Kazuya Yoshida- DDS PhD
- Head of Department at Kyōto Medical Center
Kazuya Yoshida
- DDS PhD
- Head of Department at Kyōto Medical Center
I apply botulinum toxin therapy (Botox) and surgery (coronoidotomy) for involuntary movements in the orofacial region.
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Introduction
I apply a comprehensive range of treatments including medication, injections of local anesthetic (muscle afferent block therapy) or botulinum toxin (Botox), and surgery (coronoidotomy), for involuntary movements in the orofacial region.
Current institution
Additional affiliations
April 1993 - March 1994
April 1994 - July 2007
Publications
Publications (207)
【目的】日本ではすでに16世紀前半に世界最初の陰圧によって保持する総義歯が使用されていた1，2．本研究は400年前の江戸時代と同じ材料と方法で木床総義歯を再現し、その咀嚼能力を検証することを目的とした．
【方法】90歳女性の上顎に木床総義歯を製作した．上顎を温水で軟化した蜜蝋で印象し、その印象に軟化した蜜蝋を圧接して作業模型とした．作業模型に食紅を塗布し，ツゲの木をノミで彫って作製した義歯床に圧接し，印記した部分を彫刻刀でさらに削合した3．被験者の歯槽頂部に食紅を塗布し，義歯床の適合を微調整した．人工歯は象牙で作製し，口蓋側を鳩尾形に彫り，義歯床に麦漆（生漆に小麦粉を練和した漆）で固定した3．咀嚼能力はグミゼリーテスト（ジーシー社製グルコセンサーGS-Ⅱ）と咬合力測定（ジーシー社製デンタルプ...
In Japan, during the Edo period (1603–1868), syphilis was widespread, and many people were left with missing noses. Records suggest that expert craftsmen made professional wooden artificial noses (nasal epitheses) for such patients. However, no artificial noses that were actually inserted have
been found to date, probably because they corrode afte...
Loss of facial features can result from a variety of traumatic events. Throughout history, humans have worked to develop materials and methods to repair such defects. Epithesis first appeared in medical literature in the 16th century. In Japan, wooden dentures were used during the first half of the 16th century. This review outlines the history of...
Many clinicians denied Hippocrates’ fatal prognosis after the unsuccessful reduction of TMJ dislocations. However, if Hippocrates was referring to patients with severe superior dislocations with brain damage, his original claim remains true.
Oromandibular dystonia (OMD) is a focal dystonia characterized by contractions of the masticatory, lingual, and other muscles of the stomatognathic system. We conducted a systematic review and meta-analysis to elucidate the impact and safety of botulinum toxin in OMD. The eligibility criteria were full-length original articles that provided data ev...
This study aimed to reproduce a complete wooden plate denture, which was the first in the world to retain suction under negative pressure, using the same materials and methods from 400 years ago (i.e., the Edo period) to verify its masticatory performance. A complete wooden plate denture was fabricated based on the maxilla of a 90-year-old female....
The man with “fuubyo” in “Yamai no Soshi”, which means scroll of diseases and painted in the 12th century, is depicted with involuntary movements of the fingers and face. The inscription reads, “The man was shivering and shaking as if he were naked in the bitter cold.” The man playing go had a distorted face, his mouth was open, and his mandible de...
【目的】片側咀嚼筋痙攣は片側閉口筋の発作性痙攣を特徴とするまれな不随意運動である．本研究は片側咀嚼筋痙攣患者の臨床的特徴を分析することを目的とした．【対象・方法】当科において片側咀嚼筋痙攣と診断した患者18例(女性13例，男性5例，発症時平均年齢46.8歳)の臨床および治療結果を分析した．診断基準は，1)閉口筋の発作性，断続的な収縮，2)片側性の痙攣，3)顔面の萎縮または筋肥大，4)限局性強皮症または強皮症，5)感覚トリック，共収縮，および早朝効果がないこと，6)筋電図所見のうち4項目を満たすこととした。【結果】全例が当科受診前に歯科あるいは口腔外科でブラキシズムと診断されていた。咬筋(100%)，側頭筋(38.9%)，および内側翼突筋(27.8%)に症状が認められた．16.7%で限局性強皮...
In Japan, ophthalmic diseases, such as gonorrheal conjunctivitis, were widespread during the Edo period (1603-1868), leaving many patients without one or both eyes. Numerous records indicate that many professional denturists often crafted artificial eyes for such patients; however, no evidence of inserted prosthetic eyes has been found to date. The...
The following Special Issue covers a wide range of topics, including neurological conditions such as oromandibular dystonia, pain-related disorders such as myofascial pain, primary headache, trigeminal or post-herpetic neuralgia, diseases of the temporomandibular joint such as temporomandibular joint disorder and bruxism, sialorrhea, and also cosme...
Purpose: Japan was the first country in the world to use complete dentures that retain suction under negative pressure in the 16 th century. This study aimed to reproduce a complete wooden plate denture using the same materials and methods from 400 years ago (i.e., the Edo period) and to verify its masticatory performance. Methods: A complete woode...
Movement disorders of the stomatognathic system include oromandibular dystonia (OMD), oral dyskinesia, sleep/awake bruxism, functional (psychogenic) stomatognathic movement disorders (FSMDs), tremors, and hemimasticatory spasm (HMS). Most patients first consult dentists or oral surgeons. The differential diagnoses of these involuntary movements req...
In Japan, during the Edo period (1603-1868), syphilis was widespread, and many people were left with missing noses. Records suggest that expert craftsmen made professional wooden artificial noses (nasal epitheses) for such patients. However, no artificial noses that were actually inserted have been found to date, probably because they corrode after...
Objectives
Peripherally induced movement disorders (PIMD) are hyperkinetic movement disorders that can occur after injury to a part of the body. This study aimed to identify PIMD in the stomatognathic system following dental or oral surgical procedures.
Materials and methods
A total of 229 patients with PIMD (144 women and 85 men; mean age: 53.4 y...
耳下腺気腫は耳下腺開口部より逆行性の空気流入によって発症する。ガラス工や管楽器奏者が罹患しやすい職業病とされる。睡眠時の口腔内圧の上昇に伴って耳下腺気腫を生じたと考えられる症例を経験したので報告する。症例は57歳男性。飛行機に搭乗中に入眠し、着陸直後、右側耳前部に腫脹と疼痛を生じた。到着地にて抗生剤の処方を受けた後、当科に紹介となった。初診時、右側耳下腺の腫脹、圧痛を認めた。耳下腺圧迫によって捻髪音を生じ、耳下腺開口部から気泡を含んだ泡状の唾液の流出を認めた。CTにて耳下腺管内に気泡を認め、耳下腺気腫と診断した。耳下腺の腫脹と捻髪音は起床時に最悪となった。本症例はいびきをかかず、睡眠中に口を閉じており、睡眠時に口腔内圧が上昇していることが疑われ、耳下腺気腫の発生に口腔内圧上昇が一因であると考...
【目的】Guillain-Barré症候群は急速に進行し、致命的な可能性があるまれな免疫介在性神経障害である。咀嚼筋の筋力低下に伴う咀嚼障害を主訴とした症例を経験したので報告する。【症例】17歳男性。38℃の発熱の数日後、極度の咬合力低下による咀嚼障害を生じた。1週間後に解熱したが、開口制限と咬合力の低下は持続した。某総合病院の脳神経内科を受診したが、 診断がつかず、原因不明であった。不随意運動が疑われ、発症から 35 日後、患者は脳神経内科より当科に紹介された。最大咬合力の極度の低下 (左側: 0 N、右側: 12.7 N)があり、下顎を手で持ち上げなければ咀嚼ができなかった。最大開口量は24ｍｍであった。電気生理学的検査により、Guillain-Barré症候群（急性運動軸索神経障害）と...
Background: Oromandibular dystonia (OMD) is a focal dystonia characterized by contractions of the masticatory, lingual, and other muscles of the stomatognathic system. Though botulinum toxin therapy is the first-line treatment for OMD, it lacks official approval in many countries.
Objectives: A systematic review and meta-analysis were conducted to...
Botulinum neurotoxin (BoNT) is the exotoxin of Clostridium botulinum, a Gram-positive, spore-forming bacterium [...]
The modern theory of complete denture retention using suction was applied to wooden plate dentures in Japan from the first half of the 16th century, which is an astonishing achievement since it was clinically applied in North America and Europe in the latter half of the 19th century nearly 300 years later. Wooden dentures are unique to Japan result...
Loss of facial features can result from a variety of traumatic events. Throughout history, humans have worked to develop materials and methods to repair such defects. Epithesis first appeared in medical literature in the 16th century. In Japan, wooden dentures were used during the first half of the 16th century. This review outlines the history of...
Hemimasticatory spasm (HMS) is a rare movement disorder characterized by paroxysmal spasms or twitches of the unilateral jaw-closing muscles. This study aimed to comprehensively evaluate the clinical features of patients with HMS. Data from 17 patients newly diagnosed with HMS (12 females and 5 males; mean age at onset: 46.7 years) who visited our...
Movement disorders of the stomatognathic system include oromandibular dystonia, oral dyskinesia, sleep/awake bruxism, functional (psychogenic) movement disorders, tremors, and hemimasticatory spasms. Most patients first consult dentists or oral surgeons. Differential diagnoses of these involuntary movements require both neurological and dental know...
Loss of facial features can result from a variety of traumatic events. Throughout history, humans have worked to develop materials and methods to repair such defects. Epithesis first appeared in medical literature in the 16th century. In Japan, wooden dentures were used during the first half of the 16th century. This review outlines the history of...
Background: Hemimasticatory spasm (HMS) is a rare movement disorder characterized by paroxysmal spasms or twitches of the unilateral jaw-closing muscles.
Objectives: This study aimed to comprehensively assess and evaluate the clinical features of patients with HMS.
Methods: We retrospectively analyzed data of 17 patients newly diagnosed with HMS (...
Dear Editor:
I have read the Letter to the Editor entitled “RE: BRUXISM OR DYSTONIA: THAT IS THE QUESTION” by Dr. Verhoeff and Prof. Lobbezoo.1 I feel deeply honored that two esteemed authorities in bruxism research found interest in my perspective.2
For over 35 years, I have been treating bruxism, temporomandibular disorders, and involuntary move...
Introduction: Lingual dystonia is a subtype of oromandibular dystonia characterized by involuntary contractions of the tongue muscles, often provoked by speaking or eating.
Methods: This study reports six Japanese cases (four female and two male, mean age at onset of 49.5 years) with task-specific lingual dystonia during praying. In the early phase...
Hemimasticatory spasm (HMS) is manifested by unilateral, paroxysmal contractions of the jaw-closing muscles, resulting in brief twitches and/or spasms and often accompanies hemifacial atrophy or localized scleroderma.1-6 Since the primary description by Gowers in 1892,1 there have only been limited cases described in the literature.1-6 There are so...
【目的】顎口腔ジストニアは咀嚼筋あるいは舌筋の不随意収縮を来す病態であり，患者における健康関連の生活の質はうつ，不安，疼痛など非運動症状と関連していることが多い．本研究の目的は顎口腔ジストニアの包括的な評価スケールを用いてボツリヌス治療前後の症状および健康関連の生活の質の変化を客観的に評価することである．【方法】各患者の症状に応じて咀嚼筋および舌筋にボツリヌス治療を行った。顎口腔ジストニア評価スケール(Oromandibular Dystonia Rating Scale; OMDRS)を用いて治療前後で症状と生活の質を評価した．【対象】当科で診断した顎口腔ジストニアの患者408例(女性;262例，男性;146例; 平均年齢; 52歳)．【結果】OMDRSの合計スコアは治療前の149.1から...
Background: Lingual dystonia is a subtype of oromandibular dystonia characterized by involuntary contractions of the tongue muscles, often provoked by speaking or eating.
Cases: This study reports six Japanese cases (four female and two male, mean age at onset of 49.5 years) with task-specific lingual dystonia during prayer. The average time betwee...
Peripherally induced movement disorders (PIMD) are hyperkinetic movement disorders that can occur after injury to a body part. This study aimed to identify PIMD in the stomatognathic system after dental or oral surgical procedures. A total of 229 patients with PIMD (144 women and 85 men, mean age: 53.4 years) triggered by oral surgical or dental in...
Guillain-Barré syndrome is a rare, rapidly progressive, and potentially fatal immune-mediated neuropathy. A 17-year-old male patient with a fever of 38°C developed masticatory impairment a few days later. Although the fever resolved after one week, the restricted mouth opening and decreased bite force persisted. Thirty-five days after disease onset...
Cemento-ossifying fibroma (COF) is a fibro-osseous lesion of the jaw. It was defined as a benign mesenchymal odontogenic tumor according to the World Health Organization (WHO) histological classification of 2017. COF is a relatively rare tumor that generally occurs in the mandibular molar region of adult women. Herein, we report a case of COF that...
Guillain-Barré syndrome is a rare, rapidly progressive, and potentially fatal immune-mediated neuropathy. A 17-year-old male patient who had a fever of 38 °C developed masticatory impairment a few days later. Although the fever resolved after 1 week, the restricted mouth opening and decreased bite force persisted. Thirty-five days after disease ons...
The modern theory of complete denture retention using suction was practically applied to wooden plate dentures in Japan from the first half of the 16th century, which is an astonishing achievement since it was clinically applied in North America and Europe in the latter half of the 19th century nearly 300 years later. Wooden dentures are unique to...
当初，ボツリヌス毒素製剤はジストニアなど不随意運動による筋緊張の抑制のため臨床応用されてきたが，次第に自律神経や痛覚繊維への作用も明らかとなり，適応範囲は飛躍的に拡大している．顎口腔領域でボツリヌス治療の対象となり得る疾患には顎口腔ジストニア(oromandibular dystonia)，口舌ジスキネジア，三叉神経痛，口腔顔面痛，顎関節脱臼，口蓋振戦，唾液分泌過多，フライ(Frey)症候群，機能性(心因性)不随意運動，顎関節症，歯ぎしり，ファーストバイト(first bite)症候群などが含まれる．本稿ではわが国では適応になっていない疾患も含めて概説する。
Superior dislocation of the condyle into the cranium occasionally requires invasive procedures due to the absence of timely diagnosis. This review analyzed the available clinical data to inform treatment decisions. Reports were assessed using electronic medical databases from inception to October 31, 2022. A total of 116 cases from 104 studies were...
Oromandibular dystonia (OMD) is a focal dystonia characterized by sustained or intermittent muscle contractions of the masticatory, lingual, and/or muscles in the stomatognathic system. Unfortunately, very few dentists or oral surgeons are familiar with OMD. Approximately 70% of patients with OMD visit dentists, and 60% see oral surgeons. However,...
Superior dislocation of the condyle into the cranium occasionally requires invasive procedures, including craniotomy or osteotomy, due to the absence of timely diagnosis. This review aimed to analyze the available clinical data to inform treatment decisions. Reports were assessed following the PRISMA 2020 Statement using electronic medical database...
当初，ボツリヌス毒素製剤はジストニアなど不随意運動による筋緊張の抑制のため臨床応用されてきたが，次第に自律神経や痛覚繊維への作用も明らかとなり，適応範囲は飛躍的に拡大している．顎口腔領域でボツリヌス治療の対象となり得る疾患には顎口腔ジストニア(oromandibular dystonia)，口舌ジスキネジア，三叉神経痛，口腔顔面痛，顎関節脱臼，口蓋振戦，唾液分泌過多，フライ(Frey)症候群，機能性(心因性)不随意運動，顎関節症，歯ぎしり，ファーストバイト(first bite)症候群などが含まれる．本稿ではわが国では適応になっていない疾患も含めて概説する。
Subjects: Otorhinolaryngology Contributor: Kazuya Yoshida Pneumoparotid describes retrogradely insufflated air within the Stensen's duct and/or parotid gland. It is a rare condition with variable causative factors. A literature search was conducted using electronic medical databases (PubMed, Scopus, Web of Science, EBSCO, Ovid, Google Scholar, SciE...
Pneumoparotid describes retrogradely insufflated air within the Stensen's duct and/or parotid gland. It is a rare condition with variable causative factors. This study aimed to elucidate the clinical characteristics of pneumoparotid. Reports in all languages were evaluated following the Preferred Reporting Items for Systematic Reviews and Meta-Anal...
Pneumoparotid describes the presence of retrogradely insufflated air within the Stensen's 8 duct and/or parotid gland. It is a rare condition with variable causative factors. This study aimed to 9 clarify the clinical characteristics of pneumoparotid; reports in all languages were evaluated fol-10 lowing the Preferred Reporting Items for Systematic...
Oromandibular dystonia (OMD) induces severe motor impairments, such as masticatory disturbances, dysphagia, and dysarthria, resulting in a serious decline in quality of life. Non-invasive brain-imaging techniques such as electroencephalography (EEG) and magnetoencephalography (MEG) are powerful approaches that can elucidate human cortical activity...
耳下腺気腫は耳下腺管より耳下腺への逆行性の空気流入によって発症する. われわれは耳下腺気腫の維持に睡眠時無呼吸症候群が関与したと考えられる症例を経験したので報告する. 症例：57歳, 男性. 現病歴：飛行機に搭乗中に入眠し, 着陸直後, 右側耳前部に腫脹と疼痛を生じた. 到着地にて抗生剤の処方を受けた後, 当科に紹介となった. 初診時, 右側耳下腺の腫脹, 圧痛を認めた. 耳下腺圧迫より捻髪音を生じ、耳下腺開口部から気泡を含んだ泡状の唾液の流出を認めた. CTにて耳下腺管内に気泡を認め, 耳下腺気腫と診断した. 睡眠検査の結果(無呼吸低呼吸指数：10.3, 最低酸素飽和度：81％), 睡眠時無呼吸症候群と診断した. 耳下腺気腫の維持に睡眠時の口腔内圧上昇が一因であると疑われた. 口腔内圧を低...
Oromandibular dystonia (OMD) refers to a focal dystonia in the stomatognathic system. Health-related quality of life (HRQoL) in isolated dystonia is associated with non-motor symptoms such as depression, anxiety, and pain, as well as motor symptoms. To evaluate HRQoL in patients with OMD, the therapeutic effects of botulinum neurotoxin (BoNT) thera...
Abstract: Oromandibular dystonia (OMD) refers to a focal dystonia in the stomatognathic system. Health-related quality of life (HRQoL) in isolated dystonia is associated with non-motor symp-toms such as depression, anxiety, and pain, as well as motor symptoms. To evaluate HRQoL in patients with OMD, the therapeutic effects of botulinum neurotoxin (...
Botulinum neurotoxin injection is effective and safe, with few side effects in most cases when properly administered by an experienced clinician. The diagnosis and treatment of oromandibular dystonia require both neurological and dental or oral surgical knowledge and skills, and well-designed multicenter trials with a multidisciplinary team approac...
【目的】本研究の目的は内服治療、スプリント、理学療法などの治療法では奏功しない顎関節症の筋症状に対するボツリヌス治療の効果を評価することである。【方法】対象は当科受診した顎関節症患者のうち、従来の治療が無効で、筋痛を主症状とする患者53例（女性39例、男性14例、平均年齢46.4歳）とした。症状のある筋肉に0.5％リドカインを2－3ml局注し、麻酔奏効時に症状の改善を認めることを確認した。各患者の症状に応じて、筋痛のある筋肉（咬筋、側頭筋、内側翼突筋、外側翼突筋、顎二腹筋後腹、胸鎖乳突筋）にボツリヌス毒素製剤（ボトックス；50－100単位）の注射を行った。Visual Analog Scale、1日当たりの疼痛頻度、最大開口量を治療前後で評価した。3ヵ月ごとにボツリヌス治療を繰り返した。【結...
Botulinum neurotoxin injection is effective and safe, with few side effects in most cases when properly administered by an experienced clinician. The diagnosis and treatment of oromandibular dystonia require both neurological and dental or oral surgical knowledge and skills, and well-designed multicenter trials with a multidisciplinary team approac...
Oromandibular dystonia affects the function of the mouth, tongue, and jaw, often resulting
in difficulty chewing, eating, speaking, and swallowing. The most effective way to treat it is with botulinum toxin therapy– Botox® injections. However, the muscles that cause the
problem are not always easy to access. Dr Kazuya Yoshida at Kyoto Medical Cente...
Pneumoparotid is associated with retrograde air insufflation in Stensen's duct and the parotid gland. A 57‐year‐old man experienced swelling and pain in the right parotid region after sleeping during a flight. Pneumoparotid and obstructive sleep apnea syndrome were diagnosed. Pneumoparotid was suspected as caused by increased intraoral pressure dur...
Oromandibular dystonia affects the function of the mouth, tongue, and jaw, often resulting
in difficulty chewing, eating, speaking, and swallowing. The most effective way to treat it is with botulinum toxin therapy – Botox® injections. However, the muscles that cause the
problem are not always easy to access. Dr Kazuya Yoshida at Kyoto Medical Cent...
![Injection sites for the masseter and temporalis muscles [4,45,173].](publication/359970137/figure/fig1/AS:11431281420608757@1746256829580/Injection-sites-for-the-masseter-and-temporalis-muscles-4-45-173_Q320.jpg)
Various movement disorders, such as oromandibular dystonia, oral dyskinesia, bruxism, functional (psychogenic) movement disorder, and tremors, exist in the stomatognathic system. Most patients experiencing involuntary movements due to these disorders visit dentists or oral surgeons, who may be the first healthcare providers. However, differential d...
An oral appliance with anterior opening to reduce intraoral pressure was effective for a 57-year-old man with obstructive sleep apnea syndrome accompanying pneumoparotid, which refers to the retrograde insufflation of air inside the parotid gland or Stensen’s duct.
Various movement disorders, such as oromandibular dystonia, oral dyskinesia, bruxism, functional (psychogenic) movement disorder, and tremor, exist in the stomatognathic system. Most patients experiencing involuntary movements due to these disorders visit dentists or oral surgeons, who may be the first healthcare providers. However, differential di...
Pneumoparotid is associated with retrograde insufflation of air in the Stensen’s duct and parotid gland. A 57-year-old man slept during a flight. His right parotid region was rapidly swollen and painful when the airplane landed. The patient was diagnosed with pneumoparotid, and a subsequent sleep study indicated obstructive sleep apnea syndrome. An...
【目的】顎口腔ジストニアは咀嚼筋や舌筋の不随意収縮を来す病態である．症状はきわめて多様で，疾患の重症度の客観的評価は困難であった．本研究の目的は顎口腔ジストニアの包括的な評価ツールを開発し，信頼性と妥当性を検証することである．【方法】評価者によるスケール（重症度，障害，疼痛），患者が記載する顎口腔ジストニアの特徴と症状（全般，食事，構音，審美性，社会生活/家族生活）についての問診表，さらにCervical Dystonia Impact Profile-58のサブスケール(睡眠，焦燥感，気分，心理社会的機能)を組み合わせて，顎口腔ジストニア評価スケール(Oromandibular Dystonia Rating Scale; OMDRS)を作製した．OMDRSの信頼性と妥当性を評価した．【対...
【目的】ジストニアは持続的な筋緊張により捻転性または反復性の運動や異常な姿勢をきたす病態である．局所性ジストニアには眼瞼痙攣，痙性斜頸，書痙，顎口腔ジストニア（oromandibular dystonia）などが含まれる．顎口腔ジストニアは咀嚼筋または舌筋の不随意収縮を特徴とする局所性ジストニアである．本研究は顎口腔ジストニアの有病率と年間発症率を推定することを目的とした．【対象】対象は2015年から2019年の間で，顎口腔ジストニアと診断された京都市在住の患者とした．【方法】患者144例（女性100例，男性44例，平均年齢57.5歳）の有病率（2020年1月1日）と年間発症率を推定した．【結果】発症年齢は女性（56.9歳）よりも男性（47.5歳）が有意に（p<0.01）低かった．有病率は1...
Objectives
Oromandibular dystonia is a focal dystonia characterized by sustained or intermittent contractions of the masticatory and/or tongue muscles. This epidemiological study aimed to estimate the prevalence and incidence of oromandibular dystonia in Kyoto (population: 1,465,701).
Materials and methods
The population sample was citizens of Kyo...
【目的】顎口腔ジストニア(oromandibular dystonia)は咀嚼筋あるいは舌筋の定型的、動作特異的な不随意収縮によって特徴付けられる。しかし、顎関節症または心因性疾患と誤診されることが多く、この病態を顎関節症と確定診断できるスクリーニングツールは不随意運動の経験が少ない医療従事者にとって有用であると考える。【方法】定型性、動作特異性、感覚トリック、早朝効果など、顎口腔ジストニアの臨床的徴候に関する質問と顎関節症を除外するための質問(合計 0-40点)を含む鑑別診断用問診表を作製した。不随意運動が疑われる553例の患者に本問診表を用いて、その信頼性を評価した。患者は顎口腔ジストニア(n=385)、オーラルジスキネジア(n=84)、心因性(機能性)運動障害(n=50)、および顎関節...
【目的】近年、ボツリヌス毒素製剤は疼痛を緩和する効果があることが明らかになってきた。本研究の目的は注射針を誘導するガイドを用いた第二枝の三叉神経痛に対するボツリヌス治療の有効性と安全性を分析することである。【方法】対象は脳神経外科的手術の適応にならず、内服治療の効果が不十分な第二枝の三叉神経痛の患者11名とした。歯科インプラント手術分析用のソフトウェアを使用し、コンピューター断層撮影のデータと上顎石膏模型をスキャンしたデータを融合した。コンピューター上で目標点を翼口蓋窩に設定し、CAD/CAMによって注射針誘導ガイドを作製した。ガイドを患者の上顎に装着し、注射針を分析した深さまで刺入し、生理食塩水で溶解した25-50単位のボツリヌス毒素（ボトックス）を注射した。visual analog s...
The differences in analgesic effects of botulinum toxin type A were compared in 28 patients with trigeminal neuralgia, 53 patients with myofascial temporomandibular disorders, and 89 patients with the jaw closing oromandibular dystonia. The patients were treated by injection of botulinum toxin type A into the masseter, temporalis, medial pterygoid,...
The differences in analgesic effects of botulinum toxin type A were compared in 28 patients with trigeminal neuralgia, 53 patients with myofascial temporomandibular disorders, and 89 patients with the jaw closing type of oromandibular dystonia. The patients were treated by injection of botulinum toxin type A into the masseter, temporal, medial pter...
緒言：顎口腔ジストニア(oromandibular dystonia)は不随意の咀嚼筋あるいは舌筋収縮により咀嚼障害、構音障害、審美障害などを来し、患者のQOLを下げることが多い1,2。本症の患者の約90％が顎関節症あるいは精神疾患と誤診されている3。多くの患者はチューインガムやアメなどを口の中に入れると症状が軽快する感覚トリックという臨床徴候が認められる1,2。
目的：本研究の目的は顎口腔ジストニア患者に感覚トリックを応用したスプリントの効果に影響を与える要因を検討することである。
方法：顎口腔ジストニアは動作特異性、定型性、感覚トリック、早朝効果などの局所性ジストニアの印象徴候に基づいて診断した1,2。
スプリントは昼間に使用するため、下顎に装着し，無色透明で，可及的に目立たないようにし...
Objectives: Oromandibular dystonia is a focal dystonia characterized by sustained or intermittent contractions of the masticatory and/or tongue muscles. This epidemiological study aimed to estimate the prevalence and incidence of oromandibular dystonia in Kyoto (population: 1,465,701).
Materials and methods: The population sample was citizens of K...
Zusammenfassung
Eine oromandibuläre Dystonie ist charakterisiert durch unwillkürliche tonische oder klonische Spasmen der Kau- und / oder Zungenmuskulatur bzw. der Muskeln im stomatognathen System. Sie wird oft fälschlicherweise als kraniomandibuläre Dysfunktion oder psychiatrische Erkrankung diagnostiziert. Aufgrund der klinischen Bilder wird die...
Zusammenfassung: Eine oromandibuläre Dystonie ist charakterisiert durch unwillkürliche tonische oder klonische Spasmen der Kau- und / oder Zungenmuskulatur bzw. der Muskeln im stomatognathen System. Sie wird oft fälschlicherweise als kraniomandibuläre Dysfunktion oder psychiatrischeErkrankung diagnostiziert. Aufgrund der klinischen Bilder wird die...
Background: Oromandibular dystonia manifests with sustained or task-specific contractions of the masticatory, tongue, and/or other muscles in the stomatognathic system. Since its symptoms can vary, it has been difficult to objectively measure disease severity and post-treatment changes.
Objective: To develop and validate a comprehensive measurement...
Background:
Over the past two decades, antiresorptive agent-related osteonecrosis of the jaw (ARONJ) has become a growing concern. We examined the incidence of ARONJ and identified its risk factors in lung cancer patients in the real-world clinical setting. To our knowledge, we are the first to do so.
Patients and methods:
We retrospectively ana...
がん治療に伴い様々な口腔内の有害事象が発症する。2012年に周術期口腔ケアが保険導入され、がん治療の一環としてその重要性が医療従事者に次第に認知されてきている。本シンポジウムはがん治療における周術期、化学療法あるいは放射線治療中、終末期の口腔ケアに関して、医師、歯科医師、看護師の多職種の立場から概要について講演いただいた。がん周術期患者における口腔管理介入効果、多職種連携（医師、歯科医師、薬剤師、管理栄養士、言語聴覚士）での摂食・嚥下スクリーニング、看護師の立場からのがん治療中の患者の全身、口腔内のアセスメント、アプローチに向けての計画立案、実践、緩和ケア病棟での終末期患者への口腔ケアについてお話しいただいた。
本シンポジウムにおいてがん治療における多職種による口腔ケアの重要性が再認識された...
1976 年に初めて oro-mandibular dystonia という用語が使われ，その後広く 一般的に用いられている．その日本語訳として口・下顎ジ ストニア，口顎部ジストニア，口・舌・顎ジストニアなど がある．しかし，口腔を専門とする歯科の用語として， 「口・下顎」 ， 「口顎部」 ， 「口・舌・顎」という表現は存在し ない．顎口腔系は摂食，咀嚼，嚥下，呼吸および発音に関 係する組織と器官の総称であり，顎口腔ジストニアという 語が用いられた．学会で正式に認められている用語では ないが，次第に使われるようになり，本稿では顎口腔ジス トニアを用いる． 顎口腔ジストニアには不随意に閉口する閉口ジストニ ア，舌の不随意収縮を生じる舌ジストニア，開口してしま う開口ジストニア，下顎が側方へずれ...
Background
Oromandibular dystonia manifests with task-specific or sustained contractions of the masticatory, tongue, and/or other muscles in the stomatognathic system. Since its symptoms can vary, it has been difficult to objectively measure disease severity and post-treatment changes.
Objectives
To develop and validate a comprehensive measurement...
ボツリヌス治療は顎口腔領域のさまざまな疾患に対して安全で，有効な治療法となりうると考えられた．しかしながら，ボトックスは口腔領域の疾患には適応となっていない．さらに，歯科医師には講習・実技セミナーの受講資格すらない．口腔領域への適応拡大と歯科医師も使用可能となることが今後の大きな課題である．
Background: Functional (psychogenic) movement disorders often have distinguishable clinical features in the orofacial region. Tonic mandibular deviation accompanying ipsilateral downward and lateral lip pulling is the most common phenotype seen in patients with facial functional movement disorders. However, functional movement disorders in the stom...
ボツリヌス毒素の口腔領域への臨床応用
Clinical Application of Botulinum Neurotoxin for Diseases in the Stomatognathic System
1976 年に初めて oromandibular dystonia という用語 が使われ 、その後広く一般的に用いられている。その日本語訳として口・下顎ジストニ ア、口顎部ジストニア、口・舌・顎ジストニアなどがある。しかし、口腔を専門とする歯 科の用語として、 「口・下顎」 、 「口顎部」 、 「口・舌・顎」という表現は存在しない。顎口 腔系は摂食、咀嚼、嚥下、呼吸および発音に関係する組織と器官の総称であり、顎口腔ジスト ニアという語が用いられた。学会で正式に認められていないが、次第に使われるように なり、本稿では顎口腔ジストニアを用いる。 顎口腔ジストニアには不随意に閉口する閉口ジストニア、舌の不随意収縮を生じる舌ジ ストニア、開口してしまう開口ジストニア、下顎が側方へずれる顎偏位ジストニ...
Background: Coronoidotomy, the surgical resection of the coronoid process, is often successfully performed in patients with severely limited mouth opening related to coronoid process hyperplasia, temporomandibular joint ankylosis, oromandibular dystonia, and masticatory muscle tendonaponeurosis hyperplasia. Although postoperative mouth opening trai...
Background: Coronoidotomy, the surgical resection of the coronoid process, is often successfully performed in patients with severely limited mouth opening related to coronoid process hyperplasia, temporomandibular joint ankylosis, oromandibular dystonia, and masticatory muscle tendon-aponeurosis hyperplasia. Although postoperative mouth opening tra...
Background: Functional (psychogenic) movement disorders, which can cause neurological disability, often have distinguishable clinical pictures in the orofacial region. Tonic jaw deviation, with ipsilateral downward and lateral lip pulling, is the most common phenotype, seen in patients with facial functional movement disorders. However, functional...
Aims:
To examine the effectiveness and safety of using a CAD/CAM-derived injection guide for botulinum neurotoxin block of the sphenopalatine ganglion for trigeminal neuralgia treatment.
Methods:
Ten patients with second-division trigeminal neuralgia who did not respond to submucosal administration of botulinum neurotoxin were enrolled in this s...
Aims: Subcutaneous or submucosal injection of botulinum neurotoxin type A into the trigger zone is effective for treating trigeminal neuralgia; however, not all patients respond to this treatment. Therefore, this study examined the effectiveness and safety of botulinum neurotoxin block of the sphenopalatine ganglion for trigeminal neuralgia treatme...
Lingual dystonia is a debilitating type of oromandibular dystonia characterized by involuntary, often task-specific, contractions of the tongue muscle activated by speaking or eating. Botulinum neurotoxin (BoNT) has been used to treat lingual dystonia; however, it is known to cause serious complications, such as dysphasia and aspiration. The purpos...
Objectives:
Oromandibular dystonia, which is characterized by stereotypic, task-specific, or sustained contractions of masticatory and/or lingual muscles, is frequently misdiagnosed as temporomandibular disorders or psychogenic disease. Diagnostic delay in oromandibular dystonia is not acceptable; thus, a screening tool that can distinguish this c...
Lingual dystonia is a debilitating type of oromandibular dystonia characterized by involuntary, often task-specific, contractions of the tongue muscle activated by speaking or eating. Botulinum neurotoxin (BoNT) has been used to treat lingual dystonia; however, it is known to cause serious complications, such as dysphasia and aspiration. The purpos...
【緒言】習慣性顎関節脱臼の予防あるいは治療としてオトガイ帽が臨床的に多用されるが、症例によっては全身麻酔下での手術が必要となる。高齢化社会に伴って、外科的処置が困難な高齢患者が増加しており、低侵襲な治療法が望まれる。【目的】本研究の目的は反復性顎関節脱臼に対するボツリヌス治療の効果について、さらに神経疾患に起因する筋緊張亢進の有無による相違を比較検討することである。【方法】反復性の顎関節脱臼の患者32例（女性19例、男性13例、平均年齢62.3歳）をパーキンソン病やジストニアのような筋緊張亢進を生じる神経疾患の有無によって神経因性群（女性8例、男性12例）と習慣性群（女性11例、男性1例）に分類した。29例が両側性脱臼で、3例が片側性であった。ボツリヌス毒素製剤（ボトックス）を1-2mlの生...
緒言
会話時や咀嚼時に不随意の舌筋収縮を生じる舌ジストニアは構音障害、咀嚼障害を惹き起こす。舌へのボツリヌス療法で重度の嚥下障害、誤嚥性肺炎、呼吸障害などの重篤な副作用が報告されている。 MAB(muscle afferent block)療法は局所麻酔薬を筋注し、緊張緩和を行う方法である。本研究の目的は舌ジストニアのボツリヌス療法とMAB療法の効果と副作用を検討することである。
方法
１．患者
対象は舌ジストニアの患者81例（男性：36例、女性：45例、平均年齢：46.6 ± 13.8歳）とした。診断は動作特異性、定型性、早朝効果、感覚トリックなど局所性ジストニアの臨床的特徴と筋電図検査に基づいて行った。舌の不随意収縮のパターンから口腔外まで舌が突出する前突型（58例）、舌の偏位はなく、...
It was suggested that symptoms related to OSAS might be reduced by chewing training.
Injection of botulinum neurotoxin into the lateral pterygoid muscle is an effective and safe treatment for habitual temporomandibular joint dislocation. More injections are required in cases of neurogenic temporomandibular joint dislocation than in those of habitual dislocation without muscle hyperactivity.
The aim of this study was to compare treatment outcomes following intramuscular injection of botulinum neurotoxin (BoNT) in patients with recurrent temporomandibular joint dislocation, with and without muscle hyperactivity due to neurological diseases. Thirty-two patients (19 women and 13 men, mean age: 62.3 years) with recurrent temporomandibular...
The aim of this study was to compare treatment outcomes following intramuscular injection of botulinum neurotoxin (BoNT) in patients with recurrent temporomandibular joint dislocation, with and without muscle hyperactivity due to neurological diseases. Thirty-two patients (19 women and 13 men, mean age: 62.3 years) with recurrent temporomandibular...
Aims:
To evaluate the effectiveness and safety of botulinum toxin administration into the inferior head of the lateral pterygoid muscle of patients with jaw opening dystonia by using a computer-aided design/computer-assisted manufacture (CAD/CAM)-derived needle guide.
Methods:
A total of 17 patients with jaw opening dystonia were enrolled. After...
Oromandibular dystonia is a focal dystonia that manifests as involuntary masticatory and/or tongue muscle contractions. This movement disorder is frequently misdiagnosed as a temporomandibular disorder. Hence, it would be useful to establish a method that makes it possible for patients with the condition to find appropriate medical institutions by...
Questions
Questions (11)
Dr. Hemphill RA described in Letters to the Editor "Hemphill RA. Wind parotitis. N Engl J Med 289: 1094-1095. 1973" as follows.
"At the staging area of the French Foreign Legion in North Africa, mumps appeared, and swollen parotids became epidemic, recurring and relapsing. It appeared that men had found that by blowing hard (they used bottles as resistance) they could force air up into the parotids, simulating mumps. "
It seems that the soldiers themselves blew air into the parotid glands to pretend to be mumps in order to escape military service. However, as Hemphill described in Letters, the citation is unknown as follows:
"a reference in an old textbook on communicable disease (I have forgotten the title of author --it was published about 1915)"
Does anyone know of an English textbook on communicable diseases published around 1915 with the above description (self-induced pneumoparotid)?
Have you ever learned involuntary movements (oromandibular dystonia, oral dyskinesia, etc.) in lectures or experienced cases in clinical practice when you were a student in the Faculty of Dentistry? Most patients with oromandibular dystonia are diagnosed with bruxism or temporomandibular disorders when they visit dentist or oral surgeon. I don't think involuntary movements are taught in the education of the Faculty of Dentistry.
Should we ask the government, pharmaceutical company, or academic societies?
In Japan, oral surgeons were previously eligible to use Botox. However, at present, neither oral surgeons nor dentists can participate in Botox therapy qualification courses in Japan. Therefore, if a young oral surgeon tries to start Botox treatment, he cannot use it. Although I have been injecting it for 30 years, there is no successor to the therapy.
Orolingual dyskinesias are often related to drugs such as dopamine receptor-blocking agents. It may occur in relation to neurodegenerative disorders (Huntington’s disease, neuroacanthocytosis) or neuropsychiatric conditions (chronic schizophrenia, Rett syndrome, dementia). Further, it also may be induced spontaneously or peripherally (edentulousness or ill-fitting prosthesis).
Occasionally dentists or oral surgeons experience improvement in orolingual dyskinesia after insertion of adequate dentures in patients who do not have dentures or have ill-fitting dentures. Sutcher et al. showed in their series of studies that dental prosthetic therapy is effective not only in spontaneous orofacial dyskinesia but also tardive orofacial dyskinesia. A video on YouTube shows a case in which orolingual dyskinesia significantly improved immediately after denture adjustment (https://youtu.be/Wn4YoFtPpjI). Naturally, dental prosthetic therapy is not effective in all cases with orolingual dyskinesia, but there are some cases in which it is very effective. When talking about this, some neurologists assert that it is a “superstition”. What do you think about this?
