パーキンソン病の長期罹患中に発症した習慣性顎関節脱臼２例の治療経験

Parkinson’s disease

北海道歯学会

北海道歯学雑誌

We performed a sclerotherapy on two patients with a recurrent dislocation of the condyle using OK-432 (Picibanil®). After the treatment, under the assumption that the establishment of a stable occlusion greatly contributes to the prevention of repeated condylar dislocation, we adjusted the old denture in one case and made a new one in the other case. Fortunately, a desirable oral intake was achieved and maintained in both of the two cases. “Quality of Life” was finally restored. Therefore, we present herein the outlines of the treatment course. 　Case 1 : A 68-year old male came to our hospital with a chief compliant of an eating disturbance due to the fear of recurrent condylar dislocation. He had been diagnosed with Parkinson’s disease 14 years ago, and was recuperating at his home. Under the diagnosis of the recurrent dislocation of the condyle, he underwent sclerotherapy with OK-432 (Picibanil®) bilaterally under local anesthesia. A new denture restored occlusion and appropriate oral intake could be maintained. 　Casa 2 : An 89-year-old male came to our hospital with a chief complaint of recurrent dislocation when wearing his dentures. He had been diagnosed with Parkinson’s disease 18 years ago as well and was also recuperating at his home. Almost the same procedures as case 1 were undertaken, except for the final occlusal stabilization that could be achieved by the adjustment of the old denture. Pasty food could be taken sufficiently. 　The post-operative course was not eventful in either of the two cases, and obvious amelioration of the oral function concomitantly with a general condition was obtained. 　From the above two cases, a combination of an intervention to the condyle from the standpoint of oral surgery and that to the restoration of occlusion from the standpoint of prosthesis brought about favorable results in the treatment of a recurrent dislocation of the condyle due to concurrent Parkinson’s disease.