日本顎変形症学会雑誌
Online ISSN : 1884-5045
Print ISSN : 0916-7048
ISSN-L : 0916-7048
8 巻, 3 号
選択された号の論文の11件中1~11を表示しています
  • 岡村 正彦, 松井 成幸, 龍田 恒康, 福永 秀一, 永峰 浩一郎, 山崎 康之, 中西 徹, 竹島 浩, 嶋田 淳, 清村 寛, 山本 ...
    1998 年 8 巻 3 号 p. 151-156
    発行日: 1998/12/15
    公開日: 2011/02/09
    ジャーナル フリー
    This study was undertaken to analyze the changes of frontal face of skeletal class III malocculusion following sagittal splitting ramus osteotomy.
    Cephalograms (lateral and frontal) and facial photographs of ten cases were used as samples. Facial width and height of the ear, nose, lip, and chin were measured. The soft tissue changes were analyzed by the ratio of the facial width/height. The hard tissue changes were analyzed by the ascending angle (∠ AS. A), AG-GA width, and FH-Me.
    The results were as follows:
    1. The facial width of the nose and ear increased.
    2. The facial height of the lip and chin was decreased.
    3. The ratio of the facial width/height was increased for the lip and chin.
    4. Consequently, a little increase in skeletal width of the frontal faces and decrease in the skeletal height of the frontal face were recognized.
    The interrelationship between the soft and hard tissue changes was not identified.
    The above-mentioned results suggested that the changes of the frontal face following sagittal splitting ramus osteotomy mainly occur at the lip and chin.
  • 比地岡 浩志
    1998 年 8 巻 3 号 p. 157-169
    発行日: 1998/12/15
    公開日: 2011/02/09
    ジャーナル フリー
    The purpose of this study was to analyze the relationship between changes of mandibular position and that of facial morphology before and after orthognathic surgery by sagittal splitting ramus osteotomy (SSRO) and to simulate the postoperative facial image.
    Eleven female patients with mandibular prognathism who underwent SSRO were analyzed just before and 3 months after the operation by using a noncontact three-dimensional measuring apparatus (VOXELAN NKV-300DS, Hamano Engineering) and three-dimensional analyzing software (3-D RUGLE, Medic Engineering).
    The results were as follows:
    1. It was found that the system composed of VOXELAN and 3-D RUGLE was useful for three-dimensional measurement and analysis of facial figure in jaw deformity.
    2. The morphological changes of facial soft tissue caused by the mandibular set back were maximum in the middle mental region. The upper lip region was slightly affected as well.
    3. The anatomic measurement points in the lower face showed downward and significant backward movement. Most points of the upper and middle face showed little change.
    4. Facial heights were shortened significantly.
    5. By taking the direction of the mandibular movement into account, changes of facial morphology by mandibular movement were demonstrated more clearly.
    6. It was found that the simulated postoperative facial image computed by the data were similar to the real one.
  • 上顎骨の移動方向別に分類した多変量解析による検討
    河内 満彦, 松尾 健一, 菅原 準二, 川村 仁, 三谷 英夫
    1998 年 8 巻 3 号 p. 170-185
    発行日: 1998/12/15
    公開日: 2011/02/09
    ジャーナル フリー
    The purpose of this study was to investigate the changes of soft tissue profile in the nose and upper lip region following orthognathic surgery.
    The subjects were 114 adult females who underwent two-jaw surgery to correct anterior reversed occlusion and were classified into four groups by the directions of surgical displacement of maxilla by cluster analysis. In addition to displacement of hard tissue, some of the soft tissue measurements in the nose and upper lip region such as height and thickness were evaluated with multiple regression analysis.
    The results were as follows:(1) Although the tip of the nose was displaced in the upward and forward direction, except in the group where the anterior part of the maxilla was surgically displaced downward, the displacement of the nose as a whole was minimum.(2) The displacement of the upper lip was similar to that of the front part of maxilla, except in the downward group.(3) In addition to the displacement amount of the hard tissue maxilla, thickness and height of the soft tissue in the nose and upper lip region also contributed to significant changes of the profile.
    By using a multiple regression analysis, acceptable prediction of the soft tissue profile in the upper lip region would be possible, but precise prediction would be difficult, because of the nose and alar base cinch suture, etc.
  • 下顎枝矢状分割術施行例における骨片固定法の違いによる比較
    服部 幸男, 高木 律男, 武藤 祐一, 鍛冶 昌孝, 内山 奈津子, 福田 純一, 大橋 靖, 花田 晃治
    1998 年 8 巻 3 号 p. 186-191
    発行日: 1998/12/15
    公開日: 2011/02/09
    ジャーナル フリー
    To evaluate the efficacy of screw osteosynthesis for the patient suffering from mandibular prognathism with severe open bite, postoperative stability was studied cephalometrically in 11 cases (positioning screw in 5 and transosseous wiring in 6) who underwent bilateral sagittal split ramus osteotomy. The degree of “severe” open bite was defined as the difference between pre- and postoperative Mop angle with 1.86 degrees or more considered to be severe.
    The patients ranged from 17 to 29 years old (mean: 20.5 years). The average period of intermaxillary fixation postoperatively was 16.0 days and 43.2 days for the screw group and the wire group, respectively. Cephalometric measurements at the point of Me and the angle of SN-Mp were performed preoperatively and postoperatively and at release of intermaxillary fixation, 6 months later, 1 year later, and long-term follow-up thereafter in each case.
    In conclusion, the results revealed some distinct advantages of screw osteosynthesis over transosseous wiring to reduce not only the period of intermaxillary fixation but also postoperative relapse of the distal segment.
  • 縦断的資料による
    戒能 弘子, 中村 芳樹, 関谷 利子, 桑原 洋助
    1998 年 8 巻 3 号 p. 192-202
    発行日: 1998/12/15
    公開日: 2011/02/09
    ジャーナル フリー
    The growth changes of the mandibular symphysis were examined longitudinally in fourteen female patients with severe skeletal class III malocclusion.
    The materials were lateral cephalograms of the patients when they were 10-16 years old. Detailed angular and linear measurements of the symphysis were taken. The resu ts were as follows:
    1. Mandibular symphysis tipped lingually, in accordance with the increase of skeletal discrepancy, but the extent of lingual tipping varied from individual to individual.
    2. In holizontal linear measurement, point B moved lingually with reduction of the symphyseal thickness at point B. The dislocation of pointB was larger than those of the points Is and Id. The changes of symphyseal thickness at pogonion was relatively small.
    3. In vertical liner measurement, the symphysis elongated vertically, which depended mainly on the vertical increase in the height of MP-B.
    4. The basal bone at point B showed the most conspicuous changes in both measurements.
    The results suggested that mandibular symphysis shows an adaptive mechanism by inclining itself lingually to adjust for the increase of the skeletal disharmony and so the chin becomes more prominent.
  • 川元 龍夫, 本橋 信義, 五十嵐 一吉, 小野 卓史, 森山 啓司, 馬場 祥行, 加藤 嘉之, 宮坂 貴仁, 黒田 敬之
    1998 年 8 巻 3 号 p. 203-212
    発行日: 1998/12/15
    公開日: 2011/02/09
    ジャーナル フリー
    The purpose of this study was to extract characteristic three-dimensional dentofacial changes during the retention period and to clarify morphological factors affecting the stability of postoperative occlusion in mandibular prognathic patients with open bite and asymmetry.
    Seven adult patients having negative A-B difference and overbite in the pretreatment stage and more than 5 mm mandibular setback differences between right and left side were selected for this study. The subjects were divided into the following two groups; 3 subjects who underwent mandibular setback osteotomy with the sagittal split technique (one-jaw group) and 4 subjects who underwent mandibular setback osteotomy with the sagittal split technique and Le Fort I osteotomy (two-jaw group). The lateral and frontal cephalograms taken at three stages; pretreatment, posttreatment, and under retention (more than one year after posttreatment) were used for quantitative evaluation of dentofacial changes.
    Changes in denture components, skeletal components, and anterior occlusion during the retention period were analyzed three-dimensionally, respectively. The results were as follows:
    1. As for the anteroposterior dimension, there were some relapse in the skeletal components in both groups, and the amount of relapse in the one-jaw group was larger than in the two-jaw group. However, the overjet was stable because of compensatory changes in the denture componentssuch as labial tipping of the upper incisors and lingual tipping of the lower incisors.
    2. As for the vertical dimension, the overbite in both groups decreased because of relapse in the skeletal and denture components.
    3. As for the transeverse dimension, there was a little relapse in the skeletal components in both groups. However, the midline of anterior teeth was stable because of compensatory changes of the lower incisors. These results suggested that it is important to maintain long-term stability of the anterior occlusion in the vertical dimension in patients with three-dimensional dentofacial deformity.
  • 有賀 進, 松浦 正朗
    1998 年 8 巻 3 号 p. 213-221
    発行日: 1998/12/15
    公開日: 2011/02/09
    ジャーナル フリー
    In 41 setback cases of sagittal split ramus osteotomy of the mandibular ramus with screw fixation combined with the repositioning technique for the proximal fragment, the change of the condylar position between before and after surgery wereevaluated. The movement of the condyle on a sagittal plane and the mediolateralmovement of the proximal fragments on a frontal plane were quantified with the use of lateral tomograms and frontal cephalograms taken at about the same time immediately before surgery and within 30 days after surgery.
    The relations betweentemporomandibular joint disorders and the movement of the mandible and proximal fragments were also studied.
    The results were as follows:
    1. As for the sagittalplane, there was evidence of anterioinferior movement of the mandibular condyle after surgery. As for the frontal plane, most proximal bone fragments moved medially on the right side and laterally on the left side. The effects of these movements appeared to cancel postoperative lateral movement.
    2. There wasno correlation between the lateral difference in the amount of setback and the mesiolateral movement of proximal bone fragments in a frontal plane.
    3. There was no correlation between postoperative temporomandibular joint symptoms and anteroposterior and vertical movement of the condyle in a sagittal plane or the movement of proximal fragments in a frontal plane.
  • 野口 信宏, 井原 功一郎, 成冨 貞幸, 後藤 昌昭, 香月 武
    1998 年 8 巻 3 号 p. 222-228
    発行日: 1998/12/15
    公開日: 2011/02/09
    ジャーナル フリー
    The purpose of the study was to evaluate the postoperative change in mandibular movement function and in joint noise in patients who underwent sagittal splitting ramus osteotomy (SSRO) for mandibular deformities. The following measurements were made in 22 patients before surgery and at 3, 6, and 12 months after surgery: the amount of maximum mouth opening, levels of electoromyographic activity ofmasseter muscle, and temporomandibular joint noise. At 3 months after surgery, the amount of maximum mouth opening and masseter muscle activity had not recovered sufficiently; at 6 months, both mouth opening and electromyogram activity began to increase; and at 12 months after surgery, the values of the two indices were almost the same when compared with those in normal groups. After surgery, the ratio of patients with temporomandibular joint noise decreased remarkably. Therewas no case of newly-recognized joint noise after surgery.
  • 海原 真治, 別所 和久, 山田 剛也, 森家 祥行, 藤田 茂之, 飯塚 忠彦
    1998 年 8 巻 3 号 p. 229-233
    発行日: 1998/12/15
    公開日: 2011/02/09
    ジャーナル フリー
    In this paper, a mandibular prognathism with suspected large hemangioma was reported. The patient was a 35-year-old male with the chief complaint of prognathism. Calcification in the sublingual, submandibular, and pterygomandibular region were found by X-ray examination, however, the mass and cystic leision was not found by CT examimation. It was difficult that the clinical diagnosis could be established from the clinical findings and X-ray and CT examinations. The leision was suspected to be myositis ossificans, but the pathological diagnosis of biopsy specimen, extracted from the submandibular region, was not suggested to be myositis ossificans. The biopsy specimen of calcification was observed by scanning electron microscopy (SEM) and X-ray microanalysis. SEM showed a layer pattern in the calcification. As the result of X-ray microanalysis, the main detected component elements in calcification were Ca and P, whose calculated Ca/P ratio was 1.52. These findings suggested that the calcification was a plebolith. Sagittal splitting osteotomy could be performed by the Obwegeser method without any trouble. The postoperative course was uneventful for four years.
  • 昌山 浩三, 日浦 賢治, 天真 覚, 松本 和也, 中西 秀樹, 森山 啓司
    1998 年 8 巻 3 号 p. 234-246
    発行日: 1998/12/15
    公開日: 2011/02/09
    ジャーナル フリー
    Crouzon's disease is one of the most common craniofacial syndromes that occur due to premature closure of cranial sutures. It is characterized by craniosynostosis, calvarial deformity, maxillary hypoplasia resulting in relative mandibular prognathism, hypertelorism, and exophthalmos. In this paper, the clinical findings and the treatment process of a twelveyear-old male patient with Crouzon's disease who underwent surgical orthodontic treatment before adolescence were reported.
    1. This patient presented hypertelorism, disturbance of eyelid closing dueto exophthalomos, and skeletal class III malocclusion caused by growth retardation of the maxilla.
    2. Frontal advancement was performed in order to cure the neurological symptons whilethe preoperative orthodontic treatment was underway.
    3. Le Fort III osteotomy was performed by moving the mid-face in the forwardand downward direction, as well as by rotating it clockwisely. The mandible also rotated clockwisely as a result of the displacement of the mid-face. The soft tissue profile and occlusion was markedly improved in this case.
    4. Immediatelyafter surgery, upward maxillary movement was observed. The condylar position in the fossa looked more favorable by roentgenographic observation after one year and seven months of treatment than that at the initial stage.
  • 森田 正浩, 白土 雄司, 山口 利浩, 甲斐 裕之, 大石 正道
    1998 年 8 巻 3 号 p. 247-255
    発行日: 1998/12/15
    公開日: 2011/02/09
    ジャーナル フリー
    von Recklinghausen's disease is characterized by cafe-au-lait spots and multipleneurofibromas as major findings and eye lesions, bone lesions, and endocrine abnormalities as associated findings. A 23-year-old male with von Rechlinghausen's disease associated with mandibular retrognathia was reported. He visited our clinic due to malocclusion and retrognathia.
    In the abdomen and the back, multiple small tumors and café-au-lait spots were observed. Severe deep bite (overbite: 7mm; overjet: 13mm) and narrowing of the maxillary and mandibular dental arches were noted. The interincisal distance was 41 mm, and the maximum ranges of the mandibular movements were 10 mm anteriorly, 9.5 mm to the right, and 12.0mm to the left. Microglossia showing geographical fissured tongue was observed.
    Intraoral radiographic examination revealed congenital dental missing of 21|2 and impaction of but no other findings in the jaw characteristic of this disease. He was treated by anterior movement of the mandible (12 mm) via bilateral sagittal split ramus osteotomy of the mandible and overcorrection in consideration of possible relapse after operation (overbite: 1 mm; overjet: 1 mm). Subsequently, occlusion was restored by prosthetic treatment. The final measurement values 6months after operation were as follows: overbite: 4.5 mm; overjet: 5 mm; interincisal distance: 41 mm; amount of jaw movements: 7 mm anteriorly, 10 mm on theright side, and 10 mm on the left side. After that, skeletal relapse was not noted. However, atrophic changes and underdevelopment of the mandible appear to be involved in the development of retrognathism in this case.
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