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56 巻, 9 号
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巻頭言
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天笠 光雄2010 年 56 巻 9 号 p. 497
発行日: 2010/09/20
公開日: 2013/10/31
ジャーナル フリーPDF形式でダウンロード (122K)
原著
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岩本 修, 岩屋 勝美, 田上 隆一郎, 古賀 真, 津山 治己, 楠川 仁悟2010 年 56 巻 9 号 p. 498-505
発行日: 2010/09/20
公開日: 2013/10/31
ジャーナル フリーWe measured urinary cross-linked C-telopeptide of type I collagen (CTX) in 72 patients who were receiving bisphosphonate (BPs) treatment to investigate the risk of BPs-related osteonecrosis of the jaw (ONJ) . Thirty-six of the 72 patients had developed ONJ, and the other 36 had not. Urine was collected after an overnight fast, and the CTX level was measured by enzyme-linked immunosorbent assay as creatinine-converted values (Crconverted values) . The mean Cr-converted value in the BPs-treated patients tended to be lower than the standard value. The CTX level in the group with ONJ was significantly lower than that in the group without ONJ (p < 0.001) . The cut-off value of CTX as measured by the ROC curve was 98 Cr-converted values for the risk assessment of ONJ. The Cr-converted value was 98 or lower in 29 of/36 patients (81 %) in the group with ONJ. In contrast, the Cr-converted value was higher than 98 in 28 of/36 patients (78 %) in the group without ONJ.Therefore, the risk of developing ONJ is high when the Cr-converted value of the CTX level is 98 or lower. The CTX value in the injection prescription group was lower than that in the oral prescription group (P = 0.020) .
The CTX level was also lower in the A group concurrently receiving steroids (P < 0.001) and the group concurrently receiving steroids and anticancer drugs (P = 0.023) as compared with patients not receiving these drugs.
These findings suggest that urinary CTX measurement is useful for assessing the risk of developing BPs-related ONJ.抄録全体を表示PDF形式でダウンロード (605K)
症例報告
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中本 紀道, 依田 哲也, 中本 文, 安部 貴大, 佐藤 毅, 坂田 康彰2010 年 56 巻 9 号 p. 506-510
発行日: 2010/09/20
公開日: 2013/10/31
ジャーナル フリーSupernumerary teeth are not rare, but metachronous supernumerary teeth in the same region are extremely rare. A 10-year-old boy with bilaterally impacted teeth in the mandible was referred to our hospital to undergo a detailed examination. A panoramic X-ray film showed three supernumerary teeth impacted bilaterally in the premolar region of the mandible. All of the supernumerary teeth were extracted, and the dental follicle around the supernumerary teeth was completely removed. However, about 2 years later, a panoramic X-ray film revealed four bilateral supernumerary teeth in the same region of the mandible. All of the supernumerary teeth were extracted. The extracted teeth were similar to normal permanent premolars and molars in both shape and size. A review of the past literature suggested that these supernumerary teeth might develop from the third dental laminae.抄録全体を表示PDF形式でダウンロード (708K) -
川島 渉, 高山 賢一, 倉木 美穂, 井上 智裕, 川上 哲司, 桐田 忠昭2010 年 56 巻 9 号 p. 511-514
発行日: 2010/09/20
公開日: 2013/10/31
ジャーナル フリーSynovial chondromatosis is characterized by cartilaginous metaplasia. It frequently involves the elbow, knee, and hip, but rarely involves the temporomandibular joint (TMJ) . The clinical course of this progressive disease is divided into 3 stages. We report a case of synovial chondromatosis of the right TMJ. The patient was a 62-year-old woman. Preoperative physical, radiographic, and arthroscopic examinations showed no evidence of synovial chondromatosis. However, arthroscopic surgery of the right TMJ revealed many white, small masses and loose bodies in the upper joint space of the TMJ. We excised these masses. The histopathological diagnosis was synovial chondromatosis. These findings suggested that the loose bodies of synovial chondromatosis developed and progressed during the course of therapy.抄録全体を表示PDF形式でダウンロード (694K) -
山下 雅子, 篠崎 泰久, 平塚 正樹, 上野 泰宏, 神部 芳則, 草間 幹夫2010 年 56 巻 9 号 p. 515-518
発行日: 2010/09/20
公開日: 2013/10/31
ジャーナル フリーA 66-year-old man was referred to our department because of poor healing of the socket of the right maxillary first molar, which was extracted 5 months previously. The socket showed incomplete epithelization, and alveolar bone was partially exposed. Panoramic radiographs and CT images showed a round bone defect around the socket. The clinical diagnosis was maxillary cyst, and a cystectomy was performed under local anesthesia.
The histopathological diagnosis was Langerhans cell histiocytosis. Bone scintigraphy showed no accumulation in other sites. After the operation, healing of the wound was completed and there has been no evidence of recurrence.抄録全体を表示PDF形式でダウンロード (463K) -
西澤 理史歩, 峯村 俊一, 瀧沢 淳, 伊藤 隆一, 飯島 響, 倉科 憲治2010 年 56 巻 9 号 p. 519-523
発行日: 2010/09/20
公開日: 2013/10/31
ジャーナル フリーBurkitt lymphoma is classified as a high-grade malignant non-Hodgkin's lymphoma. Because the disease has a strong tendency to infiltrate the central nervous system and invade the entire body, it has a poor prognosis when diagnosed at advenced stages. We describe a rare case of Burkitt lymphoma with initial symptoms of paresthesia of both mental regions and gingival swelling.
The patient was a 60-year-old man who received a check-up in our department. His chief complaints were paresthesia in both mental regions and gingival swelling of the mandible. We performed a biopsy of the left lower molar gingiva. The histopathological results indicated Burkitt lymphoma.
The lymphoma grew considerably after the diagnosis. The patient developed gingival swelling of the left upper cuspid, followed by bilateral swelling of the gingiva of the mandible 2 weeks later. CT images revealed osteolytic changes to the mandibular canal of both lower molar regions and destruction of the alveolar bone of the left upper cuspid. PET-CT confirmed that the lymphoma had infiltrated throughout the body, including the upper and lower jaws. The disease was classified as stage IV according to the Murphy classification.
The patient was transferred to a hematology unit in another hospital and received treatment. However, treatment was stopped because liver damage developed. He died of multiple organ failure 6 months later.抄録全体を表示PDF形式でダウンロード (652K) -
松下 明日香, 中野 旬之, 岸 正海, 真野 隆充, 森 悦秀, 上山 吉哉2010 年 56 巻 9 号 p. 524-527
発行日: 2010/09/20
公開日: 2013/10/31
ジャーナル フリーA 59-year-old man was referred to our hospital to undergo resection of torus mandibularis. Bony masses were found on the lingual side of the mandible, extending bilaterally from the incisor teeth to the premolars. The tongue was pushed backward by the lesions. The patient was sleepy during the daytime and was given a diagnosis of obstructive sleep apnea syndrome (OSAS) on polysomnography. We recognized a transient decrease in the level of sleep breathing disorder (SBD) after the resection of torus mandibularis. At that time, OSAS was attributed to torus mandibularis. After 6 months, however, the SBD level deteriorated again, except for the Epworth sleep score. We ascribed the deterioration to repositioning of the tongue and related muscles. In such patients, it is important to monitor progress over a prolonged period.抄録全体を表示PDF形式でダウンロード (631K) -
吉田 佳織, 小佐野 仁志, 河 瑠珠, 山田 茂樹, 草間 幹夫2010 年 56 巻 9 号 p. 528-532
発行日: 2010/09/20
公開日: 2013/10/31
ジャーナル フリーWe report a rare case of pyothorax-associated lymphoma arising in the mandible. A 74-year-old man with a history of artificial pneumothorax was referred to our hospital because of a swelling in the mandibular gingiva. Histopathological examination of the gingival tumor revealed a diffuse large B cell lymphoma. Positron emission tomography showed chronic empyema and marked accumulation of fluorodeoxyglucose in the right side of the mandible and the left lung. We diagnosed mandibular malignant lymphoma extending from pyothorax-associated lymphoma. We transferred the patient to the department of internal medicine, and he received chemotherapy with R-CHOP. There has been no recurrence for 24 months after treatment.抄録全体を表示PDF形式でダウンロード (774K) -
古木 良彦, 管野 貴浩, 助川 信太郎2010 年 56 巻 9 号 p. 533-537
発行日: 2010/09/20
公開日: 2013/10/31
ジャーナル フリーA 12-year-old girl was referred to our Oral and Maxillofacial Surgery Division because of spontaneous bilateral pain in the temporomandibular joint and difficulties in occlusion and mouth opening caused by a bicycle accident. A panoramic radiograph and facial CT scan showed fracture lines at the mandibular symphysis and both mandibular condylar heads. The patient was admitted immediately, and 8 hours after the accident, complained of dyspnea, and swelling of the floor of the mouth due to acute sublingual hematoma. Emergent intubation was performed under intranasal endoscopic guidance, followed by open reduction and internal fixation under general anesthesia. After surgery, she received intermaxillary fixation and was transferred to the intensive care unit. After 2 days, the endotracheal tube was safely removed. She was discharged in good condition after 10 days of active mouth-opening exercises for rehabilitation of both intracapsular condylar heads in the hospital. When evaluating and treating patients with maxillofacial trauma, we should always be aware of potential airway obstruction and means of securing the airway.抄録全体を表示PDF形式でダウンロード (668K) -
吉田 和正, 柳井 智恵, 荘司 洋文, 柳下 寿郎, 足立 雅利2010 年 56 巻 9 号 p. 538-542
発行日: 2010/09/20
公開日: 2013/10/31
ジャーナル フリーAngioleiomyoma is a benign tumor of smooth muscle origin that commonly arises in the subcutaneous tissue of the lower extremities and rarely occurs in the oral mucosa.
We report a case of angioleiomyoma arising in the lower lip. An 57-year-old woman was referred to our hospital because of a painless tumor of the lower lip. She had the lesion for more than 35 years. The clinical diagnosis was a benign tumor of the lower lip, and the tumor was surgically extirpated under local and intraveneous anesthesia. Microscopically, the tumor was composed of numerous vascular channels of venous type with thick muscular walls, and smooth muscle bundles in the tumor were not so compact.
Immunohistochemical analysis showed positive reactions for α-smooth mucle actin (SMA) and desmin in the tumor cells. Histopathologically, the specimen was diagnosed as angioleiomyoma. Postoperative observation has revealed no recurrence as of 2 years after the operation.抄録全体を表示PDF形式でダウンロード (767K)
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