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短縮歯列のコンセプト
Get PDFapplication/pdfIn the last two decades, the Shortened Dental Arch (SDA) concept has been introduced as a treatment strategy for posterior edentulous patients; i.e. there is no need to restore the missing part of the molar region. However, clinical experience suggests various possibilities for functional disturbance starting from instability of occlusion. This study investigated whether the SDA concept applies to all posterior edentulous patients. Fifteen patients with unilaterally posterior missing teeth were enrolled in this study, and multiple evaluations of SDA were performed in these patients. This evaluation consisted of an objective evaluation (radiographic evaluation for temporomandibular joint and measurement of condylar displacement during maximal voluntary contraction) and a subjective evaluation (questionnaires about satisfaction with several oral functions). Abnormal condylar appearances were observed in eleven subjects by radiographic evaluation and these phenomena coincided with edentulous-side in six subjects. Condylar displacement during clenching was significantly larger on the edentulous-side compared to that in the dentulous-side. Regarding the subjective evaluation, masticatory problems were the most serious complaint in patients with SDA. These findings indicated the potential risks for oral functions. We propose that clinical guidelines should be developed for determining whether to adopt a "Wait and See" approach for SDA patients without any proactive treatment, or to start prosthetic intervention immediately.journal articl
精神鎮静法における鎮静レベルの客観的評価法 : PAMRの変化による評価
Get PDFapplication/pdfIn clinical dental practice, conscious sedation is commonly employed because it facilitates comfortable and smooth dental treatment, and it is also useful for the prevention of complications by cerebrovascular and circulatory disorders and acute aggravation of underlying diseases. The optimal level of conscious sedation is determined mainly based on vital signs, responses to verbal command and stimulation, and reductions of tension and nictitation. Moreover, drug effects vary among individuals. In this study, we investigated the utilization of post auricular muscle response (PAMR) for objective monitoring of the degree of conscious sedation. Twenty-four adult patients in ASA grade I were participated in this study. Of these, ten and fourteen subjects were assigned to nitrous oxide inhalation and intravenous midazo-lam, respectively. The association of PAMR changes with nitrous oxide inhalation concentration, plasma midazolam level, and the clinically optimal degree of sedation were investigated.journal articl
脱落前に認められるヒト乳歯の内部吸収と炎症性サイトカイン
Get PDFapplication/pdfPrior to shedding of human deciduous, odontoclastic resorption takes place at the pulpal surface of the coronal dentin. The purpose of the present investigation was to study, immunohistochemically, the effect of inflammatory cytokines on this internal resorption of human deciduous teeth. Fifty-six human deciduous teeth (12 incisors, 18 canines, 26 molars) in the later stage of exfoliation were used in this study. Using anti-human IL-1α, IL-6, and TNF-α monoclonal antibodies, we elucidated the alteration in the distribution of various inflammatory cytokine-positive-cells in the pulp during the process of internal resorption. While the roots were being actively resorbed, there were no inflammatory cytokines positive cells in the pulp. However, when root resorption was nearly complete, numerous IL-1α-and TNF-α-positive cells started to infiltrate the coronal pulp. Then, odontoclasts were initially found on the surface of the predentin at the bottom areas of the pulp chamber. These gradually spread to the pulpal horn region along the wall of the pulp chamber. The inflammatory cytokines-positive cells in deciduous tooth pulp were increased with the progression of internal resorption, and were frequently found adjacent to odontoclasts. These findings suggest that various inflammatory cytokines play important roles in the migration, activation, and differentiation of odontoclasts during the internal resorption of human deciduous teeth prior to shedding.journal articl
下顎第二大臼歯の埋伏
Get PDFapplication/pdfTwo cases of the impacted mandibular second molars were reported with discussion of their dental therapy. Early diagnosis is needed for prevention of mesial tipped mandibular second molars and uprighted alignment of the impacted second molar into the arch.Planning should be performed by collaboration of orthodontist and oral surgeon during the second molar development.journal articl
