| Project/Area Number |
03454460
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| Research Category |
Grant-in-Aid for General Scientific Research (B)
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| Allocation Type | Single-year Grants |
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| Research Field |
外科・放射線系歯学
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| Research Institution | Yamanashi Medical College |
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Principal Investigator |
OHNISHI Masatoshi Yamanashi Medical College Professor, 医学部, 教授 (50014139)
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| Co-Investigator(Kenkyū-buntansha) |
OHTSUKI Kayoko Yamanashi Medical College Lecturer, 医学部, 講師 (20185325)
黒川 悦郎 山梨医科大学, 医学部, 助手 (30215082)
山崎 安晴 山梨医科大学, 医学部, 講師 (00210401)
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| Project Period (FY) |
1991 – 1992
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| Project Status |
Completed (Fiscal Year 1992)
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| Budget Amount *help |
¥4,900,000 (Direct Cost: ¥4,900,000)
Fiscal Year 1992: ¥2,300,000 (Direct Cost: ¥2,300,000)
Fiscal Year 1991: ¥2,600,000 (Direct Cost: ¥2,600,000)
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| Keywords | arthroscopy temporomandibular joint / arthroscopic surgery / arthroscopic disc suturing & fixation / arthroscopic suture needle / arthroscopic suture technic / arthroscopic laser surgery / habitual dislocation of TMJ / closed lock of TMJ / 鏡視下レ-ザ-手術 |
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| Research Abstract |
We have developed, through the use of a Nd-YAG laser and suturing of the lesion through the arthroscope, a new method for dealing with temporomandibular joint lesions.
1) Cadaver study on the technic: This arthroscopic suturing procedure, aimed mainly at the superior area of the articular cavity was performed primarily on the oblique protuberance in the synovial area extending from the posterior wall to the posterior aspect of the anterior disc. For recurrent dislocation and hypermobility, the procedure was performed deep within the area. In cases of disc displacement, a fresh wound was created by using the Nd-YAG laser to evaporate the surface, and then arthroscopic suturing was performed on the freshened free edge of the articular disc.
2) Development of the arthroscopic suture needle A newly devised, experimental arthroscopic suture needle made of stainless steel was used in the procedure. It consists of two parts: a needle and its holder.The full length is 21 cm, approximately half of which is the needle itself. The eye of the needle is 1.0 mm in diameter at the tip. Depending on the operative case, either 1/2 circle or 1/3 circle needle tips were used.
3) Clinical application: Eighty patients (138 temporomandibular joints) were treated by arthroscopic laser surgery including arthroscopic suturing and were postoperatively evaluated by combinations of physical examination, arthrography, and arthroscopy. There ware 30 patients with habitual dislocation and 24 patients with closed-lock condition who were treated with the Nd-YAG laser to reduce the range of motion to normal. Overall, 92% of the 54 patients treated with combinations of arthroscopic laser and/or suture techniques were relieved of their symptoms.
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