巻号一覧
60 巻, 9 号
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巻頭言
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東 雅之2014 年 60 巻 9 号 p. 513
発行日: 2014/09/20
公開日: 2015/07/11
ジャーナル フリーPDF形式でダウンロード (399K)
原著
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山崎 裕, 佐藤 淳, 大賀 則孝, 宮腰 昌明, 秦 浩信, 浅香 卓哉, 足利 雄一, 鄭 漢忠, 北川 善政2014 年 60 巻 9 号 p. 514-521
発行日: 2014/09/20
公開日: 2015/07/11
ジャーナル フリーPatients receiving oral bisphosphonates (BP) are at risk for developing bisphosphonate-related osteonecrosis of the jaw (BRONJ), but to a much lesser degree than those treated with intravenous BP. Patients treated with oral BP were reported to have less extensive and / or refractory BRONJ. However, the risk of BRONJ associated with oral BP is reported to increase when the duration of therapy exceeds 3 years.
We performed 208 extractions in 99 patients who received oral BP for more than 3 years, and their postoperative course was evaluated retrospectively. These subjects were all female (average age, 72 years). BP was orally administered to 73 patients with osteoporosis, 13 with RA, 3 with SLE, and 10 with other diseases. The mean duration of oral BP exposure was 60 months (median 54 months). Treatment with oral BP was discontinued in 83 patients. There were 24 patients receiving steroids, 13 receiving immunosuppressants, and 14 with diabetes mellitus.
Six patients had delayed healing with bone exposure in sockets 4 weeks after tooth extraction ; furthermore, BRONJ developed in 2 other patients (2%). In these 8 patients, we studied the relations between delayed healing and various clinical factors such as age, the type, duration, and holidays of BP, risk factors, steroids, immunosuppressants, steroids plus immunosuppressants, anti-inflammatory treatment before extraction, site and type of extraction, and closure of the extraction socket. Discontinuation of BP, steroids plus immunosuppressants, and type of extraction were significant independent risk factors for delayed healing.抄録全体を表示PDF形式でダウンロード (893K)
症例報告
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太田 充彦, 石原 茂人, 坂崎 未沙子, 杉田 好彦, 前田 初彦, 水野 進2014 年 60 巻 9 号 p. 522-526
発行日: 2014/09/20
公開日: 2015/07/11
ジャーナル フリーMyxomas are benign tumors derived from mesenchymal tissue that are similar to mucus. They arise in the stomatognathic system, most frequently centrally in the maxilla or mandible. In rare cases, they can also occur in soft tissue.
A 69-year-old woman visited our department because of a mass on the left side of the lower lip. Resection was performed under general anesthesia and revealed a tumor measuring 18 × 15 × 10 mm that was solid and milky white.
A histopathological diagnosis of myxoma was made. While no recurrence has occurred as of 2 years postoperatively, long-term follow-up is considered necessary.抄録全体を表示PDF形式でダウンロード (743K) -
釘本 琢磨, 小村 健, 田中 香衣, 富岡 寛文, 島本 裕彰, 原田 浩之2014 年 60 巻 9 号 p. 527-531
発行日: 2014/09/20
公開日: 2015/07/11
ジャーナル フリーThis study evaluated the usefulness of a pedicled buccal fat pad graft covered with a polyglycolic acid sheet and fibrin glue for reconstructing maxillopalatal defects associated with an oroantral fistula. This procedure was performed in 5 patients, and 5 other patients who underwent reconstruction using an obturator prosthesis were included as control. All patients underwent partial maxillectomy. The postoperative course and satisfaction score were compared between the two groups. The reconstruction group had no postoperative complications or functional disorders; they showed better results than the control group. Thus, this surgical technique is less invasive and is useful for the repair of maxillopalatal defects associated with an oroantral fistula.抄録全体を表示PDF形式でダウンロード (925K) -
濱田 正和, 木本 雅也, 竹下 彰範, 今井 琢己, 太田 嘉幸, 由良 義明2014 年 60 巻 9 号 p. 532-536
発行日: 2014/09/20
公開日: 2015/07/11
ジャーナル フリーThe first heart-lung transplantation in Japan was performed in 2009. As the number of transplantations increases with successful results, treatment in oral and maxillofacial surgery will also increase to improve the quality of life. We report on a patient who underwent heart-lung transplantation and had a fractured molar tooth that needed to be extracted. Since he had been given a bisphosphonate (BP), the BP was discontinued for 3 months. An antithrombotic drug was continued, and antibiotics were used to prevent infective endocarditis. The patient underwent extraction of a mandibular left first molar under local anesthesia in combination with intravenous sedation. During operation, his vital signs were monitored. The tooth was extracted successfully without any complications, and the postoperative course was uneventful. There were no physical problems as of 3 months after surgery. When we treat patients who undergo heart-lung transplantation, it is essential to pay attention to hemodynamics, hemorrhagic diathesis, prevention of infection, and BP-related osteonecrosis of the jaws.抄録全体を表示PDF形式でダウンロード (715K) -
丸尾 将太, 三木 真優, 山田 元太郎, 足立 圭司, 堀 信介2014 年 60 巻 9 号 p. 537-540
発行日: 2014/09/20
公開日: 2015/07/11
ジャーナル フリーConservative treatment with a chin-cap and surgical treatment are commonly used to manage habitual temporomandibular joint dislocation. In recent years, autologous blood injection therapy has been used to treat this condition. This condition is intractable in elderly people who have dementia and cerebrovascular disorder, and the selection of therapy may be difficult because of the general state of the patient.
We report a case of habitual temporomandibular joint dislocation treated by adjustment-type cervical orthosis. The patient was an 86-year-old woman with dementia. First, we performed extraoral fixation with an elastic bandage. She often opened her mouth wide unconsciously, and TMJ dislocation recurred many times. After we strengthened the fixation, many ulcers developed on her facial skin and her dietary intake became poor. Second, we performed extraoral fixation with adjustment-type cervical orthosis which restricted only maximum mouth-opening and allowed the patient to eat with the equipment attached. Ulcers did not develop on her face, and TMJ dislocation did not recur.
Although fixation with adjustment-type cervical orthosis has a limited application, we consider it effective for compromised patients who cannot control their mouth-opening consciously because of dementia and cerebrovascular disorder.抄録全体を表示PDF形式でダウンロード (839K) -
宮園 佳宏, 篠崎 勝美, 岩永 譲, 岩本 修, 木原 俊之, 楠川 仁悟2014 年 60 巻 9 号 p. 541-544
発行日: 2014/09/20
公開日: 2015/07/11
ジャーナル フリーTraumatic neuroma is a benign, hyperplastic tumor caused by neuron deformation. We report the case of a traumatic neuroma developing in the deeper portion of a recurrent tongue carcinoma that was misinterpreted to be deep invasion of the cancer.
A 65-year-old woman was referred to our hospital because of ulcer formation in the left side of the tongue. In the past history, she had received partial resection of the left side of the tongue for squamous cell carcinoma (SCC) at 54 years of age. Clinical examination of the tumor showed localized induration in the superficial layer of the tongue. However, contrast magnetic resonance (MR) images showed that the lesion extended to near the lingual septum. Because well-differentiated SCC was diagnosed on biopsy, hemiglossectomy of the mobile tongue was performed. Postoperative histological examination of the resected tongue specimens revealed neuroma tissue in the deep part of the tongue. In contrast to the MR image findings, the SCC tissue was found in only the superficial layer of the tongue. Consequently, traumatic neuroma, that was apparently coused by surgical intervention during the previous tongue cancer operation, made it difficult for us to determine the tumor extent preoperatively. No recurrence has occurred after 2 years of postoperative follow-up.抄録全体を表示PDF形式でダウンロード (772K)
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