著者
外木 守雄 有坂 岳大 塚本 裕介 佐藤 一道 山根 源之 大櫛 哲史 中島 庸也
出版者
特定非営利活動法人 日本顎変形症学会
雑誌
日本顎変形症学会雑誌 (ISSN:09167048)
巻号頁・発行日
vol.17, no.1, pp.9-15, 2007-04-15 (Released:2011-02-09)
参考文献数
16
被引用文献数
10 7

This study investigated risk factors for obstructive sleep apnea hypopnea syndrome (OSAHS) induced by orthognathic surgery for malocclusion, by analysis of preoperative and postoperative examination findings. In this first report, we discuss the relationship between the findings from the polysomnographic record and the direction of jaw movement during orthognathic surgery. The postoperative Apnea Hypopnea Index was significantly decreased in the group that underwent maxillaryadvancement with or without mandibular movement; however, there was no significant difference between the groups that underwent mandibular movement with and without maxillary movement. Mandibular morphology is frequently considered when evaluating the relationship between the maxillofacial structure and sleep-disordered breathing; our findings also indicated that maxillary morphology is an important factor. Hence, we advocate orthognathic surgery to treat malocclusion when necessary and to take sleep-disordered breathing into consideration. Additionally, we considered that the findings of this study provide important evaluation criteria for determining the indications for orthognathic surgery to treat OSAHS.
著者
清住 沙代 雨宮 智美 大屋 朋子 多比良 祐子 高柳 奈見 奥井 沙織 馬場 里奈 藤平 弘子 相川 真澄 並木 修司 會田 貴久 酒井 克彦 山崎 喜範 蔵本 千夏 渡邊 裕 外木 守雄 武井 泉 山根 源之
出版者
一般社団法人 日本老年歯科医学会
雑誌
老年歯科医学 (ISSN:09143866)
巻号頁・発行日
vol.25, no.4, pp.382-386, 2011 (Released:2011-05-25)
参考文献数
18

東京歯科大学市川総合病院 (以下当院) では, 内科, 歯科·口腔外科 (以下当科), 眼科の3科が共同で, 糖尿病患者の状態把握を行う合同調査を開始した。その結果から, 65歳以上の糖尿病患者の口腔衛生状態を調査し, 歯科衛生士がどのように介入すべきか検討を行った。対象は, 平成19年11月から平成20年10月までの1年間に, 当院内科を受診し, 当科の受診に了承された糖尿病患者142名のうち, 65歳以上の有歯顎者43名 (男性20名, 女性23名, 平均年齢69.2歳) とした。診査内容は性別, 年齢, 糖尿病の罹患期間, 網膜症の有無, 糖尿病の治療方法, HbA1c, 歯槽骨吸収程度, 現在歯数, PCR, BOPの10項目である。網膜症は, 糖尿病合併症のうち, 早期に症状が現れるため, 眼科医と協力し診査内容に含めた。今回, これらの診査内容から, 年齢, PCR, BOP, 現在歯数, HbA1cの5項目に着目し検討を行った。年齢とPCR, BOP, 現在歯数の検討を行った結果, 年齢が高い程, PCRとBOPの値は高い傾向を示し, 相関性を認めた。また, 現在歯数は70~74歳で最も多く, 75歳以上では減少傾向を示した。HbA1cとPCR, BOP, 現在歯数の検討を行った結果, 相関性は認められなかった。年齢と口腔衛生状態には相関性が認められ, 糖尿病の病態と口腔衛生状態に相関性は認められなかったことから, 糖尿病罹患の有無にかかわらず, 高齢者の増齢に伴い歯科衛生士による口腔衛生指導が重要であると考えられた。
著者
森崎 重規 蔵本 千夏 木津 康博 森本 光明 外木 守雄 山根 源之
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.54, no.3, pp.206-209, 2008-03-20
被引用文献数
1 1

Aplastic anemia is a blood disease characterized by pancytopenia due to a decrease in hematopoieticstem cells. We describe a patient who presented with submucosal hematoma of the tongue and was given a diagnosisof aplastic anemia. The patient was a 24-year-old man who visited our department because of a hematoma ofthe tongue. Two days before presentation, a dark reddish tumor with a diameter of 1-2mm was noticed at the leftmargin of the tongue. At presentation, a 20×11mm dark reddish elevation was seen at the left lateral margin ofthe tongue. On the basis of the above course and findings, a hematoma was diagnosed, and blood tests were conducted.A blood disease was suspected. The white blood cell count was 500/μl, the red blood cell count was320×104/μl, the Hb was 11.2g/dl, the Ht was 31.1%, the MCV was 96.9 fl, the MCH was 35.0 pg, the MCHCwas 36.1%, and the platelet count was 0.3×104/μl, indicating pancytopenia. A submucosal hematoma of thetongue accompanied by pancytopenia was diagnosed, and detailed examinations were performed at the hematologydepartment. A bone marrow puncture test showed that the bone marrow cell count was 4, 000/μl and themegakaryocyte count was 0/μl; aplastic anemia was thus diagnosed, and the patient received immunosuppressivetherapy. Even when the onset is gradual, aplastic anemia can be lethal if detection is late and appropriate therapyis not administered. Therefore, if the regional cause of an oral hematoma is not clear, close follow-up is necessary.If systemic factors are suspected, blood tests should be promptly performed.