@article{oai:asahi-u.repo.nii.ac.jp:00005396,
 author = {福原, 隆久 and 松下, 至宏 and 山内, 六男 and YAMAUCHI, MUTSUO},
 issue = {2017-06},
 journal = {2017-06},
 month = {2017-06, 2017-10-02},
 note = {臼歯部の咬合の不調和を訴えた慢性関節リウマチ患者2名対して補綴治療により咬合の安定化を図り、良好な経過を得たので報告する。症例1は49歳女性、症例2は66歳女性で、咬合の不調和を訴えて朝日大学附属病院に来院した。いずれも慢性関節リウマチにて加療中である。両症例ともに前歯部開咬で臼歯部の咬合接触数が少なかったが、自覚的、他覚的に顎関節症の症状はない。X線写真で症例1は両側顎関節に骨吸収を認め、症例2は左側顎関節部に骨吸収を認めた。両症例とも慢性関節リウマチによる顎関節の変形により生じた咬合不調和と診断した。両側咀嚼、日中の噛みしめ禁止などの生活指導を行うとともに、補綴による咬合の回復を計画した。症例1ではクラウンおよびブリッジにより、症例2では咬合調整により咬合の安定を図り、患者の満足を得た。咬合接触分析装置の検査では術後には完全ではないものの咬合接触状態を回復していることを確認した。今回の症例から咬合の不調和を訴える慢性関節リウマチ患者に対する補綴治療は、患者のQOLを高めるためには有効な治療法である。
We report two cases of chronic rheumatoid arthritis patients complaining of molar occlusal disharmony, who received prosthetic treatments to stabilize occlusion and achieved satisfactory outcomes. Case 1 was a 49-year old female, and Case 2 was a 66-year old female. They visited Asahi University Hospital with a chief complaint of occlusal disharmony. They had been under treatment for chronic rheumatoid arthritis. Both patients had anterior open bites and a small number of occlusal contacts in molar regions. No subjective or objective temporomandibular joint (TMJ) symptom was reported, however. On X-ray images, bone resorption was observed in bilateral TMJ joints in Case 1 and in left TMJ joint in Case 2. Both patients were diagnosed with occlusal disharmony associated with TMJ deformity induced by chronic rheumatoid arthritis. Some lifestyle guidance including bilateral mastication and prevention of daytime clenching was provided along with a prosthetic-treatment plan to restore occlusion. Their occlusions were stabilized with crown and bridge in Case 1, and with occlusal equilibration in Case 2. The patients were satisfied with the outcomes. After the operation, restoration of occlusal contact, although it was not complete, was observed in a test using a device for occlusal contact analysis device. Hence, it was revealed that a prosthetic treatment for chronic rheumatoid arthritis patients complaining of occlusal disharmony would be eff ective to improve their quality of life.},
 pages = {2017-06--2017-06},
 title = {咬合不調和を訴えた慢性関節リウマチ患者に対する補綴的治療例},
 volume = {2017-06},
 year = {}
}