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

症例の概要:臼歯部の咬合支持を喪失した多数歯欠損症例において咬合平面と水平的な顎位の設定は重要である.本症例は,上顎無歯顎,下顎両側遊離端欠損に対し上顎全部床義歯のみ装着し,臼歯部咬合支持を喪失した状態で長期期間経過していたため,顎位の不安定と咬合平面の不正を認めた.考察:本症例では咬合平面の修正,臼歯部咬合支持の確立を行ったのち,ゴシックアーチ描記法にて水平的顎位の評価をし,新義歯を製作したことで適正な下顎位を獲得することができた.結論:プロビジョナルレストレーションと治療用義歯を使用し,ゴシックアーチ描記法を用いて評価し,補綴装置製作に取りかかることができたため良好な結果が得られた.(著者抄録)

Language：Japanese   Publisher：Japan Prosthodontic Society  

<p><b>Patient</b>: The occlusal plane and horizontal mandibular position are important in cases of multiple missing teeth with loss of occlusal support of the molars. This patient had edentulous maxilla and bilateral free-end missing in the mandible and was wearing a denture only for the maxilla. The patient had lost occlusal support a long time ago and so the jaw position was unstable and the occlusal plane was declined.</p><p><b>Discussion</b>: The occlusal plane was corrected and molar occlusal support was established. The horizontal position of the jaw was evaluated using the gothic arch drawing method, and a prosthesis was fabricated at an appropriate mandibular position.</p><p><b>Conclusion</b>: Provisional restorations and treatment dentures were placed first, and then evaluated using the gothic arch drawing method. As a result, the fabricated prosthetic appliance achieved good results.</p>

DOI： 10.2186/ajps.16.147

CiNii Research

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

症例は65歳女性で、上顎右側第二小臼歯の歯根破折のため当院口腔外科にて抜歯し、補綴処置のため当科を受診した。上顎右側第二小臼歯欠損による咀嚼障害と診断し、サージカルガイドプレートを用いて十分な注水下で通法に従い埋入窩を形成、インプラント体を埋入した。3ヵ月の免荷期間の後にプロビジョナルレストレーションを装着し、約2ヵ月の十分な観察期間を経て咬合状態、清掃状態が良好であることを確認、さらにスクリュー固定式上部構造(陶材焼付金属冠)を装着し、その後ナイトガード製作を行った。最終上部構造装着後は約半年に一度のメインテナンスを継続している。2年6ヵ月経過後のエックス線所見から、インプラント周囲に骨吸収は生じていない。スクリューの緩み、上部構造の破損なども認められず、周囲粘膜の炎症所見もなく良好に経過している。

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

Language：English   Publisher：Japanese Dental Science Review  

This systematic review aimed to update the management of sleep bruxism (SB) in adults, as diagnosed using polysomnography (PSG) and/or electromyography (EMG). Management methods covered were oral appliance therapy (OAT) with stabilization splints, cognitive-behavioral therapy (CBT), biofeedback therapy (BFT), and pharmacological therapy. A comprehensive search was conducted on MEDLINE, Cochrane Library, and Web of Science up to October 1st, 2021. Reference list searches and hand searches were also performed by an external organization. Two reviewers for each therapy independently performed article selection, data extraction, and risk of bias assessment. The reviewers resolved any disagreements concerning the assortment of the articles by discussion. Finally, 11, 3, 14, and 22 articles were selected for each therapy. The results suggested that OAT tended to reduce the number of SB events, although there was no significant difference compared to other types of splints, that the potential benefits of CBT were not well supported, and that BFT, rabeprazole, clonazepam, clonidine, and botulinum toxin type A injection showed significant reductions in specific SB parameters, although several side effects were reported. It can be concluded that more methodologically rigorous randomized large-sample long-term follow-up clinical trials are needed to clarify the efficacy and safety of management for SB.

DOI： 10.1016/j.jdsr.2022.02.004

Web of Science

Scopus

PubMed

Language：English   Publisher：日本歯科医学会  

成人患者における睡眠時ブラキシズム(SB)の管理法に関してシステマティックレビューを施行した。各種文献データベースを用いて関連文献を検索し、さらに手作業で検索するなどの選択作業を2名のレビューアーが行った。最終的に、スタビライゼーションスプリント使用の口腔内装置治療(OAT)に関する文献11報、認知行動療法の3報、バイオフィードバック療法の14報、薬理学的治療の22報を選出した。評価の結果、OATによりSBイベントの数は減少する傾向にあった。OATを他の種類のスプリントと比較しても有意な差は示されなかった。認知行動療法で利益が得られる可能性については十分には支持されないことが示唆された。特定のSB測定値を有意に低下させていた治療としては、バイオフィードバック療法、ラベプラゾール、クロナゼパム、クロニジン、A型ボツリヌス毒素注射が示唆されたが、副作用もいくつか報告されていた。

Language：English   Publisher：日本大学歯学部  

単一臼歯へのモノリシックジルコニア冠(MZC)とその対合歯の3年累積生存率を評価し、同生存率に影響している要因を解析した。2014年4月～2020年9月に当大学病院で単一臼歯へのMZC修復治療を行った患者105名(女性80名、平均64.2±11.3歳)の177冠を後方視的に組み入れた。MZC失敗の定義は、抜歯などでのMZCの撤去とした。対合歯失敗の定義は、対合歯に何らかの介入が必要になったこと(ただし、再セメント固定および咬合調整が単独で行われた例を除く)とした。観察期間は22.7±10.5ヵ月で、MZCの3年累積生存率は89.8%(95%CI 80.0～95.1%)、対合歯の同率は94.8%(95%CI 89.3～97.6%)となった。生存予測因子の候補として顎(上顎か下顎か)、歯種(小臼歯か大臼歯か)、歯髄の状態(生活か失活か)、を採り上げ、調整済みのCox比例ハザードモデルで検証した。その結果、MZC失敗と有意に関連している因子としては歯髄失活が同定された(ハザード比2.8e+9、P=0.01)。対合歯失敗の独立関連因子は対合歯自身の失活状態であった(ハザード比7.8、P=0.03)。単一臼歯MZC治療の成績は臨床的に許容できるものであったが、支台歯および対合歯が失活していることはそれぞれの治療失敗の潜在的な危険因子になっていると考えられた。

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

Language：Japanese   Publisher：The Japanese Society for Temporomandibular Joint  

<p>Oral appliances (OA) are widely used in daily clinical practice as a reversible and conservative therapy for masticatory muscle pain and sleep bruxism (SB). However, there is insufficient evidence for their therapeutic effect. Hence, the objectives of this randomized clinical trial were to clarify the effects of OA on masticatory muscle pain and SB activity. Sixteen patients who were referred to the TMD clinic at Kyushu University Hospital with masticatory muscle pain and SB participated in this study. They were randomly allocated to either the splint group, who wore OA during sleep, or the control group. Electromyographic activity of the masseter muscle during sleep was recorded at baseline, immediately after, and 1, 4, and 6 weeks after the insertion of OA. At baseline and 6 weeks after starting the treatment, masticatory muscle pain was evaluated by a visual analog scale and muscle palpation, and Oral Health Impact Profile-49 (OHIP-49) scores were recorded. There were statistically significant differences in the muscle palpation index and OHIP-49 total score between the OA and control groups. There was a significant reduction in SB events immediately after wearing OA, but no change at 1, 4, or 6 weeks after starting the treatment. A simple correlation between SB activity and pain parameters was not found. In conclusion, OA had positive effects on both masticatory muscle pain and SB, but effects on SB were transient.</p>

DOI： 10.11246/gakukansetsu.34.38

CiNii Research

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

オーラルアプライアンス(OA)は,顎関節症(TMD)および睡眠時ブラキシズム(SB)の治療に広く用いられているが,そのエビデンスは不十分である。そこで本研究では,ランダム化比較試験によりOAの治療効果を調査し,TMDとSBの相互関係を調べることを目的とした。九州大学病院を受診したTMD患者のうち,咀嚼筋痛およびSBを有する者16名を対象として,OA装着群と非装着群(各8名)に無作為割付を行った。各群において6週間にわたり咀嚼筋痛の程度,口腔関連QoL(Oral Health Impact Profile-49,OHIP-49),SB(携帯型筋電図)の記録を行い,比較検討した。また,治療効果に関連する因子とそれらの関与程度を調査するため,心理学的因子とダイアリーの記録を行った。咀嚼筋痛に関して,VASによる痛みの主観的評価では群間に有意差は認められなかったが,筋圧痛スコアおよびOHIP-49スコアにおいてはOA装着群のほうが有意に改善していた。また,SBはOA装着直後において有意に減少したが,1,4,6週後には差はみられなかった。SBと咀嚼筋痛との間に相関関係は認められなかった。OA治療は,咀嚼筋痛の緩和に有効であること,また1週間程度ではあるがSBの減弱にも効果があることが明らかとなった。(著者抄録)

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

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

Language：English   Publisher：Diagnostics  

Although the clinical assessment of enamel thickness is important, hardly any tools exist for accurate measurements. The purpose of this study was to verify the precision of enamel thickness measurements using swept-source optical coherence tomography (SS-OCT). Human extracted maxillary central and lateral incisors were used as specimens. Twenty-eight sites were measured in each specimen. The optical path length (OPL) at each measurement site was measured on the OCT images, and enamel thickness (e1) was calculated by dividing OPL by the mean refractive index of enamel, 1.63. The specimens were then sectioned, and a light microscope was used to measure enamel thickness (e2). e1 and e2 were then compared. Measurement errors between e1 and e2 for the central and lateral incisors were 0.04 (0.02; 0.06) mm and 0.04 (0.02; 0.07) mm [median value: (25%, 75% percentile)], respectively. No significant differences between measurement sites were noted for measurement errors between e1 and e2. These results demonstrate that OCT can be used for noninvasive, accurate measurements of enamel thickness.

DOI： 10.3390/diagnostics12071634

Web of Science

Scopus

PubMed

Language：English   Publisher：Healthcare Switzerland  

This retrospective study aimed to investigate the survival rate of implants from 5 to 10 years after the placement of implant-supported fixed dental prostheses (ISFDPs) and the management of implant loss in the elderly population. Elderly patients (≥65 years old) who had been treated with ISFDPs and followed up with for at least 5 years between October 2009 and March 2020 were enrolled. Patient profiles and implant-related data were extracted. The survival rate of implants up to 5 years as well as the 10-year cumulative survival rate were evaluated. The management of implant loss and prosthetic interventions were also investigated. In total, 195 patients (mean age: 70.1 ± 4.5 years old) and 687 implants (287 ISFDPs) were assessed. The 5-year survival rate was 99.0% and the 10-year cumulative survival rate was 98.1%. Seven of the eleven implants lost were lost due to peri-implantitis. Only three implants in two patients were placed after the loss of the implants; most were restored using non-invasive procedures. Two patients underwent a conversion from ISFDPs to removable prostheses. This study showed that high survival rates were observed in an elderly population with ISFDPs and that non-invasive procedures were often applied after the loss of an implant.

DOI： 10.3390/healthcare10071250

Web of Science

Scopus

PubMed

Language：English   Publisher：Nihon University School of Dentistry  

<p><b>Purpose:</b> The purpose of this study was to evaluate the 3-year cumulative survival rates of posterior single monolithic zirconia crowns (MZCs) and their antagonists, and to analyze the influencing factors.</p><p><b>Methods:</b> The clinical outcomes of posterior single MZCs and their abutment teeth with antagonists, and the antagonists between April 2014 and September 2020 were evaluated retrospectively. The 3-year cumulative survival rates were calculated and associations between the survival time and predictor variables (“Jaw”, “Tooth”, and “Pulpal condition”) were also verified using Cox proportional hazards models and hazard ratios (HRs).</p><p><b>Results:</b> The 3-year cumulative survival rate of single MZCs was 89.8% (9 of 177 MZCs, 95% confidence interval (CI): 80.0-95.1%). Cox proportional hazards models showed non-vital teeth were significantly associated with failure (HR: 2.76e + 9, <i>P</i> = 0.012). The 3-year cumulative survival rate of antagonists was 94.8% (7 of 171 antagonists, 95% CI: 89.3-97.6%). Non-vital antagonists were also identified as an independent predictor for failure in Cox proportional hazards models (HR: 7.83, <i>P</i> = 0.03).</p><p><b>Conclusion:</b> Although posterior single MZCs were clinically acceptable, non-vital pulpal condition could be a potential risk factor for failures in the abutment and antagonist teeth of MZCs.</p>

DOI： 10.2334/josnusd.22-0221

Web of Science

Scopus

PubMed

CiNii Research

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