Decision tree analysis and logistic regression suggest that the leading contributors to the formation of the membranous substances were the method of ingesting nutrients, dryness of the tongue dorsum and open mouth. These three factors are related to elderly persons requiring nursing care with impaired oral cavity function, and it was suggested that dryness of the oral mucosa was the major factor behind the membrane formation.

When eating food containing both liquid and solid phases (two-phase food), the liquid component frequently enters the hypopharynx before swallowing, which may increase the risk of aspiration. We therefore tested whether preswallow bolus transport and swallow initiation would change as the viscosity of two-phase food was increased. Fiberoptic endoscopy was recorded while 18 adult subjects ate 5 g of steamed rice with 3 ml of blue-dye water. Liquid viscosity was set at four levels by adding a thickening agent (0, 1, 2, and 4 wt%, respectively). We measured the timing of the leading edge of the food reaching the base of the epiglottis, as well as the location of the leading edge at swallow initiation. As viscosity increased, the leading edge of the food reached the epiglottis significantly later during chewing and was higher in the pharynx at swallow onset. The time after the leading edge reached the epiglottis did not vary among the viscosities of the two-phase food. This study found that the initial viscosity of two-phase food significantly altered oropharyngeal bolus flow and the timing of swallow initiation. Accordingly, increased two-phase food viscosity may delay food entry into the pharynx and be of use in dysphagic diets.

Breathing pattern may become deteriorated by airway obstruction during dental treatments requiring a rubber dam.

：今回われわれは，含歯性囊胞の感染に起因した小児の Garré 骨髄炎と診断された 1 例について報告した。患者は 4 歳， 男児で右側下顎臼歯部の腫脹部の精査を主訴として来院した。受診時，左側頰部から顎下部に圧痛と開口障害を伴う腫脹を認め， 顔貌は左右非対称であり，左側下顎大臼歯部の頰側歯槽粘膜部に圧痛を伴う瀰漫性腫脹を認めた。画像所見では第二乳臼歯は歯 根吸収を認め，病変内部に一部包含され，頰側皮質骨外側には層状の骨膜反応を認めた。全身麻下にて口腔内から左側下顎第二 乳臼歯を抜去し腫瘍摘出術を行った。病理学的所見では非角化性重層扁平上皮に裏装されて囊胞様構造を認め，上皮下結合組織 は浮腫性の炎症細胞浸潤を伴っていた。臨床症状，画像所見および病理組織学的所見からの総合的診断により，含歯性囊胞の感 染に起因した Garré 骨髄炎と診断した。小児期における顎骨骨髄炎に対しては，消炎処置後に原因歯の抜去と囊胞摘出を行うこ とにより良好な治癒経過が得ら，早期の診断と治療が重要であることが示唆された。：We herein report a child with Garré osteomyelitis caused by an infected dentigerous cyst. The patient was a 4-year-old boy in whom detailed examination showed swelling of the right mandibular molar region. The swelling was accompanied by tenderness and trismus between the left cheek and submandibular region, the face was asymmetric, and there was diffuse swelling accompanied by tenderness in the buccal alveolar mucosa of the left mandibular molar region. Imaging findings revealed root resorption in the second deciduous molar that was partially encompassed by the swelling, and a laminar periosteal reaction on the lateral side of the buccal cortex. The patient underwent cystectomy under general anesthesia with extraction of the second deciduous molar in the left lower jaw via an intraoral approach.Pathologically, a cystic structure, lined with non-keratinized stratified squamous epithelium and subepithelial connective tissues accompanied by edematous inflammatory cell infiltrates, was observed. Garré osteomyelitis caused by an infected dentigerous cyst was diagnosed based on clinical symptoms and both imaging and pathological findings. Early diagnosis and treatments are suggested to be important, as osteomyelitis of the jaw in childhood may fully resolve with extraction of the culprit tooth and cyst after anti-inflammatory treatments.： Garre' s Osteomyelitis(ガレーの骨髄炎) ，dentigerous cyst(含歯性囊胞) ，child(小児) ，mandible(下顎骨)