著者

青野 淳子 遊佐 浩 石上 敏幸 白土 貴之 鬼澤 浩司郎 吉田 廣

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.48, no.3, pp.179-182, 2002-03-20 (Released:2011-04-22)

参考文献数

12

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A rare case of osteomalacia with an oronasal fistula developing after sequestrectomy is presented. The patient was a 45-year-old woman who was referred to our hospital because of an intractable ulcer at the midline of the hard palate. She had an edentulous maxilla and wore a poorly fitting complete maxillary denture. Oral examination showed ulceration with a sequestrum under the prosthesis. Removal of the sequestrum extending from the oral cavity to the nostrils resulted in an oronasal fistula of the hard palate. The case was finally diagnosed as osteomalacia based on the results of radiographic and serum chemical examinations. In this patient, continuous pressure caused by the poorly fitting maxillary denture induced the sequestrum in the hard palate, which was thin and fragile because of osteomalacia.

著者

中野 真祐 鬼澤 浩司郎 生井 友農 山縣 憲司 白土 貴之 吉田 廣

出版者

特定非営利活動法人 日本口腔科学会

雑誌

日本口腔科学会雑誌 (ISSN:00290297)

巻号頁・発行日

vol.51, no.5, pp.335-339, 2002-09-10 (Released:2011-09-07)

参考文献数

7

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Long-term corticosteroid administration induces secondary adrenal insufficiency and an increased susceptibility to infection. Surgical intervention in patients receiving steroid medication should be performed with consideration to preventing adrenal crisis, delayed wound healing, and infection. To securely manage tooth extraction in patients receiving steroid medication, 50 patients taking predonisolone (PSL) were retrospectively investigated. The mean dosage of PSL in the patients was 14.2mg/day, and the mean duration of the treatment was 7 years and 3 months. Forty-nine of the 50 patients were treated under local anesthesia, and the number of teeth concurrently removed was from 1 to 4. Preoperative supplemental steroid administration was applied to only two patients: one treated under general anesthesia, and the other during a period of reducing steroid dosage. Penicillin was commonly selected as the antibiotic to prevent infection, and it was administered preoperatively and postoperatively, for a mean duration of 4.1 days. As complications, infection occurred in 2 cases, and dry socket and discomfort in 1 case for each, in whom PSL had been taken for more than 12 years. These results suggested that removal of teeth in patients taking steroid medication can be securely performed without supplemental steroid by using effective administration of antibiotics.