Blood transfusion is occasionally needed in orthognathic surgery. In our department, to avoid allogenic transfusions and, to obtain autofibrin glue which promotes intraoperative primary hemostasis, we collected blood for autologous blood donation (ABD) during unilateral surgeries such as sagittal split ramus osteotomy (SSRO). We conducted a retrospective survey of the SSRO in our department and investigated the efficacy of ABD. Furthermore, we investigated the factors that could predict those patients whose recovery from anemia would be delayed, before phlebotomy.
We investigated the patients who required preoperative ABD before independent SSRO. Within 24 hours following the surgery, the blood was transfused. To investigate the postoperative influence of the preoperative autologous blood collection, we divided the subjects into a recovered group in whom Hb value on day 7 after the surgery was less than 5% of the value prior to ABD, and all other subjects into the non-recovered group. Moreover, we investigated whether our results contained any factors that could predict these non-recovered patients prior to surgery. Significance was established at p < 0.05.
There were 4 cases in which bleeding in excess of 20% of the predicted blood circulation was observed. Although there was no significant difference between the Hb value prior to autologous blood collection, the non-recovered group showed a higher value than the recovered group. The lowest Hb value for both groups occurred on day 4 after the surgery, irrespective of whether an ABD was performed. We predicted that, if the blood was not transfused, the Hb value at this period might be further decreased. Even in cases where allogenic transfusions were considered because of the degree of bleeding, we believe that preoperative ABD during SSRO is advantageous.
This investigation suggests that it is possible to use the patient's weight and Hb value prior to blood collection for predicting the patient's inclusion in the non-recovered group.
We investigated the efficacy of preoperative ABD during orthognathic surgery. In almost all cases, we believe that no indication for allogenic transfusions was present. However, we believe that preoperative ABD, with primary hemostasis using fibrin glue and avoiding allogenic transfusion that can cause unpredictable significant blood loss, is the preferred method of transfusion.

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Cleidocranial dysostosis (CCD) is characterized by delayed exfoliation of deciduous teeth, delayed eruption of permanent teeth, and multiple supernumerary teeth. Therefore, many CCD cases need orthodontic treatment. This report describes the long-term treatment of a CCD patient with anterior open bite. The patient was first examined at the age of 10 years. We extracted some deciduous and supernumerary teeth in the anterior maxillary region. However, the patient stopped treatment, then returned for treatment at the age of 17 years, whereupon preoperative orthodontic treatment was begun. We extracted the remaining deciduous teeth and started traction of the impacted permanent teeth. We then performed an anterior alveolar osteotomy of the upper and lower jaws at the patient's age of 24 years. One year postoperatively, the patient has stable occlusion and satisfactory results.

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Single-tooth alveolar osteotomy followed by distraction osteogenesis was applied to move an infrapositional ankylosed tooth to the normal position. A maxillary right canine of a 16-year-old female patient was at 6 mm infraposition compared with the maxillary left canine. Single-tooth alveolar osteotomy was performed under general anesthesia. After suturing the wound, an extrawound distraction device was attached to the crown of the ankylosed canine. The distance of movement was 7 mm. After the distraction movement, the fragment was fixed with wires and resin. The consolidation period was 2 months. During the treatment period, 2 complications associated with the roots occurred: injury of the root of the neighboring tooth during osteotomy and progressive inflammatory root resorption of the ankylosed tooth. The root fragments of the neighboring tooth fused spontaneously and the tooth did not show any symptoms of root resorption. The progressive inflammatory root resorption, which occurred at the cervical portion, was treated by removing the granulation in the resorption-lacuna and restoration with composite resin. It was suggested that root injury under sterile conditions probably promoted periodontal healing. Careful postoperative observation was necessary to detect and promptly treat the progressive inflammatory root resorption.

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第19回特定非営利活動法人日本顎変形症学会総会　プログラム・抄録号（第19巻2号）に掲載されました以下のポスター演題3題が取り下げ（欠演）となりましたので，ご報告いたします。
1-P-13　上顎前歯部歯槽骨切り術を施行した上顎前突症例の側貌変化に関する検討
五十嵐友彦，他　札幌医科大学　医学部　口腔外科学講座
2-P-39　患側下顎枝の骨延長術を行ったHemifacial microsomiaの2例
出張裕也，他　札幌医科大学　医学部　口腔外科学講座
2-P-40　Hemifacial microsomia患者の顎口腔形態ならびに顎運動機能に関する検討
三木善樹，他　札幌医科大学　医学部　口腔外科学講座

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