顎変形症患者の術前術後における咀嚼様式に関する研究

抄録

Difficulties in mastication, speech, esthetics and others are noted as defects of jaw deformity. In addition the systemic disorders derived from these troubles are also indicated. The orthognatic surgery is said to be a technique to improve these disorders positively. Thus pre- and postoperative evaluations referring to the jaw deformity is important as noted in numerous reports. However, no report has yet stated on the systemic matters. The authors therfore studied what masticatory patterns the patients with jaw deformity have, how they are related to the systemic health, and how they change after the surgical operation. Seventeen patients with jaw deformity examined at the Division of Detistry and Oral Surgery, Fukuoka University Hospital, in the period from April, 1989 to December, 1990 were used, including 10 patients observed 6 months after the surgery, and 6 patients observed one year after the surgery. As the control 1, 052 adults in good health were used. Observations were made in the mode of question and answer using a questionnaire on food ingestion and mastication, referring to percentages between groups, namely, that before the surgery and the control, that before the surgery and that after 6 months, and that before the surgery and that after one year respectively, and picking up the items wherein the significant difference was noted at 5% as the level of significance or below, and the items wherein the trend difference was noted at 10% as the level of significance or below. Numbers of mastication was answered based on individual experiences, and changes between before and 6 months or one year after the operation were observed. Masticatory performance was determind according to the measurement of absorbance using the ATP particle as the masticatory, and changes between before and 6 months or 1 year after the surgery were observed. As the result it was clarified as follows : 1. The patients with jaw deformity had a habit of incomplete masticasion in eating, due to the easily caused masticatory fatigue when something hard is masticated, although they hold a desire of eating with sufficient mastication. Physically, thirst and viscid sensation in mouth and other discomforts were complained, and mentally they felt miserable being unable to masticate foods. However, they easily adapted themselves to the circumstances with hopes and desires. 2. After the operation, a subjective improvement of occlusal functions, a reduction of masticatory fatigue and an increase of masticatory desire were noted, showing an increase of the habit of complete mastication. Physically discomfort in mouth disappeared, and according to the improvement of occlusion they began to feel happy showing an inrease of the adaptability to their life in a group. 3. Numbers of mastication increased from 5-7 times to 8-13 times a mouthful after the surgery. 4. Masticatory performance was improved showing an increase to 154.5% one year after the surgery.