二重下顎頭を伴った著しい顔面非対称に顎矯正手術と付随的下顎頭切除術を行った1例 A case of severe facial asymmetry with the double headed mandibular condyle treated by orthognathic surgery and excision of supplemental condyle

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Author(s)

    • 川村 仁 KAWAMURA Hiroshi
    • 東北大学歯学部口腔外科学第一講座 Department of Oral and Maxillofacial Surgery I, Tohoku University School of Dentistry
    • 鎌倉 慎治 KAMAKURA Shinji
    • 東北大学歯学部口腔外科学第一講座 Department of Oral and Maxillofacial Surgery I, Tohoku University School of Dentistry
    • 長坂 浩 NAGASAKA Hiroshi
    • 東北大学歯学部口腔外科学第一講座 Department of Oral and Maxillofacial Surgery I, Tohoku University School of Dentistry
    • 佐藤 修一 SATO Syuichi
    • 東北大学歯学部口腔外科学第一講座 Department of Oral and Maxillofacial Surgery I, Tohoku University School of Dentistry
    • 茂木 克俊 MOTEGI Katsutoshi
    • 東北大学歯学部口腔外科学第一講座 Department of Oral and Maxillofacial Surgery I, Tohoku University School of Dentistry
    • 菅原 準二 SUGAWARA Junji
    • 東北大学歯学部口腔外科学第一講座 Department of Oral and Maxillofacial Surgery I, Tohoku University School of Dentistry
    • 曽矢 猛美 SOYA Takemi
    • 東北大学歯学部歯科矯正学講座 Department of Orthodontics, Tohoku University School of Dentistry

Abstract

二重下顎頭を伴った重度の顔面非対称の治療例1例を報告した。<br>初診時年齢15歳の女性で, 約30か月間の二重下顎頭にたいする経過観察において, 下顎頭に著変を認めなかった。しかし, 顎運動障害を認めたことから, CT検査等を行うことで付随的下顎頭の切除術を適用した。下顎頭の切除術に先立って, 術後の機能訓練を考慮し, 重度の咬合不全と顔面非対称を改善した。また, 付随的下顎頭を切除するとき, 関節円板はできるだけ正常に保存した。術後経過は良好に安定した。<br>二重下顎頭の治療では, 機能障害の有無以外に, CT検査や骨シンチグラフィーが有用と考えられた。また, 二重下顎頭の外科的治療では, 正常側の下顎頭と関節円板の保存に, 術後の機能訓練を考慮し, 良好な咬合状態の確立が重要と考えられた。

A case of severe facial asymmetry with double headed mandibular condyle in a 15-year-old girl was reported at the first medical examination.<br>Clinical observation for about 30 months after the initial consultation did not disclose any alteration in the TMJ.<br>Because the patient demonstrated TMJ dysfunction, supplemental mandibualr condyle was excised with the aid of CT scan and other methods.<br>Prior to the surgery, severe malocclusion and facial asymmetry was improved so as to allow satisfactory jaw movement following the TMJ surgery.<br>In the TMJ surgery, the disc was shaped closely in the normal posture.<br>The patient's progress following the operation was favorable and steady.<br>In the treatment of double headed mandibular condyle it proved useful to examine not only TMJ function but also to use CT scan and bone scintigraphy.<br>In the surgery for double headed mandibular condyle, it was important for satisfactory postoperative training of mandibular movement both to preserve the original condyle with disc and to establish a harmonious occlusion.

Journal

  • Journal of the Japanese Society for the Temporomandibular Joint

    Journal of the Japanese Society for the Temporomandibular Joint 3(1), 47-57, 1991

    The Japanese Society for Temporomandibular Joint

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