A case report of hydrocephalus due to diffuse villous hyperplasia of the choroid plexus: surgical treatment by combination a flexible videoscope with a rigid endoscope.

PURPOSE: Diffuse villous hyperplasia of the choroid plexus (DVHCP) and choroid plexus papilloma (CPP) are rare benign tumors usually diagnosed as a result of progressive hydrocephalus, especially in childhood. We present the case of a Japanese boy diagnosed with progressive hydrocephalus due to DVHCP. METHODS: Case: A 2-year and 3-month-old Japanese boy was found to have delayed motor development (equivalent to 1 year and 2 months old), an enlarged head circumference of 51 cm within + 1.5 standard deviation (S.D.), and incomplete closure of the anterior fontanel. The magnetic resonance imaging (MRI) showed lobular enlargement of the bilateral choroid plexuses extending from the trigone to the body and inferior horn of the lateral ventricle. The endoscopic choroid plexus coagulation surgery was performed to reduce the CSF formation rate. RESULTS: DVHCP was diagnosed both pathologically and clinically. Postoperatively, the patient progressed without complications, such as cerebrospinal fluid leakage. Although ventricular enlargement persisted, the anterior fontanel recessed, and the expansion of the head circumference stopped. CONCLUSION: Few cases of bilateral DVHCP and CPP have been reported in the literature. We encountered a case in which effective choroid plexus coagulation was performed for hydrocephalus due to DVHCP using less invasive endoscopic technique. It also represented an association between DVHCP and the gain of chromosome 9p.

Periodontal disease in preoperative patients with digestive cancer: a retrospective, single-institution experience in Fukui, Japan.

BACKGROUND: The careful preoperative oral assessment may be useful for safe surgery under general anesthesia. The purpose of this study was to investigate the presence of periodontitis in patients with malignant digestive disease before surgery under general anesthesia. METHODS: Patients with digestive malignant disease who underwent periodontal examination and orthopantomograph examination for preoperative oral health assessment were participated. The authors investigated the patients' general characteristics and clinical oral information, including the presence of periodontitis. RESULTS: One hundred twenty patients participated in this study. The mean and standard deviation of the number of teeth was 20.8 ± 8.2, and there was a statistically significant correlation between age and number of teeth. The periodontal pocket depth was 3.0 ± 1.0, and mobile teeth were observed in 62 patients. There was a statistically significant correlation between number of teeth and number of mobile teeth. However, there was no significant difference between the age of patients without mobile teeth and the age of patients with mobile teeth. CONCLUSIONS: This retrospective study performed in single-institution clarified the presence of periodontitis in patients with malignant digestive disease before surgery. Regardless of age, it is important to assess the oral health, including periodontitis, for safe surgery under general anesthesia.

Personal identification systems for persons with dementia: a systematic review.

People with dementia can become missing and unable to be identified due to their cognitive decline and may not have belongings, including personally identifiable information. The aim of this systematic review was to summarise and discuss the current status of personal identification systems for missing and unidentified persons with dementia. An electronic systematic literature search was conducted by using PubMed, Web of Science, Cochrane Library, and CINAHL. By performing an electronic literature search, 128 texts were extracted. However, only three eligible texts were included in this review, and these were divided on the basis of the analysis target as follows: medical and human community support systems and digital systems. It is important to develop medical and social care systems and to construct and advance social personal identification systems, including medical and human community support systems and digital systems, for persons with dementia. However, this systematic review clarified that there have only been a few reports about the development and construction of social systems for missing and unidentified persons with dementia. People who interact with persons with dementia should consider this problem, which is increasing each year, and strive to build a social system that can be applied to personal identification as soon as possible.

Collaboration with an infection control team promoted appropriate antibiotic use for third molar extraction at a Japanese hospital.

Oral antibiotic therapy is routinely administered when a third molar (M3) is extracted to prevent infectious complications after surgery. Oral third-generation cephalosporins are frequently used after M3 extraction in Japan but at the expense of an increased risk of antimicrobial resistance. Therefore, the infection control team (ICT) at our institution recommended a reduction in use of these agents after M3 extraction. In this study, we compared the types of antibiotic agents prescribed for patients undergoing M3 extraction before and after this recommendation. We investigated the relationship between type of antibiotic used and the likelihood of infectious complications as well as cost savings in patients who underwent M3 extraction in the 6 months before and after the ICT recommendation in July 2018. There was a marked reduction in use of oral third-generation cephalosporins after M3 extraction (P < 0.0001) and increased use of oral penicillins and first-generation cephalosporins after the ICT recommendation. Moreover, surgical site infection (SSIs) were significantly less common after the ICT recommendation (P = 0.0099); however, the SSI rate was higher in patients who received a third-generation cephalosporin than in those who received penicillin (8.8% vs 0.5%). There was also a significant saving in per-patient antibiotic costs after the ICT recommendation (269.5 ± 282.0 JPY vs 454.7 ± 376.6 JPY; P < 0.0001). These findings suggest that collaboration with an ICT promotes appropriate antibiotic use, decreases the risk of an SSI, and improves the cost-benefit ratio in patients undergoing M3 extraction.

Post-Traumatic Trigeminal Neuropathy Caused by an Orbital Stab Wound.

Sensory and motor neuropathy of the trigeminal nerve due to trauma is quite rare. Furthermore, there have been no detailed reports on occlusal abnormalities and trismus associated with post-traumatic trigeminal motor neuropathy. Here, the authors report a case of trigeminal motor neuropathy and trigeminal sensory neuropathy in all 3 divisions caused by an orbital stab wound. During kendo practice, a 61-year-old man was injured in his right medial canthus with the splinter of a broken bamboo sword. Imaging examinations did not show a brain injury or orbital bone fracture. Intraoral and extraoral examination and needle electromyography revealed trismus, posterior open bite, and denervation of the right masseter. After the injury, the patient strived to use the right molars during mastication and began chewing exercises in the right molar region. A follow-up examination 7 months after the injury revealed an improvement of the functional problems in the masticatory system. Although slight facial numbness in the right ophthalmic division remained, the patient was satisfied with the present status. Further knowledge concerning the natural history of trigeminal neuropathy as well as the treatment of choice should be explored in the future.

A case of retinoblastoma metastasizing to the mandible and review of literature.

OBJECTIVES: The aim of this case report and review was to determine the characteristics of retinoblastoma. METHODS: One case report was introduced along with previous reports on retinoblastoma metastasizing to the mandible. RESULTS: Sixteen cases from 14 reports were included in this study. Including the present case, 11 of 16 patients died within 8 months. DISCUSSION: Retinoblastoma rarely metastasizes to the mandible. However, metastasis to other organs should be considered, and specialists should be consulted if retinoblastoma metastasis to the mandible is observed. Moreover, it is necessary to follow up patients after multidisciplinary therapy is completed, because subsequent complications of the teeth and jawbones associated with therapy could occur.

Risk factors for postoperative hemorrhage after minor oral surgery in patients treated with antithrombotic agents.

It has been proposed that minor oral surgery can be performed safely in patients taking antithrombotic therapy without interrupting treatment; however, there is little evidence-based guidance about how to manage postoperative hemorrhage in patients taking antithrombotics, and few randomized trials that help to inform the risk-benefit ratio of continuing or suspending antithrombotic therapy. The aim of this study was to identify risk factors for postoperative hemorrhage to create a protocol for patients undergoing minor oral surgery with antithrombotic therapy. One hundred and two patients were enrolled, who subsequently underwent 142 minor oral surgical procedures while taking antithrombotic therapy. Demographic details including age and sex, laboratory coagulation investigations, and episodes of postoperative hemorrhage were recorded. The prothrombin time-international normalized ratio (PT-INR) of participants taking warfarin was <3.0 in all cases (mean 1.89 ± standard deviation 0.52; range 1.11-2.82). The activated partial thromboplastin time (APTT) was significantly associated with postoperative hemorrhage, which was significantly increased in patients taking warfarin alone or in combination with an antiplatelet agent compared with an antiplatelet agent alone. In 7 cases, postoperative hemorrhage continued for 4 days and more, requiring additional local hemostatic management. Our findings suggest that minor oral surgery can be performed under antithrombotic therapy without the need of discontinuing the antithrombotic agents. Local hemostatic materials did not suppress postoperative hemorrhage. APTT is a possible prediction factor for postoperative hemorrhage in such patients and, therefore, should be determined prior to minor oral surgery in addition to PT-INR value.

Spindle cell carcinoma arising at the buccal mucosa: a case report and review of the literature.

AIMS: Spindle cell carcinoma (SPCC) is a subtype of squamous cell carcinoma, and it mainly occurs in the upper aerodigestive duct. On the other hand, it rarely arises in the head and neck region. The prognosis of this tumor is usually poor because of its highly malignant behavior, such as its high incidence of recurrence or metastasis to cervical lymph nodes. However, the number of accumulated cases is still too low to provide the full details of SPCC. METHODOLOGY: The case of SPCC was counted by using database, PubMed. The authors also present a case of SPCC arising at the left buccal mucosa in a 72-year-old Japanese female in the current study. RESULTS: Only six cases of SPCC arising at the buccal mucosa have been reported previously. The authors' patient died from a recurrent tumor 15 months after the first operation. CONCLUSION: The authors have added this case to the previous knowledge of SPCC arising at the buccal mucosa, and discuss the clinical behavior of SPCC to help suggest a standard treatment strategy for the disease.

Aspiration pneumonia associated with a double fracture of the mandible.

Aspiration pneumonia is one of the most life-threatening diseases in the elderly. A 73-year-old woman was diagnosed with aspiration pneumonia after a mandibular fracture. Because her persistent aspiration pneumonia was accompanied by a diminished swallowing function that was believed to be due to a double fracture of the mandible, the patient underwent an open reduction while having pneumonia. Her symptoms of aspiration pneumonia improved immediately after the surgery. The hyoid bone was repositioned to its original position, and the movements of the hyoid bone and mandible were recovered after the surgery. In cases in which the medial bone segment of the mandible moves inside because of a double fracture and the movement of the hyoid bone declines, we strongly suggest that an open reduction should be performed as soon as possible to prevent aspiration pneumonia caused by a swallowing dysfunction.

Assessment of migrated foreign bodies in the maxillae by x-ray fluorescence spectrometry.

Two cases of foreign bodies that were incidentally observed on orthopantomographs are reported in this study. The foreign bodies were analyzed using an x-ray fluorescence spectrometer to identify what the migrated foreign bodies were and what migration pathways they had taken. The removed metallic foreign bodies from the maxillae of 2 patients, who were referred to the Department of Dentistry and Oral Surgery of the University of Fukui Hospital, were analyzed using an x-ray fluorescence spectrometer in the Department of Dental and Biomedical Materials Science, Nagasaki University. The major component of foreign body in patient 1 was silver, and that in case 2 was iron. On the basis of the imaging results and the patients' clinical history, the foreign bodies were considered to be caused by iatrogenic migration. Understanding the existence of foreign bodies and their migration pathway into the jaw bone can thus make clinicians more aware of such migrations and can thereby contribute to reducing iatrogenic accidents.

Diagnostic role of magnetic resonance imaging in assessing orofacial pain and paresthesia.

The aim of this study was to compare the efficacy of CT and MRI in evaluating orofacial pain and paresthesia. A total of 96 patients with orofacial pain and/or paresthesia were included in this study. The patients who underwent CT and/or MRI examinations were assessed, and the efficacy of CT and/or MRI examinations in detecting the causative disease of the orofacial pain and paresthesia was evaluated. Seventy (72.9%) of 96 patients underwent CT and/or MRI examinations. Whereas CT examinations detected 2 diseases (4.5%) in 44 tests, 13 diseases (37.1%) were detected in 35 MRI examinations. Seven (53.8%) of 13 diseases, which were detected by MRI, were found in elderly patients. A high percentage of patients, who claimed orofacial pain and paresthesia, have other diseases in their brain, especially in elderly patients, and MRI is more useful than CT for evaluating these patients.

Dental decision-making for persons with dementia: A systematic narrative review.

Dental decision-making represents the establishment of a common understanding between the dental professional and the recipient of the intervention, which determines oral healthcare and dental treatment policies. Dental decision-making for persons with dementia can be challenging, and there have been no systematic reviews on this topic. Therefore, this systematic narrative review aimed to identify the current state of dental decision-making in persons with dementia. Literature search was performed using PubMed, Web of Science, Cochrane Library, CINAHL, and Google Scholar databases. Through the process of research selection, 7 articles with a high risk of bias were included in this study. This review clarified that there is limited information on the dental decision-making processes for persons with dementia. In conclusion, although this may be difficult due to different medical and socioeconomic conditions, the dilemma between the need to establish evidence for dental decision-making and medical ethics that prioritize a patient-centered position should be discussed globally in the future.

Efficacy of initial conservative treatment options for temporomandibular disorders: A network meta-analysis of randomized clinical trials.

PURPOSE: This network meta-analysis (NMA) of randomized controlled trials (RCTs) aimed to identify effective initial conservative treatment strategies for patients with temporomandibular joint disorders (TMD). STUDY SELECTION: RCTs comparing treatment options for TMD published between January 2000 and July 2021 were retrieved from the databases of PubMed and Embase via a comprehensive electronic search. Patients diagnosed with myalgia (muscle pain) or arthralgia (joint pain) according to pain-related Diagnostic Criteria for Temporomandibular Disorders (DC/TMD) and the Research Diagnostic Criteria for Temporomandibular Disorders (RDC/TMD) were eligible for inclusion. Twelve treatment options and a placebo were included in the mutual comparisons. The risk of bias was assessed using Risk of Bias 2.0. Forest plots of direct comparisons between individual studies were created using MetaInsight. NMA was performed using R statistical software (netmeta). RESULTS: Twenty-four RCTs involving 1336 patients assessing pain and 12 RCTs involving 614 patients assessing maximal mouth opening were identified. Low-level laser therapy (standard mean difference [SMD]: -2.12, 95% confidence interval [CI]: -3.18, -1.06), self-exercise (SMD: -1.51, 95% CI: -2.82, -0.2), and stabilization splints (SMD: -1.16, 95% CI: -2.02, -0.29) were effective in improving pain; however, the certainty of evidence was very low. Self-exercise (SMD: 0.71, 95% CI: -0.58, 2.01), stabilization splints (SMD: 0.65, 95% CI: -0.09, 1.39), and low-level laser therapy (SMD: 0.63, 95% CI: -0.34, 1.6) were effective in improving maximal mouth opening; however, the certainty of evidence was very low. CONCLUSIONS: Stabilization splints, self-exercise, and low-level laser therapy may be effective in the initial treatment of TMD.

A new scheme for sensitive detection of terahertz photons.

Charge sensitive infrared photo transistors (CSIPs) made in GaAs/AlGaAs bilayer two-dimensional electron systems (2DESs) serve as sensitive photodetectors in the mid- and long-wavelength infrared regions. A new design of CSIP is proposed to expand the wavelength range to longer wavelengths (λ > 36 µm). Remarkably improved detector performance is demonstrated for λ ≈ 39 µm. In CSIPs electrons are photo-excited in a floating gate (FG) served by an isolated region of upper layer 2DESs. In the new design (i) a bow-tie antenna couples incident radiation to an FG far smaller in size (2-3 µm) than the wavelength and (ii) excited electrons 'laterally' escape from the FG via tunneling through a barrier formed by biased metal cross gates. The charge state of the FG is sensed by a source-drain channel in the lower layer of the 2DES. The sensitivity and the quantum efficiency have been greatly improved, indicating that CSIPs are promising detectors in an expanded wavelength range exceeding 36 µm.

Impact of oral health management on mental health and psychological disease: a scoping review.

OBJECTIVE: The relationship between oral and mental health has been controversial. Few studies have assessed the direct effects of oral health management on mental health and psychological disease. Using evidence from the last 5 years, this scoping review aimed to map and discuss recent progress in understanding this relationship. METHODS: Electronic literature searches were performed using PubMed, Web of Science, the Cochrane Library, and the Cumulative Index to Nursing and Allied Health Literature databases. An additional manual search was performed using Google Scholar databases. Studies were selected using the Preferred Reporting Items for Systematic Reviews and Meta-Analyses 2020 flow diagram. RESULTS: An eligibility review process identified three randomized controlled trials for inclusion in this review. The oral health interventions and participants' target age, mental health status, and psychological diseases varied across these studies. The only study that reported an improvement included psychosocial support integrated with educational components of oral health as the intervention. The remaining two studies detected no significant impact of oral health interventions on mental health and psychological disease. CONCLUSIONS: Evidence of the impact of oral health management on mental health and psychological disease is insufficient in studies published between 2017 and 2021.

Evidence-Based Policy Making during the Coronavirus Disease 2019 Pandemic: A Systematic Review.

INTRODUCTION: The aim of this systematic review was to collect evidence and recommendations for the applicability of the concept of evidence-based policy making (EBPM) during the coronavirus disease 2019 (COVID-19) pandemic and to discuss the implementation of this concept from a medical science perspective. METHODS: This study was performed according to the guidelines, checklist, and flow diagram of Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) 2020. An electronic literature search was conducted on September 20, 2022 using PubMed, Web of Science, Cochrane Library, and CINAHL databases with the following search terms: "evidence based policy making" and "infectious disease." Study eligibility assessment was performed based on the flow diagram of PRISMA 2020, and risk of bias assessment was performed using The Critical Appraisal Skills Program. RESULTS: Eleven eligible articles were included in this review and divided into three groups as follows: early, middle, and late stages of the COVID-19 pandemic. Basics of COVID-19 control were suggested in the early stage. The articles published in the middle stage discussed the importance of the collection and analysis of evidence of COVID-19 from around the world for the establishment of EBPM in the COVID-19 pandemic. The articles published in the late stage discussed the collection of large amounts of high-quality data and the development of methods to analyze them, as well as emerging issues related to the COVID-19 pandemic. CONCLUSIONS: This study revealed that the concept of EBPM applicable to emerging infectious disease pandemics changed between the early, middle, and late stages of the pandemic. The concept of EBPM will play an important role in medicine in the future.

A preliminary study on the assessment of pain using figures among patients administered with dental local anesthesia for mandibular third molar extraction.

The aim of this study was to clarify or determine any possible association between pain reports with a visual analogue scale (VAS) and a figures based scale. This research was a preliminary study aimed at developing a new pain scale without any verbal description. Healthy Japanese patients aged 20 to 39 years who received anesthetic injections for mandibular third molar extraction at our department were enrolled. Regarding pain from dental local anesthetic injections, we recorded figures selected by participants (among options of a circle, triangle, square, bar, and cross), and VAS scores. Overall, 29 men and 31 women participated in the study. Pain caused by local dental anesthesia tended to remind both men and women of the triangle among the suggested figures. Furthermore, patients who chose a cross also reported higher VAS scores than those who chose other figures. Acute pain caused by local dental anesthesia was associated with triangles, and patients who selected a cross were associated with higher VAS scores. The results of this study provide clinicians with important information for dental practice, and could prove useful in developing new pain scales.

Impact of natural disaster on oral health: A scoping review.

Natural disasters may affect oral health as a result of serious damage to social function and public health. However, no article has systematically summarized the impact of natural disasters on oral health. This review aimed to map the existing literature on the impact of natural disasters on oral health. Targeted literature was searched using PubMed, Web of Science, Cochrane Library, and CINAHL databases with the keywords "disaster" and "oral health." Eligibility criteria were established based on the Participant-Concept-Context model, and eligible studies were identified based on the Preferred Reporting Items for Systematic Reviews and Meta-Analyses 2020 flow diagram. Eight eligible studies related to earthquakes were included in this review. Of these, 7 studies were related to the 2011 Great East Japan Earthquake. Oral health status of victims of disaster was analyzed by assessing the following parameters: questionnaire surveys; examination for fungal infection; and analyses of the teeth, periodontal, and oral hygiene condition. Six studies suggested that natural disasters had a negative impact on oral health. Two studies could not determine the impact of natural disasters on oral health. Only 1 study analyzed the impact of disasters on oral health based on pre- and postdisaster surveys. This scoping review found that there was insufficient evidence to suggest a relationship between natural disasters and oral health and that there are biases in geographical areas and types of natural disasters in this research field. Further research is needed to promote evidence-based support by dental professionals during different disaster phases.

Droplets Adhesion to Surgical Masks during Standard Oral Surgery.

The most common routes of transmission of coronavirus disease 2019 are droplet and contact infections. During dental treatment, several instruments and procedures used generate droplets of saliva and blood, such as during the extraction of an impacted third molar (M3). Surgical masks are often used during tooth extraction. However, the surface structures of surgical masks against droplets are not fully understood. Therefore, we analyzed the droplets that adhered to the surgical masks during impacted M3 extraction using electron microscopy. The surgical mask was divided into three layers and observed using electron microscopy. The outer and inner layers had a similar mesh-like structure, whereas the middle layer had a denser three-dimensional structure. Droplets ranging from 20-100 µm in size, generated during the extraction, adhered to the fibers of the outer layer of the mask. Fewer droplets adhered to the middle layer than to the outer layer. Droplets did not reach the inner layer. In conclusion, we suggest that a surgical mask can prevent droplet infection when performing impacted M3 extraction. This study is expected to contribute to the study of infection control strategies during dental treatments in the future.

Lingual bone thickness in the apical region of the horizontal mandibular third molar: A cross-sectional study in young Japanese.

BACKGROUND: Perforation of the lingual plate in the apical region of mandibular third molars will increase the risk of aberration and migration of the root tip and the risk of lingual nerve injury. The aim of this study was to analyze anatomical information, including relationships between the apical region of horizontally impacted mandibular third molars and lingual plates, in young Japanese. METHODS: Japanese patients, with horizontally impacted third molars, who underwent CT examination as a preoperative assessment for mandibular third molar extraction were included, and anatomical characteristics in the apical region of the right mandibular third molar were analyzed, in this study. RESULTS: A total of 121 patients were included based on the inclusion and exclusion criteria of this study. The mean and standard deviation of the bone thickness on the lingual side of the mandibular third molar in the apical region was 1.5 ± 1.6 mm, and the absence of lingual cortical bone in the apical region, namely, "perforation", was observed in 44 patients. The statistical analysis revealed the predictors of cases with perforation as follows: gender, age, and the available space evaluated by Pell and Gregory classification. CONCLUSIONS: This study clarified that "perforation" was sometimes observed in young Japanese, and that the predictors of those cases were as follows: gender, age, and the available space evaluated by Pell and Gregory classification.