Society of Oral and Maxillofacial Surgery (councilor)

   Japanese Stomatological Society (councilor)

   Japan Society for Oral Tumors (councilor)

   Japan Society for Head and Neck Cancer

   Japan Society for Cancer Therapy

   International Association of Oral and Maxillofacial Surgeons

   International College for Maxillo-Facial Surgery

5. Others: none.

1. Name and academic degree: Shouichi Nakamura, Assistant Professor, DDS, Ph.D.

2. Key words: oral cancer, TMJ, dysfunction

3. Published papers:
   1. Nakamura S, Miyanosita Y (1979): Postoperative speech disorders and masticatory dysfunction of patients with oral cancer. Jpn J Oral Maxillofac Surg 25(2): 296-303

   2. Nakamura S, Oka M (1982): Fiberscopic removal of a reamer from the gastrointestinal tract. Bull Yamaguchi Med Sch 29: 99-101

4. Academic society affiliation:
   Japanese Society of Oral and Maxillofacial Surgery
   Japanese Stomatological Society
   Japan Society for Oral Tumors
   Japan Society for Head and Neck Cancer

5. Others: none.

Clinical Characteristic of Our Department

1. Treatment of Oral Cancers: The purpose of our department is to develope the treatment methods that will save lives and simultaneously be able to maintain QOL of patients. Surgery is generally performed on patients, in whom tumor excision bring little or no functional disturbance. For patients with advanced cancers, the above-mentioned method is applied. This treatment method allows a considerable reduction of radical surgery.

2. Treatment of Facial Bone fractures: Miniplate osteosynthesis can be performed with a simple surgical technique, and this method allows early mandibular movement and shortening of the treatment period, because maxillomandibular fixation is not necessary. Herbert screw osteosynthesis and our treatment method for condylar fractures also have several advantages in comparison to other methods

3. Outpatient Treatment: Extraction of wisdom teeth, treatment of temporomandibular joints and the oral mucosa are often performed. Many patients with general diseases who need dentoalveolar surgery also visit our department. These patients are treated in close cooperation with professional doctors of other departments.

Time and day of the week for a new patient: 8:30 - 10: 30 a.m. on Monday, Wednesday and Friday