矯正学的な咬合再構築における現状と問題点 : 第2報 : 外科的矯正治療  [in Japanese] Present State and Remaining Problems in Orthodontic Occlusal Reconstruction : (II) Surgical Orthodontic Treatment  [in Japanese]

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Abstract

近年, 矯正歯科領域では保険導入を背景として重篤な顎の変形をともなう症例が増加している.とくに下顎非対称症例における顎矯正手術は, 下顎骨体の回転をともなった骨片の移動を要するため, 下顎枝部での大きな変位を生じ, 術後の顎関節などへの影響や後戻りが懸念される.<BR>本稿では, 下顎の左側への偏位を認める症例に対し, 顎関節機能異常の誘発を防ぎ, 下顎変形の改善を目標として, 左側は下顎枝垂直骨切り術, 右側は下顎枝矢状分割術という左右で異なる手法の顎離断術を行い下顎変形の改善を試みた.しかし動的治療終了後, 下顎突出感の改善と緊密な咬合状態を確立することはできたが, 下顎の左側への偏位は改善するに至らなかった.<BR>顎変形症における咬合異常に対する咬合再構築を通じて, 矯正歯科が担当する手法の問題点と今後の展望について以下のような必要性が考察された.<BR>1.高精細・高次元の画像診断法の開発<BR>2.個々の症例における生体力学解析・予測シミュレーションの開発<BR>3.遺伝子診断手法の開発<BR>4.効率的な歯の移動を行うための矯正裝置の開発・発展

Recently, the number of patients with severe jaw deformation who undergo treatment has been increasing in the orthodontic field since the start of health insurance coverage of the treatment of such disorders.<BR>In this study, to prevent the induction of functional problems in the mandibular joint and to improve mandibular deformity, we used different osteotomy methods in the left and right mandibular ramus, i.e., intraoral vertical ramus osteotomy in the left side and sagittal splitting ramus osteotomy in the right side. Improvement of mandibular protrusion and normal occlusion were obtained by surgical orthodontic treatment, but the mandibular asymmetry could not be improved.<BR>From experience of the reconstruction of malocclusion in jaw deformity, development of the following methods was considered necessary based on problems in orthodontic treatment and future prospects:<BR>1. Diagnostic method by highly accurate and high-dimensional imaging, <BR>2. Biomechanical analysis and a simulation method in each patient, <BR>3. Genetic diagnosis method, <BR>4. Development and improvement of orthodontic devices for the efficient movement of teeth.

Journal

  • The Journal of Clinical Dentistry

    The Journal of Clinical Dentistry 26(1), 148-155, 2006-04-18

    THE ACADEMY OF CLINICAL DENTISTRY

References:  11

Cited by:  1

Codes

  • NII Article ID (NAID)
    10020404803
  • NII NACSIS-CAT ID (NCID)
    AA11582107
  • Text Lang
    JPN
  • Article Type
    Journal Article
  • ISSN
    13468111
  • Data Source
    CJP  CJPref  J-STAGE 
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