| 連載名 | ［連載］Case Report | |
|---|---|---|
| 題名 | 炎症症状を繰り返した透析療法中患者に発症した顎骨骨髄炎の1例 | |
| 発刊年月 | 2008年 07月 | |
| 著者 | 篠原 治征 | 日本歯科大学新潟病院口腔外科 |
| 著者 | 田中 彰 | 日本歯科大学新潟病院口腔外科 |
| 著者 | 堀川 恭勝 | 新潟県厚生農業組合連合会村上総合病院歯科・口腔外科 |
| 著者 | 又賀 泉 | 日本歯科大学新潟生命歯学部口腔外科学第二講座 |
| 【 要旨 】 | 顎骨骨髄炎に対する治療は，近年新しい抗菌薬が開発され，その治療成績は確実に向上してきているが，現在も未だ難治性である．また高齢化に伴い基礎疾患も多様化し，顎骨骨髄炎の症状や経過が複雑になり，診断に苦慮する非定型的な症例も少なくない．さらに嫌気性菌や耐性菌感染も加わって疾患の内容も複雑化している．今回，血液透析患者で歯性感染症から顎骨骨髄炎へ移行した症例を経験した．症例は61歳，男性．糸球体腎炎により1978年より血液透析療法を受けていた．口腔内は高度の乾燥状態を呈しており，清掃状態は不良であった．1996年に右側下顎大臼歯，2005年に右側上顎大臼歯の抜歯後，治癒不全から顎骨骨髄炎へと移行した．治療は抗菌薬の投与と掻爬術，腐骨除去術を基本とした治療により良好な結果を得られた． | |
| Series | ［Series］Case Report | |
|---|---|---|
| Title | Osteomyelitis of the mandible in the patient maintained by hemodialysis therapy ; Report of a case | |
| Author | Haruyuki Shinohara | Oral and Maxillofacial Surgery, The Nippon Dental University Niigata Hospital |
| Author | Akira Tanaka | Oral and Maxillofacial Surgery, The Nippon Dental University Niigata Hospital |
| Author | Yasukatu Horikawa | Department of Oral and Maxillofacial Surgery, Murakami General Hospital |
| Author | Izumi Mataga | Department of Oral and Maxillofacial Surgery 2, The Nippon Dental University School of Life Dentistry at Niigata |
| [ Summary ] | Osteomyelitis of the mandible remains difficult to treat even with the development of chemotherapy along with new antibiotics. Recently, diagnosis of osteomyelitis of the mandible has become more difficult why systemic and local condition has remarkably changed because number of compromised host and geriatric generation are increased. This is also due to resident bacteria against antibiotics and pseudomonas. A 61 years old male patient, who had been receiving hemodialysis since 1978 and who was affected by chronic glomerulonephritis was observed. The patient complained of dryness in the mouth and discomfort in the mandible. Radiographic imaging indicated bone destructive change was observed and clinically diagnosis of chronic osteomyelitis in the molar area of the mandible. The mandibular molar tooth was extracted in 1996. The maxillary molar tooth was extracted in 2005 due to destructive dental caries. Post surgical condition was poor due to delayed healing after both extractions. Curretage and post surgical medication with antibiotics were the only effective treatments for this condition. |
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