口腔顎顔面外傷 : 日本口腔顎顔面外傷学会誌
Online ISSN : 2434-3366
Print ISSN : 1347-9903
最新号
選択された号の論文の3件中1~3を表示しています
原著
  • 笠原 清弘, 星野 照秀, 杉浦 慧, 西山 明弘, 吉田 秀児, 髙野 正行, 片倉 朗
    2022 年 21 巻 1 号 p. 1-5
    発行日: 2022年
    公開日: 2022/05/28
    ジャーナル フリー
    The mandible is a site that is easily subject to direct external forces, and biting and chewing abnormalities are often recognized due to mandibular fractures. Here, we report the clinical characteristics of cases with mandibular joint protrusion fracture managed in our department, with a review of the literature.
    This study included 29 cases (25 unilateral cases and 4 bilateral cases; 33 sides) diagnosed as fracture of the mandibular condyle after undergoing oral surgery at Tokyo Dental College Suidobashi Hospital from January 2018 to March 2021.
    The survey items were sex, age, cause of injury, place of injury, medical examination route, number of days until our consultation, fracture site (SORG classification), mode of fracture (classification described by MacLennan), treatment, opening amount before and after treatment, and period of interchinular fixation.
    The study included 16 men and 13 women with an average age of 49.8 years. The most common cause of injury was falling (23 people), and most injuries were sustained on the road. In terms of consultation, most referrals (20 people) were from the dental clinic associated with our hospital. There were 16 sides in the condyle neck of the mandibular fracture and 16 sides in the subcondylar area of the mandibular fracture. Displaced fracture was the most common type of fracture, while subcondylar area was the most common form of fracture. The treatment strategies included conservative treatment in seven cases (seven sides), non-invasive reduction and fixation in 14 cases (16 sides), and surgical treatment in five cases (seven sides). All seven cases of invasive reduction and fixation were basilar displaced fractures. Two sides were approached from the oral cavity and five from outside the oral cavity. Among the cases that underwent oral surgery, facial nerve paralysis was observed in two cases. Osteosynthesis was performed using one titanium mini-plate on five sides and two titanium mini-plates on two sides. The opening increased in all cases regardless of the treatment strategy. The average duration of opening restriction was 17.3 days for non-invasive reduction and fixation and 11.8 days for surgery.
    This study confirmed that the opening in all cases increased regardless of the treatment strategy. In addition, because there are cases where opening restrictions were difficult due to cases of elapsed time and intellectual disabilities, the study results also reaffirm the importance of selecting an appropriate treatment taking into account the patients’ background.
臨床統計
  • 齊藤 輝海, 寺沢 史誉, 伊藤 洋平, 佐々木 惇, 柏原 捷, 長谷川 令賀
    2022 年 21 巻 1 号 p. 6-13
    発行日: 2022年
    公開日: 2022/05/28
    ジャーナル フリー
    Bicycles are used relatively easily by people of all ages for a variety of purposes. In this study, we analyzed 187 cases of accidents that occurred while riding a bicycle among patients that visited our department with oral maxillofacial injuries, in order to clarify the actual situation of bicycle accidents.
    The annual number of bicycle accidents has tended to increase slightly in recent years. The gender of the patients was 122 males and 65 females, about twice as many males as females. The age of injury ranged from 2 to 83 years old, with a large number of accidents occurring in the teens for both sexes. The most common time of day for accidents was in the evening (45 cases, 24.1%), followed by early morning (32 cases, 17.1%). The causes of injury were tumbles in 117 cases (62.6%), collisions in 67 cases (35.8%), and falls in 3 cases (1.6%). The most common oral and maxillofacial injuries were soft tissue plus tooth injuries in 74 cases. Maxillofacial fractures were observed in 63 cases (33.7%). The most common fracture site was the mandible alone in 27 cases, midface bone alone in 25 cases, and mandible + midface bone in 11 cases. Concomitant damage was observed in 55 cases (29.4%), with head injuries in 25 cases being the most common, followed by trunk injuries in 19 cases and limb injuries in 17 cases.
    The present study found that bicycle accidents are increasingly slightly. The age distribution was markedly higher among those in their teens, which was thought to be a characteristic of bicycle accidents. Maxillofacial fractures were found in 33.7%, comorbid injuries were found in 29.4%, and serious injuries were also observed. Maxillofacial fractures were observed in 33.7% of the cases, and concomitant damage was observed in 29.4% of the cases, and serious injuries were also observed. Head injuries were the most common complication, suggesting the necessity of raising awareness of wearing helmets for safety.
臨床症例
  • 中原 和美, 奥村 俊哉, 小野 重弘, 武知 正晃
    2022 年 21 巻 1 号 p. 14-18
    発行日: 2022年
    公開日: 2022/05/28
    ジャーナル フリー
    We report herein a case of tetanus. The patient was a 75-year-old man who was referred to our hospital because of difficulty in mouth opening. Physical examination revealed severe trismus. However, there was no sign of inflammation in the maxillofacial region. The clinical diagnosis was temporomandibular disorder. The next day, he visited the emergency department because of dysphagia. The patient was given a diagnosis of tetanus on the basis of the clinical course and symptoms such as rapidly progressive trismus and dysphagia. The patient was admitted to our hospital and given tetanus antitoxin, antitetanic human immunoglobulin and antibiotics. He was discharged on the 13th hospital day. Although tetanus has become rare in recent years in Japan, it is a fatal disease if early treatment is not appropriately performed. When examining patients with trismus, we should consider the possibility of tetanus and observe them carefully.
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