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上條によると、成人の口裂幅は約50mmであるが、口裂の大きさの評価は難しい。今回われわれはHSV感染による小口症の悪化が原因で義歯作製に苦慮した1例を経験したので報告した。患者は48歳の女性、平成19年11月に咀嚼障害を主訴に来院。約20年義歯を作らず、わずかな残存歯で咀嚼していた。平成19年9月に近医で抜歯後無歯顎となったが、小口症のために義歯作製が困難で、当院を紹介された。口裂幅は30mmで、口角炎を認め、義歯印象トレーが挿入不可能であった。診断は小口症、ウイルス性口角炎を疑い、HSV抗体価を測定したところ高値を示したので抗ウイルス剤軟膏を塗布した。口角炎が改善し、口角の柔軟性も向上し、義歯作製が可能となった。平常小さめの口であったが再発性ウイルス性口角炎によりさらに瘢痕拘縮を起こしたため伸展性が著しく低下し義歯作製に苦慮した1例を経験し、再発性ウイルス性口角炎も小口症悪化の原因となりうることがわかった。Kamijyo reported that the width of the oral fissure in adult is approximately 50 mm, although, the width of the oral fissure is difficult to evaluate. This study reports a case of microstomia complicated by infection with Herpes Simplex Virus (HSV) that presented a challenge in preparing dentures. Patient and Method: A 48-year-old female patient complaining of masticatory dysfunction was referred to our hospital in November 2007. She was edentulous and had never used dentures. She had managed to masticate with a few remaining teeth for more than 20 years before those teeth were extracted in September 2007. The dentist referred her to us because she was unable to prepare dentures due to microstomia. The oral fissure width was 30 mm with cheilosis, which prevented the use of denture impression trays. She was diagnosed as having microstomia and suspected of virus infection. The HSV antibody test yielded a high value, and an antiviral salve was applied to the labial commissures. Cheilosis improved and the resulting improvement of flexibility of the labial commissures allowed the procedure necessary for denture preparation.Conclusion: A case of microstomia in combination of angular cheilosis presented an extremely challenging situation for denture preparation, indicating the potential of cheilosis to cause further deterioration factor of microstomia. We report of a case of cicatrical microstomia due to recurrent virus infection causing angular cheilosis. |
