明海大学歯学雑誌 40‐2☆/1.前川
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1 J Meikai Dent Med 40, 97 0, : ml Investigation of Jaw-Deformity Surgery Enforced by the Department for last 8 years Yuya MAEKAWA, Toru TAKUSAGAWA, Ryo YAMADA, Shuichiro KANAGAWA, Toshiyuki NANBU, Shumei YOSHIKAWA, Masahiko KOBAYASHI, Kumi HIRANO, Yuji BEPPU and Jun SHIMADA Division of Oral and Maxillofacial Surgery, Department of Diagnostic & Therapeutic Sciences, Meikai University School of Dentistry Abstract : We report a retrospective examination with discussion about changes in orthodontic surgery, which study was conducted on 0 surgical orthodontic patients treated for maxillofacial deformity by the Division of Oral and Maxillofacial Surgery, Department of Diagnotic & Therapeutic Sciences, Meikai University School of Dentistry. These cases covered an 8-year period for 00 until 00.. The average annual number of patients for the period covered was 5., and there was an upward tendency for the past 5 years.. The patients were 58 males and 4 females male to female ratio of :.5., and all were young under 0 years old. For the surgical technique, we used sagittal splitting ramus osteotomy in of the 5 cases The duration of an operation was 8 minutes as the shortest only mentoplasty, and the mean time was 45. minutes. 5. The mean volume of blood lost during the operation was 8. ml, and it was tropesis which a volume of blood loss increases, so that the content of a technique was complicated. Key words : clinio-statistical study, maxillofacial deformity, surgical orthodontics
2 98 前川雄哉 田草川徹 山田 遼ほか 緒 言 近年 顎変形症に対する外科矯正手術は手術器具の改 良 開発に伴い安全性の向上が図られ症例数が増加傾向 にある さらに 矯正歯科医とのチームアプローチによ 明海歯学 40, 0 下顎枝垂直骨切り術 Intraoral Vertical Ramus Osteotomy 以下 IVRO と SSRO を組み合わせた症例が 例 5.5 となった Table ④手術時間 麻酔時間 手術時間と麻酔時間の各平均時間は両側 SSRO 単独 り手術症例に対する集学的治療がなされ 様々なケース が 09 分と 7 分 上顎 LeFortⅠ型骨切り術と SSRO に対応することが可能となり 口腔外科の手術症例の主 を行った例が 99 分と 4 分 SSRO と IVRO を左右片 体を成すものとなっている 筆者らは当科で 00 年 側ずつ行った例 分と 99 分 両側 IVRO が 74 分と 月から 00 年 月までに施行された顎変形症に対する 9 分 LeFortⅠ型骨切り術単独が 64 分と 57 分 LeFort 外科矯正手術 0 例を対象に臨床統計的検討を行った Ⅰ型骨切り術と SSRO, IVRO を行った例が 9 分と 05 また 004 年に本学会誌で田草川ら が報告したものと 分 オトガイ形成術 以下 Genioplasty が 8 分と 98 比較し検討を行ったので報告を行う 分 上顎前方歯槽骨切り術 以下 Wassumund 単独が 対象および方法 対象は 00 年 月から 00 年 月まで当科で施行 された顎変形症に対して外科矯正手術を行った 0 例で ある 47 分と 05 分 骨皮質骨切り術 以下 Corcicotomy 87 分と 57 分 Wassumund と SSRO を行った例が 05 分 と 67 分 LeFortⅠ型骨切り術と SSRO, IVRO を行った 例は 9 分と 60 分であった 平均出血量は SSRO 単独が 95. ml, IVRO 単独が 8.8 検討項目は①年次別症例数 ②年齢 性別分布 ③術 式別症例数 ④手術時間 麻酔時間 出血量 ⑤手術後 の経過の 5 項目に設定し 過去に行われた報告 と比較 し検討を行った 結 果 ①年次別症例数 年次的に 00 年 006 年の間症例数は増減をくりか えしているが 007 年からは前年を超える症例数を確 保している Fig ②年齢 性別分布 性別では男性 58 例に対し女性 4 例であり 男女比 は :.5 であった 女性が男性の倍以上に多く見られ Fig Number of cases in each year. Fig Distribution age and sex. た 手術施行時の年齢別では 0 歳までが 76 例 0 5 歳が 6 例 6 0 歳が 4 例 0 5 歳が 4 例 5 40 歳が 8 例 40 歳以上が 6 例であった Fig 男性 の平均年齢は.86 歳 女性の平均年齢は 4.48 歳であ った また最少年齢が 5 歳 最高年齢が 5 歳であり 共に女性であった ③術式別症例数 術式別では下顎枝矢状分割術 以下 SSRO を単独で 施行されたものが 5 例で最も多く術式全体の 57. を占めた 次いで上顎 LeFortⅠ型骨切り術 以下 Le Fort Ⅰ と両側下顎枝矢状分割術 Sagittal Splitting Ramus Osteotomy 以下 SSRO を併用した例が 40 例 9.9 別刷請求先 前川雄哉 埼玉県坂戸市けやき台 - 明海大学病態診断治療学講座口腔顎顔面外科学分野Ⅰ
3 8 99 Table Frequency of operative technique. Operation procedures Operation procedures Caces One jaw surgery Sagittal Splitting ramus osteotomy SSRO SSRO Intraoral vertical ramus osteotomy IVRO IVRO Genioplasty SARPE Corticotomy Genioplasty Le Fort Corticotomy Wassmund Two jaw surgery Le Fort peace SSRO Wassmund SSRO Le Fort SSRO Kole U : Corcicotomy L : Genioplasty Le Fort SSRO Le Fort SSRO IVRO Wassumund Genioplasty Total 0 00 Table The time of operation and blood loss according to surgical procedures Ooeration procedures Cases Operation Times min Blood Loss ml One jaw surgery Sagittal Splitting ramus osteotomy SSRO SSRO Intraoral vertical ramus osteotomy IVRO IVRO Genioplasty SARPE Corticotomy Genioplasty Le Fort Corticotomy Wassmund Two jaw surgery Le Fort peace SSRO Wassmund SSRO Le Fort SSRO Kole Upper : Corcicotomy Lower : Genioplasty Le Fort SSRO Le Fort SSRO IVRO Wassumund Genioplasty Total Mean
4 00 40, 0 ml, SSRO IVRO 08 ml, Le Fort SSRO 7.8 ml, Le Fort SSRO IVRO 5 ml, Genioprasty 50 ml, Le Fort 86.6 ml Table SSRO Wassmund SSRO, Le Fort SSRO, 8, 9, , :.5 : : 4, SSRO Le Fort SSRO SSRO IVRO 5.9 SSRO SSRO IVRO 4 SSRO 6. mm 9.8 mm 00 SSRO 6.5 Le Fort SSRO
5 ml 5 ml 0 ml 7 ml Le Fort SSRO 90 Bone saw 008 Piezo Surgery Mectron, Italy Piezo Surgery Bone saw 6, 7, Le Fort SSRO Le Fort SSRO IVRO Le Fort SSRO 99 Le Fort SSRO IVRO 9 7 Le Fort SSRO 7.8 ml Le Fort SSRO IVRO 5 ml 00 ml Le Fort ml Le Fort SSRO ml Le Fort Le Fort piece SSRO Le Fort SSRO Le Fort SSRO 7.8 ml, ml 5,000 ml Le Fort SSRO :.5 00 : SSRO Le Fort SSRO 8 8.9
6 0 40, 0 00 SSRO 6.5 Le Fort SSRO ml 05.4 ml 6 6, 7 0, , 00 05, 007 4, 6 4, , 9 96, , 97 04, 00 8, 07, 007 0, 75 8, 00 0, 7 4, 00 5, 57 6, 00, 5, 999, 94 0, 00 Orthod Waves Jpn Edit 6, 49 59, 004 8, 7 50, , , , 7 44, 996 Landes CA, Stübinger S, Rieger J, Williger B, Linh Ha TK and Sader R : Critical evaluation of piezoelectric osteotomy in orthognathic surgery : operative technique, blood loss, time requirement, nerve and vessel integrity. J Oral Maxillofac Surg. 66, ,
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