著者

矢島 優己 藤盛 真樹 嶋崎 康相 佐藤 栄晃 吉田 将亜 竹川 政範

出版者

公益社団法人 日本口腔外科学会

雑誌

日本口腔外科学会雑誌 (ISSN:00215163)

巻号頁・発行日

vol.66, no.11, pp.565-571, 2020-11-20 (Released:2021-01-20)

参考文献数

15

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Calcium hydroxide formulation is frequently used in the treatment of root canals. We report a case where this formulation caused maxillary vascular embolism. A patient received an injection of calcium hydroxide formulation in to the right maxillary lateral incisor in a dental clinic. Immediately after, he presented with swelling of the surrounding gingiva, right cheek swelling, pain, and malaise. Necrosis of the right palate mucosa was observed. A CT image showed calcium hydroxide formulation confirmed to running from the greater palatal artery to the maxillary artery. We diagnosed maxillary vascular embolism caused by calcium hydroxide. On day 32, necrotic tissue of the palate mucosa was removed as much as possible under local anesthesia. On Day 233, the right upper 2 teeth were extracted and a radicular cyst was removed. On day 335, the redness on the right cheek skin almost disappeared, and the opening increased to 42 mm. The right oral and extraoral hypoesthesia remained, but was improving, and the right palate mucosa was completely epithelialized.

著者

藤盛 真樹 鳥谷部 純行 角 伸博 嶋﨑 康相 宮澤 政義 宮手 浩樹 北田 秀昭 佐藤 雄治 三澤 肇 山下 徹郎 中嶋 頼俊 針谷 靖史 小林 一三 西方 聡 太子 芳仁 杉浦 千尋 笠原 和恵 浅香 雄一郎 榊原 典幸 岡田 益彦 柴山 尚大 末次 博 鈴木 豊典 阿部 貴洋 谷村 晶広 工藤 章裕 道念 正樹 川口 泰 野島 正寛 牧野 修治郎

出版者

公益社団法人 日本口腔外科学会

雑誌

日本口腔外科学会雑誌 (ISSN:00215163)

巻号頁・発行日

vol.68, no.4, pp.168-183, 2022-04-20 (Released:2022-06-20)

参考文献数

38

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Tooth extraction is reported as the main trigger of bisphosphonate (BP) -related osteonecrosis of the jaw (BRONJ). A method to prevent BRONJ has not been scientifically proven. The American Association of Oral and Maxillofacial Surgeons (AAOMS) differs from the International Task Force on Osteonecrosis of the Jaw with regard to the prevention of BRONJ via prophylactic withdrawal before tooth extraction. We performed a multicenter prospective study regarding the development of BRONJ after tooth extraction in BP-treated patients for the purpose of determining factors associated with the frequency of BRONJ. We extracted teeth from patients with a history of current or prior treatment with BP preparations; teeth were extracted using a common treatment protocol. The presence or absence of BRONJ and adverse events were evaluated. A total of 1,323 cases were targeted for this study; 2,371 teeth were extracted. The overall incidence of BRONJ was 1.74%; in the prophylactic withdrawal group it was 1.73%, whereas in the prophylactic non-withdrawal group it was 1.75%. Factors associated with the onset of BRONJ were sex, preparation adaptation classification, oral hygiene state, site of tooth extraction, and Denosumab usage. From analysis that considered the effect of confounding using the propensity score, prophylactic BP withdrawal did not result in a reduction of BRONJ (onset odds ratio with withdrawal: 1.13, 95%CI 0.36-3.57).