Publishing type：Research paper (scientific journal)   Publisher：MDPI AG  

(1) Background: The impacts of metal artifacts (MAs) on the contouring workload for head and neck radiotherapy have not yet been clarified. Therefore, this study evaluated the relationship between the contouring time of the MAs area and MAs on head and neck radiotherapy treatment planning. (2) Methods: We used treatment planning computed tomography (CT) images for head and neck radiotherapy. MAs were classified into three severities by the percentage of CT images containing MAs: mild (<25%), moderate (25–75%), and severe (>75%). We randomly selected nine patients to evaluate the relationship between MAs and the contouring time of the MAs area. (3) Results: The contouring time of MAs showed moderate positive correlations with the MAs volume and the number of CT images containing MAs. Interobserver reliability of the extracted MAs volume and contouring time were excellent and poor, respectively. (4) Conclusions: Our study suggests that the contouring time of MAs areas is related to individual commitment rather than clinical experience. Therefore, the development of software combining metal artifact reduction methods with automatic contouring methods is necessary to reducing interobserver variability and contouring workload.

DOI： 10.3390/tomography9010009

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Language：Japanese   Publisher：(NPO)日本口腔科学会  

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Language：Japanese   Publishing type：Research paper (scientific journal)  

DOI： 10.11242/dentalradiology.61.41

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Language：Japanese   Publisher：(一社)日本口腔ケア学会  

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Language：Japanese   Publisher：(一社)日本口腔ケア学会  

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Language：Japanese   Publisher：(一社)日本口腔ケア学会  

当院(大学病院)で過去に実施した医科歯科連携実態調査で歯科への診療依頼の多かった呼吸器・感染症内科との医療連携の実態について、2018年1月〜2020年12月に当院呼吸器・感染症内科からの診療依頼患者154例(男性98例、女性56例、平均年齢67.3歳)を対象に、骨修飾薬(Bone modefying agent:BMA)の有害事象としての薬剤関連顎骨壊死(Medication related Osteonecrosis of the jaw:MRONJ)に焦点を当て調査した。その結果、依頼目的はBMA関連での診療依頼が110例(71.4%)で、そのうち癌治療に関連する症例は54例(癌治療患者群)、非癌治療が56例(非癌治療患者群)であった。BMA関連での診療依頼があった110例中、BMAが投与されたのは70例で、そのうち7例(癌治療患者群6例、非癌治療患者群1例)をMRONJと判定した。MRONJ発症率は、非癌治療患者群の3.0%(1/31)に対し、癌治療患者群では15.4%(6/39)であった。

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Language：Japanese   Publisher：(一社)日本口腔ケア学会  

当院(大学病院)で過去に実施した医科歯科連携実態調査で歯科への診療依頼の多かった呼吸器・感染症内科との医療連携の実態について、2018年1月～2020年12月に当院呼吸器・感染症内科からの診療依頼患者154例(男性98例、女性56例、平均年齢67.3歳)を対象に、骨修飾薬(Bone modefying agent:BMA)の有害事象としての薬剤関連顎骨壊死(Medication related Osteonecrosis of the jaw:MRONJ)に焦点を当て調査した。その結果、依頼目的はBMA関連での診療依頼が110例(71.4%)で、そのうち癌治療に関連する症例は54例(癌治療患者群)、非癌治療が56例(非癌治療患者群)であった。BMA関連での診療依頼があった110例中、BMAが投与されたのは70例で、そのうち7例(癌治療患者群6例、非癌治療患者群1例)をMRONJと判定した。MRONJ発症率は、非癌治療患者群の3.0%(1/31)に対し、癌治療患者群では15.4%(6/39)であった。

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Language：Japanese   Publisher：(一社)日本有病者歯科医療学会  

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Language：Japanese   Publisher：(一社)日本口腔診断学会  

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Publishing type：Research paper (scientific journal)   Publisher：Wiley  

DOI： 10.1002/osi2.1129

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Other Link： https://onlinelibrary.wiley.com/doi/full-xml/10.1002/osi2.1129

Language：Japanese   Publisher：(一社)日本口腔内科学会  

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Language：Japanese   Publisher：(一社)日本口腔内科学会  

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Publishing type：Research paper (scientific journal)   Publisher：Public Library of Science (PLoS)  

<sec id="sec001">
<title>Objectives</title>
This retrospective study examined how a pharmacist-involved education program in a multidisciplinary team (PEMT) for oral mucositis (OM) affected head-and-neck cancer (HNC) patients receiving concurrent chemoradiotherapy (CCRT).


</sec>
<sec id="sec002">
<title>Materials and methods</title>
Total samples data of 53 patients during the stipulated timeframe were retrospectively collected from electronic medical records from February 2017 to January 2019. We compared the presence/absence of OM (OM: yes/no) between patients with and without PEMT (PEMT: yes/no) as the primary endpoint and OM severity as the secondary endpoint. The following information was surveyed: age, gender, weight loss, steroid or immunosuppressant use, hematological values (albumin, white blood cell count, blood platelets, and neutrophils), cancer grade, primary cancer site, type and use of mouthwash and moisturizer, opioid use (yes/no, days until the start of opioid use, and dose, switch to tape), and length of hospital day (LOD). The two groups were compared using Fisher’s exact test for qualitative data and the Mann-Whitney U test for quantitative data, and a significance level of <italic>p&lt;0</italic>.<italic>05</italic> was set.


</sec>
<sec id="sec003">
<title>Results</title>
The group managed by PEMT had significantly lower weight loss and a significantly lower incidence of local anesthetic and opioid use and switch to tape compared with the group not managed by PEMT (<italic>p&lt;0</italic>.<italic>05</italic>). The two groups showed no significant difference in OM (yes/no) or OM severity. The PEMT group had significantly shorter LOD at 57 (53–64) days compared with the non-PEMT group at 63.5 (57–68) days (<italic>p&lt;0</italic>.<italic>05</italic>).


</sec>
<sec id="sec004">
<title>Conclusions</title>
Our results showed that PEMT did not improve OM (yes/no) or OM severity in HNC patients undergoing CCRT. However, the PEMT group had a lower incidence of grades 3 and 4 OM than the non-PEMT group, although not significantly. In addition, PEMT contributed to oral pain relief and the lowering of the risk for OM by reduction in weight loss.


</sec>

DOI： 10.1371/journal.pone.0260026

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Language：Japanese   Publisher：(一社)日本有病者歯科医療学会  

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Publishing type：Research paper (scientific journal)   Publisher：Springer Science and Business Media LLC  

DOI： 10.1007/s00520-021-06447-8

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Other Link： https://link.springer.com/article/10.1007/s00520-021-06447-8/fulltext.html

Publishing type：Research paper (scientific journal)   Publisher：Springer Science and Business Media LLC  

<title>Abstract</title>The clinical features of xerostomia induced by immune checkpoint inhibitors (ICI) are similar to those of Sjögren’s syndrome (SS), whereas the immunohistological and serological features are known to differ from those of SS. However, the radiologic imaging features of salivary glands are not yet well known. We report a case of a 56-year-old male patient diagnosed with ICI-induced xerostomia. The patient underwent various imaging examinations to investigate the condition of the salivary glands, which indicated the following: (1) less specific findings on contrast-enhanced computed tomography, (2) mixed with intermediate and low signal intensity on both <italic>T</italic>_{<italic>1</italic>}-weighted and fat-suppressed <italic>T</italic>_{<italic>2</italic>}-weighted magnetic resonance imaging and poor “salt and pepper” appearance on magnetic resonance sialography, and (3) multiple ovoid hypoechoic areas with hyperechoic bands without acute sialadenitis on ultrasound. These radiologic imaging findings suggested remarkable lymphocyte infiltration, which could be a characteristic of ICI-induced xerostomia.

DOI： 10.1007/s11282-020-00480-9

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Other Link： https://link.springer.com/article/10.1007/s11282-020-00480-9/fulltext.html

Language：Japanese   Publisher：(公社)日本歯科医師会  

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Language：Japanese   Publisher：(NPO)日本口腔科学会  

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Language：Japanese   Publisher：(NPO)日本口腔科学会  

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Language：Japanese   Publisher：(NPO)日本歯科放射線学会  

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Language：Japanese   Publisher：(NPO)日本歯科放射線学会  

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Language：Japanese   Publisher：(一社)日本口腔ケア学会  

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Language：Japanese   Publisher：(一社)日本口腔ケア学会  

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Language：Japanese   Publisher：(一社)日本口腔ケア学会  

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Language：Japanese   Publisher：(NPO)日本歯科放射線学会  

口腔内超音波検査により小唾液腺の口腔内超音波正常像について検討した。口腔乾燥感を含め口腔内に自覚症状のない健常な成人20名(女性13名、男性7名、平均29.4歳)を対象とした。超音波診断装置には、本体としてHIVISION Preirusを、超音波プローブには日常臨床で口腔内超音波走査に使用しているホッケースティック型術中用小型リニアプローブEUP-O54Jを使用した。口唇腺は上下唇とも口腔粘膜直下に一〜二層になって分布が確認された。また、腺葉群の大きさはそれぞれ後方の口角付近の方が大きく、厚みに相当する短径は上唇で平均1.5mm、下唇で2.2mmであった。さらに、血流表示画像において腺葉群内部の血流の確認が可能であり、マイクロスコピーコイルを用いたMRIに近い画像所見を得ることが可能であったと判断された。

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Other Link： https://search.jamas.or.jp/index.php?module=Default&action=Link&pub_year=2021&ichushi_jid=J00567&link_issn=&doc_id=20210406250001&doc_link_id=10.11242%2Fdentalradiology.60.35&url=https%3A%2F%2Fdoi.org%2F10.11242%2Fdentalradiology.60.35&type=J-STAGE&icon=https%3A%2F%2Fjk04.jamas.or.jp%2Ficon%2F00007_3.gif

Language：English   Publishing type：Research paper (scientific journal)  

The aim of this study was to compare the estimated public medical care cost of measures to address metallic dental restorations (MDRs) for head and neck radiotherapy using high-energy mega-voltage X-rays. This was considered a first step to clarify which MDR measure was more cost-effective. We estimated the medical care cost of radiotherapy for two representative MDR measures: (i) with MDR removal or (ii) without MDR removal (non-MDR removal) using magnetic resonance imaging and a spacer. A total of 5520 patients received head and neck radiation therapy in 2018. The mean number of MDRs per person was 4.1 dental crowns and 1.3 dental bridges. The mean cost per person was estimated to be 121 720 yen for MDR removal and 54 940 yen for non-MDR removal. Therefore, the difference in total public medical care cost between MDR removal and non-MDR removal was estimated to be 303 268 800 yen. Our results suggested that non-MDR removal would be more cost-effective than MDR removal for head and neck radiotherapy. In the future, a national survey and cost-effectiveness analysis via a multicenter study are necessary; these investigations should include various outcomes such as the rate of local control, status of oral mucositis, frequency of hospital visits and efforts of the medical professionals.

DOI： 10.1093/jrr/rrab003

PubMed

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Language：English   Publishing type：Research paper (scientific journal)  

OBJECTIVES: This retrospective study examined how a pharmacist-involved education program in a multidisciplinary team (PEMT) for oral mucositis (OM) affected head-and-neck cancer (HNC) patients receiving concurrent chemoradiotherapy (CCRT). MATERIALS AND METHODS: Total samples data of 53 patients during the stipulated timeframe were retrospectively collected from electronic medical records from February 2017 to January 2019. We compared the presence/absence of OM (OM: yes/no) between patients with and without PEMT (PEMT: yes/no) as the primary endpoint and OM severity as the secondary endpoint. The following information was surveyed: age, gender, weight loss, steroid or immunosuppressant use, hematological values (albumin, white blood cell count, blood platelets, and neutrophils), cancer grade, primary cancer site, type and use of mouthwash and moisturizer, opioid use (yes/no, days until the start of opioid use, and dose, switch to tape), and length of hospital day (LOD). The two groups were compared using Fisher's exact test for qualitative data and the Mann-Whitney U test for quantitative data, and a significance level of p<0.05 was set. RESULTS: The group managed by PEMT had significantly lower weight loss and a significantly lower incidence of local anesthetic and opioid use and switch to tape compared with the group not managed by PEMT (p<0.05). The two groups showed no significant difference in OM (yes/no) or OM severity. The PEMT group had significantly shorter LOD at 57 (53-64) days compared with the non-PEMT group at 63.5 (57-68) days (p<0.05). CONCLUSIONS: Our results showed that PEMT did not improve OM (yes/no) or OM severity in HNC patients undergoing CCRT. However, the PEMT group had a lower incidence of grades 3 and 4 OM than the non-PEMT group, although not significantly. In addition, PEMT contributed to oral pain relief and the lowering of the risk for OM by reduction in weight loss.

DOI： 10.1371/journal.pone.0260026

PubMed

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Language：Japanese   Publisher：新潟歯学会  

新潟大学医歯学総合病院医療連携口腔管理チームは、2020年4月から医療連携口腔管理治療部として活動を行っている。今回、活動実態の把握と今後の課題を明らかにすることを目的に実態調査を行ったのでその結果を報告する。対象は2013年1月〜2020年6月の期間に当チームおよび当治療部を受診した患者とした。診療録および診療台帳を基に患者数、依頼目的、原疾患の診療科などを後方視的に調査・検討した。調査期間における新患数は4,077人で、その数は経年的に増加していた。依頼目的は感染予防が最も多く、年々増加していた。粘膜炎対応、顎骨壊死予防・対応は増加ののち、一定数で推移していた。原疾患の診療科は耳鼻咽喉・頭頸部外科が最も多く、ついで、腎・膠原病内科、呼吸器感染症内科、腫瘍内科、血液内科であった。新患数は年々増加していたが、周術期等口腔機能管理での介入が求められる全症例への介入には至っていなかった。今後は、介入対象の拡大に向け、より効率的な診療体制と病院内での協力体制の構築、地域医療機関との連携が必要であると考える。(著者抄録)

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Language：Japanese   Publisher：新潟歯学会  

新潟大学医歯学総合病院医療連携口腔管理チームは、2020年4月から医療連携口腔管理治療部として活動を行っている。今回、活動実態の把握と今後の課題を明らかにすることを目的に実態調査を行ったのでその結果を報告する。対象は2013年1月〜2020年6月の期間に当チームおよび当治療部を受診した患者とした。診療録および診療台帳を基に患者数、依頼目的、原疾患の診療科などを後方視的に調査・検討した。調査期間における新患数は4,077人で、その数は経年的に増加していた。依頼目的は感染予防が最も多く、年々増加していた。粘膜炎対応、顎骨壊死予防・対応は増加ののち、一定数で推移していた。原疾患の診療科は耳鼻咽喉・頭頸部外科が最も多く、ついで、腎・膠原病内科、呼吸器感染症内科、腫瘍内科、血液内科であった。新患数は年々増加していたが、周術期等口腔機能管理での介入が求められる全症例への介入には至っていなかった。今後は、介入対象の拡大に向け、より効率的な診療体制と病院内での協力体制の構築、地域医療機関との連携が必要であると考える。(著者抄録)

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Language：Japanese   Publisher：(NPO)日本口腔科学会  

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Language：Japanese   Publisher：(NPO)日本口腔科学会  

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Language：Japanese   Publisher：(一社)日本耳鼻咽喉科学会  

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Other Link： https://search.jamas.or.jp/index.php?module=Default&action=Link&pub_year=2019&ichushi_jid=J01099&link_issn=&doc_id=20190926390015&doc_link_id=%2Fdz0jibik%2F2019%2F012209%2F017%2F1269-1270%26dl%3D0&url=http%3A%2F%2Fwww.medicalonline.jp%2Fjamas.php%3FGoodsID%3D%2Fdz0jibik%2F2019%2F012209%2F017%2F1269-1270%26dl%3D0&type=MedicalOnline&icon=https%3A%2F%2Fjk04.jamas.or.jp%2Ficon%2F00004_2.gif

Language：Japanese   Publisher：新潟歯学会  

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Language：English   Publishing type：Research paper (scientific journal)   Publisher：Elsevier Ireland Ltd  

Objective: Recent data indicated that concurrent chemoradiotherapy (CCRT) using high dose cisplatin (CDDP) is the most useful treatment for advanced head and neck squamous cell carcinoma (SCC). Regarding the dose of CDDP, 100 mg/m2 is most recommended in Western countries. However, in terms of a balance of efficacy and adverse events, appropriate dose of cytotoxic drugs such as CDDP may be different among the different ethnic groups. In this multicenter phase I/II study, we aimed to identify the optimal dose of CDDP in CCRT for patients with advanced head and neck SCC in the Japanese. Methods: Patients were eligible for inclusion if they had head and neck SCC that was treated with radical CCRT comprising whole-neck irradiation of the primary lesion and level II–IV lymph nodes on both sides. For the phase I study, a CDDP dose was 70 mg/m2 for level 0, 80 mg/m2 for level 1, and 100 mg/m2 for level 2. Maximum tolerated dose (MTD) and dose-limiting toxicity (DLT) were examined by phase I trial, by which CDDP dose for phase II was determined. The primary endpoint for the phase II was CCRT completion rate, and the secondary endpoint was full-dose-CCRT completion rate, the percentage of patients receiving a total CDDP dose of ≥200 mg/m2, response rate, and incidences of adverse events. Results: A CDDP dose of 100 mg/m2 was the MTD for phase I, and the recommended dose for phase II was 80 mg/m2. Forty-seven patients were evaluated in the phase II trial. CCRT completion rate, full-dose-CCRT rate, and the percentage of patients receiving a total CDDP dose of ≥200 mg/m2, were 93.6%, 78.7%, and 93.6%, respectively. One patient (2.1%) developed grade 2 renal dysfunction, and no patient developed febrile neutropenia or a grade 4 adverse event. Conclusion: The present phase I study indicated that a CDDP dose of 80 mg/m2 is the optimal dose in terms of safety. The phase II study revealed that CCRT completion rate, response rate, and rates of adverse events were not inferior for a CDDP dose of 80 mg/m2 as compared with a dose of 100 mg/m2, and a dose of 80 mg/m2 is therefore recommended in CCRT for the Japanese. This study was registered with the University Hospital Medical Information Network Clinical Trials Registry (UMIN-CTR
identification No. UMIN000010369).

DOI： 10.1016/j.anl.2018.02.008

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Language：Japanese   Publisher：医歯薬出版(株)  

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Language：Japanese   Publisher：(NPO)日本歯科放射線学会  

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Language：Japanese   Publisher：(NPO)日本歯科放射線学会  

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Language：Japanese   Publisher：(NPO)日本歯科放射線学会  

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Language：Japanese   Publisher：新潟歯学会  

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Language：Japanese   Publisher：(NPO)日本歯科放射線学会  

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Language：Japanese   Publishing type：Research paper (scientific journal)   Publisher：(一社)日本口腔ケア学会  

当院では2012年4月からSystematic Oral Management(以下OM)介入を開始した。今回、2010年3月〜2013年8月に高度無菌治療部で同種造血幹細胞移植を受けた患者26例を対象とし、OM介入開始前の群(非介入群13例)とOM介入群(13例)に分け、口腔粘膜炎(以下;粘膜炎)の発生率・重篤度・病悩期間を群間比較した。粘膜炎の評価には有害事象共通用語規準v4.0日本語訳JCOG版を改変したものを用いた。粘膜炎の発生率に群間差は認められず両群とも100%であったが、Grade 3〜4粘膜炎の発生率をみるとOM非介入群85%、介入群54%で介入群が有意に低かった。病悩期間の中央値は非介入群19.6日、介入群13.1日で介入群が有意に短かった。OMの具体的な内容を紹介した。

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Language：Japanese   Publisher：(NPO)日本歯科放射線学会  

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Language：English   Publishing type：Research paper (scientific journal)   Publisher：SPRINGER  

Objectives This study evaluated the effects of combined topical sodium fluoride and casein phosphopeptide-amorphous calcium phosphate (CPP-ACP) paste application on root surface conditions in cancer patients undergoing head and neck radiotherapy.
Patients and methods Nineteen patients undergoing conventional external radiotherapy in head and neck cancer were enrolled and divided into CPP-ACP (topical sodium fluoride/daily CPP-ACP paste application) and Non-CPP-ACP (topical fluoride application alone) groups. Chronological root surface texture changes were prospectively investigated for 1 year.
Results The mean radiation dose of the parotid gland did not differ significantly between the CPP-ACP and Non-CPP-ACP groups. From baseline to 6 and 6-12 months, the CPP-ACP group had significantly better root surface textures than those in the Non-CPP-ACP group (p = 0.001 and p &lt; 0.001, respectively). The hard surface numbers in the CPP-ACP group increased from 347 to 350 in 12 months. The respective soft lesion incidence rates from baseline to 6, 6-12, and baseline to 12 months were significantly lower in the CPP-ACP group than those in the Non-CPP-ACP group (per patient: p = 0.038, p = 0.038, and p = 0.029; per root surface: p = 0.026, p &lt; 0.001, and p &lt; 0.001).
Conclusions The present results suggest that dental management with a combination of topical sodium fluoride and CPP-ACP paste application can control root surface caries more effectively than topical sodium fluoride alone in patients undergoing head and neck radiotherapy.

DOI： 10.1007/s11282-015-0218-4

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Language：English   Publishing type：Research paper (scientific journal)   Publisher：Hindawi Limited  

Most cases of hypophosphatasia (HPP) exhibit early loss of primary teeth. Results of microcomputed tomography (micro-CT) analysis of teeth with HPP have rarely been reported. The purpose of the present study was to describe the mineral density distribution and mapping of exfoliated teeth from an HPP patient using micro-CT. Four exfoliated teeth were obtained from a patient with HPP. Enamel and dentin mineral densities of exfoliated teeth were measured on micro-CT. The mean values of enamel and dentin mineral densities in mandibular primary central incisors with HPP were 1.61 and 0.98 g/cm3, respectively. The corresponding values in the mandibular primary lateral incisors were 1.60 and 0.98 g/cm3, respectively. Enamel hypoplasia was seen in the remaining teeth, both maxillary and mandibular primary canines and first and second molars. Micro-CT enables nondestructive, noninvasive evaluation and is useful for studying human hard tissues obtained from patients.

DOI： 10.1155/2016/4898456

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Language：Japanese   Publisher：新潟歯学会  

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Language：Japanese   Publisher：(株)第一歯科出版  

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Language：Japanese   Publisher：(NPO)日本歯科放射線学会  

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Language：Japanese   Publisher：(一社)日本口腔ケア学会  

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Language：Japanese   Publisher：(一社)日本口腔ケア学会  

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Language：Japanese   Publisher：(株)デンタルダイヤモンド社  

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