進行性化骨性筋炎を有する患者の歯科治療経験 A case experience of dental treatment for a patient with fibrodysplasia ossificans progressiva

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Author(s)

    • 丸岡 豊 Maruoka Yutaka
    • Oral and Maxillofacial Surgery, Department of Oral Restitution, Division of Oral Health Sciences, Graduate School, Tokyo Medical and Dental University
    • 三枝木 友美 Saeki Tomomi
    • Anesthesiology and Clinical Physiology, Department of Oral Restitution, Division of Oral Health Sciences, Graduate School, Tokyo Medical and Dental University
    • 稲田 穣 Inada Minoru
    • Clinic for Persons with Disabilities, University Hospital, Faculty of Dentistry, Tokyo Medical and Dental University
    • 小村 健 Omura Ken
    • Oral and Maxillofacial Surgery, Department of Oral Restitution, Division of Oral Health Sciences, Graduate School, Tokyo Medical and Dental University

Abstract

われわれは進行性化骨性筋炎を有する21歳女性患者の歯科治療を経験したので, その概要を報告する.<BR>主訴は開口障害と6〓の疼痛であった. 化骨性筋炎の症状が初めて現れたのは6歳の時で, 7歳時, 生検により進行性化骨性筋炎と診断された. 12歳時, 開口障害が出現し, その後も全身的に骨化が進行した. 2001年9月20日頃より6〓に自発痛が出現したため, 某歯科口腔外科を受診した. 開口障害の治療として, 全身麻酔下での骨性癒着部の離断術を勧められた. セカンドオピニオンを求めて当科を受診した. 全身状態と予備力低下のため全身麻酔は不可能と判断し, 患者の同意のもと, 6〓の抜歯術のみを施行した. 抜歯部は通常の治癒経過をたどり, 現在も経過観察中である. このような全身疾患を有する患者の歯科治療に際しては, 全身状態や疾患の本態を十分に把握したうえで治療方針を立てる必要があると考えられた.

We herein report a case of a 21-year-old female patient treated for fibrodysplasia ossificans progressiva. The symptoms of the disease first appeared at age 6 and was diagnosed as fibrodysplasia ossificans progressiva by biopsy at the age of 7. Trismus appeared at age 12 and ossification progressed gradually. In September 2001, she visited her oral surgeon due to severe tooth pain in the lower right region of the first molar. The surgeon suggested (recommended) surgical transection of the bony fusion as treatment for trismus under general anesthesia. The patient was referred to our clinic for a second opinion. In account of her poor general condition and diminishing reserve capacity, it was impossible to administer general anesthesia. After obtaining informed consent, the tooth was extracted under local anesthesia. At present, the patient's postoperative course of recovery is stable and uneventful.<BR>This case underlines the importance of understanding both the patient's systemic disease and general condition during the course of treatment.

Journal

  • Journal of Japanese Society of Dentistry for Medically Compromised Patient

    Journal of Japanese Society of Dentistry for Medically Compromised Patient 12(3), 139-145, 2003

    Japanese Society of Dentistry for Medically Compromised Patient

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