顎骨骨硬化に関する X 線学的並びに病理組織学的研究
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概要
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A variety of causes such as inflammation and tumors have been considered for osteosclerosis of human mandibles. However, histopathological studies on osteosclerosis, analysis of its genesis, developments, and state have not been made sufficiently. Consequently, some confusion in roentgenographic diagnosis cannot be denied. In order to ascertain the true state, the author made a comparative study of roentgenological and histopathological findings of the mandibles of autopsy cases. For the materials, 85 parts of 41 cases roentgenologically proven to be osteosclerosis, among 195 mandibles ranging in age from 13 to 83, were selected. Osteosclerosis was roentgenologically classified into diffuse type and localized types (L-1, L-2, L-3). All the specimens were undecalcified and comparison with microradiogram was made for each specimen. The results were as follows : 1. A large number of incidence of osteosclerosis was found in the middle and old ages of males. 2. Osteosclerosis was most frequently found in the premolar and molar regions. 3. Hypertrophy and proliferation of the cortical bone and trabecular bone were found, in agreement with the roentgenological osteosclerosis. 4. Microradiograms of sclerotic bone revealed low calcification. 5. There were no remarkable changes of the mandibular canals. 6. Osteosclerosis was histopathologically classified into inflammatory type and non-inflammatory type. Inflammatory type was subdivided into active inflammatory type and inactive inflammatory type. 7. Eighty-seven per cent of osteosclerosis revealed a close relation with inflammatory changes, and histopathological findings were as follows ; a. Fibrous changes and inflammatory cell infiltration were found in the bone marrow in and about the sclerotic lesions. b. New bone formation and bone resorption were observed on the surface of sclerotic bone. c. A variety of regressive changes of osteocytes (atrophy, swelling, clearing, disappearance of osteocytic process, necrosis), empty lacunae, and enlarged lacunae were very frequently observed in sclerotic bone. d. The matrix of sclerotic bone was stained deeply and irregularly. Lamella of sclerotic bone was irregular and vague. e. In the cases of inactive inflammatory type, inflammatory cell infiltration, new bone formation, and bone resorption were hardly observed. 8. Among the cases classified as non-inflammatory type, enostosis, exostosis, and cementoid mass were found. Roentgenologically, exostosis and cementoid mass revealed L-3 type and enostosis revealed L-2 type. Based on the foregoings, it may be suggested that osteosclerosis is of significance for defence and repair process of human beings and a considerable relation is found between roentgenological and histopathological findings.
- 九州歯科学会の論文
- 1980-03-25