In the 3rd edition of the International Headache Classification, trigeminal neuralgia （13.1.1） is classified into three categories: classical trigeminal neuralgia （13.1.1.1）, secondary trigeminal neuralgia （13.1.1.2）, and idiopathic trigeminal neuralgia （13.1.1.3）. We aimed to clarify features of trigeminal neuralgia by investigating its clinical statistics. Clinical data of 105 patients with trigeminal neuralgia who visited the pain clinic of Nihon University Dental Hospital between November 2005 and December 2016 were analyzed retrospectively. Classical trigeminal neuralgia （13.1.1.1） was the most observed （n=97）, including 86 patients of classical trigeminal neuralgia with purely paroxysmal pain and 11 patients of classical trigeminal neuralgia with concomitant continuous pain. Seven patients with secondary trigeminal neuralgia （13.1.1.2）, attributed to space-occupying lesions, and one patient with idiopathic trigeminal neuralgia （13.1.1.3） were observed. Two of the seven cases originally had positive and/or negative signs of trigeminal nerve dysfunction, which subsequently changed to typical features with secondary trigeminal neuralgia （13.1.1.2）. Carbamazepine was effective against classical trigeminal neuralgia with purely paroxysmal pain; however, it showed low effectiveness against both classical trigeminal neuralgia with concomitant continuous pain and idiopathic trigeminal neuralgia. Based on the classification, stage, and progress of trigeminal neuralgia, it is necessary to choose an effective treatment such as medication therapy, microvascular decompression, or high-frequency thermal coagulation.

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In today’s aging society, the number of patients suffering from taste disorders is increasing. The most frequent cause of taste disorder in older people is drug-induced; this is a serious side effect that affects the ability of older people to lead healthy lives. Therefore, it is necessary to assess the dissemination of information and establish a system for intervention as soon as possible. Herein we describe four cases of drug-induced taste disorder caused by amlodipine besylate, topiramate, tegafur, and prednisolone.

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A total of 421 patients with iatrogenic injury to the inferior alveolar nerve or lingual nerve injuries, including 3 patients with injury to both nerves, who visited the Acute Nerve Repair Outpatient at Tokyo Dental College from May 2011 to March 2019 were included in the study. We examined the sex, increase or decrease in the number of patients, time of visit, classification of the nerve disturbance, cause of nerve injury, annual trends in the injured nerve, route of visit, and number of conservative treatments. The number of cases were on the increase. The shortest time between the occurrence of the nerve injury and consultation was 1 day and the longest was 40 years 22 days. The number of patients indicated to peak at less than 2 months from onset and after 12 months. The inferior alveolar nerve and lingual nerve were affected in 282 and 142 patients, respectively. Nerve injury most commonly occurred during wisdom tooth extraction. Forty-seven patients underwent surgical treatment. Severe lingual nerve injury caused more severe symptoms and required surgical treatment more commonly than inferior alveolar nerve injury. It is necessary to educate dental clinicians regarding nerve injuries, anatomy of the lingual nerve, and symptoms of lingual nerve injury.

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We report a case of bone resorption inhibitor-related osteonecrosis of the jaw （ARONJ） in an 85-year-old woman with dementia and breast cancer. Although we initially selected conservative therapy, we switched to surgical therapy due to the progress of osteonecrosis. Prior to extensive sequestrectomy （sequestrectomy and surrounding bone shaving） under general anesthesia, it was necessary to solve various problems such as breast cancer control, underlying disease problems, and family cooperation. The postoperative course was favorable and no recurrence was noted until 15 months. It is expected that the number of elderly ARONJ patients with cancer and dementia will increase in the future. Therefore, oral surgeons should be able to collaborate with multiple occupations flexibly and appropriately.

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The patient was a 77-year-old man who consulted with a complaint of bilateral buccal mucosal discomfort during treatment for IgDλ-type multiple myeloma. Many dark red nodular lesions were found on both buccal mucosa, and two months later, mass lesions similar to buccal mucosa appeared on both lateral sides of the tongue. A biopsy was performed and the patient was diagnosed with AL amyloidosis. After the biopsy, there was no significant change in the lesions, however, one month later, he died of poor control of multiple myeloma.

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Metastatic cancer in the oral cavity is relatively rare. An 89-year-old man was hospitalized for lung adenocarcinoma. The radiological findings revealed multiple metastasis of lung cancer. Before beginning treatment with human anti-RANKL monoclonal antibody to inhibit bone metastasis, the patient was referred to our department for investigation of the oral cavity. The patient underwent extraction of a poor-prognosis premolar. Six months after the extraction, an aggressive large-sized mass with no bone resorption was observed in the maxillary region. Subsequently, a biopsy of the lesion was performed and the resulting histopathological and clinical findings were consistent with lung cancer metastasis into the oral cavity.

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