ATLAS of Oral Disease

Total Page:16

File Type:pdf, Size:1020Kb

ATLAS of Oral Disease ATLAS of Oral Disease Nagato Natsume Guang-yan Yu Preface There are wide variety of oral diseases. Oral diseases treated with oral and maxillofacial surgery have a broad range of symptoms, which requires the doctors’ advanced knowledge, treatment techniques and experiences for accurate diagnosis and adequate treatment. This textbook, written by distinguished doctors in the field, provides the latest information necessary for such diagnosis and treatment. For the diagnosis, we have to evaluate the possible diseases corresponding to the observation with a cool-headed manner and careful decision. We believe that doctors should take care of patients as if the patients were members of their own family. It is one of the important aspects of these characteristic diseases that require the doctors to attend to the patients with tender care. On behalf of the authors, we hope this textbook is beneficial for the doctors in dentistry or stomatology, and also for the patients with various oral diseases all over the world. We express our gratitude for all persons involved in publishing this textbook. Particularly, Prof. S.M. Balaji, who advised in proofreading and editorial process, is acknowledged by editors. We are also grateful to Dr. Xia Hong, Dr. Kumiko Fujiwara and our secretaries, Ms. Rie Osakabe , and Ms. Xiao-jing Li for their supports. We thank them for all their efforts. This textbook was published under the patronage of Japan Society for the Promotion of Science, Grant-in-Aid for Publication of Scientific Research Results(Grant No. 266006). February 28, 2016 NAGATO NATSUME GUANG- YAN YU Aichi Gakuin University, Japan Peking University School of Stomatology, China 3 Contents Preface… …………………………………………………………………………………………… ……3 1. Jaw Deformity 1-1 Mandibular protrusion (and/or maxillary deficiency)… …………………………………… ……9 1-2 Maxillary protrusion (and/or mandibular deficiency)… …………………………………… 12 1-3 Condylar hyperplasia………………………………………………………………………… 15 2. Infection 2-1 Dental caries and non-caries tooth tissue loss… …………………………………………… 19 a . Dental caries… ………………………………………………………………………… 19 b . Non-caries tooth tissue loss……………………………………………………………… 21 2-2 Periodontic infections………………………………………………………………………… 26 a . Pericoronitis… ………………………………………………………………………… 26 b . Periapical periodontitis… ……………………………………………………………… 27 2-3 Infection of jaw… …………………………………………………………………………… 29 a . Periostitis………………………………………………………………………………… 29 b . Osteomyelitis… ………………………………………………………………………… 30 2-4 Infection of soft tissue… …………………………………………………………………… 32 a . Cellulitis of the floor of the mouth……………………………………………………… 32 b . Lymphadenitis…………………………………………………………………………… 33 c . Maxillary sinusitis… …………………………………………………………………… 34 2-5 Specific inflammation… …………………………………………………………………… 37 a . Actinomycosis of Jaw…………………………………………………………………… 37 b . Tuberculosis… ………………………………………………………………………… 38 c . Syphilis… ……………………………………………………………………………… 40 2-6 Others………………………………………………………………………………………… 42 3. Trauma 3-1 Tooth trauma… ……………………………………………………………………………… 47 3-2 Trauma to the soft tissues… ………………………………………………………………… 52 a . Abrasions………………………………………………………………………………… 52 b . Contusions… …………………………………………………………………………… 53 c . Lacerations……………………………………………………………………………… 53 d . Avulsions………………………………………………………………………………… 54 e . Bites……………………………………………………………………………………… 55 f . Traumatic facial nerve injury…………………………………………………………… 56 4. Cysts 4-1 Odontogenic cysts… ………………………………………………………………………… 78 a . Radicular cysts… ……………………………………………………………………… 78 b . Follicular cyst (dentigerous cyst)… …………………………………………………… 80 4-2 Non-odontogenic cyst………………………………………………………………………… 82 a . Nasopalatine duct cyst…………………………………………………………………… 82 b . Globulomaxillary cyst…………………………………………………………………… 82 c . Nasoalveolar cyst (median palatine cyst)… …………………………………………… 83 4-3 Cystic lesion… ……………………………………………………………………………… 84 4-4 Soft tissue cysts……………………………………………………………………………… 85 a . Dermoid and epidermoid cysts… ……………………………………………………… 85 b . Throglossal duct cyst… ………………………………………………………………… 86 c . Others…………………………………………………………………………………… 88 c-1 Sebaceous cyst……………………………………………………………………… 88 c-2 Branchial cleft cysts………………………………………………………………… 88 c-3 Cysts of facial fissure… …………………………………………………………… 91 5. Tumor and Tumor-like lesions 5-1 Odontogenic tumor; benign tumors… ……………………………………………………… 95 a . Ameloblastoma… ……………………………………………………………………… 96 b . Squamous odontogenic tumor…………………………………………………………… 101 c . Calcifying epithelial odontogenic tumor (Pindborg tumor)… ………………………… 102 d . Adenomatoid odontogenic tumor… …………………………………………………… 103 e . Keratocystic odontogenic tumor………………………………………………………… 104 4 f . Ameloblastic fibroma/fibrodentinoma/fibro-odontoma………………………………… 108 g . Odontoma, complex type/compound type……………………………………………… 109 h . Odontoameloblastoma…………………………………………………………………… 111 i . Calcifying cystic odontogenic tumore (Gorlin cyst)/ dentinogenic ghost cell tumor……111 j . Odontogenic fibroma… ………………………………………………………………… 113 k . Odontogenic myxoma/myxofibroma…………………………………………………… 113 l . Cementoblastoma… …………………………………………………………………… 114 m . Ossifying fibroma… …………………………………………………………………… 116 n . Fibrous dysplasia………………………………………………………………………… 117 o . Osseous dysplasia… …………………………………………………………………… 118 p . Central giant cell lesion… ……………………………………………………………… 119 q . Cherubism… …………………………………………………………………………… 119 r . Aneurysmal bone cyst…………………………………………………………………… 120 s . Simple bone cyst………………………………………………………………………… 121 5-2 Non-odontogenic tumor……………………………………………………………………… 123 a . Palilloma………………………………………………………………………………… 123 b . Fibroma and similar disorders…………………………………………………………… 124 c . Myxoma………………………………………………………………………………… 127 d . Lipoma… ……………………………………………………………………………… 128 e . Neurofibroma…………………………………………………………………………… 130 f . Hemangioma and lymphoma…………………………………………………………… 135 g . Osteoma… ……………………………………………………………………………… 140 5-3 Odontogenic carcinoma……………………………………………………………………… 142 a . Metastasizing (malignant) ameloblastoma……………………………………………… 142 b . Ameloblastic carcinoma………………………………………………………………… 142 c . Primary intraosseous squamous cell carcinoma………………………………………… 144 5-4 Non-odontogenic malignant tumor………………………………………………………… 146 a . Squamous cell carcinoma… …………………………………………………………… 146 b . Kaposi’s sarcoma… …………………………………………………………………… 150 c . Fibrosarcoma… ………………………………………………………………………… 151 d . Osteosarcoma…………………………………………………………………………… 153 e . Malignant melanoma… ………………………………………………………………… 156 f . Wegener’s Granulomatosis……………………………………………………………… 158 g . Malignant lymphoma…………………………………………………………………… 160 6. Salivary Gland Diseases 6-1 Sialadenitis…………………………………………………………………………………… 167 a . Acute suppurative parotitis……………………………………………………………… 167 b . Chronic recurrent parotitis……………………………………………………………… 168 c . Chronic obstructive parotitis… ………………………………………………………… 169 6-2 Sialolithiasis and sialadenitis of submandibular gland… …………………………………… 171 6-3 Sjögren’s syndrome… ……………………………………………………………………… 173 6-4 Tumor-like lesions…………………………………………………………………………… 176 a . Mucocele………………………………………………………………………………… 176 b . Ranula…………………………………………………………………………………… 177 6-5 Salivary gland tumors………………………………………………………………………… 178 a . General consideration…………………………………………………………………… 178 b . Pleomorphic adenoma…………………………………………………………………… 187 c . Warthin tumor…………………………………………………………………………… 188 d . Mucoepidermoid carcinoma… ………………………………………………………… 190 e . Adenoid cystic carcinoma… …………………………………………………………… 191 7. TMDs (Temporomandibular Joint Diseases) 7-1 The anatomy structure and function of the temporomandibular joints……………………… 197 7-2 Congenital or developmental disorders of temporomandibular joint………………………… 199 a . Aplasia and hypoplasia… ……………………………………………………………… 199 b . Oculo-auriculo-vertebral spectrum……………………………………………………… 200 c . Condylar hyperplasia… ………………………………………………………………… 202 7-3 Inflammatory diseases of temporomandibular joint… ……………………………………… 204 a . Septic arthristis of the temporomandibular joint………………………………………… 204 b . Rheumatoid arthritis of the temporomandibular joint…………………………………… 205 c . Osteoarthritis of the temporomandibular joint… ……………………………………… 206 5 8. Diseases of Nerve a . Palsy of facial nerve (Bell’s palsy)……………………………………………………… 211 b . The other diseases of facial nerve… …………………………………………………… 215 9. Congenital Anomalies 9-1 Cleft lip and/or palate… …………………………………………………………………… 221 a . Pre-surgical treatment…………………………………………………………………… 223 b . Surgical treatment… …………………………………………………………………… 225 c . Bilateral cleft lip/nose repair after PNAM……………………………………………… 231 d . Palatoplasty……………………………………………………………………………… 231 9-2 Syndrome… ………………………………………………………………………………… 234 a . Treacher Collins syndrome……………………………………………………………… 234 b . Goldenhar syndrome… ………………………………………………………………… 235 10. Soft Tissue and Mucosal Disease 10-1 Labial lesions… …………………………………………………………………………… 239 a . Chronic cheilitis………………………………………………………………………… 239 b . Granulomatous cheilitis (GC)…………………………………………………………… 239 c . Angular stomatitis… …………………………………………………………………… 240 d . Hemangioma and vascular malformation of the lip… ………………………………… 241 10-2 Tongue lesions……………………………………………………………………………… 244 a . Median rhomboid glossitis……………………………………………………………… 244 b . Georaphic tongue… …………………………………………………………………… 245 c . Fissured tongue… ……………………………………………………………………… 246 d . Black hairy tongue……………………………………………………………………… 248 e . Tongue coating… ……………………………………………………………………… 249 f . Hemangioma and vascular malformations of the tongue… …………………………… 250 g . Hunter’s glossitis… …………………………………………………………………… 252 10-3 Potential malignant oral lesions… …………………………………………………………
Recommended publications
  • Glossary for Narrative Writing
    Periodontal Assessment and Treatment Planning Gingival description Color: o pink o erythematous o cyanotic o racial pigmentation o metallic pigmentation o uniformity Contour: o recession o clefts o enlarged papillae o cratered papillae o blunted papillae o highly rolled o bulbous o knife-edged o scalloped o stippled Consistency: o firm o edematous o hyperplastic o fibrotic Band of gingiva: o amount o quality o location o treatability Bleeding tendency: o sulcus base, lining o gingival margins Suppuration Sinus tract formation Pocket depths Pseudopockets Frena Pain Other pathology Dental Description Defective restorations: o overhangs o open contacts o poor contours Fractured cusps 1 ww.links2success.biz [email protected] 914-303-6464 Caries Deposits: o Type . plaque . calculus . stain . matera alba o Location . supragingival . subgingival o Severity . mild . moderate . severe Wear facets Percussion sensitivity Tooth vitality Attrition, erosion, abrasion Occlusal plane level Occlusion findings Furcations Mobility Fremitus Radiographic findings Film dates Crown:root ratio Amount of bone loss o horizontal; vertical o localized; generalized Root length and shape Overhangs Bulbous crowns Fenestrations Dehiscences Tooth resorption Retained root tips Impacted teeth Root proximities Tilted teeth Radiolucencies/opacities Etiologic factors Local: o plaque o calculus o overhangs 2 ww.links2success.biz [email protected] 914-303-6464 o orthodontic apparatus o open margins o open contacts o improper
    [Show full text]
  • Oral Diagnosis: the Clinician's Guide
    Wright An imprint of Elsevier Science Limited Robert Stevenson House, 1-3 Baxter's Place, Leith Walk, Edinburgh EH I 3AF First published :WOO Reprinted 2002. 238 7X69. fax: (+ 1) 215 238 2239, e-mail: [email protected]. You may also complete your request on-line via the Elsevier Science homepage (http://www.elsevier.com). by selecting'Customer Support' and then 'Obtaining Permissions·. British Library Cataloguing in Publication Data A catalogue record for this book is available from the British Library Library of Congress Cataloging in Publication Data A catalog record for this book is available from the Library of Congress ISBN 0 7236 1040 I _ your source for books. journals and multimedia in the health sciences www.elsevierhealth.com Composition by Scribe Design, Gillingham, Kent Printed and bound in China Contents Preface vii Acknowledgements ix 1 The challenge of diagnosis 1 2 The history 4 3 Examination 11 4 Diagnostic tests 33 5 Pain of dental origin 71 6 Pain of non-dental origin 99 7 Trauma 124 8 Infection 140 9 Cysts 160 10 Ulcers 185 11 White patches 210 12 Bumps, lumps and swellings 226 13 Oral changes in systemic disease 263 14 Oral consequences of medication 290 Index 299 Preface The foundation of any form of successful treatment is accurate diagnosis. Though scientifically based, dentistry is also an art. This is evident in the provision of operative dental care and also in the diagnosis of oral and dental diseases. While diagnostic skills will be developed and enhanced by experience, it is essential that every prospective dentist is taught how to develop a structured and comprehensive approach to oral diagnosis.
    [Show full text]
  • June 18, 2013 8:30 Am – 11:30 Am
    Tuesday – June 18, 2013 8:30 am – 11:30 am Poster Abstracts – Tuesday, June 18, 2013 #1 ORAL LESIONS AS THE PRESENTING MANIFESTATION OF CROHN'S DISEASE V Woo, E Herschaft, J Wang U of Nevada, Las Vegas Crohn’s disease (CD) is an immune-mediated disorder of the gastrointestinal tract which together with ulcerative colitis, comprise the two major types of inflammatory bowel disease (IBD). The underlying etiology has been attributed to defects in mucosal immunity and the intestinal epithelial barrier in a genetically susceptible host, resulting in an inappropriate inflammatory response to intestinal microbes. The lesions of CD can affect any region of the alimentary tract as well as extraintestinal sites such as the skin, joints and eyes. The most common presenting symptoms are periumbilical pain and diarrhea associated with fevers, malaise and anemia. Oral involvement has been termed oral CD and may manifest as lip swelling, cobblestoned mucosa, mucogingivitis and linear ulcerations and fissures. Oral lesions may precede gastrointestinal involvement and can serve as early markers of CD. We describe a 6-year-old male who presented for evaluation of multifocal gingival erythema and swellings. His medical history was unremarkable for gastrointestinal disorders or distress. Histopathologic examination showed multiple well-formed granulomas that were negative for special stains and foreign body material. A diagnosis of granulomatous gingivitis was rendered. The patient was advised to seek consultation with a pediatric gastroenterologist and following colonoscopy, was diagnosed with early stage CD. Timely recognition of the oral manifestations of CD is critical because only a minority of patients will continue to exhibit CD-specific oral lesions at follow-up.
    [Show full text]
  • Management of Dental Trauma in a Primary Care Setting Abstract
    Guidance for the Clinician in Rendering Pediatric Care CLINICAL REPORT Management of Dental Trauma in a Primary Care Setting Martha Ann Keels, DDS, PhD, and THE SECTION ON ORAL abstract HEALTH The American Academy of Pediatrics and its Section on Oral Health have KEY WORDS developed this clinical report for pediatricians and primary care physi- dental trauma, dental injury, tooth, teeth, dentist, pediatrician cians regarding the diagnosis, evaluation, and management of dental ABBREVIATION trauma in children aged 1 to 21 years. This report was developed CT—computed tomography through a comprehensive search and analysis of the medical and den- This document is copyrighted and is property of the American tal literature and expert consensus. Guidelines published and updated Academy of Pediatrics and its Board of Directors. All authors have filed conflict of interest statements with the American by the International Association of Dental Traumatology (www.dental- Academy of Pediatrics. Any conflicts have been resolved through traumaguide.com) are an excellent resource for both dental and non- a process approved by the Board of Directors. The American dental health care providers. Pediatrics 2014;133:e466–e476 Academy of Pediatrics has neither solicited nor accepted any commercial involvement in the development of the content of this publication. The guidance in this report does not indicate an exclusive INTRODUCTION course of treatment or serve as a standard of medical care. Variations, taking into account individual circumstances, may be By 14 years of age, 30% of children have experienced a dental injury.1 appropriate. Many of these children are taken directly to their medical home, an urgent care center, or an emergency department for evaluation and treatment.
    [Show full text]
  • Saving Smiles Avulsion Pathway (Page 20) Saving Smiles: Fractures and Displacements (Page 22)
    Greater Manchester Local Dental Network SavingSmiles Improving outcomes following dental trauma First Edition I Spring 2017 Practitioners’ Toolkit Contents 04 Introduction to the toolkit from the GM Trauma Network 06 History & examination 10 Maxillo-facial considerations 12 Classification of dento-alveolar injuries 16 The paediatric patient 18 Splinting 20 The AVULSED Tooth 22 The BROKEN Tooth 23 Managing injuries with delayed presentation SavingSmiles 24 Follow up Improving outcomes 26 Long term consequences following dental trauma 28 Armamentarium 29 When to refer 30 Non-accidental injury 31 What should I do if I suspect dental neglect or abuse? 34 www.dentaltrauma.co.uk 35 Additional reference material 36 Dental trauma history sheet 38 Avulsion pathways 39 Fractues and displacement pathway 40 Fractures and displacements in the primary dentition 41 Acknowledgements SavingSmiles Improving outcomes following dental trauma Ambition for Greater Manchester Introduction to the Toolkit from The GM Trauma Network wish to work with our colleagues to ensure that: the GM Trauma Network • All clinicians in GM have the confidence and knowledge to provide a timely and effective first line response to dental trauma. • All clinicians are aware of the need for close monitoring of patients following trauma, and when to refer. The Greater Manchester Local Dental Network (GM LDN) has established a ‘Trauma Network’ sub-group. The • All settings have the equipment described within the ‘armamentarium’ section of this booklet to support optimal treatment. Trauma Network was established to support a safer, faster, better first response to dental trauma and follow up care across GM. The group includes members representing general dental practitioners, commissioners, To support GM practitioners in achieving this ambition, we will be working with Health Education England to provide training days and specialists in restorative and paediatric dentistry, and dental public health.
    [Show full text]
  • Journal 2017
    Journal of ENT masterclass ISSN 2047-959X Journal of ENT MASTERCLASS® Year Book 2017 Volume 10 Number 1 YEAR BOOK 2017 VOLUME 10 NUMBER 1 JOURNAL OF ENT MASTERCLASS® Volume 10 Issue 1 December 2017 Contents Free Courses for Trainees, Consultants, SAS grades, GPs & Nurses Welcome Message 3 CALENDER OF FREE RESOURCES 2018-19 Hesham Saleh Increased seats for specialist registrars & exam candidates ENT aspects of cystic fibrosis management 4 Gary J Connett ® 15th Annual International ENT Masterclass Paediatric swallowing disorders 8 Venue: Doncaster Royal Infirmary, 25-27th January 2019 Hayley Herbert and Shyan Vijayasekaran Special viva sessions for exam candidates Paediatric tongue-tie 14 Steven Frampton, Ciba Paul, Andrea Burgess and Hasnaa Ismail-Koch rd ® 3 ENT Masterclass China Paediatric oesophageal foreign bodies 20 Beijing, China, 12-13th May 2018 Emily Lowe, Jessica Chapman, Ori Ron and Michael Stanton Biofilms in paediatric otorhinolaryngology 26 3rd ENT Masterclass® Europe S Goldie, H Ismail-Koch, P.G. Harries and R J Salib Berlin, Germany, 14-15th Sept 2018 Intracranial complications of ear, nose and throat infections in childhood 34 Alice Lording, Sanjay Patel and Andrea Whitney ® ENT Masterclass Switzerland The superior canal dehiscence syndrome 41 Lausanne, 5-6th Oct 2018 Simon Richard Mackenzie Freeman Tympanosclerosis 46 ® ENT Masterclass Sri Lanka Priya Achar and Harry Powell Colombo, 16-17th Nov 2018 Endoscopic ear surgery 49 Carolina Wuesthoff, Nicholas Jufas and Nirmal Patel o Limited places, on first come basis. Early applications advised. o Masterclass lectures, Panel discussions, Clinical Grand Rounds Vestibular function testing 57 o Oncology, Plastics, Pathology, Radiology, Audiology, Medico-legal Karen Lindley and Charlie Huins Auditory brainstem implantation 63 Website: www.entmasterclass.com Harry R F Powell and Shakeel S Saeed CYBER TEXTBOOK on operative surgery, Journal of ENT Masterclass®, Surgical management of temporal bone meningo-encephalocoele and CSF leaks 69 Application forms Mr.
    [Show full text]
  • Abfraction Myth Or Reality
    IOSR Journal of Dental and Medical Sciences (IOSR-JDMS) e-ISSN: 2279-0853, p-ISSN: 2279-0861. Volume 13, Issue 2 Ver. III. (Feb. 2014), PP 70-73 www.iosrjournals.org Abfraction Myth or Reality Dr Pragya Tripathi, Dr Deepak Chopra, Dr Sukhchain Bagga Sr Lecturer Dept of Periodontics, Inderprastha Dental College, Sahibabad, Ghaziabad (UP) India. Reader Dept of Periodontics, Inderprastha Dental College, Sahibabad, Ghaziabad (UP) India. Reader Dept of Periodontics, Inderprastha Dental College, Sahibabad, Ghaziabad (UP) India. Abstract: Abfraction is the loss of tooth structure at the cervical region from heavy occlusal forces. It is described as one of the causes of lesions found along the cervical margins of teeth. This article critically reviews the literature in favour and against the theory of abfraction. From the literature there is little direct evidence supporting the theory of abfraction, apart from laboratory studies, to indicate that abfraction exists other than as a hypothetical component of cervical wear. I. Introduction Abfraction is the micro structural loss of tooth substance in areas of stress concentration. This occurs most commonly in the cervical region of teeth, where flexure may lead to a breaking away of the thin layer of enamel rods, as well as micro fracture of cementum and dentin1. Since the publication of one of the text books for dentistry by anatomist and physiologist John Hunter in 1778, the definitions and classifications of the terms “attrition”, “abrasion” and “erosion” have been in a state of confusion. Furthermore, the more recent introduction of the terms “abfraction” to designate stress induced non carious lesions have not resolved this dilemma fully2.
    [Show full text]
  • Agranulocytic Angina
    University of Nebraska Medical Center DigitalCommons@UNMC MD Theses Special Collections 5-1-1939 Agranulocytic angina Louis T. Davies University of Nebraska Medical Center This manuscript is historical in nature and may not reflect current medical research and practice. Search PubMed for current research. Follow this and additional works at: https://digitalcommons.unmc.edu/mdtheses Part of the Medical Education Commons Recommended Citation Davies, Louis T., "Agranulocytic angina" (1939). MD Theses. 737. https://digitalcommons.unmc.edu/mdtheses/737 This Thesis is brought to you for free and open access by the Special Collections at DigitalCommons@UNMC. It has been accepted for inclusion in MD Theses by an authorized administrator of DigitalCommons@UNMC. For more information, please contact [email protected]. AGRANULOCYTIC ANGINA by LOUIS T. DAVIES Presented to the College of Medicine, University of Nebraska, Omaha, 1939 TABLE OF CONTENTS Introduction • . 1 Definition •• . • • 2 History . 3 Etiology ••• . • • 7 Classification .• 16 Symptoms and Course • . • • • 20 Experimental Work • • •• 40 Pathological Anatomy • • • . 43 Diagnosis and Differential Diagnosis •• . • 54 Therapy Prognosis • • • • • . 55 Discussion and Summary • • • • • • • 67 Conclusions • • • • • • • • • • • • • 73 ·Bibliography • • • • • • • • • • 75 * * * * * * 481028 _,,,....... ·- INTRODUCTION Agranulocytic Angina for the past seventeen years has been highly discussed both in medical centers and in literature. During this time the understanding of the disease has developed in the curriculum of the medical profession. Since 1922, when first described as a clinical entity by Schultz, it has been reported more frequently as the years passed until at the present time agranulocytosis is recognized widely as a disease process. Just as with the development of any medical problem this has been laden with various opinions on its course, etiology, etc., all of which has served to confuse the searching medical mind as to its true standing.
    [Show full text]
  • Naruto Ninja Storm Free Download PC Naruto Shippuden: Ultimate Ninja Storm Revolution Free Download
    Naruto Ninja Storm free download PC Naruto Shippuden: Ultimate Ninja Storm Revolution Free Download. The latest instalment of the NARUTO SHIPPUDEN: Ultimate Ninja STORM series will offer players a new experience in the deep & rich NARUTO environment. Tons of new techniques, enhanced mechanics, over 100 playable characters & Support Ninjas, and a brand new exclusive character (Mecha-Naruto) designed by Masashi Kishimoto. Ninja Battle Action – Amazing fights and original animation heighten the incredible action and interactive experience of the STORM series like never before. Improved Gameplay – New Gameplay mechanics with the powerful Combo Ultimate Jutsu and combined attacks. Never-before- seen Roster –100 Playable & Support Ninjas, including new characters and variations appearing for the first time! Exclusive Character – A brand new character (Mecha-Naruto) designed by Masashi Kishimoto exclusively for the game. Ninja World Tournament – A fresh and thrilling single player mode where 4 different Ninjas brawl and the one gathering the most Battle orbs wins! The Akatsuki origins revealed! – For the first time ever, the untold story behind the infamous gang will be told through an animation woven into gameplay! How to Download & Install Naruto Shippuden: Ultimate Ninja Storm Revolution. Click the Download button below and you should be redirected to UploadHaven. Wait 5 seconds and click on the blue ‘download now’ button. Now let the download begin and wait for it to finish. Once Naruto Shippuden: Ultimate Ninja Storm Revolution is done downloading, right click the .zip file and click on “Extract to Naruto.Shippuden.Ultimate.Ninja.Storm.Revolution.zip” (To do this you must have 7-Zip, which you can get here).
    [Show full text]
  • Computed Tomography of the Buccomasseteric Region: 1
    605 Computed Tomography of the Buccomasseteric Region: 1. Anatomy Ira F. Braun 1 The differential diagnosis to consider in a patient presenting with a buccomasseteric James C. Hoffman, Jr. 1 region mass is rather lengthy. Precise preoperative localization of the mass and a determination of its extent and, it is hoped, histology will provide a most useful guide to the head and neck surgeon operating in this anatomically complex region. Part 1 of this article describes the computed tomographic anatomy of this region, while part 2 discusses pathologic changes. The clinical value of computed tomography as an imaging method for this region is emphasized. The differential diagnosis to consider in a patient with a mass in the buccomas­ seteric region, which may either be developmental, inflammatory, or neoplastic, comprises a rather lengthy list. The anatomic complexity of this region, defined arbitrarily by the soft tissue and bony structures including and surrounding the masseter muscle, excluding the parotid gland, makes the accurate anatomic diagnosis of masses in this region imperative if severe functional and cosmetic defects or even death are to be avoided during treatment. An initial crucial clinical pathoanatomic distinction is to classify the mass as extra- or intraparotid. Batsakis [1] recommends that every mass localized to the cheek region be considered a parotid tumor until proven otherwise. Precise clinical localization, however, is often exceedingly difficult. Obviously, further diagnosis and subsequent therapy is greatly facilitated once this differentiation is made. Computed tomography (CT), with its superior spatial and contrast resolution, has been shown to be an effective imaging method for the evaluation of disorders of the head and neck.
    [Show full text]
  • ED482773.Pdf
    DOCUMENT RESUME ED 482 773 FL 027 934 AUTHOR Tatsuki, Donna, Ed. TITLE JALT Journal, 2003. INSTITUTION Japan Association for Language Teaching, Tokyo. ISSN ISSN-0287-2420 PUB DATE 2003-05-00 NOTE 118p.; Published semi-annually. Only issue number 1 of 2003 is included in this document. For the 2002 issues, see ED 477 568 AVAILABLE FROM JALT Central Office, Urban Edge Building, 5F 1-37-9 Taito, Taito-Ku, Tokyo 110-0016, Japan. Tel: 03-3837-1630; Fax: 03- 3837-1631; e-mail: [email protected]. PUB TYPE Collected Works - Serials (022) JOURNAL CIT JALT Journal; v25 n1 May 2003 EDRS PRICE EDRS Price MF01/PC05 Plus Postage. DESCRIPTORS Business Communication; Communication Apprehension; Educational Change; Elementary Secondary Education; *English (Second Language); Foreign Countries; Grammar; Higher Education; Language Proficiency; Language Teachers; Phonetics; Second Language Instruction; *Second Language Learning; Student Attitudes; Student Characteristics; Student Motivation; Study Abroad IDENTIFIERS *Japan ABSTRACT This collection of papers includes the following: "Learner Characteristics of Early Starters and Late Starters of English Language Learning: Anxiety, Aptitude, and Motivation" (Tomoko Takada); "Uncovering First Year Students' Language Learning Experiences, Their Attitudes, and Motivations in a Context of Change at the Tertiary Level of Education" (Kevin O'Donnell); "Study Abroad, Language Proficiency, and Learner Beliefs about Language Learning" (Koichi Tanaka and Rod Ellis); and "What Do We Know About the Language Learning Motivation of University Students in Japan? Some Patterns and Survey Studies" (Kay Irie) .There are also four review: "Intercultural Business Communication" (Robert Gibson), reviewed by Peter J. Farrell; "Individual Freedom in Language Teaching" (Christopher Brumfit), reviewed by Tim Knight; "Phonetics" (Peter Roach), reviewed by Matthew White; and "The Atoms of Language: The Mind's Hidden Rules of Grammar" (Mark C.
    [Show full text]
  • 1000 Lives Plus Website 1000 Lives Plus ‘Improving Mouth Care for Patients in Hospital’ Page
    Improving Mouth Care for Adult Patients in Hospital Mouth Care for Adult Patients in Hospital / Vers 5 (07/13) This resource is for nurses, health care support workers and other health care professionals (for example, doctors, respiratory physiotherapists, speech and language therapists, dieticians) who provide or give advice on mouth care for adult patients in hospital. It is designed to Improve oral health knowledge and skills for health care professionals who support patients in hospital and those living with complex medical conditions and advanced illness. Enable health care professionals to provide and deliver a high standard of mouth care for adult patients in hospital. Support person centred training, and to suit individual needs and local circumstances. Support hands on training and teaching, and will be helpful for health and care professionals who find it difficult to clean a patients mouth. Learning Outcomes 1 Demonstrate an understanding of why good oral health is important for patients in hospital 2 Recognise risk factors that contribute to poor oral health and the association with systemic disease 3 Identify risk factors associated with Dental Caries (tooth decay) 4 Identify risk factors associated with Gingivitis and Periodontitis (gum disease) 5 Understand the mouth care documentation (e.g. mouth care risk assessment, care plans and documentation forms) 6 Complete a mouth care risk assessment / care plan 7 Process and report any oral health concerns (depending on local protocols) 8 Identify techniques and strategies that may help patients with challenging behaviour or who resist oral care / are unable to co-operate 9 Recognise the need for specialised mouth care / support for patients who require assistance Mouth Care for Adult Patients in Hospital / Vers 5 (07/13) This resource is in several sections, some of which can be used on their own.
    [Show full text]