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Wang W. Congenital mandibular coronoid process hyperplasia and associated diseases. Oral Dis 2023; 29:2438-2448. [PMID: 36214115 DOI: 10.1111/odi.14400] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/03/2022] [Revised: 09/27/2022] [Accepted: 10/07/2022] [Indexed: 11/26/2022]
Abstract
Coronoid process hyperplasia (CPH) is an oral and maxillofacial surgical disease that can result in restricted jaw movement due to an enlarged and elongated mandibular coronoid process. It is characterized by the painless progressive restriction of unilaterally or bilaterally mouth opening. Clinically, unexplained bilateral CPH is less common and therefore often overlooked or misdiagnosed, and coronoidectomy can be very effective on improving mouth opening. Currently, the exact etiology and mechanism of congenital CPH have not yet been fully understood, but it is generally believed to be genetically related. In this paper, the relationship of the congenital mandibular CPH with the related diseases was examined based on cases collected in our clinic and literature review for the clinical diagnosis and treatment of patients with restricted mouth opening associated with CPH.
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Affiliation(s)
- Weihong Wang
- Department of Oral and Maxillofacial Surgery, Affiliated Stomatology Hospital of Kunming Medical University, Kunming, China
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Tajima R, Okazaki A, Sato T, Ozaki K, Motooka D, Okazaki Y, Yoda T. Genetic Landscape of Masticatory Muscle Tendon-Aponeurosis Hyperplasia. Genes (Basel) 2023; 14:1718. [PMID: 37761858 PMCID: PMC10530891 DOI: 10.3390/genes14091718] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/31/2023] [Revised: 08/19/2023] [Accepted: 08/23/2023] [Indexed: 09/29/2023] Open
Abstract
Limited mouth opening is a characteristic of masticatory muscle tendon-aponeurosis hyperplasia (MMTAH). Although genetic involvement is suspected where familial onset is frequently observed, the genetic background of MMTAH is yet to be elucidated. In this study, we conducted whole genome sequencing of 10 patients with MMTAH and their family members when available. We also conducted RNA sequencing of normal temporal tendon (as disease region) and Achilles tendon (as control region) from commercially available pig samples. We identified 51 genes that had rare variants in patients with MMTAH and were highly expressed in the temporal tendons of pigs. Among the 51 genes, 37 genes have not been reported to be causative for human genetic diseases so far. As an implication of genetic involvement in the pathogenesis of MMTAH, 21 of these 37 genes were identified in two independent families. In particular, PCDH1 and BAIAP3 were identified in one affected individual in a family and consistently segregated in unrelated family, indicating they could be candidate causative genes of MMTAH. Our findings will help elucidate the genetic landscape of MMTAH and provide insights into future possibilities for tendon regeneration treatment.
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Affiliation(s)
- Rina Tajima
- Department of Maxillofacial Surgery, Graduate School of Medical and Dental Sciences, Tokyo Medical and Dental University, 1-5-45 Yushima, Bunkyo-ku, Tokyo 113-8549, Japan;
| | - Atsuko Okazaki
- Diagnostics and Therapeutics of Intractable Diseases, Intractable Disease Research Center, Graduate School of Medicine, Juntendo University, 2-1-1 Hongo, Bunkyo-ku, Tokyo 113-8421, Japan;
| | - Tsuyoshi Sato
- Department of Oral and Maxillofacial Surgery, Saitama Medical University, 38 Morohongou, Moroyama-machi, Iruma-gun 350-0495, Saitama, Japan;
| | - Kokoro Ozaki
- Laboratory for Comprehensive Genomic Analysis, RIKEN Center for Integrative Medical Sciences, 1-7-22 Suehiro-cho, Tsurumi-ku, Yokohama 230-0045, Kanagawa, Japan;
| | - Daisuke Motooka
- Genome Information Research Center, Research Institute for Microbial Diseases, Osaka University, Suita 565-0871, Osaka, Japan;
- Integrated Frontier Research for Medical Science Division, Institute for Open and Transdisciplinary Research Initiatives (OTRI), Osaka University, Suita 565-0871, Osaka, Japan
| | - Yasushi Okazaki
- Diagnostics and Therapeutics of Intractable Diseases, Intractable Disease Research Center, Graduate School of Medicine, Juntendo University, 2-1-1 Hongo, Bunkyo-ku, Tokyo 113-8421, Japan;
- Laboratory for Comprehensive Genomic Analysis, RIKEN Center for Integrative Medical Sciences, 1-7-22 Suehiro-cho, Tsurumi-ku, Yokohama 230-0045, Kanagawa, Japan;
| | - Tetsuya Yoda
- Department of Maxillofacial Surgery, Graduate School of Medical and Dental Sciences, Tokyo Medical and Dental University, 1-5-45 Yushima, Bunkyo-ku, Tokyo 113-8549, Japan;
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Ito K, Go Y, Tatsumoto S, Usui C, Mizuno Y, Ikami E, Isozaki Y, Usui M, Kajihara T, Yoda T, Inoue KI, Takada M, Sato T. Gene expression profiling of the masticatory muscle tendons and Achilles tendons under tensile strain in the Japanese macaque Macaca fuscata. PLoS One 2023; 18:e0280649. [PMID: 36656905 PMCID: PMC9851512 DOI: 10.1371/journal.pone.0280649] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/24/2022] [Accepted: 01/05/2023] [Indexed: 01/20/2023] Open
Abstract
Both Achilles and masticatory muscle tendons are large load-bearing structures, and excessive mechanical loading leads to hypertrophic changes in these tendons. In the maxillofacial region, hyperplasia of the masticatory muscle tendons and aponeurosis affect muscle extensibility resulting in limited mouth opening. Although gene expression profiles of Achilles and patellar tendons under mechanical strain are well investigated in rodents, the gene expression profile of the masticatory muscle tendons remains unexplored. Herein, we examined the gene expression pattern of masticatory muscle tendons and compared it with that of Achilles tendons under tensile strain conditions in the Japanese macaque Macaca fuscata. Primary tenocytes isolated from the masticatory muscle tendons (temporal tendon and masseter aponeurosis) and Achilles tendons were mechanically loaded using the tensile force and gene expression was analyzed using the next-generation sequencing. In tendons exposed to tensile strain, we identified 1076 differentially expressed genes with a false discovery rate (FDR) < 10-10. To identify genes that are differentially expressed in temporal tendon and masseter aponeurosis, an FDR of < 10-10 was used, whereas the FDR for Achilles tendons was set at > 0.05. Results showed that 147 genes are differentially expressed between temporal tendons and masseter aponeurosis, out of which, 125 human orthologs were identified using the Ensemble database. Eight of these orthologs were related to tendons and among them the expression of the glycoprotein nmb and sphingosine kinase 1 was increased in temporal tendons and masseter aponeurosis following exposure to tensile strain. Moreover, the expression of tubulin beta 3 class III, which promotes cell cycle progression, and septin 9, which promotes cytoskeletal rearrangements, were decreased in stretched Achilles tendon cells and their expression was increased in stretched masseter aponeurosis and temporal tendon cells. In conclusion, cyclic strain differentially affects gene expression in Achilles tendons and tendons of the masticatory muscles.
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Affiliation(s)
- Ko Ito
- Department of Oral and Maxillofacial Surgery, Saitama Medical University, Saitama, Japan
| | - Yasuhiro Go
- Exploratory Research Center on Life and Living Systems (ExCELLS), National Institutes of Natural Science, Okazaki, Aichi, Japan
- Department of System Neuroscience, National Institute for Physiological Science, Okazaki, Aichi, Japan
- Department of Physiological Science, School of Life Science, SOKENDAI (The Graduate University for Advanced Studies), Okazaki, Aichi, Japan
| | - Shoji Tatsumoto
- Exploratory Research Center on Life and Living Systems (ExCELLS), National Institutes of Natural Science, Okazaki, Aichi, Japan
| | - Chika Usui
- Exploratory Research Center on Life and Living Systems (ExCELLS), National Institutes of Natural Science, Okazaki, Aichi, Japan
| | - Yosuke Mizuno
- Division of Morphological Science, Biomedical Research Center, Saitama Medical University, Saitama, Japan
| | - Eiji Ikami
- Department of Oral and Maxillofacial Surgery, Hirosaki University Graduate School of Medicine, Hirosaki, Japan
| | - Yuta Isozaki
- Department of Oral and Maxillofacial Surgery, Saitama Medical University, Saitama, Japan
| | - Michihiko Usui
- Division of Periodontology, Department of Cardiology and Periodontology, Kyushu Dental University, Fukuoka, Japan
| | - Takeshi Kajihara
- Department of Obstetrics and Gynecology, Saitama Medical University, Saitama, Japan
| | - Tetsuya Yoda
- Department of Maxillofacial Surgery, Graduate School of Medical and Dental Sciences, Tokyo Medical and Dental University, Tokyo, Japan
| | - Ken-ichi Inoue
- Systems Neuroscience Section, Department of Neuroscience, Primate Research Institute, Kyoto University, Inuyama, Aichi, Japan
| | - Masahiko Takada
- Systems Neuroscience Section, Department of Neuroscience, Primate Research Institute, Kyoto University, Inuyama, Aichi, Japan
| | - Tsuyoshi Sato
- Department of Oral and Maxillofacial Surgery, Saitama Medical University, Saitama, Japan
- * E-mail:
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Tendon and multiomics: advantages, advances, and opportunities. NPJ Regen Med 2021; 6:61. [PMID: 34599188 PMCID: PMC8486786 DOI: 10.1038/s41536-021-00168-6] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/20/2020] [Accepted: 09/01/2021] [Indexed: 02/08/2023] Open
Abstract
Tendons heal by fibrosis, which hinders function and increases re-injury risk. Yet the biology that leads to degeneration and regeneration of tendons is not completely understood. Improved understanding of the metabolic nuances that cause diverse outcomes in tendinopathies is required to solve these problems. 'Omics methods are increasingly used to characterize phenotypes in tissues. Multiomics integrates 'omic datasets to identify coherent relationships and provide insight into differences in molecular and metabolic pathways between anatomic locations, and disease stages. This work reviews the current literature pertaining to multiomics in tendon and the potential of these platforms to improve tendon regeneration. We assessed the literature and identified areas where 'omics platforms contribute to the field: (1) Tendon biology where their hierarchical complexity and demographic factors are studied. (2) Tendon degeneration and healing, where comparisons across tendon pathologies are analyzed. (3) The in vitro engineered tendon phenotype, where we compare the engineered phenotype to relevant native tissues. (4) Finally, we review regenerative and therapeutic approaches. We identified gaps in current knowledge and opportunities for future study: (1) The need to increase the diversity of human subjects and cell sources. (2) Opportunities to improve understanding of tendon heterogeneity. (3) The need to use these improvements to inform new engineered and regenerative therapeutic approaches. (4) The need to increase understanding of the development of tendon pathology. Together, the expanding use of various 'omics platforms and data analysis resulting from these platforms could substantially contribute to major advances in the tendon tissue engineering and regenerative medicine field.
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Yoda T. Masticatory muscle tendon-aponeurosis hyperplasia accompanied by limited mouth opening. J Korean Assoc Oral Maxillofac Surg 2019; 45:174-179. [PMID: 31508348 PMCID: PMC6728625 DOI: 10.5125/jkaoms.2019.45.4.174] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/09/2019] [Accepted: 08/12/2019] [Indexed: 11/30/2022] Open
Abstract
Patients with masticatory muscle tendon-aponeurosis hyperplasia (MMTAH) experience limited mouth opening due to restricted muscle extension. Hyperplastic aponeurosis and tendons lead to the restriction of muscle extension. The criteria for the diagnosis of MMTAH are limited mouth opening that progresses very slowly from adolescence, intraoral palpation reveals a hard cord-like structure along the overhang of the anterior border of the masseter muscle on maximum mouth opening, and a square mandible. Conservative treatment, including pharmacotherapy, occlusal splint and physical therapy are ineffective. The standard therapy is surgical treatment, such as anterior partial aponeurectomy of the masseter muscle and coronoidectomy. The long-term results are very satisfying.
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Affiliation(s)
- Tetsuya Yoda
- Department of Maxillofacial Surgery, Graduate School of Medical and Dental Sciences, Tokyo Medical and Dental University, Tokyo, Japan
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Hayashi N, Sato T, Yumoto M, Kokabu S, Fukushima Y, Kawata Y, Kajihara T, Mizuno Y, Mizuno Y, Kawakami T, Kirita T, Hayata T, Noda M, Yoda T. Cyclic stretch induces decorin expression via yes-associated protein in tenocytes: A possible mechanism for hyperplasia in masticatory muscle tendon-aponeurosis hyperplasia. JOURNAL OF ORAL AND MAXILLOFACIAL SURGERY, MEDICINE, AND PATHOLOGY 2019. [DOI: 10.1016/j.ajoms.2018.12.012] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/27/2022]
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Hayashi N, Sato T, Kokabu S, Usui M, Yumoto M, Ikami E, Sakamoto Y, Nifuji A, Hayata T, Noda M, Yoda T. Possible association of oestrogen and Cryba4 with masticatory muscle tendon-aponeurosis hyperplasia. Oral Dis 2018; 25:274-281. [PMID: 29683234 DOI: 10.1111/odi.12876] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/09/2018] [Revised: 04/10/2018] [Accepted: 04/12/2018] [Indexed: 11/29/2022]
Abstract
OBJECTIVE Masticatory muscle tendon-aponeurosis hyperplasia, which is associated with limited mouth opening, progresses very slowly from adolescence. The prevalence rates of this disease are higher among women than among men, suggesting oestrogen involvement. As parafunctional habits are frequently observed, mechanical stress is likely involved in the pathogenesis and advancement of this disease. To elucidate the pathological condition, we examined the effect of oestrogen on tenocyte function and the relationship between mechanical stress and crystallin beta A4 (Cryba4), using murine TT-D6 tenocytes. MATERIALS AND METHODS Cell proliferation assays, RT-PCR, real-time RT-PCR, Western blot analysis and mechanical loading experiments were performed. RESULTS The physiological dose of oestrogen increased the levels of scleraxis and tenomodulin in TT-D6 tenocytes. In contrast, forced expression of Cryba4 inhibited scleraxis expression in these cells. Surprisingly, oestrogen significantly promoted cell differentiation in the Cryba4-overexpressing TT-D6 tenocytes. Moreover, tensile force induced Cryba4 expression in these tendon cells. CONCLUSION Oestrogen and Cryba4 may be associated with the progression of masticatory muscle tendon-aponeurosis hyperplasia.
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Affiliation(s)
- N Hayashi
- Department of Oral and Maxillofacial Surgery, Saitama Medical University, Saitama, Japan
| | - T Sato
- Department of Oral and Maxillofacial Surgery, Saitama Medical University, Saitama, Japan
| | - S Kokabu
- Department of Oral and Maxillofacial Surgery, Saitama Medical University, Saitama, Japan.,Division of Molecular Signaling and Biochemistry, Department of Health Promotion, Kyushu Dental University, Kitakyushu, Fukuoka, Japan
| | - M Usui
- Division of Periodontology, Department of Cardiology and Periodontology, Kyushu Dental University, Fukuoka, Japan
| | - M Yumoto
- Department of Oral and Maxillofacial Surgery, Saitama Medical University, Saitama, Japan
| | - E Ikami
- Department of Oral and Maxillofacial Surgery, Saitama Medical University, Saitama, Japan
| | - Y Sakamoto
- Division of Analytical Science, Department of Biomedical Research Center, Saitama Medical University, Saitama, Japan
| | - A Nifuji
- Department of Pharmacology, Tsurumi University School of Dental Medicine, Yokohama, Japan
| | - T Hayata
- Department of Molecular Pharmacology, Medical Research Institute, Tokyo Medical and Dental University, Tokyo, Japan
| | - M Noda
- Department of Molecular Pharmacology, Medical Research Institute, Tokyo Medical and Dental University, Tokyo, Japan
| | - T Yoda
- Department of Oral and Maxillofacial Surgery, Saitama Medical University, Saitama, Japan
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A two-year follow-up of surgical and non-surgical treatments in patients with masticatory muscle tendon-aponeurosis hyperplasia. Int J Oral Maxillofac Surg 2017; 47:199-204. [PMID: 28823904 DOI: 10.1016/j.ijom.2017.07.011] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/11/2017] [Revised: 05/25/2017] [Accepted: 07/13/2017] [Indexed: 11/21/2022]
Abstract
This study re-examined the usefulness of surgery for the management of masticatory muscle tendon-aponeurosis hyperplasia (MMTAH) through a comparison of the outcomes between patients who underwent surgery and those who did not. The duration of follow-up was 2 years. Twenty-eight patients who attended the study hospital and were given a diagnosis of MMTAH were included. Nineteen patients underwent surgery (surgical group) and nine patients were instructed to open their mouths wide once a day and did not undergo surgery (non-surgical group). Maximum mouth opening, impairment of daily activities, satisfaction, and the status of mouth opening training were evaluated after surgery. The mean increase in mouth opening after 2 years was 20.2mm in the surgical group and 2.4mm in the non-surgical group. Adequate mouth opening training led to satisfactory results 2 years postoperative, and sustained mouth opening training for 6 months after surgery was a key factor for obtaining good outcomes. The general condition and personality of individual patients should be evaluated carefully before surgery to estimate whether or not they can endure the pain associated with postoperative mouth opening training. The results of this study suggest that the surgical procedure is useful for the management of MMTAH.
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Sato T, Yoda T. Masticatory muscle tendon-aponeurosis hyperplasia: A new clinical entity of limited mouth opening. JAPANESE DENTAL SCIENCE REVIEW 2017; 52:41-48. [PMID: 28408955 PMCID: PMC5382786 DOI: 10.1016/j.jdsr.2015.11.001] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/12/2015] [Revised: 10/24/2015] [Accepted: 11/11/2015] [Indexed: 11/26/2022] Open
Abstract
Limited mouth opening is a common health problem that interferes with eating, makes examination of the oral cavity difficult, and may increase the mortality rate during emergency intubation. Here we introduce a disease designated as masticatory muscle tendon-aponeurosis hyperplasia, which is a new clinical condition of limited mouth opening. Most oral surgeons and dentists are still unaware of this disease condition, thus increasing the risk of incorrect diagnosis as some other disease, such as temporomandibular joint disorder. We will review the clinical features, epidemiology, pathophysiology, etiology, diagnosis, treatment, and prognosis of this disease and also appraise the literature available on the subject.
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Affiliation(s)
- Tsuyoshi Sato
- Department of Oral and Maxillofacial Surgery, Saitama Medical University, Saitama, Japan
| | - Tetsuya Yoda
- Department of Oral and Maxillofacial Surgery, Saitama Medical University, Saitama, Japan
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Surgical Intervention for Masticatory Muscle Tendon-Aponeurosis Hyperplasia Based on the Diagnosis Using the Four-Dimensional Muscle Model. J Craniofac Surg 2016; 26:1871-6. [PMID: 26352365 PMCID: PMC4568892 DOI: 10.1097/scs.0000000000001932] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022] Open
Abstract
OBJECTIVES The surgical target of Masticatory muscle tendon-aponeurosis hyperplasia (MMTAH) is the masseter or temporal muscle. In our clinic, the 4-dimentional muscle model (4DMM) has been used to decide if we should approach to the masseter or temporal muscle. The aim of this study is validate the clinical usefulness of 4DMM on the basis of the surgical results. METHODS The 4DMM was constructed from the digital data of 3D-CT and 4-dimentional mandibular movements of the patients. It made us to able to visually observe the expansion rate of masticatory muscles at maximum mouth opening comparing to their length at closed mouth position. Fifteen patients were applied the 4DMM before the surgical treatment and 2 healthy volunteers were enrolled as control group. RESULTS The expansion rate of temporal muscle at the maximum mouth opening in the patient group was significantly less than that in the control group (P < 0.05). On the other hand, the masseter muscles of all patients were expanded as same as the control group. Therefore the main cause of limitation of mouth-opening was suggested to be a contracture of the temporal muscle. Consequently, we performed successful bilateral coronoidectomy with no surgical intervention to the masseter muscles in all patients. CONCLUSION The present 4DMM would be valuable modality to decide the target muscle of surgical treatment for patients with MMTAH. In this pathology, contracture of the temporal muscle seems to be main cause of limited mouth opening.
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Re: Limited mouth opening of unknown cause cured by diagnostic coronoidectomy: a new clinical entity? Br J Oral Maxillofac Surg 2015:53(3):230-4. Br J Oral Maxillofac Surg 2015; 53:476-7. [PMID: 25770017 DOI: 10.1016/j.bjoms.2015.02.016] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/22/2015] [Accepted: 02/18/2015] [Indexed: 11/22/2022]
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Sato T, Hayashi N, Enoki Y, Okubo M, Nakaoka C, Nakamoto N, Yoda T. Limited mouth opening with a square mandible configuration: a case of masticatory muscle tendon-aponeurosis hyperplasia. J Surg Case Rep 2015; 2015:rjv020. [PMID: 25770956 PMCID: PMC4359355 DOI: 10.1093/jscr/rjv020] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Abstract
Most clinicians throughout the world are probably unaware of the existence of masticatory muscle tendon-aponeurosis hyperplasia (MMTAH), potentially leading to misdiagnoses such as temporomandibular joint disorder (TMD). Here, we introduce this disease from the viewpoint of education. In February 2013, a 39-year-old woman presented with limited mouth opening. Her facial configuration was characterized by a square mandible. There was no evidence of TMD. Magnetic resonance imaging (MRI) showed bilateral enlargement of the masseter muscles. Additionally, a ‘thick’ aponeurosis of the anterior aspect of the masseter muscle was noted bilaterally. On maximal mouth opening, intraoral palpation along the anterior border of the masseter muscle confirmed a hard cord-like structure, consistent with the findings on MRI. MMTAH was diagnosed. When clinicians notice limited mouth opening on oral examination, they should be knowledgeable about diseases associated with limited mouth opening and a square mandibular configuration, such as MMTAH.
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Affiliation(s)
- Tsuyoshi Sato
- Department of Oral and Maxillofacial Surgery, Saitama Medical University, Saitama, Japan
| | - Naoki Hayashi
- Department of Oral and Maxillofacial Surgery, Saitama Medical University, Saitama, Japan
| | - Yuichiro Enoki
- Department of Oral and Maxillofacial Surgery, Saitama Medical University, Saitama, Japan
| | - Masahiko Okubo
- Department of Oral and Maxillofacial Surgery, Saitama Medical University, Saitama, Japan
| | - Chieri Nakaoka
- Department of Oral and Maxillofacial Surgery, Saitama Medical University, Saitama, Japan
| | - Norimichi Nakamoto
- Division of Oral and Maxillofacial Biopathological Surgery, Tottori University Faculty of Medicine, Tottori, Japan
| | - Tetsuya Yoda
- Department of Oral and Maxillofacial Surgery, Saitama Medical University, Saitama, Japan
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