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

インプラント部位へドリルプレパレーション処置を行う場合、特に同部位の骨密度が低い症例では、プレパレーション寸法を小さめにとることがある(underpreparation;アンダー処置)。こうしたドリルプレパレーションのアンダー処置と通常の処置の違いが臨床成功率に及ぼす影響を、骨密度の点で区別しつつ調査する系統的レビューとメタアナリシスを施行した。3種のデータベースの全登録文献を対象に関連キーワードでの検索を行った。適格とする研究は、少なくとも症例10名の転帰を評価していたランダム化または非ランダム化での臨床試験、および後方視的コホート研究とした。最終的に14報をメタ回帰分析に組み入れた。算出された骨吸収量は、ドリルプレパレーションの通常処置群では平均-0.43±0.28mm、アンダー処置群では平均-0.80±0.37mmとなった。骨密度が高い群から低い群まで4群に分けてインプラント周囲骨レベル(MBL)を比較した本メタ回帰分析から、MBLはドリルプレパレーションの種類および骨密度によって影響されることが示された。特に骨密度が最も高い群では、アンダー処置群よりも通常処置群の方がMBLは低くなっていた。骨密度が最も低い群を除いた3群においては、骨削除部位に対しインプラントがより大きくミスマッチであることがMBL上昇と正に関連していた。

Language：English   Publishing type：Research paper (scientific journal)   Publisher：Japan Prosthodontic Society  

<p><b>Purpose:</b> There is no clinical consensus to determine the right balance between underpreparation and marginal bone level changes. The purpose of this systematic review and meta-regression was to investigate the influence of the type of drilling preparation of the implant site in relation to the bone mineral density on the clinical success, expressed in terms of the MBL and implant failure rate.</p><p><b>Study Selection:</b> A thorough search was performed using the digital databases MEDLINE PubMed, EMBASE, and Cochrane Central Register of Controlled Trials by entering research lines or various combinations of free words. The main keywords used were “dental implants”, “bone density”, and “torque”.</p><p><b>Results:</b> The mean bone resorption in the conventional preparation group was -0.43 (± 0.28) mm, whereas it was -0.80 (± 0.37) mm in the underprepared group. For the D1/D2/D3 bone group, the slope was significantly different from zero and linearity; the D4 bone group slope was not significantly different from zero and was almost parallel, although it was significantly different from linearity. The box and whiskers plot shows that the MBL in underprepared sites tended to be significantly higher with a higher variation than that in conventionally prepared sites.</p><p><b>Conclusions:</b> Within its limits, our meta-regression analysis showed that MBL is influenced by the type of drilling preparation and bone mineral density. In particular, a lower MBL was observed in the D1 bone with conventional preparation than with underpreparation. Moreover, a greater implant-to-osteotomy site mismatch was positively associated with greater MBLs in the bone densities of D1/D2/D3.</p>

DOI： 10.2186/jpr.jpr_d_21_00275

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Bone augmentation using artificial bone is an important option in dental defect prostheses. A bone substitute using carbonate apatite (CO3Ap), an inorganic component of bone, was reported to have promising bone formation and bone replacement ability. However, the osteoinductivity of artificial bone is less than autogenous bone (AB). In this study, CO3Ap with AB is demonstrated as a clinically effective bone substitute. For in vitro experiments, an osteoclast-like cell (RAW-D) was cultured in the presence of AB, CO3Ap, or both (Mix), and the number of osteoclasts was evaluated. Osteoblasts were also cultured under the same conditions, and the number of adherent cells was evaluated. For in vivo experiments, a few holes were created in the rat tibia and AB, CO3Ap, or Mix were added. At 0, 14, and 21 days, the tissue morphology of the wound area was observed, and the thickness of the cortical bone was measured. In vitro, Mix did not increase the number of osteoclasts or osteoblasts. However, in vivo, the rate of bone replacement remarkably increased with Mix on dome-shape. A bone-grafting material combining osteoinductive AB with abundant artificial bone is expected to be clinically easy to use and able to form bone.

DOI： 10.3390/ma15228100

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Currently, along with titanium (Ti), zirconia is widely used as an abutment material for dental implants because it makes it possible to avoid gingival discoloration; however, the epithelial sealing capability of zirconia remains unknown. The purpose of the present study is to elucidate the localization of integrin β4 subunit (Inβ4), one of the main proteins in the attachment structure between gingival junctional epithelial (JE) cells and substrata. Maxillary first molars were extracted from rats, and implants were placed with Ti or zirconia transgingival parts; then, the localization of Inβ4 was observed. Morphological and functional changes in rat oral epithelial cells (OECs) cultured on a culture dish (Dish) and Ti and zirconia plates were also evaluated with Inβ4 immunofluorescence histochemistry and Western blotting. After four weeks of implant placement, the morphology of the peri-implant epithelium (PIE) and the localization of Inβ4 around the Ti and zirconia transgingival parts were similar. However, both exhibited markedly shorter Inβ4-positive bands in the PIE than in the JE around natural teeth. Decreased expression levels of Inβ4 were observed in OECs cultured on Ti and zirconia plates compared with those cultured on Dish. In conclusion, although inferior to natural teeth, zirconia implants are thought to have epithelial sealing properties comparable to those of titanium.

DOI： 10.3390/jcm9103331

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DOI： 10.1563/aaid-joi-d-19-00217

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DOI： 10.1016/j.jmbbm.2019.103598

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DOI： 10.3390/jcm8101560

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DOI： 10.1016/j.bjoms.2018.11.014

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DOI： 10.1111/clr.13262

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DOI： 10.11607/jomi.6278

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DOI： 10.5037/jomr.2016.7402

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DOI： 10.1097/ID.0000000000000447

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DOI： 10.1097/ID.0000000000000392

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OBJECTIVES: When implants are inserted, the initial implant stability is dependent on the mechanical stability. To increase the initial stability, it was hypothesized that bone condensation implants will enhance the mechanical stability initially and that the moderately rough surface will further contribute to the secondary stability by enhanced osseointegration. It was further hypothesized that as the healing progresses the difference in removal torque will diminish. In addition, a 3D model was developed to simulate the interfacial shear strength. This was converted to a theoretical removal torque that was compared to the removal torque obtained in vivo. MATERIAL AND METHODS: Condensation implants, inducing bone strains of 0.015, were installed into the left tibia of 24 rabbits. Non-condensation implants were installed into the right tibia. All implants had a moderately rough surface. The implants had an implantation time of 7, 28, or 84 days before the removal torque was measured. The interfacial shear strength at different healing time was estimated by the means of finite element method. RESULTS: At 7 days of healing, the condensation implant had an increased removal torque compared to the non-bone-condensation implant. At 28 and 84 days of healing, there was no difference in removal torque. The simulated interfacial shear strength ratios of bone condensation implants at different implantation time were in line with the in vivo data. CONCLUSIONS: Moderately rough implants that initially induce bone strain during installation have increased stability during the early healing period. In addition, the finite element method may be used to evaluate differences in interlocking capacity.

DOI： 10.1111/clr.12748

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© 2016, International Journal of Clinical and Experimental Medicine. All rights reserved. Objective: To compare the comprehensive quality between eight-year Stomatology Medical Doctor (S.M.D) Program students of China and doctoral dental students of Japan, hoping to provide some references for improving dental education in China. Methods and materials: Data were collected from self-answered scoring questionnaires, answered by participants from China and Japan. Results: The study showed Chinese student got higher scores in fields of basic knowledge, basic medical knowledge and basic legal knowledge, although their knowledge still needed improving. Chinese students also got higher scores in dental professional quality items, except for teaching capability. They should improve scientific research ability and teaching capability as well. Japanese students got lower scores in items of oral professional diagnosis, treatment level and professional foreign language proficiency. Conclusion: For general quality, Chinese students got higher scores except for social acceptability. Innovation capability and international communication skills were shortcomings for both Chinese and Japanese students. The comparison provides insight of this new dental education program and the program requires further reform in the future.

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DOI： 10.1007/978-3-662-45379-7_10

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DOI： 10.1111/idj.12065

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DOI： 10.1111/idj.12064

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DOI： 10.1111/j.1600-0501.2011.02163.x

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DOI： 10.1111/j.1365-2842.2009.02011.x

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DOI： 10.1016/j.biomaterials.2010.01.016

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DOI： 10.1111/j.1600-0501.2008.01665.x

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

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Language：Japanese   Publisher：(株)ヒョーロン・パブリッシャーズ  

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

インプラント体周囲硬組織の評価は,治療計画の立案から経過観察に至るまでのすべてのタイミングにおいて治療の成功・失敗に直結する重要事項である.臨床現場における主な硬組織評価法はエックス線診断・埋入トルク値の計測・共振周波数解析であり,非常に有効な評価方法であることがすでに多くの基礎研究・臨床研究で示されている.さらなるインプラント治療の高い成功率の達成のためには,これらの硬組織評価方法では評価できない骨内変化を理解することが必要であると考えている.本論文では主に埋入術式の違い,荷重負荷の有無による骨内変化に焦点を当てて解説する.研究データの積み重ねにより,解剖学的なリスクの回避,適切な部位への埋入といった従来の評価基準に加え,適切な埋入術式,適切な荷重負荷開始時期,さらには周囲骨吸収の予測などが術前に評価可能となるオーダーメイド型の硬組織評価法が構築されていくことを期待している.(著者抄録)

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

Publishing type：Book review, literature introduction, etc.  

Purpose: The aim of this study was to review the literature on current surface modification strategies used to improve the binding efficiency of an emerging biological material, polyetheretherketone (PEEK), with bone and soft tissues. Study selection: This review was based on articles retrieved from PubMed, Google Scholar, Web of Science, and Scien-ceDirect databases. The main keywords used during the search were “polyetheretherketone (PEEK),” “implant,” “surface modification,” “biomaterials,” “bone,” “osseointegration,” and “soft tissue.” Results: The suitability of PEEK surface modification strategies has been critically analyzed and summarized here. Many cell and in vivo experiments in small animals have shown that the use of advanced modification technologies with appropriate surface modification strategies can effectively improve the surface inertness of PEEK, thereby improving its binding efficiency with bone and soft tissues. Conclusions: Surface modifications of PEEK have revealed new possibilities for implant treatment; however, most results are based on in vitro or short-term in vivo evaluations in small animals. To achieve a broad application of PEEK in the field of oral implantology, more in vivo experiments and long-term clinical evaluations are needed to investigate the effects of various surface modifications on the tissue integration ability of PEEK to develop an ideal implant material.

DOI： 10.2186/jpr.JPR_D_22_00138

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インプラント治療は,口腔内欠損補綴治療になくてはならない治療オプションの一つである.初期固定はオッセオインテグレーション獲得の必要条件であり,即時負荷・早期負荷が一般的な術式になるに従い,より安定した初期固定が要求されるようになってきた.高い初期固定値獲得のため,インプラント体のマクロ・マイクロレベルのデザインの変更,新しい術式など多くの工夫が紹介されてきた.アンダーサイズドリリングテクニックは最も一般的に臨床採用されているインプラント外科手技である.埋入するインプラント体の直径より小さな径の埋入窩を形成することにより,インプラント体と骨の界面で生じる圧縮応力に期待し初期固定を得る術式である.外科医は,埋入トルク値としてその効果を感じることができる.アンダーサイズドリリングは広く普及した術式であるが,まだまだ解明されていない側面も多い.インプラント体埋入時の大きな圧縮力が周囲骨組織の微小損傷を惹起し,治癒期間中にネガティブな影響を与える.すなわち骨の材料特性の低下・インプラント体の安定の低下・周囲骨の吸収・そして最悪の場合インプラント体の喪失につながる可能性があるという仮説のもと,アンダーサイズドリリングテクニックについてさらなる理解を深めることが本論文の目的である.われわれの研究の着想に至った背景および,第48回日本口腔インプラント学会学術大会・シンポジウム10で発表した研究結果を紹介する.(著者抄録)

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インプラントの表面性状に関する研究は過去20年間活発に行われている。開発当初のインプラント体表面は滑面であったが、治療期間の短縮と、より強固なオッセオインテグレーション獲得を目指して、様々な粗面性状の研究がなされてきた。これまでのインプラント表面改質に関する研究の変遷と現状、さらに今後の展望について解説した。

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症例の概要:患者は初診時61歳の男性。悪性リンパ腫に対する放射線治療後の部分無歯顎に対する補綴治療の症例である。右下顎歯7、6、5部にインプラントを埋入し、コーヌス型オーバーデンチャーで補綴を行った。考察:インプラント体埋入位置が限定され、最終補綴装置の設計も力学的に問題のある設計となった。しかし、最終補綴装置装着後の定期的なメインテナンスによりインプラント体自体に大きな問題は生じていない。今後さらに経過を観察していく必要がある。結論:放射線治療後の下顎部分無歯顎症例に対し、インプラントを用いたコーヌス型オーバーデンチャーで咬合支持を再建することができた。(著者抄録)

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インプラント治療において、骨量不足症例への挑戦が増加し、骨増生の重要性が高まっている。骨増生に関する我々の研究を紹介する。(1)骨増生の簡便化を目指し新術式の開発を行っている。単回のスタチン注射投与による無切開・非侵襲的骨増生を提案する。スタチンの骨形成作用に関する研究から、今回の開発に至った経緯について解説する。(2)"骨を模倣する"というコンセプトで骨補填材料の開発を行っている。組織再生に必要な要素として、細胞、成長因子、足場、血流が知られており、骨とりわけ海綿骨はすべての要素を含んでいる。合成高分子化合物をスタート材料とした、海綿骨を模倣した自己細胞侵入型骨補填材を紹介する。(著者抄録)

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咀嚼能力はその評価すべき特性の多面性からこれまでに直接的及び間接的な評価法が多数検討されており、グミゼリーを被験食品とした研究では、成分の溶出計測や粉砕状況に応じたスコア化など種々の評価法を用いた報告がなされている。しかし、グミゼリー食塊粒子の詳細な粒度解析と成分溶出との関係についてはいまだ明らかになっていない。そこで本研究は、検査用グミゼリーを被験食品として含有β-カロチンの溶出量と、視覚判定による咀嚼能率スコアならびに画像解析による粒度解析との比較を行うことを目的とした。被験者は、成人健常有歯顎者17名(男性9名、女性8名、25～53歳、平均30.8±6.9歳)とした。粒度計測はデジタル画像解析にて行い、β-カロチンは35℃の水に対する規定条件下での溶出量を評価した。咀嚼能率スコアは標準画像との比較により視覚的に決定した。咀嚼能率スコアと被験食塊中の最大粒子面積との間には有意の負の相関関係(p<0.001)が認められた。また1mm2～50mm2の面積をもつ粒子の合計面積が咀嚼塊総面積に占める比率と溶出評価用センサ出力電圧との間に有意の負の相関関係(p<0.001)が認められた。以上の結果より、検査用グミゼリーからのβ-カロチン溶出量、目視による咀嚼能率スコアならびに粒度解析の結果は互いに相関関係が認められることが示された。(著者抄録)

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Comparative Studies of the Peri-implant Epithelium of Rat Gingivae between "Step-type" and "Straight-type" Implant System

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