| Project/Area Number |
18K09751
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| Research Category |
Grant-in-Aid for Scientific Research (C)
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| Allocation Type | Multi-year Fund |
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| Section | 一般 |
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| Review Section |
Basic Section 57060:Surgical dentistry-related
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| Research Institution | Wakayama Medical University |
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Principal Investigator |
Fujita Shigeyuki 和歌山県立医科大学, 医学部, 博士研究員 (50228996)
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| Co-Investigator(Kenkyū-buntansha) |
東條 格 和歌山県立医科大学, 医学部, 博士研究員 (70405439)
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| Project Period (FY) |
2018-04-01 – 2023-03-31
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| Project Status |
Completed (Fiscal Year 2022)
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| Budget Amount *help |
¥4,420,000 (Direct Cost: ¥3,400,000、Indirect Cost: ¥1,020,000)
Fiscal Year 2020: ¥390,000 (Direct Cost: ¥300,000、Indirect Cost: ¥90,000)
Fiscal Year 2019: ¥1,820,000 (Direct Cost: ¥1,400,000、Indirect Cost: ¥420,000)
Fiscal Year 2018: ¥2,210,000 (Direct Cost: ¥1,700,000、Indirect Cost: ¥510,000)
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| Keywords | lower third molar / lingual nerve injury / microsurgery / neuroma / cDNA microarray / S-100 protein / pathway analysis / Tinel’s reaction / 智歯抜歯 / 舌神経損傷 / 神経断端種 / アロデイニア / 人工神経 / 静脈被覆 / S-100 / マイクロアレイ / cDNAマイクロアレイ解析 / 神経損傷 / 舌神経 / 断端神経腫 / 神経再生 |
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| Outline of Final Research Achievements |
Lingual nerve injury rarely occurred on the extraction of mandibular wisdom teeth. Since it is impossible to recover the function of the injured lingual nerve, we must perform to remove the degenerated nerve and reconstruct the healthy gap between the lingual nerve stumps.
Since simple suturing between the nerve stumps does not promote nerve regeneration, transplantation of nerve tissue from other sites or artificial nerve replacement have been operated, but prognostic analysis has been inadequate. We found that even in cases where this repair surgery was delayed, the sensory perception and taste could be restored two years after the surgery, just as in the case of the early surgery. We conformed the recovery of taste in the case of the delayed operation was slow. We carried out cDNA microarray analysis on resected specimens and identified 5 types of gene expression with significant differences in the incidence between good and poor prognosis cases.
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| Academic Significance and Societal Importance of the Research Achievements |
下顎智歯の抜歯後、舌神経損傷が稀に発症する。損傷した部位の機能回復は不可能で変性した部位を切除し、健全な神経断端間を修復する外科手術が行われて来た。その予後解析は不十分であったが、我々は修復手術が遅延した症例でも術後2年目には、早期手術症例と同じく知覚、味覚回復をも込めるが、術後1年目の時点ではシュワン細胞数が減少し味覚回復が遅延する事実を確認した。手術時期が遅れても積極的に修復手術をするべきという意義を見出した。また切除標本にcDNAマイクロアレイ解析を行い、予後良好群と不良群間に有為な出現率の差がある5種類の遺伝子発現を同定し、今後はその欠乏因子を補填すれば予後が改善しうる事が示唆された。
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