著者

安田 浩一 古澤 清文 奥田 大造 堀口 文嗣 長谷川 貴史 山岡 稔

出版者

Japanese Society of Oral and Maxillofacial Surgeons

雑誌

日本口腔外科学会雑誌 (ISSN:00215163)

巻号頁・発行日

vol.41, no.6, pp.546-548, 1995-06-20 (Released:2011-07-25)

参考文献数

9

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Two cases of gas gangrene in the maxillofacial region and neck that developed after odontogenic infection are reported. Case 1, a 35-year-old man, developed gas gangrene after removal of the mandibular right third molar. In case 2, a 61-year-old man, gas gangrene occurred after apical periodontitis of the mandibular right second premolar. Both cases were treated by digitally opening the site where computed tomography (CT) revealed extension of gas bubbles early after the onset of symptoms and surgical debridement with antibiotics. CT was useful in monitoring the location of gas bubbles to permit opening of the progressive large focus in multiple spaces of maxillofacial region and neck. Digital preparation of the fascia was useful for opening the focus in the early stage of the disease.

著者

島原 政司 有吉 靖則 今井 裕 水城 春美 嶋田 淳 古澤 清文 森田 章介 上山 吉哉

出版者

Japanese Society of Oral and Maxillofacial Surgeons

雑誌

日本口腔外科学会雑誌 (ISSN:00215163)

巻号頁・発行日

vol.53, no.10, pp.594-602, 2007-10-20

参考文献数

20

被引用文献数

32 12

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Bisphosphonates are used for the management of bone metastatic disease and hypercalcemia caused by malignancy, as well as the treatment of osteoporosis. Recently, a number of patients with bisphosphonate-associated osteomyelitis and osteonecrosis of the jaws have been reported in the English-language literature. This report describes patients with bisphosphonate-related osteomyelitis and osteonecrosis of the jaws in Japan. The subjects were enrolled using questionnaires sent to 239 institutions certified as training facilities by the Japanese Society of Oral and Maxillofacial Surgeons in 2006. Thirty patients (4 men and 26 women) from 18 different institutions (mean age at diagnosis, 66.9 years) were studied. As for local features, pain with or without swelling was the most common symptom and sign. The mandible was affected in 22 patients, the maxilla in 6, and both jaws in 2. Twenty patients received intravenous bisphosphonates, 8 received only oral bisphosphonates, and 1 received both types of treatment. The reasons for bisphosphonate treatment were bone metastasis from breast carcinoma (13 patients), multiple myelomas (6 patients), osteoporosis (8 patients), and hypercalcemia related to malignancy. More than 50 % of the patients underwent oral surgery including tooth extraction just before or during treatment with bisphosphonates, while 5 patients received no dental treatment. In addition to antibiotic therapy, surgery, including sequestrectomy and curettage, was performed. As for outcome, 8 of the patients were completely cured, while 17 patients remained under treatment at the time of this writing.