It has been reported that bacteriemia during dental procedures is one of the most frequent causes of infective endocarditis (IE) . A questionnaire was given to general dental practitioner to investigate how they treat patients with IE. The results were as follows: 1) Most dentists knew IE to some extent but did not understand the exact methods of preventing it during dental procedures, 2) Most dentists knew the importance of prophylaxis of IE when surgical procedures were conducted, but did not pay much attention when scaling was performed. These results indicated an insufficient understanding of IE among dentists.

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Roxithromycin (RXM), a macrolide antibiotic, is currently prescribed in a dose of 150 mg twice a day (BID) . In our study, efficacy, safety, and usefulness of a dose of 300 mg once a day (OAD) of RXM was clinically investigated.
1) A single dose of 300 mg of RXM was preoperatively administered to 98 patients who were undergoing oral surgery, and drug concentration levels were determined in their blood, effusion in tooth extraction wound, and various oral tissues. The blood levels were 0.085-19.0 iig/ml 0.67-20.05 hours after administration. The levels in the effusion in the tooth extraction wound were ND-14.4 ii g/ml 1.05-20.17 hours after administration. Concentration levels in various oral tissues were ND-5.06 ii g/ml in gingivae 0.58-26.5 hours after administration ; ND-4.79 tLg/ml in the cyst wall 1-10.37 hours after administration ; and ND-2.99, ig/ml in the mandibula, alveolar bone, etc. 1-10.37 hours after administration.
2) A dose of 300 mg OAD of RXM was clinically studied in 112 patients with dental and oral surgery infections. The evaluation of clinical efficacy was 83.0 % (93/112) in the scoring evaluation and the efficacy rate (good or excellent) was 81.6 % (93/114) in the attending physicians'evaluation.
3) In 49 patients, germs were detected in the closed abscess at the start of administration, and the bacterial eradication rate was 89.6 % (43/48) for these patients.
4) Concomitant symptoms were observed in 5 patients, representing 4.35 % (5/115) in incidence : facial edema, vomiting and discomfort in the stomach, soft stool, eruption, and vomiting and abdominal pain in one case each. None were serious. Abnormal laboratory findings were obtained in 11.3 % (12/106) .
5) Safety rate (mostly safe or no problem) was 96.2 % (102/106) .
6) Usefulness rate (useful or markedly useful) was 81.1 % (86/106) .

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The amount and kinds of injections for carcinoma purchased between Apr. 1, 1995 and Mar. 31 1996, at 10 national university dental hospitals in Japan were investigated.The most commonly used anticancer agents were the platinum complexes. Although three different platinum comlex agents were used, cisplatin was the most commonly used agent. The second commonly used agent was Picibanil^®; four different potency preparations (0.1-5KE) were available on the market. The most frequently used Picibanil^® agent was 1KE, which constituted 81 % of these prescriptions. The antimetabolites agents were the third most commonly purchased anticancer preparations. Tegaful and 5-fluorouracil were the two approved agents of this class used by dental hospitals for cancer of the head and neck. Antibiotics were the fourth most commonly used class of anticancer agents. Peplomycin sulfate was the most frequently used antibiotic (50 %), bleomycin was second (27 %), and mitomycin C was third (20%) in this class of agents.
Other anticancer agents used in the field of oral surgery were methotrexsate, dacarbazine doxisorubicin hydrochloride, teceleukin, etc.
In our hospitals, the appropriateness of selected anticancer agents for injections was higher than had been anticipated.

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The total number of prescriptions and the total amount of oral drugs for carcinoma purchased at 10 national university dental hospitals in Japan were investigated. During the fiscal year, Apr. 1, 1995 to Mar. 31, 1996, the total number of prescriptions for ambulatory patients at the 10 hospitals was 101, 707. They included 2, 646 prescriptions of anticancer drugs, which was 2.06 % (2, 646/101, 707) of all prescriptions. The most prescribed drug for carcinoma at the 10 hospitals surveyed was UFT^®, with 206, 975 × 100mg doses dispensed per year. A small amount of off-labeling drugs such as Ubenimex (Bestatin^® ), PSK (Krestin^® ), Tegafur (Fental^® ), and Doxifluridine (Furtulon^® ) was used at six hospitals.

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Cefdinir was administered in a oral dose of 100 mg three times a day to 55 patients with odontogenic infections to investigate the clinical and bacteriological effects. The overall clinical efficacy rate of cefdinir was 89.1 %, 92.7 % (38 of 41 patients) for periodontitis and 83.3% (10 of 12) for pericoronitis.
Of these patients, 5 had diabetes. Cefdinir was effective in 4 patients. The bacteriological effect was obtained as follows : The eradication rates were 84.0% (42 of 50 strains) for oral streptococci, 88.2% (15 of 17) for Peptostreptococci, and 100% (14 of 14) for Gram negative anaerobe bacilli (Prevotella, Porphyromonas, Fusobacterium) . The eradication rates were 83.6% for all the aerobic bacteria and 90.6% for the anaerobic bacteria. The clinical efficacy and bacteriological eradication rate in this study was confirmed to be nearly the same as those obtained when cefdinir was marketed in 1991.

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Oral symptom of chronic GVHD (graft-versus-host-disease) prolongs the illness period of a patient with an eating disorder.
Allopurinol mouthwash (ALP) was used for a 35-year-old male who developed an eating disorder due to an oral symptom of chronic GVHD after bone marrow transplantation after diagnosis of a myelodysplastic syndrome. As a result, the oral symptoms disappeared 40-60 days after gargling was started which was early in comparison with the change of constitutional symptoms such as trunk efflorescence, GOT, and GPT, and its efficacy was suggested.
ALP was reported for prevention and treatment of the stomatitis, which develops during cancer chemotherapy, with the usefulness, and the action is reported with the anti-inflammatory action mainly on active oxygen scavenging and generation inhibitory effect. As for therapy of chronic GVHD, administration of the immunosuppressive agent is central, and the local therapy has not been established. The use of ALP was convenient only in gargling, and no side effect was recognized, so it seemed to be a useful drug.

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An aqueous soft alkaline electrolyte solution is obtained by diaphramless electrolysis of water with a small amount of sodium chloride. Soft alkaline solution water included about 60 ppm effective chlorine that exhibits a bactericidal effect. In order to evaluate the possibility of using a soft alkaline solution water for periodontal treatment, the bactericidal effect of the solution on periodontopathic bacteria was investigated. Bactericidal effect of soft alkaline solution water was compared with hard oxidized water. The effect of saliva and serum and soft alkaline solution were compared to determine the bactericidal effect.
The results revealed that soft alkaline solution water bactericidal effect is the same as hard oxidized water on all bacteria. Moreover, the bactericidal effect of soft alkaline solution water plus 10% saliva was stronger than hard oxidized water. The results suggested the usefulness of soft alkaline solution water in the periodontal treatment.

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This investigation was conducted to review morphine use in 10 of 11 dental hospitals attached to national universities.
In 1995, 10 hospitals purchased the equivalent of 395g of pure morphine. Four hospitals purchased quantities of 70 to 100g per year. The other facilities purchased only minute quantities. Among three formulations of controlled release morphine sulphate tablets available, the purchase of 10mg tablets was 80% of the total purchases made by the 10 hospitals. D hospital purchased the largest quantity of 10mg equivalent tablets being 65% of their total purchases. H hospital purchased the largest quantity of 10mg equivalent suppositories, being 78% of their total purchases. The other hospitals purchased only minute quantities of suppositories. E and F hospitals purchased large quantities of morphine for injection, while five hospitals had no record of purchase of any injectable preparations.

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