日本口腔科学会雑誌
Online ISSN : 2185-0461
Print ISSN : 0029-0297
ISSN-L : 0029-0297
59 巻, 3 号
選択された号の論文の5件中1~5を表示しています
原著
  • ―20歳代発症者との比較―
    岡崎 敦子, 宮島 久, 八木 稔, 高木 律男
    2010 年 59 巻 3 号 p. 105-112
    発行日: 2010/07/10
    公開日: 2010/10/29
    ジャーナル フリー
    To evaluate the characteristics of temporomandibular disorders (TMD) in elderly patients, we performed a clinicostatistical study in 122 patients aged ≥60 years. Based on medical records, panoramic X-ray images, and MR images, clinical findings (sex-related differences, chief complaint, disease duration, frequency of complication, disorder type classification, joint sound (crepitation), maximum mouth opening, and occlusal support) and imaging findings (articular disc position in type IV, disc configuration, mandibular condyle bony changes) were compared between the elderly subjects and 125 patients in their 20s. As a result, significant differences were observed in disease duration, disorder type classification, and disc configuration, showing prolongation, increases in types I and IV, and an increase in cases of severe deformation, respectively, in the elderly patients. Therefore, management with consideration of these characteristics may be important in the diagnosis and treatment of TMD.
  • 藤盛 真樹, 西村 泰一, 谷 和俊, 岡田 益彦, 吉田 将亜, 松田 光悦
    2010 年 59 巻 3 号 p. 113-122
    発行日: 2010/07/10
    公開日: 2010/10/29
    ジャーナル フリー
    We clinically evaluated postoperative bleeding in patients undergoing antithrombotic therapy. To this end, we assessed 487 cases of tooth extraction under antithrombotic therapy between June 2001 and January 2008. Warfarin monotherapy was administered in 123 cases (warfarin monotherapy group); combination therapy with warfarin and antiplatelet drugs was administered in 155 cases (combination therapy group); and antiplatelet monotherapy was administered in 209 cases (antiplatelet monotherapy group). The control group comprised 564 cases of tooth extraction without signs of hemorrhage. Five of the 564 cases in the control group showed postoperative bleeding (0.9%). Postoperative bleeding was observed in 8 of the 123 cases in the warfarin monotherapy group (6.5%), 16 of the 155 cases in the combination therapy group (10.3%), and 6 of the 209 cases in the antiplatelet monotherapy group (2.9%). Patients receiving warfarin monotherapy and combination therapy were more susceptible to postoperative bleeding than the patients in the control group. Local inflammation and PT-INR values of ∼2.01 were associated with an increased risk of postoperative bleeding. Only one case in the combination therapy group required blood transfusion and administration of vitamin K. In conclusion, discontinuation of antiplatelet therapy is not essential for simple dental extraction, and for patients with PT-INR values within the therapeutic range, warfarin therapy need not be discontinued or modified for simple dental extraction because sufficient hemostasis can be obtained in most cases of simple dental extraction under anticoagulant therapy.
症例
  • 宗像 源博, 中野 佳央, 新中 康史, 樋口 雅俊, 原田 清
    2010 年 59 巻 3 号 p. 123-127
    発行日: 2010/07/10
    公開日: 2010/10/29
    ジャーナル フリー
    Endogenous bacterial endophtalmitis is a rare but serious condition. It occurs in the eyeball when bacteria cross the blood-ocular barrier. We report a case of endogenous bacterial endopthalmitis arising from severe periodontitis without any noticeable systemic anamnestic.
    A 53-year-old man was referred to the ophthalmology department in our university hospital complaining of reduced visual acuity in the right eye. His visual acuity was hand movements right and 0.7 left eye, respectively. His right eye showed hypopyon, dense vitreous opacity and retinal hemorrhages. Because of a finding peculiar to infective endocarditis from an echocardiography, we diagnosed the patient with endogenous endophthalmitis that caused infective endocarditis. Although there was no infection impact on his general condition, α-streptococcus was detected in his blood culture examination. Therefore, he was referred to our clinic for oral examination and care. He was diagnosed with chronic periodontitis and severe resorption of alveolar bone and gum swelling by oral examination and X-rays. The α-streptococcus was detected in a bacterial examination of the exudate from the gingival pocket. Fourteen teeth with severe periodontitis were extracted. The visual acuity in the right eye increased up to 0.07 at 6 months after the teeth extraction.
    Though bacteriological identification was not accomplished completely, the endogenous endophtalmitis in the present case seemed to be affected with mitral regurgitation and vegetation, following infective endocarditis by oral Streptococci.
  • 吉田 祥子, 岸本 晃治, 銅前 昇平, 矢尾 真弓, 目瀬 浩, 佐々木 朗
    2010 年 59 巻 3 号 p. 128-132
    発行日: 2010/07/10
    公開日: 2010/10/29
    ジャーナル フリー
    Subperiosteal implants have been applied for a reduced alveolar bone. However, many cases ended in failure, and some caused severe bone absorption. We report a case of a subperiosteal implant that caused severe bone absorption of the maxilla with perforation of the nasal cavity and maxillary sinus.
    In October 2005, a 65-year-old man was referred to our department because of pain in the bilateral upper molar region. He received a surgical operation for a maxillary subperiosteal implant at another dental clinic in 1989. Sixteen years had passed without any symptoms. However, the maxillary subperiosteal implant that extended to the bilateral alveolar region caused severe bone absorption of the maxilla with a large perforation of nasal cavity and maxillary sinus. Swelling of mucous membrane in the nasal cavity and maxillary sinus and thickening of the maxillary sinus were observed in CT. Therefore, removal of the implant frame was performed. Bone absorption under the implant frame was observed due to the occulusal force. Two months later, the occulusal function was recovered using a new maxillary complete denture, which was used to preserve the perforation of the nasal cavity. More than three years have passed and the patient has experience no symptoms and no occlusal disturbance by the denture.
宿題報告
  • 中川 洋一
    2010 年 59 巻 3 号 p. 133-140
    発行日: 2010/07/10
    公開日: 2010/10/29
    ジャーナル フリー
    The management of dry mouth is essential for patients with Sjögren's syndrome. Since the condition of dry mouth induces various complications, such as tooth caries, periodontitis and oral candidiasis, all of which lead to a reduction in the QOL, the management of such complications due to oral dryness are also important. Recently, treatment approaches for the causal factors of dry mouth in Sjögren's syndrome, such as management of immunopathy and suppression of oxidative stress have been studied, in addition to the symptomatic treatment of dry mouth using a cholinergic agents, saliva substitutes and lubricating devices.
    In review of this, recent improvements in symptomatic therapy as well as the associated improvement in the QOL that have been achieved by comprehensively treating both oral candidiasis and neuropsychiatric symptoms are herein described.
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