著者

片桐 渉 小林 正治 佐々木 朗 須佐美 隆史 須田 直人 田中 栄二 近津 大地 冨永 和宏 森山 啓司 山城 隆 齋藤 功 高橋 哲

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.30, no.3, pp.213-225, 2020 (Released:2020-09-11)

参考文献数

21

被引用文献数

2 2

---

The Japanese Society for Jaw Deformities performed a nationwide survey from 2006 to 2007 and the results were reported in 2008. In the last 10 years, new surgical procedures and medical devices have been developed and brought major changes to surgical orthodontic treatment. Accordingly, we need to assess the current status of surgical orthodontic treatment.A nationwide survey of surgical orthodontic treatment between April 2017 and March 2018 was carried out and 99 surgical facilities and 64 orthodontic facilities were enrolled in the survey. The number of patients who received orthognathic surgery was 3,405, about 69% of whom were diagnosed with mandibular protrusion. Before the surgery, 3D-simulation was performed for about 40% of patients at both surgical and orthodontic facilities. Computer-aided design and computer-aided manufacturing (CAD/CAM) wafers were used at 12.1% of surgical facilities and at 17.7% of orthodontic facilities. Sagittal split ramus osteotomy (SSRO) was performed in 2,768 patients (85.5%) and Le FortⅠosteotomy in 1,829 patients (56.5%). Blood loss during the surgery was reduced compared with that in the previous survey. Autologous blood transfusion tended to be performed in cases as necessary such as surgery for maxilla and anemia of the patient. Duration of intermaxillary fixation and hospital stay were also shortened. This survey revealed the current status of surgical orthodontic treatment in Japan in comparison with the previous survey.

著者

大塚 雄一郎 藤田 昌樹 江川 広人 三條 恵介 藤本 舞 龍田 恒靖 松井 成幸 嶋田 淳 須田 直人

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.25, no.1, pp.32-41, 2015-04-15 (Released:2015-04-27)

参考文献数

30

被引用文献数

4

---

The osteotomy line in sagittal split ramus osteotomy (SSRO) has a wide variation among surgeons. Recently, short lingual osteotomy (SL), in which the lingual split is limited up to the area near the mandibular foramen, is performed in many facilities. The reason for this is that SL can reduce the amount of interference between the proximal and distal segments, and shorten the operation time compared with Obwegeser osteotomy (Ob). However, since medial pterygoid muscles (MPM) are included in the proximal segments, SL is prone to induce backward rotation and distal positioning of the mandibular ramus due to the interference between MPM and distal segments when mandibular setback is performed.The purpose of this study was to compare the postoperative outcome of SL and Ob for mandibular prognathism. Twenty-two skeletal Class III cases without lateral deviation treated by SSRO in Meikai University Hospital, were examined. Among the 22 cases, 15 and 7 cases underwent SL and Ob, respectively. The postoperative changes of the proximal and distal segments were evaluated in lateral and postero-anterior cephalograms taken immediately before the surgery (T1), immediately after the surgery (T2), and one year after the surgery (T3). At T1, there was no significant difference in SNB, FMA, or gonial angle between the SL and Ob groups. No significant difference in the amount of mandibular setback was found between the two groups. Comparing values at T1 and T2, the proximal segments tended to rotate backward in the SL group, but there was no significant difference in the anterio-posterior position of proximal segments between the two groups. Comparing values at T2 and T3, counter-clockwise rotation of proximal segments was seen in the SL group but not in the Ob group. It is likely that this rotation of proximal segments in the SL group was caused by the muscular strength of MPM attached mainly to the proximal segments. Moreover, a significant negative correlation in the amount of rotation of proximal segments was detected between T1-T2 and T2-T3 in the Ob group, but not in the SL group.These findings indicate that special attention to the rotation in SL cases is important since a wider variation in the rotation of proximal segments may occur compared with the Obwegeser method.

著者

須田 直人 友村 明人 安達 一典 長谷川 直哉

出版者

明海大学

雑誌

挑戦的萌芽研究

巻号頁・発行日

2012-04-01

---

歯の移動に伴って誘発される侵害受容機構や口腔内の組織変性が定量可能な実験モデルを、ラットの歯を移動し刺激用電極を用いて開口反射を評価することにより構築した。このモデルにおいて歯の移動後に起こった歯の移動測の開口反射閾値の低下は、数日間継続し、7日後には非移動測と同程度になった。一方、圧迫測における破骨細胞による歯槽骨吸収は、移動開始数日後より活発になり移動距離も増加した。これらの変化は、矯正歯科における歯の移動に伴う症状や所見と近似していた。このように本動物モデルは、臨床的な歯の移動に伴う疼痛を再現し、発痛メカニズムの解明や分子制御を考える上で有用な評価系と考えられる。