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特集：歯の細胞生物学 10．全身疾患と歯周病．
Get PDFapplication/pdf歯周病と全身疾患との相互関係を構築する研究分野は,ペリオドンタルメディシン(periodontal medicine)と総称され,一つの学問体系を確立するに至った.現在まで肥満,糖尿病,心臓血管疾患,骨粗鬆症,誤嚥性肺炎,早産･低体重児出産などと歯周病との関係が報告され,20年になろうとしている.さまざまなエビデンスが提供されるとともに,近年では新たに悪性腫瘍やアルツハイマー病といった老年病との関連も登場し,研究領域の広がりをみせると同時に,若干の混乱も生じている.そこで,本稿では歯周病と腎臓疾患との関連を含めたペリオドンタルメディシンの現状整理を行い,解説する.journal articl
口蓋の容積と舌圧の関係
Get PDF松本歯科大学博士（歯学）2015甲第189号application/pdf１．目的. これまで申請者らは総義歯舌房や口蓋容積の大きさを確保する観点より、上顎臼歯から人工歯排列を行うことを提唱してきた。義歯装着により舌房が狭くなると舌機能に影響する可能性が考えられる．しかしながら義歯装着と舌機能との関連は不明な点が多い。一方、舌の機能評価法の一つとして舌圧測定法がある。現在、センサーシートやバルーンを用いた方法が応用されているが、前者は必ずしも簡便とは言えない。そこで、今回、バルーン式舌圧測定器を用い、未だほとんど検討されていない舌圧と義歯装着との関連について明らかにするための基礎的研究として口蓋の容積と舌圧の関係について検討を行った。２．方法. 舌圧測定器（TPM‐01：JMS社製）を用い，舌背に置いた舌圧プローブを最大の力で7秒間口蓋に押しつぶした時のPeak値を測定し、舌圧の性差を解析した（実験１）。口蓋容積は被験者上顎のアルジネート印象採得後に製作した石膏模型を用い，咬合面形状認識装置（オプトレース：SHOFU社製）に3次元スキャンを行い，計測ソフト（大阪歯科大学小児歯科学講座）により算出した。口蓋形態の計測項目として、歯槽基底幅径・長径・口蓋最深部の深さを計測し、これらの計測項目と最大舌圧の関係をSpearman の相関関数で評価した（実験２）。さらに、口蓋容積の変化が舌圧に及ぼす影響を調べるため、被験者5名を対象に各種厚み（厚さ1.5、3.0mm）の口蓋床で、全口蓋被覆型（口蓋床A）、馬蹄形型（口蓋床B）、前歯-第1小臼歯近心までの部分被覆型（前歯部型：口蓋床C）のそれぞれの形態を装着し、最大舌圧を測定した。その際、口蓋床A、B、C装着時の口蓋容積をオプトレースで算出、口蓋床未装着時の口蓋容積との減少率を求め、また、各種口蓋床装着時の異物感をVASを用いて観察。舌圧、口蓋容積の減少率ならびに異物感が装着した口蓋床の相違で変化するかどうかをFriedman 検定後、Wilcoxon の順位和検定により評価した（実験３）。３．結果および考察. 舌圧は男性で平均39.9±2.2KPa、女性で平均5.9±2.4KPaで有意差を認めた（実験１）。口蓋の形態と舌圧の関係では、いずれの計測値とも舌圧との間に有意な相関は認められなかった（実験２）。各種口蓋床装着時の舌圧の変化の関係は、厚さ1.5mmの場合は口蓋床A、B、Cで舌圧に有意な変化は認められなかったが、厚さ３mmの場合は口蓋床A、B、Cで舌圧に有意な差を示し、多重比較検定の結果、口蓋床A、Bを装着した時に比べて口蓋床Cを装着した時には、舌圧に有意差を認め大きかった。また、いずれの厚さとも、口蓋床A、B、Cで異物感のVAS値に有意差を認めた（実験３）。欠損補綴装置装着者の舌圧に関する経時的観察結果によると、装置の装着後50日までは舌圧は減少し、それ以降は増加することが報告されている。本研究の口蓋床の装着による舌圧の変化は、短期間の結果と一致する。この様な結果が得られた一因として、形態学的な口蓋容積の減少、すなわち舌房の狭小によることが想定され、その可能性として口蓋床装着にともなう異物感を考察している。また一時的であれ、口蓋容積の減少が舌圧を減少させると考えると、義歯製作に際して口蓋容積の減少率をできるだけ低くする必要性が示唆された。doctoral thesi
Effects of viscosity on food transport and breathing-swallow pattern during eating of two-phase food in elderly individuals
Get PDF松本歯科大学博士（臨床歯学）2015甲第190号application/pdfWhen eating food containing both liquid and solid phases (two-phase food), the liquid component frequently enters the hypopharynx before swallowing, which may increase the risk of aspiration. The aim of this study was to test whether the initial viscosity of two-phase food would alter pre-swallow food transport and breathing-swallowing coordination in elderly persons. Fiberoptic endoscopy was recorded while 18 healthy young and 19 elderly subjects ate 5 g of steamed rice with 3 ml of blue-dye water. Liquid viscosity was set at three levels by adding a thickening agent (0, 2, and 4 wt%, respectively). We measured the timing of swallow initiation and the respiratory phase at swallow initiation. For thin twophase food, the timing of swallow initiation was not significantly different between young and elderly subjects, but swallows more initiated during inspiration in elderly subjects. For thicker two-phase foods, in contrast, the timing of swallow initiation was delayed in elderly subjects, but swallows usually initiated during expiration in both groups. In elderly individuals, for thin two-phase, swallow initiation is reserved but breathing swallowing coupling was declined. For higher viscosities, swallow initiation is delayed during eating food, but breathing swallowing coordination is not perturbed probably due to slow bolus flow into the hypopharynx. Coordination between swallowing and breathing pattern during eating of food would decrease with aging, which may expose a risk of pre-swallow aspiration.doctoral thesi
加工硬化された市販チタンの耐食性と機械的性質
Get PDFapplication/pdfJIS type 2 titanium is cold–worked for work–hardening, and is commercially available (G2W), and this material is used to produce implants. In this study, the mechanical characteristics and corrosion resistance of this work–hardened material (G2W) were compared with those of JIS type 2 titanium (G2), JIS type 4 titanium (G4), and JIS SSH4650–60E (G5). The following results were obtained: ①The tensile strength was highest in G5, and lowest in G2. No marked difference was observed between G2W and G4. ②The proof stress was highest in G5, and lowest in G2. No significant difference was noted between G2W and G4. ③The elongation was highest in G2, and lowest in G5. No significant difference was present between G2W and G4. ④The fracture toughness showed a significant difference between G2 and G2W, whereas no significant differences were observed among G2W, G4, and G5. ⑤The maximum bending load at an inclination angle of 30° was lowest in G2, and no significant differences were noted among G2W, G4, and G5. ⑥The hardness was highest in G5, and lowest in G2. No significant difference was present between G2W and G4. ⑦The released volume of titanium was highest in G5, and lowest in G2W. The released volume was higher in G4 than in G2. Vanadium and aluminum were released from G5. ⑧Work–hardened titanium (G2W) showed mechanical characteristics equivalent to those of G4, and excellent corrosion resistance, and is considered to be useful as an implant material.journal articl
根管充填剤の逸出に起因した上顎洞炎の1 症例
Get PDFapplication/pdfA case of iatrogenic sinusitis secondary to overfilling of a root canal filling material was reported. A 50–year old male was referred to our hospital with a symptom of nasal discharge. The cone–beam CT and panoramic x–ray images showed the soft–tissue density mass in right maxillary sinus and also the excess of root canal filling material from distobuccal root of right upper molar. After the administration of antibiotics and the root canal treatment, the excess material was surgically removed together with the amputation of the affected root, which resulted in the complete resolution of right maxillary sinusitis. The present case and the other related reports showed the risk of iatrogenic maxillary sinusitis even with a small fragment of overextended root canal filling materials. Dentists should be aware of this possibility for the ordinary root canal treatment.journal articl
