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全文: "吉田健美"
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  • 岡田 政俊, 前田 芳信, 奥野 善彦, 前田 早智子, 吉田 建美, 作田 守, 西尾 順太郎, 宮崎 正
    日本口蓋裂学会雑誌
    1982年 7 巻 2 号 223-230
    発行日: 1982/12/30
    公開日: 2013/02/19
    ジャーナル フリー
    成人唇顎口蓋裂患者において, 通常の矯正治療または補綴処置ではその機能ならびに審美性の改善が困難な場合, 外科的矯正法が有効であることが多い.
    このような外科的矯正処置による治療効果を上げるためには, 診断の時点より, 術前矯正, 外科処置, 術後処置ならびに最終的な補綴処置を一貫したものとして考え, 互いに緊密な連絡をとって行う, いわゆるチームアプローチが必要であることは言うまでもない.
    ところで, 症例によっては, 複数回の手術を要し, 最終的な補綴による固定までに長期間を要する場合も起ってくる.そのような場合, 審美性の点ばかりでなく, 機能的な面, 患者の心理的な安定の問題などからも暫間的な補綴物が必要となってくる.
    しかし, その暫間補綴物は, 十分な維持と安定を有しながら, 構造が簡単で術後の口腔内環境をあまり変化させないものが望ましく, 患者自身による管理もしやすいものがよいと考えられる.
    そこで今回, 片側性唇顎口蓋裂を有する症例において, 外科的矯正処置による治療を試み, その際複数回の手術を要した症例において, 矯正治療による拡大後の保定装置を利用してアタッチメント(CM-Riderattachment)を応用した暫間義歯を作製した.その結果, 十分な維持力と安定性を得たばかりでなく, 審美性, 機能の面においても満足のゆく結果が得られた.
  • 瀧口 玲子, 佐藤 通泰
    九州歯科学会雑誌
    1988年 42 巻 2 号 312-317
    発行日: 1988/04/25
    公開日: 2017/12/21
    ジャーナル フリー
    A case of six supernumerary teeth impacted in the maxilla and mandible is presented. The patient was a 13-year old female who presented a chief complain of falure in eruption of permanent incisors. The patient showed the clinical characteristics such as, short statures, broad base of nose, ocular hypertelorism, high arched palate, open bite, and failure in eruption of permanent teeth. The characteristic roentgenological findings of the patient were delayed closure of sutures, numerous wormina bone ormation, aplastic clavicle, underdeveloped palanasal sinus, and multiple supernumerary teeth. The above clinical and roentgenological characteristic findings were developed symptom of uncommon congenital disease such as cleidocranial dysostosis.
  • 韮澤 敏, 岩片 信吾, 平野 秀利, 小林 博, 野村 修一, 石岡 靖, 小林 正治, 中島 民雄, 八巻 正樹, 花田 晃治, 林 豊彦
    下顎運動機能とEMG論文集
    1993年 11 巻 133-138
    発行日: 1993年
    公開日: 2010/10/13
    ジャーナル フリー
  • 田中 進平, 後藤 滋巳, 根来 武史, 深谷 昌彦
    日本顎変形症学会雑誌
    1995年 5 巻 2 号 190-196
    発行日: 1995/10/30
    公開日: 2011/02/09
    ジャーナル フリー
    The number of the patients with skeletal Class III malocclusion, requiring surgical orthodontic treatment, has increased, patients' complaints range over minute details, and patients expect remarkable aesthetic prognoses.
    A number of patients with skeletal Class III malocclusion have upper incisors which are inclined labially and lower incisors which are inclined lingually before treatment. Following surgical orthodontic treatment, axial inclination of upper incisors greatly affects patients' labial forms and that of lower incisors and migration range of mandibles often affect patients' mentum forms. Consequently, in presurgical orthodontic treatment, axes of incisors must be greatly corrected. Nevertheless, in some cases, mandibular migration is so slight that little aesthetic alteration results. In these cases, some patients complain of unaesthetic mouths, therefore the patients' aesthetic appearance after orthodontic treatment must be taken into consideration before the treatment.
    In this report, a patient with skeletal Class III malocclusion with labially inclined upper incisors and protruding upper lip was presented. This patient had upper premolars extracted in presurgical orthodontic treatment so that she obtained morphologically good prognosis. Furthermore, the effects on the appearance of mouth were discussed when upper premolars were extracted in surgical orthodontic treatment.
  • 正面顔面規格写真の有用性に関して
    陳 信光, 中納 治久, 片岡 洋子, 柴崎 礼子, 久保田 雅人, 槇 宏太郎
    昭和歯学会雑誌
    2006年 26 巻 1 号 19-28
    発行日: 2006/03/31
    公開日: 2012/08/27
    ジャーナル フリー
    顎顔面形態に著しい変形が認められる骨格性不正咬合症例においては, 矯正治療のみでは十分な機能的・審美的改善が期待できないため, 外科的矯正治療が積極的に行われる.したがって, 外科的矯正治療によって生じる顎顔面の硬組織上の形態変化と, それに対応する軟組織の関係を明らかにすることは, 治療計画立案上で極めて重要である.そこで本研究では, 心理的・社会的背景からも重要である正面顔貌の評価に対して, 顔面規格写真が有用であるか検証した.さらに, 正面顔貌規格写真の治療前後における変化と正面・側面エックス線規格写真の硬組織変化の関連性について検討を加えた.その結果, 骨格的下顎前突症に下顎枝矢状分割術を施行した際, 治療後の正面顔貌は丸くなることがわかった.また, 近位骨片の側方移動を伴うような下顎の移動は, 顔面各部位の幅径や高径, 非対称率や口唇の傾斜にも影響を与えるが, その影響は鼻翼や内眼角には及ぼないことが示唆された.しかし, 今回の結果から顔貌写真の限界も明らかとなった.規格化された顔貌写真から治療前後で有意な差を抽出できたのは, 正面顔貌の幅径や高径に関する一部の計測項目, オトガイ部の角度, SMe deviation, Go planeなどに限られていた.したがって, 顔面規格写真は正面顔貌の水平方向の評価には有用であるが, 更に正確な評価と予測のためには, 新しい三次元シミュレーション技術の開発が必要であると考えられた.
  • 齋藤 卓麻, 山添 清文, 北村 昌夫, 森田 修一, 花田 晃治
    日本顎変形症学会雑誌
    1995年 5 巻 1 号 45-52
    発行日: 1995/04/30
    公開日: 2011/02/09
    ジャーナル フリー
    The purpose of this study was to investigate the positional changes of the hyoid bone following surgical correction of mandibular prognathism. The materials consisted of cephalograms of 10 patients before surgery and one and five years after surgery. To eliminate the influence of head posture, the position of the hyoid bone was revised on cephalogram with SH and C3H before surgery. The results as follows:
    1. In the stable group after surgery, the position of the hyoid bone changed back-and downward. In the relapse group, the hyoid bone position did not change back-and downward. However, there were two cases which the hyoid bone position changed back-and upward, and three cases showed a forward and downward change.
    2. The same result was apparently observed in the stable group and relapse group in one year after surgery.
    3. In the stable group, the hyoid bone position also changed back-and downward five years after surgery. In the relapse group, the hyoid bone position changed back-and downward in three cases, and returned to the preoperative position in one case.
  • 黒田 敬之
    口腔病学会雑誌
    1981年 48 巻 4 号 311-320
    発行日: 1981/12/25
    公開日: 2010/10/08
    ジャーナル フリー
  • 下顎枝矢状分割法を適用した下顎前突症例について
    陳 亮宏
    日本口腔科学会雑誌
    1989年 38 巻 4 号 1023-1036
    発行日: 1989/10/10
    公開日: 2011/09/07
    ジャーナル フリー
    Moiré topography was employed to evaluate pre- and post-facial contour changes in 42 cases of mandibular prognathism treated by sagittal split osteotomy. The relation between bony changes and related soft-tissue change induced by surgery was also studied.
    In the mandibular prognathism without asymmetry group:
    1) Marked retraction was noticed in the chin region ; i. e. aproximately 1: 1 correlation with underlying bony change was observed, and this decreased progressively upward and backward.
    2) The upper lip was slightly reduced by the osteotomy. No direct effect, however, was observed in the buccal region.
    3) Soft tissue chages in the lower third of the face were strongly correlated to the movement of the underlying skeletal structure. The degree of mandibular set-back and mandibular counterclockwise rotation correlated highly with soft-tissue changes around the chin.
    In the mandibular prognathism with asymmetry group:
    1) No definite changes were noticed in the lower soft-tissue around the chin area.
    2) In addition to backward movement and counterclockwise rotation, lateral rotation of the mandible also played a role in post-operative facial soft-tissue changes. Precise pre-operative prediction proved difficult.
    More detailed three dimentional facial evaluation using Moiré topography may be obtained as compaired with the previous reports by using sagittal plane analysis of the lateral cephalogram.
  • 九州病害虫研究会報
    1992年 38 巻 201-206
    発行日: 1992/10/30
    公開日: 2009/05/22
    ジャーナル フリー
  • 番匠谷 綾子, 海原 康孝, 中江 寿美, 鈴木 淳司, 香西 克之
    小児歯科学雑誌
    2007年 45 巻 1 号 109-117
    発行日: 2007/03/25
    公開日: 2013/01/18
    ジャーナル フリー
    鎖骨頭蓋異骨症は,鎖骨の低形成もしくは欠損,頭蓋骨骨化障害,歯の形成異常,低身長などを特徴とする常染色体優性遺伝の骨系統疾患である.
    今回著者らは,永久歯の萌出遅延を主訴に当科を受診し,それが契機となって鎖骨頭蓋異骨症と診断された10歳10か月の二卵性双生児姉妹を経験した.諸検査により次のような姉妹に相似した所見を得た.
    1.鎖骨に両側性の部分欠損を認めた.
    2.GH補充療法を行っているにも関わらず低身長を認めた.
    3.頭蓋骨に大泉門の閉鎖不全,wormian boneが存在した.
    4.多数の乳歯が存在し,残存乳歯の歯根吸収もほとんど認められなかった.
    5.永久歯は姉に6歯,妹に7歯のみの萌出を認め,その他の埋伏永久歯の萌出もかなり遅れていた.
    6.埋伏過剰歯は,姉には上顎3歯,下顎6歯の計9歯,妹には上顎3歯,下顎5歯の計8歯を認めた.
    7.下顎の過成長と下顎骨の前方位による著しい反対咬合を呈していた.
    8.歯列弓は上下顎ともに著しく狭窄していた.
    9.高口蓋で正中口蓋縫合に沿う裂溝を認めた.
  • 遠藤 敏哉, 小貫 まゆみ, 長谷川 優, 下岡 正八
    小児歯科学雑誌
    2001年 39 巻 3 号 587-594
    発行日: 2001/06/25
    公開日: 2013/01/18
    ジャーナル フリー
    小臼歯非抜歯でエッジワイズ装置により治療したAngle I級叢生症例において,治療前後の下顎結合部の形態変化を比較検討し,合わせて本治療方法の有用性を検討した.そして,次の結果を得た.
    1.下顎結合部は有意に基底骨が舌側傾斜し,歯槽骨が唇側傾斜した.
    2.基底骨の舌側傾斜は下顎の後退と負の相関,咬合平面の時計回りの回転と正の相関が認められた.
    3.歯槽骨の唇側傾斜は下顎前歯の唇側傾斜と正の相関があった.
    4.歯槽骨と基底骨のなす角度は有意に増加した.
    5.下顎結合部の厚径はB点において有意に減少した.
    6.下顎結合部の高径はB点,Id点,Lle点において有意に増加した.
    7.B点とLle点における下顎結合部の高径の増加は咬合平面傾斜角の増加と負の相関があった.
    8.Id点における下顎結合部の高径の増加は下顎切歯の唇側傾斜と負の相関,上下中切歯歯軸傾斜角の減少と正の相関があった.
    以上の結果から,下顎結合部は柔軟な形態変化を示し,B点付近が骨のリモデリングの中心的役割を果たすことが示唆された.また,混合歯列期における叢生症例の治療計画の確立に際して,本治療方法が一考に値する臨床的手技であることが示された.
  • II-2.実験的口蓋床が発音中の舌筋筋放電活動, 舌運動および下顎運動に及ぼす経日的変化様相
    有輪 芳明
    日本補綴歯科学会雑誌
    1990年 34 巻 6 号 1199-1210
    発行日: 1990/12/01
    公開日: 2010/08/10
    ジャーナル フリー
    In order to evaluate the kinematic function and the coordinated movement of articulatory organs, attention was focused on the palatal form in various factors related to pronunciation abilities with complete dentures. After an experimental palatal plate was inserted into 13 natural dentitions ranging from 21 to 24 years old, muscular discharge of tongue muscules, tongue movement and mandibular movement during pronunciation were recorded longitudinally. Data was comparatively evaluated with that before insertion of the experimental palatal plate, and the following conclusions were obtained:
    This study has been established that changes in muscular discharge of tongue muscles, tongue movement and mandibular'movement during pronunciation before and after insertion of an experimental palatal plate, are fast in some degree in recovering of kinematic function and the coordinated movement among articulatory organs, comparing with them of before pronunciation.
  • II-1. 実験的口蓋床が発音前の内舌筋筋放電活動, 舌運動および下顎運動に及ぼす経日的変化様相
    萩原 正明
    日本補綴歯科学会雑誌
    1990年 34 巻 3 号 467-479
    発行日: 1990/06/01
    公開日: 2010/08/10
    ジャーナル フリー
    As the first step of evaluating the kinematic function and the coordinative movement among articulatory organs, attention was focused on the palatal form in various factors related to the function of pronounciation on complete denture. After the experimental palatal plate was inserted into 13 natural dentitions in the age ranging from 21-24 years old, muscular discharge of intrinsic muscles, tongue movement and mandibular movement before pronounciation were recorded longitudinaly.
    These data were comparatively evaluated with those before insertion ofthe experimental palatal plate, and the following conclusion were obtained.
    It has been made clear in this study that from the change of muscular discharge of intrinsic muscles, tongue movement and mandibular movement before pronounciation between before and after the insertion of the experimental palatal plate, correction aspect of the kinematic function and the coordinative movement among articulatory organs varied with point and method of articulation on each sound. And these facts suggested that it was necessary to diagnose and treat under consideration of the relation between the palatal form and articulatory function of tongue and mandible in removable prosthodontic treatment.
  • 阿部 遼, 坂上 馨, 福井 忠雄, 深町 直哉, 林 孝文, 齋藤 功
    日本顎変形症学会雑誌
    2019年 29 巻 3 号 229-236
    発行日: 2019年
    公開日: 2019/11/15
    ジャーナル フリー
    Purpose: There is little information available regarding swallowing tongue dynamics in cases that show remarkable discordance in the relationship between the upper and lower jaws. In this study, we measured the tongue motion during swallowing by ultrasonography in patients with mandibular prognathism and compared them with volunteers with normal occlusion.
    Methods: The subject group comprised 10 patients with mandibular prognathism (6 males, 4 females). Ten volunteers with normal occlusion (2 males, 8 females) served as controls. The subjects were instructed to swallow about 4ml of tasteless jelly, and the tongue movement during swallowing was measured by ultrasonography. We measured the following times on the M-mode waveform in the center of the tongue, “Duration of grooving formation (T1)”, “Duration of grooving disappearance (T2)”, “Duration from grooving disappearance until tongue-palate contact (T3)”, “Duration of tongue-palate contact (T4)”, “Duration of return to rest (T5)” and “Total swallowing duration (T6)”. In the periphery of the tongue, we measured “Total swallowing duration (T7)” and qualitatively assessed the tongue waveform as well.
    Results: In the center of the tongue, T3, T5 and T6 were significantly longer in the subject group than in the control group. In the periphery of the tongue, T7 was also significantly longer in the subject group than in the control group. The tongue position of patients with mandibular prognathism tends to be low, so a longer time was necessary to lift the tongue to the palate and the anchoring effect of the contact between the tip of the tongue and the anterior palate became weak. Due to this, a longer swallowing time at the periphery of the tongue was possibly needed in the subject group. Further, the type of tongue movement seems to have been specialized because of frequent up-and-down movement of the tongue during swallowing.
    Conclusions: The present findings suggest that patients with mandibular prognathism, due to their morphological disharmony, need excessive time to lift the tongue surface to the palate, resulting in a longer swallowing time at the periphery of the tongue as well as a specialized tongue movement.
  • 顎変形症研究会会誌
    1990年 1990 巻 9 号 121-148
    発行日: 1990/10/01
    公開日: 2011/06/02
    ジャーナル フリー
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