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障害者歯科における高次医療機関への紹介基準の検討−循環型地域連携クリニカルパスのために−
Get PDFapplication/pdfBackground : Periodic dental examinations for persons with special needs will usually be carried out in at dental clinics. However, there are some special needs patients who are difficult to treat. Such patients require special behavior management when receiving general or intravenous anesthesia to treat the teeth in a highly advanced medical institution. If there are objective criteria for referring patients to an advanced medical institution, it provides benefit to the patient and also allows for the effective use of medical resources. Objective : The aim of this study was to create clear, simple and easy referral criteria to a highly advanced medical institution to use for people with special needs. Subjects and Methods : The subjects were 86 people with special needs who required dental care (2 years and 8 months to 70 years old, with an average age of 20.5±18.2 years old). A decision tree analysis was carried out with patients under special behavior management as the dependent variable and a total of 51 independent variables : 9 variables from the patients’ general and oral health histories, 10 variables from disease, 12 variables for strength of the behavior disorder, 12 variables from the kind of dental treatment, 1 variable from going to hospital time, 6 variables from developmental age and 1 variable from the behavior of oral examination. The resulting tree diagram provided a visual representation of the relationship between these input variables and their relative impact on the judgment of need of special behavior management for special needs patients. Results : The highest priority item was adaptability to examination of the oral cavity when judging the need for special behavior management. The second most important item was a development age 3 years and two months old in the field of personal relationships. The hit rate of persons who required a highly advanced medical institution was 93.1%. It was suggested that the two criteria should be used when evaluating patients for referral to an advanced medical institution for clinical pathways of the cycloid−type patients.journal articl
歯肉退縮の原因となった外傷性咬合を改善した１症例
Get PDFapplication/pdfIn clinical of pediatric dentistry, we sometimes encounter patients in whom cross bite with gingival recession is caused by ectopic tooth eruption in maxilla anterior region. The present report describes the cases with gingival recession due to occlusal interference in the right maxilla and mandibular incisors. In this cases, the lingual arch is suggested to lead to an improved overbite, and an excellent healing of gingival recession was obtained without periodontal surgical treatment.journal articl
異なる製造方法で製作したCAD/CAM 用Co−Cr 合金の曲げ特性
Get PDFapplication/pdfTo investigate the usability of Co−Cr alloy produced by metal injection molding as a material for CAD/CAM, we compared the bending strength of laser−sintered Co−Cr alloy (LAS), cast Co−Cr alloy (CAS), commercially available Co−Cr alloy for CAD/CAM (HCP), and Co−Cr alloy produced by metal injection molding. As a result, although the bending strength of the test specimen produced by metal injection molding was sufficient, the proof stress was 400−570 MPa lower than that of CAS and HCP. As a result of tissue observation, it was considered that the cause of this was the presence of pores. It was suggested that, if the proof stress improves by eliminating pores using hot forging, materials produced by metal injection molding will become available for CAD/ CAM.journal articl
Comparative studies on the formation of pathogenicity related enzymes and protein among four strains of Porphyromonas gingivalis
Get PDFapplication/pdfPorphyromonas gingivalis の研究上使われる代表的な４株（ATCC３３２７７，３８１，W５０，W８３）を用いて，病原因子と深い関係のある，RGP，KGP を含むプロテイナーゼ，ペプチダーゼおよびヘモグロビンとミオグロビン結合タンパクを通しての結合活性について比較検討した．プロテイナーゼに関して，４株ともにその産生が見られ，それぞれの株で３画分での分布状況を調べたところ，RGP，KGP，アゾコル分解酵素ともに，培養上清，粗抽出液，エンベロープの順に多かった．RGP，KGP に関しては，ATCC３３２７７，３８１，W５０で培養上清にほぼ６０％ほど含まれていたが，W８３では９４％を含んでいた．これに反して，ペプチダーゼ（PTP，DPP−I，DPP−II，DPP−IV）は４株ともに培養上清には検出されず，そのほとんどが粗抽出液に認められ，数％のみがエンベロープに分布しており，ペプチダーゼには細胞外への分泌機構が作用しないものと思われる．いずれの株でもPTP 産生単位数がDPP のどれよりも高かった．菌体細胞のヘムタンパクへの結合もいずれの株でも見られたが，ともにpH 依存性が見られ，酸性で強く，中性，アルカリでは非常に弱かった．結合の度合いはヘモグロビンとミオグロビンでは違いはほとんど認められず，これはミオグロビンがヘモグロビン分子の四分の一から成っていることから当然と言えよう．他のヘムタンパク（チトクロームC，カタラーゼ）への結合も弱いながら観察された．journal articl
Primary Intraosseous Odonfogenic Carcinoma Arising from a Dentigerous Cyst
Get PDFapplication/pdfMalignant tumors arising from dentigerous cysts are classified as primary squamous cell carcinoma derived from an odontogenic cyst or as odontogenic carcinoma according to the 2005 WHO classification and are extremely rare. We report a malignant tumor arising from a dentigerous cyst in the right maxillary anterior teeth , together with a literature review. The patient was a 75-year-old man who visited a hospital with complaining of discomfort in the lingual part of the right maxillary anterior teeth. On panoramic radiography and plain computed tomography (CT), dentigerous cyst, keratocystic odontogenic tumor or ameloblastoma was suspected. The extirpated material was histopathologically diagnosed as an odontogenic carcinoma (in situ) arising from the dentigerous cyst. Postoperative ultrasonography (US) and contrast enhanced CT revealed no metastasis to the cervical lymph nodes. The patient is currently being followed up without resection or anticancer drug administration. Neither local recurrence nor metastases were observed 18 month after surgery.journal articl
