閉塞性睡眠時無呼吸は, 様々な診療科が関与すべき全身性疾患である. 歯科医師は, 病態生理解明, 顎顔面形態解析による原因検索, 口腔内装置や顎顔面手術, 歯科矯正による治療など, すでに重要な役割を果たしている. 今後, 歯科的, 歯科矯正的なアプローチによりこの疾患の予防まで視野に入れた研究の発展が期待される.

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Globalization in dental education is an important issue in Japan. However, implementing strategies for globalization related to aspects such as infrastructure, educational goals and content, educational methodologies, and standards is not easy. The dental training programmes at the Faculty of Dentistry at The University of Hong Kong can offer some insight into the process. While The University of Hong Kong is world-renowned and has embraced globalization, it is located in Asia, where English is not the native language. The latter reflects the same situation as in Japan, but the Hong Kong and Japanese dental schools differ considerably in the medium of education, teaching styles, undergraduate curriculum, postgraduate education system, character of the students, and duties of the academic staff. Dental education at The University of Hong Kong may thus provide a role model for the planning and integration of globalization within the tertiary dental education system in Japan.

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過去10年, 免疫学では自然免疫系分野における進展が目覚しい. 自然免疫はマクロファージや好中球, 樹状細胞などの貪食系細胞が主役の免疫細胞集団である. 自然免疫細胞は炎症応答を引き起こすことによってもう一つの免疫系である獲得免疫系の活性化を促す. これら二つの免疫系の緊密な相互作用によって我々の体は病原性微生物の攻撃から保護されている. この時, マクロファージ活性化のオン・オフは厳密にコントロールされる必要がある. 前半では, 転写因子レベルや受容体レベルなど様々な仕組みの制御メカニズムについて概説する. また, 自然免疫には体の中のゴミ掃除など感染防御以外にも重要な役割を有しており, 通常とは異なる分化誘導の存在が議論されているが, 詳細なメカニズムはまだ不明である. 後半では今後免疫研究の中心課題となるオルタナティブマクロファージの分化機構について概説する.

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The osseointegration capacity of implant surfaces deteriorates over time. However, the treatment of titanium surfaces with ultraviolet (UV) light restores the original properties of the surface and causes considerable acceleration in the process of osseointegration. This study reviews two recent findings: the aging-like time-dependent biological degradation of titanium surfaces and the discovery of UV photofunctionalization as a solution to this phenomenon. This technology and the associated knowledge herald a new age of implant treatment and provide a novel concept of osseointegration in the science and therapeutics of implant dentistry. In addition, we expect to revolutionize clinical implant therapy through these new concepts.

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The A7 cell group in the dorsolateral pons provides noradrenergic innervation of the spinal cord. Activation of this descending pathway (the A7 descending system) produces bi-directional effects on nociceptive processing in the dorsal horn, which are facilitation mediated by α₁-adrenoceptor and inhibition via α₂-adrenoceptor. Peripheral nerve injury sometimes results in neuropathic pain. Hypersensitivity of dorsal horn neurons under neuropathic conditions is linked to activity in descending pathways from the brain. The aim of this study was to examine the involvement of the A7 descending system under neuropathic conditions. Experiments were performed on male Sprague-Dawley rats (n=35). Bilateral lesions of the A7 area were performed by microinjection of kainic acid. The tibial and common peroneal the nerves were sectioned produce neuropathic conditions (spared nerve injury, SNI). For estimating mechanical allodynia, mechanical hypoalgesia and cold allodynia, paw withdrawal threshold (PWT), paw withdrawal latency (PWL) and paw withdrawal frequency (PWF) were measured. PWTs significantly decreased following A7 lesions. After SNI, PWTs significantly decreased in A7-lesioned and sham-lesioned rats. However, no significant difference was observed between the decreased rates of PWTs in A7-lesioned and sham-lesioned rats. PWLs significantly increased in sham-lesioned rats compared with A7-lesioned group. PWFs significantly increased in the A7-lesioned and sham-lesioned rats. Intrathecal injection of prazosin, an α1-adrenoceptor antagonist, failed to change the PWT, PWL and PWF in non-A7-lesioned neuropathic rats. These results suggest that (1) the A7 descending inhibitory system has tonic activity under normal conditions, and (2) this system functions in a complex manner during the neuropathic pain state.

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後天的に開咬を生じる原因として, 臼歯の挺出や舌癖, 指しゃぶりなどが挙げられる. なかでも第二大臼歯萌出時期, 一過性にみられる開咬については咬合力によって改善される場合が一般的である. 本症例は初診時年齢15歳4か月の女性で「物が咬めない」ということを主訴に来院した. 患者は以前, 顎関節に疼痛およびクリック音を自覚し一般歯科にて13歳頃よりスプリント療法をうけている. スプリント療法後, 顎関節の症状は改善されたが物が噛み切れなくなったため矯正歯科を受診した. 口腔内所見は第二大臼歯以外すべての部位に咬合接触が認められず, いわゆるtotal open-biteであったが犬歯の咬頭には咬耗が認められた. 今回, 上顎両側第二大臼歯を抜去しマルチブラケット装置による治療を行ったところ, 短期間で良好な結果を得られたため報告する.

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The Invisalign system is widely used to treat mild to moderate tooth crowding. Recently, Invisalign appliances have been used in orthodontic patients with increasingly complex malocclusions. When using an Invisalign appliance to correct severe tooth crowding, root positions must be carefully controlled during extraction space closure. We report our treatment of a 34-year-old man who presented with a Class I relationship, a midline deviation, severe overjet, and severe tooth crowding in the maxillary and mandibular anterior regions. The treatment plan involved extraction of the maxillary and mandibular first premolars on both sides. We treated this patient with severe anterior tooth crowding using an Invisalign appliance combined with a fixed appliance with power arms and elastics. Treatment by Invisalign as an application of computational calculated result, especially in extraction cases, doctors should have professional skill and experience as an orthodontist.

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我々が, 日常の臨床にて向き合っている歯 (歯根膜・歯髄) から獲得出来る細胞は再生医療の分野においても注目され, 歯根膜や歯髄そのものを再生する研究や有効活用する研究は盛んに行われている. 歯 (歯根膜・歯髄) 由来細胞はheterogeneityな細胞集団でありそれらの能力について未だ解明されていない部分も多い. また, 歯の形態異常や重度の歯周疾患を特徴とする全身疾患のある患者において歯 (歯根膜・歯髄) を採取し, 細胞の特徴を把握することが出来れば, 歯周疾患や外傷, 矯正歯科治療などにおける歯周組織の再生および恒常性の維持に必要な間葉系幹細胞の遊走制御やrecruitmentの機構を解明することも期待できる. そこで本稿は, 歯 (歯根膜・歯髄) 由来細胞の分離培養方法について報告する.

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歯科恐怖症患者は恐怖心により歯科治療が困難となり, 十分な治療を受けられない, 治療を拒否されるなど, 治療を諦める例も少なくない. そのため口腔内の健康が損なわれ, 生活のQOLが低下し大きな問題となっている. 当講座では地域歯科医院や院内から紹介された多くの歯科恐怖症患者に対して個々に適した方法で治療を行い, 患者より満足を得ている. しかし, 歯科恐怖症患者の治療には多くの時間とマンパワーを要するのが現状であり問題点も多い. そこで本稿では, 歯科恐怖症患者の治療の実態と問題点についてその概要を説明する.

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