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52 巻, 7 号
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竹本 真一郎, 山口 晃, 中野 みゆき, 佐野 公人2006 年 52 巻 7 号 p. 386-392
発行日: 2006/07/20
公開日: 2011/04/22
ジャーナル フリーThe extraction of impacted third molars is a rather invasive procedure among dental treatments. In this study, how the sound and stress of the extraction of impacted third molars affects patients was objectively evaluated by examining changes in plasma catecholamine concentrations and hemodynamics. We also examined whether intravenous sedation was useful for the management of problems associated with extraction.
Twenty healthy patients who had impacted third molars (Class I Position A) were randomly assigned to receive local anesthesia (LA group, n=9) or intravenous sedation with midazolam (IVS group, n=11). Both groups received infiltration anesthesia with 3.6ml of 3% hydrochloric acid propitocaine with felypressin. The bone was removed with a bone chisel and mallet. Study variables were measured at five time points: after local anesthesia, before bone removal, during bone removal, after bone removal, and just after the end of operation.
The plasma epinephrine concentration in the WS group was significantly lower than that in the LA group at all time points. The plasma norepinephrine concentration in the WS group was significantly lower than that in the LA group before and during bone removal. Hemodynamics did not significantly differ between the groups.
Intravenous sedation with midazolam was considered a useful method to suppress the stress of patients caused by bone removal during the extraction of impacted third molars.抄録全体を表示PDF形式でダウンロード (1030K) -
川野 真太郎, 大部 一成, 松永 和秀, 川野 英子, 見立 英史, 鈴木 華子, 小林 家吉, 清島 保, 中村 誠司2006 年 52 巻 7 号 p. 393-400
発行日: 2006/07/20
公開日: 2011/04/22
ジャーナル フリーOne hundred fifty-one patients with salivary gland tumors histologically diagnosed at the Department of Oral and Maxillofacial Surgery, Kyushu University Hospital from 1982 through 2001 were clinicostatistically studied. The following results were obtained: 1. Of the total, 56.3% had benign tumors and 43.7% had malignant tumors.
2. Pleomorphic adenomas were most common, comprising 47.8% of all tumors and 84.7 % of benign tumors.
3. Both benign tumors and malignant tumors occurred more frequently in women.
4. The average age of the patients with malignant tumors (56.6 years) was higher than that of the patients with benign tumors (49.3 years).
5. With respect to the primary site, parotid gland tumors were most common, comprising 33.8% of all tumors. All sublingual gland tumors (100%) were malignant.
6. The cause-specific cumulative survival rate for all patients with malignant tumors was 67.6% at 5 years and 61.7% at 10 years. Mucoepidermoid carcinoma had a good outcome, but adenoid cystic carcinoma and carcinoma in pleomorphic adenoma had poor outcomes. According to primary site, submandibular gland tumors were associated with a significantly lower cumulative survival rate than minor salivary gland or parotid gland tumors.抄録全体を表示PDF形式でダウンロード (1171K) -
有吉 靖則, 島原 政司, 小村 健, 山本 悦秀, 水城 春美, 千葉 博茂, 今井 裕, 藤田 茂之, 篠原 正徳, 瀬戸 皖一2006 年 52 巻 7 号 p. 401-410
発行日: 2006/07/20
公開日: 2011/04/22
ジャーナル フリーWe studied 1809 patients with oral cancer who visited and were treated in 2002 at the 148 institutions certified as training facilities by the Japanese Society of Oral and Maxillofacial Surgeons, which comprise 39 dental university hospitals, 44 medical university hospitals, 64 general hospitals, and 1 unknown institution. The patients were 1071 (59.2%) males and 738 (40.8%) females (male: female ratio, 1.45: 1), who had a mean age of 65.2 years. The tongue (40.2%) was the most common site affected, followed by the gingiva (32.7%), buccal mucosa (10.1%), and oral floor (9.0%). There were 6 cases of intraoral multiple cancer. Histopathologically, squamous cell carcinoma (88.7%) was the most common type, followed by adenoid cystic carcinoma (2.1%), and mucoepidermoid carcinoma (1.7 %). Non-epithelial tumors comprised 1.8% of the total, among which malignant melanoma was the most common type. Cases classified as T2NO were the most common (32.1%), followed by T1NO (21.4%), T4NO (8.0%), and T2N1 (7.6%). Distant metastasis occurred in 17 patients (1.0%). The sizes of the non-epithelial malignant tumors ranged from 1.0 to 7.0cm, with a mean size of 3.7cm.抄録全体を表示PDF形式でダウンロード (1633K) -
林 常敏, 猟山 大, 藤内 祝, 上田 実2006 年 52 巻 7 号 p. 411-415
発行日: 2006/07/20
公開日: 2011/04/22
ジャーナル フリーA case of methicillin-resistantStaphylococcus aureus (MRSA) osteomyelitis arising in the mandible secondary to a fracture is presented. A 16-year-old boy was transported to our hospital after a traffic accident. Clinical examination revealed that he had suffered multiple trauma, including a mandibular fracture. After intensive treatment by brain surgeons for 2 weeks, open reduction and fixation of the mandible were performed. About 3 weeks after surgery, an abscess had formed on the surgical wound, and microbial culture yielded MRSA. A bony abnormality was detected on computed tomography. The patient received Teicoplanin (TEIC) and sequestrectomy was performed. Histopathological findings of the excised bone were consistent with osteomyelitis. After observation for a month, a bone graft was performed. MRSA was not detected in bone specimes obtained at the time of surgery. No recurrence has been noted as of 1 year after the last operation.抄録全体を表示PDF形式でダウンロード (2968K) -
高橋 喜久雄, 川畑 彰子, 小池 博文, 唐司 則之2006 年 52 巻 7 号 p. 416-419
発行日: 2006/07/20
公開日: 2011/04/22
ジャーナル フリーRecently, bisphosphonates have been widely used to treat bone metastasis from malignant tumors, multiple myeloma, osteoporosis, and secondary hypercalcemia caused by these osteoclastic diseases. However, bisphosphonates can cause avascular bone necrosis of the jaw in some patients. This is the first report of such a case of osteonecrosis in Japan.
An 81-year-old woman was referred to our clinic because of oral bleeding at night. The upper jaw of the patient was edentulous, and oral examination showed exposed necrotic bone with swelling of the surrounding soft tissue and purulent discharge. A CT scan revealed extensive osteonecrosis of the right side of the maxilla. The patient had a history of breast cancer with bone metastasis that was treated by intermittent chemotherapy with 45 mg pamidronate in weekly cycles. We suspected that this rare case of osteonecrosis was caused by chemotherapy with a bisphosphonate. Palliative treatments, including antibiotic therapy and local irrigation, were administered. Osteonecrosis of the jaw is being reported more frequently in patients receiving bisphosphonates. In the future, special precautions should be taken in such patients in dental practice.抄録全体を表示PDF形式でダウンロード (2898K)
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