日本口腔科学会雑誌
Online ISSN : 2185-0461
Print ISSN : 0029-0297
ISSN-L : 0029-0297
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選択された号の論文の6件中1~6を表示しています
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  • 緒方 謙一, 大部 一成, 森山 雅文, 新井 伸作, 中村 誠司, 川野 真太郎
    2024 年 73 巻 3 号 p. 229-235
    発行日: 2024年
    公開日: 2024/09/30
    ジャーナル 認証あり
    Accidental iatrogenic foreign bodies in the oral and maxillofacial region can be caused by broken dental needles. Most of these cases occur during inferior alveolar nerve block anesthesia. We report a case of a broken dental needle during infiltration anesthesia, which was removed by the submandibular approach under X-ray fluoroscopic guidance. The patient was a 17-year-old female, who visited a nearby dental office for extraction of a right lower wisdom tooth. During infiltration anesthesia of lingual gingiva, a dental needle broke off from the base. Therefore, she was referred to our department to have it removed. A CT scan was performed on the same day, and the needle was found in the right internal pterygoid muscle. The next day, we attempted to remove it immediately by the intraoral approach under X-ray fluoroscopic guidance. However, the fractured needle had migrated to the mandibular angle, so we eventually switched to a submandibular approach to remove it. The patient’s postoperative course was good with no major complications.
  • 萩原 嵩之, 山縣 憲司, 内田 文彦, 福澤 智, 菅野 直美, 武川 寛樹
    2024 年 73 巻 3 号 p. 236-242
    発行日: 2024年
    公開日: 2024/09/30
    ジャーナル 認証あり
    Lymphatic malformation (LM) is thought to result from residual tissue of the primary lymph sac during embryonic development. LM is most commonly congenital and is found in children, although it can rarely occur in adults. In this case report, we present a 58-year-old female patient with LM in the submandibular region who underwent sclerotherapy with OK-432. The T2-weighted and STIR images showed a multi-cystic mass measuring 30×60×40mm with a heterogeneous high signal in the right sublingual to submandibular to parapharyngeal space. Puncture aspiration cy­tol­o­gy revealed no morphological abnormalities, with predominantly lymphocytes observed, leading to a diagnosis of LM based on the images. While the initial local injection of OK-432 (1KE) resulted in some reduction in lesion size, it persisted. Subsequently, OK-432 was locally injected twice, first with 1KE after 2 months, and then with an additional 0.6KE after another 2 months, totaling 2.6KE. Adverse effects included a fever of 39.5℃ and swelling, but no occurrence of upper airway obstruction was observed. No lesions were found in the submandibular or parapharyngeal space on T2-weighted images from the post-treatment MRI, and there has been no recurrence detected for more than 5 years after completion of the treatment.
症例報告
  • 雨宮 剛志, 長谷部 充彦, 米田 栞奈, 濱田 良樹
    2024 年 73 巻 3 号 p. 243-250
    発行日: 2024年
    公開日: 2024/09/30
    ジャーナル 認証あり
    Drug-induced immune thrombocytopenia (DITP) is diagnosed based on the clinical course due to the lack of a disease-specific diagnostic approach. However, general diagnostic criteria for DITP advocated by George et al. included two prospective items, which are impractical for clinicians when facing patients in the clinic. On the other hand, Arnold et al. proposed alternative diagnostic criteria which include no prospective items. In this report, we describe the clinical course of a case with DITP caused by carbamazepine (CBZ), which was diagnosed using Arnold’s criteria and successfully managed. A 77-year-old woman presented to our clinic with the chief complaint of left tongue pain. She was diagnosed as idiopathic trigeminal neuralgia, and we prescribed CBZ. The pain disappeared, but she noticed petechial purpura on her extremities on day 10 of CBZ administration. Four days after that, it expanded to the breast and back. On day 15 of CBZ administration, blood tests revealed a marked decrease in platelet count of 1.1×104/μl. At that time, she met Arnold’s criteria, and was diagnosed as DITP caused by CBZ. No evidence of intracranial hemorrhage was indicated, and the patient was instructed to rest in hospital. Also, we stopped the administration of CBZ. Consequently, the platelet count began to improve from day 3 of stopping CBZ to 20.4×104/μl on day 6 and the petechial purpura disappeared on day 14. Since then, we have prescribed precavalin as a substitute for CBZ, and her clinical course has been uneventful.
  • 澤木 廉, 川口 拓郎, 齊藤 昌樹
    2024 年 73 巻 3 号 p. 251-257
    発行日: 2024年
    公開日: 2024/09/30
    ジャーナル 認証あり
    Congenital factor Ⅶ deficiency (F7D), a rare bleeding disorder, is a coagulation disorder characterized by prothrombin time prolongation with normal activated partial thromboplastin time. F7D may be asymptomatic and may remain undiagnosed. An 86-year-old woman without professional follow-up for F7D was referred to our department for tooth extraction. The patient had dementia, so F7D was unknown at first visit, but a blood test showed that factor Ⅶ activity of less than 3%. Recombinant active Factor Ⅶ was transfused before and after tooth extraction for hemostatic management, and the patient was discharged 2 days postoperatively without posterior bleeding. Because oral surgery is often performed as invasive treatment, careful history noting, laboratory testing, and appropriate hemostatic management are important.
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