Language：Japanese   Publisher：新潟歯学会  

今回われわれは、関節隆起部の骨蜂巣内に炎症性変化が波及した変形性顎関節症の1例を報告する。症例は52歳の女性で、開口障害と左側顎関節部の疼痛を主訴に当院顎関節治療部を受診した。アプライアンス治療と薬物療法を受けたが疼痛が増悪したため当科を紹介で初診した。開口量は上下顎中切歯間距離で22mmであった。CT像では、左側下顎頭の関節面と関節隆起の後斜面が開閉口時に干渉し、同部の表面皮質骨には吸収像が認められた。MRIでは、左側顎関節円板は前方に転位して復位を認めず、T2強調像にて関節隆起部の骨蜂巣内に広がる高信号領域が認められた。パンピングマニュピレーションにて疼痛と開口障害は一時的に改善したが翌日には症状が再燃した。よって、顎関節開放手術にて、顎関節円板切除、関節隆起整形、高位下顎頭切除を行った。術後は早期より開口練習を行い、生じた咬合の偏位に関しては顎間ゴム牽引と補綴治療で対応した。術後のMRIでは、関節隆起内にみられた高信号は減少していた。術後に疼痛は消失して開口量は34mmを維持し、術後7年で転居のため転院となった。(著者抄録)

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Language：Japanese   Publisher：(一社)日本顎関節学会  

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Language：Japanese   Publisher：(一社)日本顎関節学会  

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

OBJECTIVES: Failed implant removal using a high-frequency electrosurgical device (HFED) has been reported to be less invasive than other surgical techniques. We sought to clarify the mechanism of removal torque reduction in an implant by heating with HFED. MATERIALS AND METHODS: Sixty-eight Wistar rats received titanium implants on the maxillary bone 4 weeks after extraction of the first and second molars. The control group was sacrificed 6 weeks after implant installation. In the experimental group, the implant was heated by HFED for 10 s using three different power outputs, and samples were collected at 3, 7, and 14 days after heating. Removal torque measurement and histological analysis were performed in the control and experimental groups. Implant surfaces were observed using an electron-probe microanalyzer (EPMA). Data were analyzed using Mann-Whitney U test at a significance level of 5%. RESULTS: The removal torque could not be measured in the control group due to fracture of the implant. After heating, the removal torque was measurable without fracture and decreased significantly at 14 days as compared with that at 3 days (p < .05). Heating with "min" power output resulted in a significantly smaller blank lacunae area and fewer osteoclasts at 14 days after heating (p < .05). EPMA revealed bone matrix adherence to outer surface of heated implant. CONCLUSIONS: After heating, an enlarged area of blank lacunae around the implant and an increased number of osteoclasts into the bone marrow cavity were observed, which may have contributed to the reduction in removal torque.

DOI： 10.1111/clr.13793

PubMed

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Language：Japanese   Publisher：(一社)日本顎関節学会  

下顎頭の退行性変化に起因する二次的咬合異常として,前歯部開咬を呈することがある。今回両側変形性顎関節症に起因すると考えられた前歯部開咬に対し,オクルーザルオーバーレイスプリントを用いて咬合機能を回復した1例について報告する。患者は37歳の女性で,顎関節痛と開口障害を主訴に2006年11月に当院を受診した。臨床診査から両側変形性顎関節症と診断された。保存療法を施行中の2007年2月に前歯部開咬を認めた。顎関節の状態および複数の治療法について説明し治療方針に同意を得たうえで,同年7月に開咬による咀嚼障害を改善する目的で下顎オクルーザルオーバーレイスプリントを製作し,食事中および日中装着可能なときに使用させた。就寝中はスタビライゼーションアプライアンスを継続使用させた。2013年10月のCT検査により下顎頭骨吸収は進行していないことが確認できた。長期間にわたり顎関節症の症状の再発はなく,また咀嚼機能の回復は維持されている。オクルーザルオーバーレイスプリントは,両側変形性顎関節症に起因する前歯部開咬に対する有効な治療法の一つであることが示唆された。(著者抄録)

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Language：Japanese   Publisher：(公社)日本補綴歯科学会  

症例の概要:患者は57歳の女性.下顎の右側偏位と顔貌の非対称による審美障害を主訴に来院した.右側下顎頭骨軟骨腫の診断にて右側下顎頭切除術施行後に右側第二小臼歯から左側第二大臼歯までの広範囲な開咬が生じたため,プロビジョナルレストレーションを装着し,開咬の改善と安定する顎位を長期間にわたり検討した.下顎位が安定し,顎関節症状が生じないこと,良好な顎運動を行えること,咀嚼と審美性に支障が無いことを確認した後に最終補綴治療を行った.考察:下顎頭骨軟骨腫は比較的緩慢な経過をたどる良性腫瘍であり,本症例も顔貌の非対称を自覚するまでに長期間を要した.この間に行われた補綴治療は,右側下顎頭が過形成した状態で製作されたと考えられる.今回右側下顎頭部腫瘍切除によって,腫瘍により右側に偏位した咬合関係で補綴され,歯冠長の大きな右側臼歯部補綴装置のみが早期接触した結果,その他の部位に広範囲な開咬が生じたと考えられた.結論:下顎頭切除後に生じた広範囲な開咬に対して,プロビジョナルレストレーションを用いて慎重に経過を確認することで,顎関節や咀嚼筋,新たな咬合に適応した下顎位が得られ,最終補綴装置の装着が可能となった.下顎頭切除後の口腔リハビリテーションにおいては,術後の顎関節や咀嚼筋の安定には数ヵ月から1年ほどの期間を要する可能性が高く,顎位の3次元的な計時的変化に応じた慎重な補綴介入の重要性が示唆された.(著者抄録)

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Other Link： https://search.jamas.or.jp/index.php?module=Default&action=Link&pub_year=2020&ichushi_jid=J05334&link_issn=&doc_id=20201016320005&doc_link_id=130007929902&url=http%3A%2F%2Fci.nii.ac.jp%2Fnaid%2F130007929902&type=CiNii&icon=https%3A%2F%2Fjk04.jamas.or.jp%2Ficon%2F00003_1.gif

Authorship：Lead author   Language：English   Publishing type：Research paper (scientific journal)  

PURPOSE: The purpose of this study was to determine whether removing the superstructure of the implant bridge in cases of full-arch implant restorations for edentulous atrophic arches at the abutment level during professional mechanical plaque removal (PMPR) affects bacterial counts. METHODS: This crossover clinical trial included 20 patients who received screw-retained prostheses at the abutment level. Patients were randomly assigned to two groups and received PMPR with or without removal of the superstructure. After a three-month washout period, the type of treatment was reversed between the groups. Bacterial counts around the cylinder and abutment were measured and compared before and after PMPR. RESULTS: Bacterial numbers around the cylinder and abutment were significantly reduced after PMPR as compared with before PMPR regardless of whether the superstructure was removed (p <0.05). However the ratio of subjects with bacteria at 1.0 × 105 colony forming unit/ml (cfu/ml) or more after PMPR was significantly higher when the superstructure was not removed (p < 0.05). Among patients with bacterial counts of less than 10 × 105 cfu/ml, bacterial loads were reduced to less than 1.0 × 105 cfu/ml even when superstructures were not removed. Among patients with bacterial load of >10 × 105 cfu/ml, bacterial numbers were not reduced to <1.0 × 105 cfu/ml when PMPR was performed without removing the superstructure. CONCLUSIONS: Removal of the superstructure in cases of full-arch implant restorations for edentulous atrophic arches during PMPR reduces bacterial numbers around the implant bridge at the abutment level.

DOI： 10.2186/jpr.JPOR_2019_431

PubMed

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Language：Japanese   Publisher：(公社)日本口腔インプラント学会  

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Language：Japanese   Publisher：(一社)日本顎関節学会  

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Language：Japanese   Publisher：(公社)日本補綴歯科学会  

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Authorship：Last author,　Corresponding author   Language：Japanese   Publishing type：Research paper (scientific journal)   Publisher：Japan Prosthodontic Society  

<p><b>Purpose:</b> Previous clinical studies have indicated that the loss of retention between post and tooth is a major cause of failure in the restoration of endodontically treated teeth. Since bubble-like defects were found in the cement layer of the debonded post, we hypothesized that this cement defect decreases the adhesive strength. The purpose of this study was to evaluate if the technique used to insert resin cement influences the presence of bubbles and the push-out bond strength.</p><p><b>Methods:</b> The root canal of a transparent resin block and bovine tooth were parallel-wall drilled with a Peeso Reamer to achieve a post length of 10 mm. Prefabricated metal posts were cemented using self-adhesive resin cement, for nine combinations of three tools and three cement application sites. The resin block was scanned with a digital camera, then image analysis software was used to calculate the percentage of bubbles in the cement layer. Bovine teeth were sectioned into five 1-mm thick slices for the push-out bond strength test.</p><p><b>Results:</b> The bubbles were concentrated at the apical side for all methods. When we used the plastic needle to apply cement to the post and root canal, the bubble mixture rate was significantly lower than that of the other methods. Using the brush resulted in a significant decrease in the push-out bond strength at the apical side, whereas there was no significant difference in the push-out bond strength between the sites with other tools.</p><p><b>Conclusions:</b> It is considered that there is less adherence at the site of air bubbles, and therefore a decrease in the adhesive strength. We conclude that it is important to use a tool that reaches the deepest part of the prepared root canal to reduce the air bubble mixture rate and to obtain the highest adhesive strength.</p>

DOI： 10.2186/ajps.12.264

CiNii Article

CiNii Books

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Language：Japanese   Publisher：(公社)日本顎顔面インプラント学会  

新潟大学医歯学総合病院では2006年4月インプラント治療部が開設された。今回、開設後10年間(2006年4月から2016年3月)における外来患者、入院患者、インプラント手術を総括し、今後の当治療部の運営に資することを目的に臨床的検討を行った。10年間の外来患者の総数は1,606人(男性598人、女性1,008人)であった。年齢は50〜60歳代が多くを占め、平均55.1歳(最低16歳、最高87歳)であり、また院外からの紹介患者は43%と多くを占めた。インプラント埋入手術件数(本数)は年間90〜150件(150〜260本)、平均114件(198本)であった。10年間に顎堤形成術や上顎洞底挙上術を含めた骨増生術は入院下に計183件に施行された。10年間のインプラント埋入総数1,986本のうち、インプラント脱落本数(率)は54本(2.7%)であった。外来患者数は一時的な増減がみられたが、最近、一定の患者数があり、インプラント埋入手術および骨増生術件数は安定して推移していた。今後も特定機能病院としてインプラント治療成績向上に貢献すべく、入院治療を含めた総合的な医療提供を務めることが肝要である。(著者抄録)

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Language：Japanese   Publisher：(公社)日本口腔インプラント学会  

腫瘍治療のための下顎骨区域切除後は,腓骨や腸骨などの自家骨を用いて再建されることが多い.一方,欠損の大きさや病態,年齢等によりプレートのみで再建せざるを得ない患者が少なからず存在する.そのような患者の場合,プレート上の皮弁で可撤性有床義歯を支持させることは非常に困難である.今回,下顎片側切除後にプレートのみで再建し,インプラントオーバーデンチャー(IOD)で長期間良好な口腔機能を維持できた無歯顎症例を経験したので報告する.患者は74歳の女性で,下顎歯肉癌の診断にて右側下顎半側切除後D-P皮弁による再建術を受けた.その後マラソンが趣味であることから腸骨や腓骨採取の同意を得られず,プレートのみで二次再建をした.上下顎総義歯によってきわめて柔らかい食物のみ摂食可能となったが,断端部の床下粘膜に常時疼痛を訴えた.そこで残存顎堤の断端部にインプラントを埋入し,再建プレート上の皮弁とインプラントを埋入した残存顎堤で支持した下顎IODとしたところ,疼痛の訴えはなくなり,食べられる食品も増加した.再建プレート上の皮弁に一度も潰瘍が生じることなく,良好な咀嚼機能を12年間維持できた.インプラント周囲の粘膜の異常所見やパノラマエックス線写真による骨吸収は認めず,患者の口腔関連QOLは高く維持されている.下顎再建プレート上の義歯にインプラントを応用することで,12年間の長期にわたり良好な口腔機能を維持することができた.(著者抄録)

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Other Link： https://search.jamas.or.jp/index.php?module=Default&action=Link&pub_year=2019&ichushi_jid=J02151&link_issn=&doc_id=20191105450009&doc_link_id=%2Fes7impla%2F2019%2F003203%2F013%2F0230-0235%26dl%3D0&url=http%3A%2F%2Fwww.medicalonline.jp%2Fjamas.php%3FGoodsID%3D%2Fes7impla%2F2019%2F003203%2F013%2F0230-0235%26dl%3D0&type=MedicalOnline&icon=https%3A%2F%2Fjk04.jamas.or.jp%2Ficon%2F00004_2.gif

Language：Japanese   Publisher：(公社)日本口腔インプラント学会  

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Language：Japanese   Publisher：(一社)日本顎関節学会  

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Language：Japanese   Publisher：(一社)日本顎関節学会  

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Language：Japanese   Publisher：(一社)日本顎関節学会  

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Language：Japanese   Publisher：(公社)日本補綴歯科学会  

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Language：Japanese   Publisher：(公社)日本補綴歯科学会  

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Language：Japanese   Publisher：(一社)日本形成外科学会  

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Language：English  

Background: The free vascularized fibula flap presents many advantages such as sufficient length of the bony segment, good vascularization, better quality of the bone, and a long vascular pedicle, but it is also associated with some disadvantages with regard to prosthetic rehabilitation because of its limited height. Improvement in bone height is necessary for ideal dental implant treatment of reconstructed mandibles. Case presentation: For two squamous cell carcinoma patients, mandibular bone reconstruction was performed secondarily with the peroneal flap after tumor resection. Since the bone height was insufficient at the time of implant treatment, occlusion reconstruction by dental implant was performed after vertical distraction osteogenesis. Conclusions: Vertical distraction osteogenesis is a suitable treatment option for alveolar ridge deficiency resulting from fibula transplantation for mandibular reconstruction following tumor surgery.

DOI： 10.1186/s40902-018-0172-2

PubMed

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Language：Japanese   Publisher：(一社)日本歯科心身医学会  

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Language：Japanese   Publisher：(一社)日本歯科心身医学会  

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Language：Japanese   Publisher：(公社)日本口腔インプラント学会  

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Authorship：Corresponding author   Language：English   Publishing type：Research paper (scientific journal)  

PURPOSE: This study analyzed risk factors for post-loading implant loss in cases of implant-supported prostheses applied to edentulous jaws of Japanese patients. METHODS: In total, 245 dental implant fixtures placed in 54 edentulous jaws of 46 patients performed at Niigata University Hospital were retrospectively analyzed. Kaplan-Meier curves were used to estimate the cumulative survival rate (SR) of implants, and multiple Cox regression analysis was used to identify predictive factors of implant loss. The following risk factors for implant failure were examined: age, sex, survival time, implant length, implant location, smoking habit, bone density, bone augmentation, opposing dentition, loading period, and type of final restoration. The Cochran-Mantel-Haenszel test was used to examine difference in survival curves of the extracted predictors. RESULTS: Sixteen implants failed during the observation period (SR=92.8 %). Multiple Cox regression analysis revealed that male sex [hazard ratio (HR)=16.1; p=0.007] and use of maxillary removable restorations (HR=12.7; p<0.000) were risk factors for implant failure. Other factors had no significant effect on implant failure. The SR of implants for males (SR=86.9%) was significantly lower than that for females (SR=99.1%). The SR of implants for maxillary removable restorations (SR=76.4%) was significantly lower than for maxillary fixed restorations (SR=99.1%) and mandibular fixed restorations (SR=97.8%). CONCLUSIONS: Maxillary implants with removable restorations and male sex were risk factors for implant failure among Japanese edentulous patients.

DOI： 10.1016/j.jpor.2018.01.004

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Language：Japanese   Publisher：(一社)日本顎関節学会  

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Language：Japanese   Publisher：(一社)日本顎関節学会  

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

BACKGROUND: Long-term changes of trabecular microstructure in human tooth extraction socket have not been investigated. PURPOSE: To examine the trabecular microstructure of human residual ridges at various intervals following tooth extraction, and to determine whether bone remodeling activity can attain points of relative stability and when such points are reached. MATERIALS AND METHODS: Forty-four bone biopsy specimens were obtained from lower molar or premolar regions of residual ridges. Postextraction times ranged from 1.6 to 360 months. Samples were analyzed using micro-computed tomography and three-dimensional bone morphometry with histological analyses. Trabecular bone parameters were plotted against postextraction times, and a stepwise piecewise linear regression analysis was performed to determine at which points of time these parameters either increased or decreased. RESULTS: Using piecewise linear regression, "inflection points" were found in most trabecular bone parameters between 7 and 12 months postextraction. Among the residual ridge samples, woven trabecular structure became mature, consisting of thick lamellar trabeculae with sufficient bone density, under dynamic bone remodeling until the 7th to 12th month post-tooth extraction. After this period, the mature network structure remained stable with low remodeling activity. CONCLUSION: Bone remodeling of trabecular structure in human residual ridge after tooth extraction had a stabilization period.

DOI： 10.1111/cid.12591

Scopus

PubMed

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

Streptococcus pneumoniae is a leading cause of bacterial pneumonia. Our previous study suggested that S. pneumoniae autolysis-dependently releases intracellular pneumolysin, which subsequently leads to lung injury. In this study, we hypothesized that pneumococcal autolysis induces the leakage of additional intracellular molecules that could increase the pathogenicity of S. pneumoniae. Liquid chromatography tandem-mass spectrometry analysis identified that chaperone protein DnaK, elongation factor Tu (EF-Tu), and glyceraldehyde-3-phosphate dehydrogenase (GAPDH) were released with pneumococcal DNA by autolysis. We demonstrated that recombinant (r) DnaK, rEF-Tu, and rGAPDH induced significantly higher levels of interleukin-6 and tumor necrosis factor production in peritoneal macrophages and THP-1-derived macrophage-like cells via toll-like receptor 4. Furthermore, the DNA-binding activity of these proteins was confirmed by surface plasmon resonance assay. We demonstrated that pneumococcal DnaK, EF-Tu, and GAPDH induced the production of proinflammatory cytokines in macrophages, and might cause host tissue damage and affect the development of pneumococcal diseases.

DOI： 10.1016/j.cellimm.2018.01.006

PubMed

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

We developed an ethylene vinyl acetate (EVA) containing surface pre-reacted glass-ionomer (S-PRG) filler, as a new mouthguard material for preventing intraoral bacterial infection. We examined its physical properties, antimicrobial activity against a major cariogenic bacterium Streptococcus mutans and a periodontopathogen Porphyromonas gingivalis, and its cytotoxicity toward human gingival epithelial cells. S-PRG filler was added to EVA copolymer at 5, 10, 20, or 40 wt% and was processed into disc-shaped test specimens. Only minor differences between the Shore hardness and rebound resilience properties of EVA materials with and without the S-PRG filler were observed. The specimens with S-PRG filler showed bacteriostatic activity toward S. mutans and P. gingivalis and inhibited S. mutans biofilm formation. No cytotoxicity against the gingival epithelial cells was observed. Our findings show that EVA containing S-PRG filler has antimicrobial activity toward pathogenic oral bacteria and may be an effective material for maintaining the oral health of athletes.

DOI： 10.4012/dmj.2016-321

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Language：English   Publishing type：Research paper (scientific journal)   Publisher：ELSEVIER IRELAND LTD  

PURPOSE: The aim of this study was to quantify masseter muscle stiffness in patients with masticatory myofascial pain. METHODS: Stiffness was measured using shear wave elastography, which expresses stiffness as shear wave velocity (Vs). A phantom study was conducted to confirm the reliability of the measuring device. The study participants were 26 females with bilateral masseter muscle pain who were classified into either Research Diagnostic Criteria for Temporomandibular Disorders (RDC/TMD) group Ia (myofascial pain; n=13) or RDC/TMD group Ib (myofascial pain with limited opening; n=13). Healthy controls consisted of 24 female volunteers with normal teeth and jaws, who were not classified into groups I/II/III by RDC/TMD. RESULTS: Muscle stiffness was 1.96m/s (12.5kPa) in 13 patients in group Ia, 2.00m/s (13.0kPa) in 13 patients in group Ib and 1.27m/s (5.25kPa) in 24 control subjects. Vs was significantly greater in groups Ia and Ib than in the control group (p<0.05). Characteristic pain intensity (CPI) became clear as an independent factor impacting Vs (partial regression coefficient=0.714; multiple regression analysis , p<0.05). Masseter muscle stiffness was positively correlated with CPI (p< 0.05) and negatively correlated with maximum assisted mouth opening (p<0.05) and painless mouth opening (p<0.05). CONCLUSION: Shear wave elastography is useful to quantify masticatory muscle stiffness. Masseter muscle stiffness of females measured using shear wave elastography was about two-fold greater in group Ia and Ib than in the healthy control group.

DOI： 10.1016/j.jpor.2017.01.003

Web of Science

PubMed

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Language：Japanese   Publisher：(公社)日本口腔インプラント学会  

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Language：Japanese   Publisher：(公社)日本口腔インプラント学会  

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Language：Japanese   Publisher：(一社)日本顎関節学会  

顎関節症の寄与因子として、身体的因子に加えて心理・精神的因子が考えられる。しかし、顎関節症における心理・精神的因子は身体的因子と比較して客観的な評価を得づらく、いまだ不明な点が多い。そこで本研究は心理・精神的因子の一つである自我状態が、顎関節症の病悩期間にどのように影響を及ぼしているか検討することを目的とした。対象は2010年の1年間に新潟大学医歯学総合病院顎関節治療部を新規受診した患者とし、対象患者236名(女性:174名、男性:62名)にエゴグラムチェックリスト(ECL)を用いエゴグラムを作成し、自我状態について分析した。患者は専門医3名により、顎関節症の症型分類(日本顎関節学会2001年改訂版)を用いて診断した。患者のエゴグラムのCP/NP様式、FC/AC様式、年齢、性、症型分類について、顎関節症患者の病悩期間にどのように影響を与えているか比較検討した。統計学的解析はロジスティック回帰分析を用いた。統計学的有意差は有意水準を5%とした。その結果、自己否定および交流回避を特徴とする自我状態を示すFC&lt;ACである患者、性別が女性である患者は、6ヵ月以上の病悩期間に有意に影響を与えていることが明らかになった。(著者抄録)

DOI： 10.11246/gakukansetsu.29.92

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Language：Japanese   Publisher：(公社)日本補綴歯科学会  

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Language：Japanese   Publisher：(一社)日本顎関節学会  

近年、顎関節症の寄与因子の一つとして歯列接触癖(TCH)が注目されてきた。しかし、TCH是正の介入効果を検証した報告は少なく、特に歯科衛生士によるものは見つけられない。そこで、本研究では咀嚼筋痛障害を有する患者を対象に、歯科衛生士による行動変容法を用いたTCH是正指導を行い、その介入効果を検証することを目的とした。咀嚼筋痛障害患者をランダムに介入群(14人)と対照群(14人)に割り付け、歯科衛生士が患者に対し「張り紙法」による行動変容アプローチを行い、その効果を無痛自力開口量、最大自力開口量、強制開口量、圧痛部位数、現在の痛み、過去1週間の最大の痛み、過去1週間の平均の痛み、顎機能に関する活動制限項目数について比較検討した。再診時には、介入群で無痛自力開口量、強制開口量、圧痛部位数が有意に改善し、一方、対照群では無痛自力開口量、最大自力開口量が有意に改善した(p&lt;0.05)。群間比較では過去1週間の最大の痛みと過去1週間の平均の痛みに有意差が認められた(p&lt;0.05)。歯科衛生士による行動変容支援は咀嚼筋痛障害患者の症状改善に有効であることが示された。また、指導内容実施調査において、介入群患者の全員が「できた」「だいたいできた」と回答しており、歯科衛生士による介入の容易性や有用性が示唆された。本研究の結果から、歯科衛生士による行動変容サポートは、歯科衛生士の患者に対する新しい介入分野として期待できる。(著者抄録)

DOI： 10.11246/gakukansetsu.28.135

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Language：Japanese   Publisher：(一社)日本顎関節学会  

本研究の目的は、顎関節症状を訴える初診患者の身体的・心理社会的スクリーニング検査として、Research Diagnostic Criteria for Temporomandibular Disorders(RDC/TMD)Axis IおよびAxis IIを用いることにより、本院におけるTMD患者の現状を把握することである。2012年6月から2014年5月までの24ヵ月間に、新潟大学医歯学総合病院顎関節治療部を受診した初診のTMD患者287人(男性65人、女性222人)を対象とした。身体的スクリーニングはRDC/TMD Axis Iに基づいて行い、また心理社会的スクリーニングとしてRDC/TMD Axis IIのGraded Chronic Pain Scale、depressionおよびsomatizationを分析し、Axis Iとの関連を評価した。身体的スクリーニングの結果、Group I(筋障害)は対象患者の49.1%と最も多く認められ、Group IaとGroup Ibの割合はほぼ同等であった。Axis II診断に関して、depressionでは全体の34.0%がmoderateからsevereであり、somatizationでは43.3%がmoderateからsevereであった。Graded Chronic Pain Scaleでは、9.6%に疼痛による心理社会的問題を認めた。depressionとsomatizationをRDC/TMD Axis IのGroup別に比較すると、depressionとsomatizationともにGroup I患者がGroup II・III患者と比較して有意に高い値を示した(p<0.01)。このことから、Group I患者においては心理社会的因子へのアプローチの重要性が示されるとともに、Axis II診断の有用性が示唆された。(著者抄録)

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Language：English   Publishing type：Research paper (scientific journal)   Publisher：ELSEVIER SCIENCE INC  

OBJECTIVE: Alveolar cancellous bone biopsy samples were extracted during dental implant preparation for investigating microstructural changes due to menopause and relationships between these changes and bone turnover markers. STUDY DESIGN: Subjects were 18 women receiving mandibular implants: premenopausal (n = 5), early postmenopausal (≤5 years; n = 3), and late postmenopausal (>5 years; n = 10). Bone turnover markers were measured and the samples analyzed using microscopic computerized tomography and 3-dimensional bone morphometry. RESULTS: The alveolar bone volume was significantly less in late postmenopausal women than in premenopausal ones. The trabeculae in early postmenopausal women were more separated and rod-like than in premenopausal ones (P < .05). Each alveolar bone parameter was significantly (P < .05) related to at least 1 bone turnover marker. CONCLUSIONS: Alveolar cancellous bone structure begins changing even in early postmenopausal women, and this structure varies in close relationship to bone turnover markers.

DOI： 10.1016/j.oooo.2011.10.028

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PURPOSE: The aim of this study was to develop and apply a new method for easy intraoperative adjustment of a provisional fixed full-arch restoration, in order to allow immediate implant loading following computer-guided surgery, regardless of any implant positioning errors compared to the virtual planning. METHODS: In accordance with the NobelGuide™ protocol, a provisional restoration for immediate loading of six maxillary implants was prepared prior to surgery. Because small shifts between the planned and the actual implant positions were to be expected, the provisional restoration was not fabricated directly on temporary cylinders as a conventional one-piece superstructure, but was divided into two portions: six custom made abutments and a long span fixed restoration which were left unconnected. After implantation, the custom abutments were attached to the six implants to be immediately loaded, and the superstructure was cemented simultaneously to all abutments using dual cure resin cement. After the excess cement was cleaned and polished, the superstructure was then reseated. Passive fit was achieved between implants and the superstructure. CONCLUSION: The superstructure described in this article can be easily seated and adjusted to accommodate any possible shifts in implant positioning occurring during computer-guided surgery. Through this method uneventful immediate implant loading can be achieved in a reasonable operative time.

DOI： 10.1016/j.jpor.2010.11.002

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Language：Japanese   Publisher：Japan Prosthodontic Society  

<B>Patient: </B> The patient was 40 years old woman with chief complaint by intermittent jaw lock with severe pain. CT and MRI examination showed disc displacement without reduction on both sides and a typical osteoarthrosis of head of mandible, but the mobility of condyles was good. Neurology examination did not show the disorder, but in electromyogram, left side masseter and temporal muscle showed involuntary muscle activity more than 3 times of MVC. It was diagnosed as jaw lock by the hemimasticatory spasm. A prosthetic therapy using the overlay removable partial denture succeeded and was able to control it for masticatory spasm well for 10 years.<br><B>Discussion:</B> It contributed to dramatic decrease of the masticatory spasm onset that occlusal vertical dimension of the overlay removable partial denture decided EMG examination in reference.<br><B>Conclusion:</B> The overlay removable partial denture contributed to control of masticatory spasm and recovery of a chewing function.

DOI： 10.2186/ajps.1.195

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過去の報告を踏まえ,主として顎関節症に対する遠隔診断支援システムの構築を計画した.今回,予備的調査を行い,診断支援の必要性と適切な情報交換の方法について検討し,歯科領域での遠隔診断支援について運用可能な形式を検討した.新潟県歯科医師会全会員1310名にアンケートを郵送した.診断支援は,口腔外科,顎関節症,隣接医学,歯科放射線,口腔病理など口腔外科に関連した分野の希望が多かった.診断支援の際に利用を希望する通信方法は,電子メールの希望者が多かった.診査・診断機器では顎機能検査機器の利用者は少なかった.顎関節症患者は個人開業医よりも病院歯科に集まる傾向が明らかになった.診断支援の必要性については,必要性を認めている回答が多かった

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The mechanism of condylar dislocation is not clearly understood. Temporomandibular (TMJ) surgery is a common option in the treatment of chronic condylar dislocation, but some authors have reported disappearance of its symptomatology after occlusal treatment.<BR>A case in which condylar dislocation disappeared by changing the location of anterior guidance is presented. The patient was an 18-year-old male with an Angle class III malocclusion who had been suffering from condylar dislocation of the right TMJ upon waking up for almost one year. Clinical inspection showed that the mandibular right second molar was guiding the mandibular eccentric movements. Dislocation of the TMJ disappeared by shifting anteriorly the tooth guidance with a stabilization splint. Jaw and condyle movements were recorded by a 6-degree-of-freedom measuring device during lateral excursions with and without wearing of the splints in order to assess the influence of shifting anteriorly the location of tooth guidance on the cure of dislocation. It was found that the direction of condylar movements changed markedly during parafunctional grinding tasks. Therefore, it was concluded that

DOI： 10.2186/jjps.41.763

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Language：Japanese   Publisher：The Japan Prosthodontic Society  

The purpose of this study was to clarify the change of abutment teeth mobility by insertion ofpartial dentures for a short period.Twenty patients who received partial dentures at the Dental Clinic of Niigata University School ofDentistry, between August and November 1994, were selected.To evaluate changes in tooth mobility, the Periotest (PT) value of 49 abutment teeth within 3 months afterinitial insertion were measured and the following factors were ana1yzec[.l. change in PT value of all abutment teeth2 . change in PT value of upper abutment teeth3. change in PT value of lower abutment teeth4. the relationship between the type of edentulous space, the type of clasp and the amount of PT valuechangeThe results were as follows :l. PT value of all abutment teeth decreased after insertion of the dentures.2. PT value of upper abutment teeth showed no significant change within 3 months after initial insertionof the dentures.3. PT value of lower abutment teeth decreased from 2 weeks after insertion, and these decreases wereclearly detected in free-end dentures.4. PT value of lower abutment teeth of free-end dentures decreased irrespective of the type of the clasp.

DOI： 10.2186/jjps.40.59

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顎関節治療部における設置後4年間の顎関節症治療に関する臨床的検討を行った。新患として来院した1190例に対し、初診時のプロトコールをもとに、患者数と性別、紹介率、居住地域、年齢構成と全身疾患の有無、主訴、診断、初期治療法の項目に関して、年ごとに比較検討した。患者数は毎年300例前後で推移し、性別も女性が約70%で変動は少なかった。紹介率は平均45.1%であった。主訴は年度による大きな変動は認めず、疼痛が78.4%と最も多かった。診断結果には例年大きな変動はなく、3a型が最も多く、次いで1型、3b型、2型、4型の順であった。初期治療として、病態の説明とセルフケア指導を行っているが、これのみで終了となった症例が38.9%と最も多かった。次いで薬物療法30.1%、スプリント療法27.3%、理学療法7.9%、補綴的療法3.1%の順であった。

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Other Link： http://search.jamas.or.jp/link/ui/2010288432

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下顎タッピング運動や咀嚼時の頭部と下顎の協調運動は中枢性に制御されているという報告があるが、これらの運動に後頸筋群がどのように関与しているかについては明らかにされていない。本研究では、頸筋が顎機能にいかに関わるかを検索することを目的とし、下顎運動と顎筋および頭頸部筋の筋電図の同時記録を行った。被験者は全身と顎口腔系に臨床的な異常を認めない健常成人11人(男性、平均年齢29.3歳)とした。記録内容は右側咬筋及び舌骨上筋群、両側胸鎖乳突筋及び後頸筋群の表面筋電図、ならびに頭部及び下顎運動の3次元運動とした。被験者には、頭部無拘束下、90度座位にて椅子に定位させた後、1)咬頭嵌合位ならびに後方歯牙接触位時の記録、2)75/60Hzの速度での下顎タッピング運動を12秒間、十分に軟化したガム(8.7g)の右咀嚼を12秒間行った際の記録を行った。結果として、1)下顎を咬頭嵌合位から後方歯牙接触位に後退させることにより舌骨上筋群の活動とともに胸鎖乳突筋および後頸筋群の筋活動が増加した。2)下顎タッピング時の顎開口量と頭部前後屈量は、いずも咀嚼時のものに比べて有意に大きかった。個体内での運動の安定性を調べた変動係数は、規定された運動であるタッピング時のほうがいずれの値においても小さい傾向があった。3)胸鎖乳突筋および後頸筋群はいずれのリズム下顎運動時にも開口相に明らかな活動を認めた。4)胸鎖乳突筋には、閉口相にもピークが観察された。ことに咀嚼側の活動は、タッピング時と咀嚼時で有意差が認められた。結論:胸鎖乳突筋、後頸筋群はともに顎位の決定や頭頸部協調活動に深く関与するが、その協調様式は互いに異なる可能性をもつ。また、咀嚼時の閉口時における胸鎖乳突筋活動は食物粉砕に関わる咬筋活動の上昇に伴い発現するものであると示唆された。(著者抄録)

DOI： 10.7144/sgf.16.112

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Other Link： http://search.jamas.or.jp/link/ui/2008156706

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

遊離端欠損に適用するシングルスタンドインプラントの場合には、補綴物が回転する方向に直接咬合力が加わることは避けるべきで、咬合接触の位置については若干の配慮が必要となる。(著者抄録)

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It is well known that the range of motion during mouth opening changes with the food size. We have previously reported the relation of head movement to the mandibular movement ; the head moves in the extended direction during mouth opening. In this study, we analyzed the head movement simultaneously with the mouth opening during food intake. One male and two female adults (age range : 24-26yrs. ) without any craniomandibular dysfunction were selected as subjects. The test food consisted of an apple cut into the different square size (6 to 35mm). Then, we recorded the head and mandibular movements at two head positions (horizontal to the Frankfort and Camper plane) with the 6-degree-of-freedom measuring device without any restrictions of the subjects' head. The results were as follows : 1 ) The food space was observed during food intake. The size of this space at the same food size was kept constant even when the head position was changed. 2 ) The head movement was larger when the head position was horizontal to the Frankfort plane than to the Camper plane. This suggests that the head movement exists in order to acquire support for the mandible during mouth opening.

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We have previously demonstrated that the head moves rhythmically and coordinately with the mandible during functional mandibular movements ; however, in those studies we could not provide information on the movement of the head as a whole because only the mandibular and maxillar incisal points were tracked. The objective of the present study was to assess sagittal head movement through analysis of the vectors of several reference points in the head and a mandibular incisal point during open-close tapping movements of different frequency. The same 6-degree-of-freedom measuring device employed in our precious studies was used again to analyze data from four male adults, age 26-27 years old. Results:1)During mandibular tapping movement, head reference points moved in a rotation-like movement ; i. e. , during opening the head moved clockwise and counter-clockwise during closing in the left side's sagittal plane. 2)There were no signigicant differences of angulation of the vectors between 1 Hz tapping movement and 3 Hz in all reference points. However, the range of motion of all reference points depended on the frequency of tapping movements in this case. The motion of the 1Hz tapping movement was larger than the 3 Hz one. 3)The hypothetical rotation center was located above the cervical vertebrae, and its sagittal position was dependent on each tapping movement.

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Language：Japanese   Publisher：Japanese Society of Stomatognathic Function  

It has been reported that duringmandibular tapping movements the head moves in functional coordination with the mandible in subjects with a normal occlusion and free of TMD symptoms. However, whether this finding can be applied to TMD patients remains unclear. The purpose of this study was to confirm the coordination of head and mandibular movements during tapping in TMD patients. Using the Trimet system, we measured tridimensionally both the movement of the head and the mandible by tracking upper and lower incisal points respectively during tapping movements, then analyzed chronometrically the vertical component of these movements. We found that the incidence of coordinated head and mandibular movements in TMD patients was lower than in normal subjects. Our findings confirmed the existence of coordination between the head and mandibular movements during tapping, and conclude that it is different for normal subjects and TMD patients. Our results raise the question on whether there is a relation between the presence and intensity of the TMD symptoms and the decrease in the incidence of the coordinated head and the mandible movements during tapping in TMD patients.

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DOI： 10.2186/jjps.41.468

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This study was conducted to examine the influence of changing the location of guidance teeth on the movements of the condyles during simulated parafunctional unilateral clenching.<BR>Two healthy adults volunteered for this study. To simulate bruxist behaviour, they were asked to perform maximal clenching in a lateral edge to edge position with onlay-like metal guidances that increased by 10 degrees the inclination of the lateral excursions, but did not change at all the vertical dimension in intercuspal position.<BR>A 6-degree-of-freedom jaw movement measurement system was used to record 3-dimensionally the condylar movements.<BR>When the contact point of the anterior guidance was moved posteriorly along the arch from canine to second molar, the trajectory of working condyle movement was an antero-superior one up to the first premolar; but from the first molar this trajectory changed dramatically to an inferior one during unilateral clenching. All the trajectories of nonworking condyle movement were superior during unilateral clenching.<BR>In consideration of the movements of the working condyle during eccentric movement in a parafunctional environment, the results suggested that the location of guidance teeth should be relegated to the anterior region of the working side.

DOI： 10.2186/jjps.41.468

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Language：Japanese   Publisher：Japanese Society of Stomatognathic Function  

Temporomandibular(TMJ)surgery is a common option in the treatment of chronic condylar dislocation, but some authors have reported disappearance of its symptomatology after occlusal therapy. A case in which condylar dislocation(CD)disappeared by changing the location of anterior guidance is presented. The patient was an 18 year-old male with an Angle class III malocclusion who had been suffering-one year-from condylar dislocation of the right TMJ upon waking up. Initially, he did not seek medical assistance for he was able to reduce it by himself. Clinical inspection showed that the mandibular right second molar was guiding mandibular eccentric movements. A stabilization splint was successfully used as therapy; within 24 hours most of the symptomatology had disappeared. Thereafter , we made removable metal appliances shich fixed anterior guidance either on the canine tooth of the afflicted side or on the healthy side, and requested the patient to wear them alternately in order to determine whether changing the location of anterior guidance would contribute to the cure of CD. Moreover, we recorded jaw and condyle movements with a 6-degree-of-freedom measuring device during lateral excursions with and without wearing of the splints. By shifting anteriorly the location of tooth guidance, the range of mandibular border movements increased ; and the condylar range of motion decreased during parafunctional grinding tasks. The condyle's rotation and movement became smoother and smaller within the confines of the glenoid fossa. CD of the right TMJ disappeared by shifting anteriorly the tooth guidance. We conclude that correction of anterior guidance is a non-invasive alternative therapy in some cases of condylar dislocation.

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Language：Japanese  

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Language：Japanese   Publisher：Japanese Society of Stomatognathic Function  

Masticatory movements are rhythmical movements carried out by the coordinated activity of masticatory muscles, head and neck muscles, lingual muscles and intra-oral soft tissues. It has been reported that changes in head posture affect stomatognathic functions. Therefore it is hypothesized that the head is moving rhythmically simultaneous with mandibular movements during mastication. The purpose of this study was to observe the head movement and to investigate the coordination between movements of the head and the mandible. We used a system that tracks head and mandibular movements at the same time, and simultaneously recorded bilateral electromyographic signals from Masseter and Sternocleidomastoid muscles. During the experiment the subjects' head was not restrained. Three male adults who have no craniomandibular dysfunctions were selected. The task was to chew unilaterally a piece of chewing gum. Results were as follows;1. During tapping movements, the maxillary incisor point moved vertically and rhythmically. This movement occured at the same time with vertical movement of the mandibular incisor point. The lateral movement of the maxillary incisor point was very slight. 2. During masticatory movements, the head made lateral cyclic movements cooperatively to the lateral component of the mandibular movement. 3. This cooperative movements were observed frequently in the early stage of mastication. 4. Lateral cyclic movements of the head showed a time delay of approximately 170-190msec from those of the mandible. So we conclude that the head produces vertical and lateral cyclic movements cooperative to those of the mandible during mastication. It is possibly brought about by the coordinated activity of masticatory and neck muscles.

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Language：Japanese  

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Language：Japanese   Publisher：Japanese Society of Stomatognathic Function  

Mastication is rhythmical movements that co-activate with masticatory muscles, cephalic-cervical muscles, lingual muscles and soft tissues of the mouth. Some authors reported simultaneous EMG activities of masticatory muscles, sternocleidomastoid muscles and lingual muscles during mandibular movements. It is estimated from these neuromuscular co-activations with mandibular movements that the head will also move rhythmically. But there are no reports available about it. The purpose of this study was to elucidate the co-operative head movement during mastication according to the method of measuring maxillary and mandibular incisal points at the same time. Results : 1)The maxillary incisal point moved cyclically in progress of mastication. 2)The movements of the maxillary incisal point during one chewing cycle projected on the frontal plane showed closed circuits like those of the mandibular incisal point movements. 3)The maxillary incisal point moved in direction of the non-chewing side 0.2 seconds before the end of the chewing cycles. 4)The maxillary incisal point moved in upper direction at jaw opening period, and moved in lower direction at jaw closing period but hardly moved in horizontal direction during tapping. Therefore these observed maxillary incisal point movements can be considered as co-operative head movements during mastication.

DOI： 10.7144/sgf.1.183

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DOI： 10.7144/sgf.1.183

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