1型糖尿病を有する顎変形症患者に対する上下顎移動術の経験

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  • A Case of Two-jaw Orthognathic Surgery in a Jaw Deformity Patient with Type 1 Diabetes Mellitus

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Type 1 diabetes mellitus is a disease in which insulin is completely lacking due to the autoimmune destruction of β-cells of pancreatic islets. Since diabetic patients often develop complications after surgery, special consideration is necessary for perioperative management. <br>We report a patient with jaw deformity complicated with type 1 diabetes mellitus who was successfully treated by two-jaw surgery without complications. The patient was a 16-year-old female with a chief complaint of mandibular protrusion and open bite. She had type 1 diabetes mellitus and had been treated with insulin. After preoperative orthodontic treatment, orthognathic surgery was planned at the age of 19. However, blood sugar level was poorly controlled and unstable. Therefore, she was hospitalized to control her blood sugar level by proper diet and insulin therapy before surgery. Then, two-jaw surgery by Le Fort Ⅰ osteotomy and sagittal split ramus osteotomy was performed. Perioperatively, blood sugar level was strictly controlled in addition to local management．The postoperative course was uneventful, without infection or delay of wound healing. Facial appearance and occlusion were remarkably improved. Three years after surgery, occlusion was stable without relapse tendency.

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