顎関節鏡視下レーザーおよび円板縫合・固定術を用いた習慣性顎関節脱臼治療の長期経過

  • 大月 佳代子
    山梨大学大学院医学工学総合研究部臨床医学系歯科口腔外科学講座
  • 大西 正俊
    山梨大学大学院医学工学総合研究部臨床医学系歯科口腔外科学講座
  • 木野 孔司
    東京医科歯科大学歯学部附属病院顎関節治療部
  • 牧野 兼三
    山梨大学大学院医学工学総合研究部臨床医学系歯科口腔外科学講座
  • 吉田 雅之
    山梨大学大学院医学工学総合研究部臨床医学系歯科口腔外科学講座
  • 渡井 幸雄
    山梨大学大学院医学工学総合研究部臨床医学系歯科口腔外科学講座
  • 中村 猛
    山梨大学大学院医学工学総合研究部臨床医学系歯科口腔外科学講座
  • 市川 寛子
    山梨大学大学院医学工学総合研究部臨床医学系歯科口腔外科学講座
  • ゼアアルゴン ザグレブ
    山梨大学大学院医学工学総合研究部臨床医学系歯科口腔外科学講座
  • 神林 秀昭
    山梨大学大学院医学工学総合研究部臨床医学系歯科口腔外科学講座 神林歯科医院
  • 若尾 徳男
    歯科若尾
  • 矢崎 芳人
    山梨大学大学院医学工学総合研究部臨床医学系歯科口腔外科学講座
  • 小林 葉子
    山梨大学大学院医学工学総合研究部臨床医学系歯科口腔外科学講座

書誌事項

タイトル別名
  • Arthroscopic laser surgery and disc suture-fixation technique for recurrent dislocation of temporomandibular joint

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抄録

A variety of surgical procedures are available for the treatment of recurrent dislocation of the temporomandibular joint, among which less invasive procedures are always preferred. We have developed an arthroscopic Nd-YAG laser surgery procedure (1986) combined with disc suture-fixation technique (1989) and applied these techniques without opening the joint in cases of recurrent dislocation of the temporomandibular joint requiring surgical treatment. This report briefly reviews the long-term follow-up data on these treated cases. The procedure comprises arthroscopic observation of the upper joint cavity and subsequent endoscopic infliction of fresh wounds from the posterior aspect of the disc in the upper joint cavity structures such as the oblique protuberance of the posterior wall of the upper joint cavity, the mandibular fosse, the articulator tubercle and the medial wall synovium by means of arthroscopic laser surgery (Advanced Medical Care, Ministry of Health and Welfare, Health Insurance Bureau, No. 5). Through the subsequent endoscopic disc suture-fixation process, sutured/stitched tissues posterior to the articular disc are fixed by traction onto the posterior wall and eventually adhere to the mandibular fossa and tubercle surface, resulting in contraction or disappearance of the upper joint cavity and in limitation of mandibular head movement. This surgical procedure has proven to be useful as a minimally invasive surgical technique for correction of recurrent temporomandibular joint dislocation. It permits the objectve to be achieved without involving joint opening, is repeatable, and hence is less invasive than the conventional open surgical procedures. Surgical treatment with this operative procedure has been indicated for a total of 35 jaw joints in 23 patients during the 17-year period from 1986 to 2002, and of these, only a single joint developed recurrence necessitating re-operation. All patients including this one case have since been progressing without recurrence or any problematic events.

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