日本口腔外科学会雑誌
Online ISSN : 2186-1579
Print ISSN : 0021-5163
ISSN-L : 0021-5163
50 巻, 4 号
選択された号の論文の13件中1~13を表示しています
  • 吸収性縫合糸固定とチタンミニプレート固定との比較
    森 亮太, 安田 浩一, 杉浦 真貴, 中山 洋子, 松浦 隆, 古澤 清文
    2004 年 50 巻 4 号 p. 223-226
    発行日: 2004/04/20
    公開日: 2011/04/22
    ジャーナル フリー
    Morphological changes in the maxillary sinus after the anterior wall had been reconstructed in a radical antrum operation for odontogenic sinusitis were evaluated in 24 patients. In nine patients, the bone replacement of the anterior wall was fixed by using synthetic absorbable surgical sutures. In the remaining 15 patients, the bone replacement was fixed by using a titanium micro-plate. We compared these two techniques for fixation. No patient in either group complained of any clinical problems since the radical antrum operation. However, the bone replacement was absorbed only in 4 of the 24 patients. Some of the other patients had a depression in the inner side of the maxillary sinus, scar tissue in the sinus, or both. Hence, we undertook quantitative analysis by computed tomography to evaluate the depression of the anterior wall and the scar tissue on the maxillary sinus in the different fixation groups. Bone depression of the anterior wall and the amount of scar tissue were slightly greater in the synthetic absorbable surgical suture fixation group than in the titanium micro-plate fixation group. These findings suggest that titanium micro-plates are particularly useful for fixation of the anterior wall of the maxillary sinus.
  • 谷口 佳孝, 中原 寛和, 小原 浩田, 田中 恵美子, 飯田 征二, 古郷 幹彦
    2004 年 50 巻 4 号 p. 227-230
    発行日: 2004/04/20
    公開日: 2011/04/22
    ジャーナル フリー
    We report on a 20-year-old Japanese man with mandibular prognathism and an abnormal position of inferior alveolar canal. This paper describes the surgical technique and modified intraoral inverted L ramus osteotomy used for mandibular setback. With this technique and examination by computed tomographic scanning, we could perform osteotomy as initially planned and avoid damage to the inferior alveolar nerve.
  • 小林 孝憲, 高木 律男, 小野 和宏, 飯田 明彦, 碓井 由紀子, 安島 久雄
    2004 年 50 巻 4 号 p. 231-234
    発行日: 2004/04/20
    公開日: 2011/04/22
    ジャーナル フリー
    We report on two children with infantile condylar fractures, caused by falling from front child seats of bicycles.
    Patient 1 was a 5-year-old boy, and patient 2 was a 2-year-old boy. Both patients had fractures of the mandible with complete condylar fractures. The first patient had a complete left fracture, and the second patient had complete right and incomplete left fractures.
    Circumferential wiring with an occlusal plate was performed for fixation of the mandibular body fractures, and mouth opening exercises were started several days after wiring. The occlusal plate was extremely useful, but many potential problems, such as caries or tooth luxation, were considered in patient 1.
    These patients show that a child riding in a front child seat of a bicycle can sustain a hard blow to the face, head, or both in the event of an accident. Increased external force due to the mother's weight can increase the severity of fractures.
  • 望月 美江, 新井 直也, 鵜澤 成一, 山根 正之, 山口 聰, 天笠 光雄
    2004 年 50 巻 4 号 p. 235-238
    発行日: 2004/04/20
    公開日: 2011/04/22
    ジャーナル フリー
    We describe a maxillary odontoma 48mm in longest diameter that was removed intraorally. An 18-yearold woman lacked right upper molar teeth and had a diffuse and hard swelling in this region. A computed tomographic scan showed a radiopaque mass lesion occupying most of the right sinus. While attempting to preserve the surrounding tissues, the lesion was segmented into several pieces by using bars and chisels and was then extracted. The reconstructed lesion measured 48 ×40×32mm. It was a complex odontoma. Odontoma consists of tooth elements, which can make cutting difficult. However, the hardness of odontomas has not been examined. We measured the microvickers hardness of the odontoma, as compared with that of teeth and cortical bones. The median values of enamel, dentin, and cortical bone were 312.0, 65.1, and 28.4, respectively. The median hardness of odontoma was 33.9, but hardness widely ranged from 13.6 to 295.1. The median hardness of the odontoma in our patient was greater than that of cortical bone, and cutting a long distance was not necessarily easy. However, the lesion could be removed with minimal invasion of the surrounding tissues. There has been no sequela, and the patient's progress remains good as of 21 months after the operation.
  • 立花 哲也, 千葉 博茂, 伊能 智明, 渡辺 正人, 飯田 裕, 竹村 昌浩
    2004 年 50 巻 4 号 p. 239-242
    発行日: 2004/04/20
    公開日: 2011/04/22
    ジャーナル フリー
    Solitary fibrous tumor (SFT) was first described in 1931. This tumor often arises in the pleura, but is uncommon in the head and neck region.
    We report a case of SET arising from the left preauricular region. The patient was a 29-year-old woman with a 4-year history of a painless mass in the left preauricular region.
    Computed tomography showed a clearly demarcated tumor. On magnetic resonance imaging, the tumor showed low signal intensity on T 1 weighted images and high signal intensity on T 2 weighted images.
    On March 28, 2001, tumor resection was performed by an external approach with the patient under general anesthesia.
    Histopathologically and immunohistochemically, the diagnosis was SFT.
    The postoperative course was good, and there has been no evidence of tumor recurrence as of 3 years after the operation.
    Since previous reports have indicated that 13 % to 37 % of SFTs are associated with local recurrence or are sometimes transformed to malignant tumors, long-term follow-up is very important.
  • 長島 弘征, 浅田 洸一, 栃原 しほみ, 佐藤 徹, 渡邉 宣之, 石橋 克禮
    2004 年 50 巻 4 号 p. 243-246
    発行日: 2004/04/20
    公開日: 2011/04/22
    ジャーナル フリー
    Myoepithelioma is a rare salivary gland tumor that appears mainly in the parotid gland and palate. We report a case of myoepithelioma originating from the buccal gland. A 19-year-old woman presented with a painless elastic hard mass beneath the left buccal mucosa. The mass was well defined and showed no ulcer. The mass was surgically removed under the clinical diagnosis of a benign minor salivary gland tumor. Macroscopically, the tumor was solid and nodular, surrounded by a thin fibrous capsule. Histopathologically, the tumor consisted of spindle-shaped and/or stellate cells with scanty cytoplasm. These tumor cells formed a trabecular structure and small nests in some regions; however a tubular structure was not seen. Immunohistochemistry showed positive staining for cytokeratin, S-100 protein, actin, and GFAP.
    The tumor was diagnosed as a myoepithelioma arising from the buccal gland.
  • 矢郷 香, 朝波 惣一郎, 金納 利絵, 中川 種昭
    2004 年 50 巻 4 号 p. 247-250
    発行日: 2004/04/20
    公開日: 2011/04/22
    ジャーナル フリー
    Rituximab is a chimeric monoclonal antibody directed against the B-cell CD20 antigen, which has been used for the therapy of B-cell non-Hodgkin lymphoma. It was approved by the Japanese Ministry of Health, Labour and Welfare in June 2001.
    We report a case of malignant lymphoma in the oral and maxillofacial region that was treated with rituximab and a combination of cyclophosphamide, doxorubicine, vincristin, and prednisolone (CHOP) and had an excellent response.
    The patient was a 62-year-old woman who had a swelling on the right side of the cheek. A computed tomographic scan revealed a mass measuring 33×30mm in the cheek with several swollen cervical lymph nodes. Biopsy of the cheek revealed lymphoid proliferation, consistent with malignant non-Hodgkin lymphoma (diffuse large Bcell lymphoma). Immunohistochemical staining was positive for CD20. The patient was therefore treated with rituximab and CHOP, and the tumor disappeared. One year 3 months have passed since treatment, and there is no evidence of recurrence.
    This is the first reported case of an excellent response of a malignant lymphoma in the oral and maxillofacial region to rituximab and CHOP in Japan.
  • 松井 竜太郎, 山口 孝二郎, 田畑 雅士, 副島 健太郎, 向井 洋, 杉原 一正
    2004 年 50 巻 4 号 p. 251-254
    発行日: 2004/04/20
    公開日: 2011/04/22
    ジャーナル フリー
    In March 1999, a 70-year-old man presented with ulceration of the oral mucosa and difficulty in swallowing accompanied by pain.
    Clinically, the oral ulcerations were characterized by a punched-out appearance, and the circumscribed lesions showed a trend toward bleeding with pain. The clinical diagnosis was herpetic gingivostomatitis.
    After admission, the patient received systemic antiviral agents (aciclovir), and corticosteroid ointment was applied to the oral lesions. Despite treatment, the oral ulcers remained unchanged, and the patient had a fever of unknown origin. Microscopic examination of a specimen of the oral ulcer revealed no definitive evidence of viral infection. On immunological examination, anti-ATLA was positive, and PPD reaction was negative. Subpopulation analysis of blood lymphocytes showed an increase in CD 4-positive cells and an increased CD 4/CD 8 ratio.
    Viral esophagitis was confirmed histopathologically by gastrointestinal examination. These findings suggested severe immune deficiency. A diagnosis of acute adult T-cell leukemia (ATL) was made at the Third Department of Internal Medicine of our university hospital. Chemotherapy for ATL was performed; however, the patient died of respiratory dysfunction caused by ATL cell infiltration of the lung in May 2000.
  • 山之内 浩司, 鎌田 伸之, 宮本 洋二, 桃田 幸弘, 北岡 栄一郎, 長山 勝
    2004 年 50 巻 4 号 p. 255-258
    発行日: 2004/04/20
    公開日: 2011/04/22
    ジャーナル フリー
    Body piercing is becoming more popular. Increasing popularity of tongue piercing has led to a rise in infectious complications and secondary metal allergy. We report a rare case of a deeply impacted metal barbelltype pierced ornament into the tongue.
    A 19-year-old man was referred to our hospital by a general practitioner bacause of discomfort of the tongue and difficulty in eating. The patient had a slight swelling of the tongue. Physical examination revealed a hard mass in the body of the tongue. Mandibular occlusal radiographs showed a radiopaque body measuring about 3×3mm in the center of the tongue. The clinical diagnosis was a foreign body in the tongue. The foreign body was removed surgically under local anesthesia. We performed element analysis of the removed foreign body. The patient's progress has been good, without functional disorders of the tongue.
  • 雨海 稔, 松井 義郎, 丹生 かず代, 松浦 光洋, 根本 敏行, 大野 康亮
    2004 年 50 巻 4 号 p. 259-262
    発行日: 2004/04/20
    公開日: 2011/04/22
    ジャーナル フリー
    This report describes a case of mediastinum emphysema caused by root canal therapy of the lower first molar.
    A 54-year-old woman presented with swelling of the right submandibular region and dysphagia. She had momentary pain during root canal disinfection with H2O2and NaOCI in the morning. Palpation and ultrasonic echography revealed subcutaneous emphysema extending to the contralateral side. She complained of dyspnea due to airway obstruction. The symptoms disappeared immediately after administration of methylprednisolone sodium succinate. Computed tomography, performed the next day, demonstrated that the emphysema extended to the upper mediastinum. The clinical course was rather good.
    We need to recognize the possibility that emphysema caused by dental treatment might extend to the mediastinum and lead to respiratory symptoms. Treatment should be performed promptly and adequately in such cases.
  • 根本 敏行, 高橋 浩二, 宇山 理紗, 松井 義郎, 道脇 幸博, 藤島 昭宏
    2004 年 50 巻 4 号 p. 263-266
    発行日: 2004/04/20
    公開日: 2011/04/22
    ジャーナル フリー
    A case of accidental insertion of a broken 30-gauge disposable injectionneedle in a patient receiving conduction anesthesia of the mandibular foramen is reported. Computed tomographic examination showed a broken injection needle inserted into the inferior head of the lateral pterygoid muscle behind the lateral pterygoid plate. Under general anesthesia, the broken needle was removed after difficulty infinding it. The length of the broken needle was 21mm. Electron microscopic examination showed deformation of the broken needle contour caused by bending force, with a spiral pattern of the broken plane. The break point was apparently formed by strong bending and torsion, causing the needle to break.
  • 中山 敦史, 丹下 和久, 黒岩 裕一朗, 松浦 宏昭, 福田 幸太, 前多 雅仁
    2004 年 50 巻 4 号 p. 267-270
    発行日: 2004/04/20
    公開日: 2011/04/22
    ジャーナル フリー
    As compared with the Miniplate (LEIBINGER), the Microplus plate (LEIBINGER) is very small and thin, and the screw is short. Therefore, more than 2 plates can be used for the reduction of mandibular condylar fractures. We used a Microplus titanium plating system for mandibular condylar fractures. Seven patients (4 males and 3 females) 14 to 72 years of age (mean, 36.9 years) were treated. The duration of maxillo-mandibular fixation was 0 to 28 days (mean, 16.9 days). The plates broke in 4 patients afterr elease of the fixation. In these patients, however, dislocation and displacement of the condylar fragments were minimal, and no dysfunction of mouth opening occurred.
  • 里見 貴史, 渡邊 裕之, 續 雅子, 蔵口 潤, 千葉 博茂, Adrian W SUGAR
    2004 年 50 巻 4 号 p. 271-272
    発行日: 2004/04/20
    公開日: 2011/04/22
    ジャーナル フリー
    Occlusal wafers are commonly used to establish the position of occlusion during orthognathic operations. Various problems have been encountered in the construction of these wafers. To overcome problems related to labor intensity, dimensional stability, and occlusal accuracy, a new technique for making wafers has been developed using light-cured acrylic resin. To stabilize the wafer during operation, an orthodontic elastic power chain is incorporated into the wafer. Advantages of this new technique include a shorter intermaxillary fixation time after orthognathic operations and a shorter construction time in the laboratory as compared with conventional techniques.
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