We studied maxillofacial fractures treated by departments of oral and maxillofacial surgery in Tokyo. A retrospective review of records and radiographs for patients admitted during the 5‐year period from 2000 to 2004 was conducted at five departments in Tokyo. Date, age, gender, cause of injury, fracture site, concomitant injury, domestic violence against women, and treatment were reviewed. 674 patients with maxillofacial fractures were admitted. Male‐to‐female ratio was 3.6 : 1. The most frequent age group was 21–25 years. Fractures of the mandible were most frequent (87%), followed by the maxilla (14%) and the zygomatic bone (12%). Thirty‐one percent of fractures were due to traffic accidents, 29% to accidental falls, 23% to violence and 14% to sports. The incidence of maxillofacial fractures caused by traffic accidents was lower, and that caused by falls and violence were higher than in other countries. Seventeen percent of the maxillofacial fracture patients had concomitant injuries. The incidence of domestic violence‐related maxillofacial fracture was 1.6% of all cases. These cases were mainly caused by a husband (55%) or a sexual partner (36%). Most patients (67%) were treated by open reduction surgery. However, condylar fracture alone was usually treated by closed reduction surgery.

Journal of Hard Tissue Biology 16[1] (2007) p31-35 © 2007 The Society for Hard Tissue Regenerative BiologyPrinted in Japan, All rights reserved. CODEN-JHTBFF, ISSN 1341-7649 Original 31Abstract: We encountered a patient on long-term oral corticosteroids for systemic lupus erythematosus, who did not complain of pain during caries treatment. Since the patient had no subjective sense of dental pain, all her remaining teeth became stumps, and total tooth extraction was conducted 25 years after presentation. We examined her premolar stumps histopathologically and obtained the following findings: 1. the dental pulp was narrowed in nearly all samples; 2. odontoblasts were not observable; 3. regions with dentinal tubules forming lamellae and regions with fibrotic dentinal tubules were observed. 4. fibrosis of the entire dentin was observed in some regions. 5. nerve fibers stained by anti-neurofilament protein antibody were observed in the dental pulp cavity, but the nerve fibers appeared degenerate and no nerve fiber endings were observed.

To develop a new mucoadhesiveˆlm containing an analgesic combining clinical e‹cacy and patient comfort, we prepared and evaluated a two-layeredˆlm consisting of an adhesive layer containing indomethacin (IM) as the active ingredient and carboxyvinyl polymer (CP) as a bonding agent and a nonadhesive layer containing polyethylene glycol (PEG) to improveˆlm texture. In in vitro and in vivo adhesive tests, the optimal concentration of CP that could be applied to the mucous membrane was 0.2％ or 0.3％. Stability testing determined that the optimal storage conditions and expiration period were 4°C without shade and 4 weeks, respectively. Theˆlm was clinically evaluated in patients with oral pain. IM at concentrations of 0.5％ and 1％ provided optimum analgesic eŠects, and the eŠects were the greatest in the 1％ IM group. The addition of PEG to the nonadhesive layer reduced the number of patients experiencing discomfort at the site where theˆlm was applied. Therefore thisˆlm formulation may be useful for local analgesic application due to its low dose requirement, moderate adhesion, and comfortable texture.

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