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A Case Report of Dental Findings of The Sotos Syndrome
Get PDFapplication/pdfSotos症候群は脳性巨人症とも言われ,巨大頭蓋,精神発達遅滞を伴う成長過剰と末端肥大症に類似した症状を示す症候群であり,口腔領域の所見では上下顎前突,高口蓋が特徴的である。病因は不明であるとされているが,常染色体優性遺伝の可能性が高いと考えられている。本症例は現在10歳6か月の男児で,全身所見では身長129.5cm,体重28kg,脊柱側彎を合併しているため,身長が全国平均138.7±5.9cmより低い値を示した。また,漏斗胸,前頭部突出,眼間開離といったSotos症候群に合併する症状を認めた。口腔内所見は,臼歯部の咬合はAngleのII級で上顎前突の状態を示し,高口蓋が認められた。また上下左右第二小臼歯の歯胚の欠如が認められた。10歳6か月時の頭部エックス線規格写真分析結果よりSNP,SNBは-1SDより小さく,SNAは平均値内であるが,上下顎とも劣成長で頭蓋底に対し後方に位置していた。また,Gonial Angleは平均値内であるが,下顎の後方への回転がみられた。journal articl
壊死性筋膜炎
Get PDFapplication/pdfBacterial resistance to antimicrobial agents increases rapidly outside as well as in hospitals. Antimicrobials may remove sensitive organisms from the bacterial flora, but they also foster the establishment of a resistant strain, not only inducing infection by bacteria which had not previously been considered pathogens, but also preventing spontaneous healing. Although necrotizing fasciitis has been seen in the past 20 years throughout the world, it remains unclear which cases are attributable to new forms of infectious disease because no data are available on their incidence. Regional clusters of cases of necrotizing fasciitis in England and Norway suggest the differential geographic distribution of certain bacteria with high toxicity, such as beta-hemolytic Streptococcus (mainly invasive group A Streptococcus). For the most part, gram-negative rods and anaerobes were simultaneously isolated from tissue fluid cultures. Necrotizing fasciitis occurs within 24 hours after the onset of cellulitis. The progression of necrotizing fasciitis is usually rapid, resulting in widespread gangrene of the subcutaneous fat and fascia around the scalp and into the deep neck spaces. Crepitus, cutaneous anesthesia due to gas bubbles in the soft tissues, and foul-smelling gray watery discharge are found. Some cases are seen as post-operative infection after maxillofacial surgery. Frequently, septic shock, mediastinitis and multiple organ failure are associated with necrotizing fasciitis, leading to a fatal outcome. Some patients have a history of systemic diseases, particularly those associated with compromised status, accounting for the increased risk of necrotizing fasciitis. In some cases, however, there is no such history. This suggests that the toxicity of the bacteria influences the onset of this disease in addition to the widely accepted risk factor of compromised host. Computed tomography can be diagnostic when there is evidence of gas bubbles in the deep tissue even in the absence of crepitation, foetor, and anesthesia of the skin. Abnormally elevated C-reactive protein concentration is a sensitive quantitative measure of the inflammatory response associated with necrotizing fasciitis. Necrotizing fasciitis requires prompt surgical referral for immediate debridement to reduce necrotic tissue and expose anaerobes to oxygen, followed by antibiotics such as clindamycin. The precription of antibiotics alone is not helpful because of the ischaemic focus in necrotic tissue. One of our patients developed septicemia, but all of our patients including the one with septicemia recovered fully without skin grafting. Our findings point to the clinical significance of the computed tomographic findings and débridement associated with eradication of gas bubbles. The patient without objective findings may be misdiagnosed as having a form of cellulitis, such as Ludwigs angina. Any patient with cellulitis should be referred for an early surgical evaluation to prevent the development of the disease and dyspnea due to pharyngeal edema. Prompt evaluation and surgical treatment might reduce the overall mortality in necrotizing fasciitis. It was recently noted that invasive streptococcal infection is associated with a substantial risk of transmission in households and health care institutions. Infections seen throughout the world should be continuously and carefully reviewed.journal articl
多孔質ハイドロキシアパタイト溶射インプラント体界面の組織学的観察
Get PDFapplication/pdfImplantation of the hydroxyapatite-coated implant into the jaw has been available for some time. However, the success rate of this implant does not seem to be high in comparison with other osseointegrated type implants. So attention was paid to the characteristic biocompatibility of the porous HA coated implant. Therefore, the purpose of this investigation was to observe the histological study of interface of porous HA coated implant under the light microscope and the scanning electron microscope during and experiment with Japanese monkeys. In the histological findings 3 months after implantation, newly formed bone tissue was observed surrounding the implant at the light microscope level. The porous HA coated implants were encapsulated with the newly formed bones. On the other hand, the implant was surrounded with newly formed bone tissue, but the surface of newly bone was adjacent to the macrophage-Iike giant cell without an inflammatory reaction at some patrs. At 6 months after implantation, a large amount of newly formed trabecular bone was seen on the surface of HA coated layer of implant. Immature osteoid tissue was found in the interstice of the HA coated layer at 6 months after implantation. However, it seemed that interstiate collagenous tissue at 12 months after implantation. Those results suggest that the porous HA coated implant must be stabilized to external forces.journal articl
歯肉メラニン色素沈着に対するCO²レーザーによる治療方法
Get PDFapplication/pdfIrradiation by a CO² laser was studied in seven patients aged 23 to 29 years with gingival melanin pigmentation. The CO² laser irradiated the surface of the pigmented gingiva under the conditions of diameter of the probe tip 0.8mm, output 3W and local anesthesia using spray of the 8% Lidocaine. Immediately after irradiation, the gingiva surface showed opaque dark white colors and carbonization appeared. After several days, the pigmentation of the gingiva disappeared in all cases without hemorrhage and epidermal detachment. We conclude that CO² laser irradiation is a useful and safe technique for the removal of gingival pigmentation.journal articl
各種増殖性病変における核小体形成体の動態
Get PDFapplication/pdfWe compared the number of NORs in necrotizing sialometaplasia (NSM), hyperkeratosis (HYP) and low-keratinizing squamous cell carcinoma (SCC) by a fixing-substitution method. As a result, the mean numbers of NORs in NSM were 7.1±0.2 (mean±S.E.), HYP, 10.2±0.3 and SCC, 23.8±0.7. There was a significant difference between the number of NORs of NSM and that of HYP in t-test analysis. Similar tendencies were observed in the relationship between HYP and SCC, and between SCC and NSM. We thought that NORs is a good index to evaluate the potency for proliferation of cells rather than an index to discriminate benign or malignant tumors.journal articl
ミリング型セラミックインレーシステム"セレイ"の評価 : 第2報 窩壁適合性について
Get PDFapplication/pdfAs the demand for aesthetic restorations has increased in the past few years, tooth color materials have been used frequently in posterior teeth. Ceramics are widely used as dental restorative materials. The CELAY system that creates a ceramic inlay by a milling technique has been developed and introduced recently. The purpose of this study was to investigate the marginal adaptation and internal fit of ceramic inlays made using the CELAY system. Twenty extracted upper premolars were used. Only one clinician prepared all twenty box-shaped class II (MO) cavities to make the cavities uniform. The fabricated ceramic inlay that each of five ceramic inlays made by four clinicians whose clinical experience period differed was luted in the individual cavity with a dual-cured composite resin cement. Then all of them were cut mesio-distally through the center of the inlay. The cut surface of the specimens were observed under a profile projector. Marginal adaptation and internal fit were defined as inter facial distances between a ceramic inlay and cavity wall, and measured at nine preselected points. The following results were obtained; 1) The average gap width for all measured points was 170.2±111.8μm. 2) Statistical analysis showed that there were no significant differences among the nine preselected points. But there were significant differences (P<0.01) among the operators. 3) The fitness of the ceramic inlay to the cavity wall had decreased in the order of the central cavity wall, the margin of the cavity and line angle of the cavity, when compared with the nine measuring points. It may be concluded that if the operator is greatly experienced in the ways of the CELAY system he can reduce operating time and can improve adaptation.journal articl
下顎枝および下顎体の成長変化が歯列形成に及ぼす影響について
Get PDFapplication/pdfThe purpose of this study was to investigate whether there was any morphological difference in the mandible, including the mandibular corpus and the ramus, between subjects with anterior crowding of teeth in the mandible and subjects with no crowding of anterior teeth. The samples consisted of two groups of patients. One group was made up of 15 females with an average age of 7.92 years. The other group consisted of 15 females with an average age of 8.01 years. The materials for the analysis were dental casts and lateral cephalometric radiographs. The dental casts were used for evaluating the crowding status and the size of teeth. The lateral cephalometric radiographs were traced and measured according to the method proposed by Lin et al. The results showed that there was no significant difference in the anteroposterior dimension of the mandible between the group with tooth crowding and the group without it. But significant difference was found in the mandibular corpus and the ramus between the two groups.journal articl