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下顎前歯部歯槽骨切り術を併用し上下顎移動術を行った骨格性開咬の一例
Get PDFapplication/pdfThe report describes a 38 year 4 month old female patient with skeletal openbite and mandibular retrognatism. The facial profile was the Skeletal Class 2 convex type with a high angle of FMA 41.0°. These was lingual inclination at an upper incisor (U1 to FH 104.5°), labial inclination at a lower incisor (FMIA 45.0°), and the intrusion of an upper incisor and extrusion of an upper molar. The patient showed : overjet＋1.0 mm, overbite－5.0 mm, Angle Class III (Lt) and Angle Class I (Rt). The pre−surgical orthodontic treatment duration was 18 months. In order to avoid excess extrusion of the upper incisor and succeed in mandibular anterior segmental osteotomy, the space between the mandibular first premolar and second premolar on both sides was expanded to 1.5 mm for the safety of the surgical procedure. Le Fort typeⅠosteotomy was applied for the upper molar intrusion. Counterclockwise mandibular rotation was achieved by sagittal splitting ramus osteotomy. For the improvement of openbite, mandibular anterior segmental osteotomy was conducted as the first surgical treatment. Eight months after the above mentioned surgery, the improvement of mandibular retrognathism by genioplasty including plate removal of mini−plate fixation was accomplished as the second operation. At present, 18 months after the completion of active treatment, the occlusion is stable although slight relapse remains. After post−surgical orthodontic treatment, the facial profile was significantly improved, and acceptable occlusion was achieved.journal articl
Chapter 7 : Clinical and Radiographic Examinations of Pulpectomy in Deciduous Teeth
Get PDF9784905130062application/pdfClinical and radiographic examinations were done on 163 deciduous teeth treated with a root canal filling material called Vitapex, which contains calcium hydroxide and iodoform. Anesthesia was administered, followed by pulp extirpation and immediate root canal filling, with observation for 5 to 1307 days. The following results were obtained. 1: Excessive bleeding during pulp extirpation seemed to adversely affect the overall clinical and radiographic results. The poor clinical condition of the pulp resulted in a higher incidence of poor results based on radiographs. 2: Deciduous teeth are susceptible to overfilling after a certain period due to root resorption. A higher incidence of good pathological scores was obtained when the root canal filling was flush, not overfilled. Radiographs confirmed resorption of excess root canal filling material in all cases. 3: During the observation period, root canal filling materials were in a stable condition and only few roots exhibited resorption. Root resorption occurred earlier or at the same time as the resorption of root canal filling material. 4: During the observation period, eruption of the succeeding permanent teeth was observed in 18 cases. In 12 out of 18 cases, eruption of the succeeding tooth did not occur at the same time as on the contralateral side (control). In 6 out of 12 cases, eruption of the succeeding permanent tooth was earlier than on the contralateral side but in 4 out of 12 cases, a delay in the replacement was observed. Also, 2 cases were replaced almost immediately. 5: During the observation period, pathological root resorption was observed in cases where root canal filling material was rapidly resorbed. 6: Until the last observation day, 127 out of 163 cases (77.9%) showed no clinical discomfort or adverse radiographic findings and only 36 out of 163 cases (22.1%) showed some discomfort. 7: Signs and symptoms observed in the study were the following: 5 cases of spontaneous pain, 3 cases of pain during mastication, 10 cases of pain on percussion, 3 cases of gingival swelling, 1 case of redness, 1 case of tenderness, 3 cases of fistula and 3 cases of drainage. Discomfort was felt from the 1st to 3rd day after treatment and was mostly of a mild degree. 8: Radiographic findings of those with clinical discomfort were the following: 2 cases with loss of lamina dura, 12 cases with incomplete resorption, 8 cases with root resorption and 5 cases with pathological lesion. 9: In 36 cases with clinical discomfort and adverse radiographic findings, 12 cases (33.3%) had clinical discomfort only, 17 cases (47.2%) had clinical discomfort associated with adverse radiographic findings and 7 cases (19.5%) were asymptomatic but with adverse radiographic findings. Adverse radiographic findings were observed in 13 out of 91 cases (14.3%) in anterior and 23 out of 72 cases (31. 9%) in posterior teeth. The clinical diagnosis of cases with adverse radiographic findings was observed in the most infectious pulpitis particularly acute suppurative pulpitis and chronic hyperplastic pulpitis. 10: The overall clinical and radiographic results obtained in the study were the following: out of 163 cases, 127 obtained good results (77.9%) and 25 cases were fair (15.3%) for a total of 93. 2% had satisfactory results. Only 11 cases had poor results (6. 8%). In 151 cases with stable periodontal tissue condition from the radiograph, 117 cases obtained good results (77. 5%), 23 cases were fair (15. 2%) and 11 cases were poor (7. 3%). Resorption of about 1/4 to 2/3 of the root occurred in 12 cases, in which 10 cases obtained good results (83.3%), 2 cases were fair (16.7%) and none of the cases was classified as poor. Root canal filling immediately after anesthesia and pulp extirpation in cases with advanced root resorption was thought to be significant. 11: There was no change in the condition of the root in 92 cases until the last observation day. In 92 cases, 72 cases obtained good results (78.3%), 9 cases were fair (9.8%) and 11 cases were poor (11. 9%). The remainder of the 59 cases with root resorption became stable within the observation period. In 59 cases, 45 cases obtained good results (76.3%), 14 cases were fair (23.7%) and no case was classified as poor. Vitapex employed in root canal filling of deciduous teeth mostly did not induce clinical signs and symptoms, and adverse radiographic findings as well as affecting physiological root resorption confirming that this is an excellent root canal filling material.Editor, Toshiyuki KawakamiLanguage Editor, David M Carlsonviii, 232 p. ill. (some col.)boo
Neural-inducing Factor Netrin-1 is Regulated in Chondrogenesis and Osteogenesis by BMP or Noggin
Get PDFapplication/pdfThis is the first report describing neurogenic factor of Netrin-1 related to chondrogenesis or osteogenesis in a human cells. Netrin is a morphogenetic factor that induces a growth cone of an axial filament of the nervous system. However, the roles of Netrin in chondrogenesis or osteogenesis are not yet understood. We analyzed the relationship between Netrin and bone morphogenetic protein-2 (BMP-2) in chondrogenesis or osteogenesis, using a human chondrocyte-like cell line (USAC), which also retains multi-potency to differentiate into osteoblasts and adipocytes. Netrin-1 mRNA was decreased in USAC cells, though the expression was increased during osteogenic differentiation at the stage when osteocalcin mRNA were increased by BMP-2. Furthermore, inhibition of Netrin-1 gene increased Cbfa1 mRNA expression, and decreased Sox9 mRNA expression. We also found that Netrin-1was strongly expressed in immature chondrocytes of cartilage-like tissues that were formed in an exo vivo experiment with diffusion chambers. The se findings indicate that Netrin-1 and BMP-2 regulates in the stage dependent process of mesenchymal cell differentiation to chondrocytes or osteoblasts.journal articl
大きな下顔面高を伴う骨格性下顎前突の１症例
Get PDFapplication/pdfThe report describes orthodontic treatment of a 24- year 11 months old female patient with skeletal mandibular protrusion and large lower facial height.The facial profile was concave type because of the mandibular overgrowth. The maxillary incisors were labially inclined and the molar relationship was Angle Class III. This patient was diagnosed as having mandibular protrusion and large lower facial height. After extraction of the maxillary first premolars, 0.018 inch pre−adjusted edgewise brackets were placed to treat the compensated upper incisor inclination and minor crowding. Orthognathic surgery , sagittal splitting ramus osteotomy, was performed at 26 years 10months and genioplasty was performed at the removal of mini−plate fixation of the mandible at 27 years 8 months. After post−surgical orthodontic treatment, the facial profile was significantly improved, and an acceptable occlusion was achieved. No relapse was observed after two years of retention.journal articl