Japan is facing with the world's highest rate of growth in the percentage of aged citizens.
Questists are now required to provide dental care with sufficient emphasis on the QOL for the patients with edentulous jaws.
In order to deliver highly predictable treatment, dentists must adhere to the principles of prosthetic dentistry, i.e., conservation of remaining structures, improvement of functional, recovery rates, and restoration of aesthetic characteristics.

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Nowadays it is popular to use the implant in partially edentulous patients. The ease with which prognosis can be made and the high level of patient satisfaction are commonly recognized. Often, however, the implant cannot be used under certain conditions. On the other hand, to choose suitable cases and to keep basic items of RPD (Removable Partial Denture) from which both clients and doctors are likely to refrain, also make the prognosis more reliable. This paper presents several cases of curing by RPD carried under each condition.

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[in Japanese]

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To treat advanced furcation area lesions (degrees II and III ) ^{1, 2, 3, 4, 5)} , excision therapy such as root amputation and hemisection, and regenerative therapy such as GTR, are applied based on the degree of progression. However, in planning comprehensive treatment, it is necessary to determine the treatment methods of furcation area lesions considering the relationship with the adjacent teeth and the opposing teeth. In particular, when root amputation or hemisection was performed, prosthetic treatment becomes necessary, and it is important to obtain good oral hygiene habits and appropriate occlusion.
Although it has been proposed that implantation should be performed extracting the teeth with low predictability, it is impossible to treat all cases only by implantation. Therefore, to treat furcation area lesions, root amputation and hemisection is considered necessary to preserve the teeth as much as possible. In this study, root resection (trisection) was performed to treat maxillary furcation area lesions, and hemisection was performed for mandibular furcation area lesions, and prosthetic treatment was performed in the comprehensive dentistry.

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It seems that the most frequent complaint of patients is “toothache” in our dairy treatments.
In the majority of the patients, we can diagnose such disease as “pulpitis”, “periodontitis”, “trauma genic inflammation”, and so on. However some of the patients complain of their “toothache” without having any problems.
We took a new approach based on “occlusal examination” to such patients, and we gained good results.

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[in Japanese]

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Imbalanced muscles related to masticatory movement have great influence on mandibular position and its movement. Well-balanced mandibular position is closely related to smooth mandibular movement. Occlusal splint gives relaxation for the tension of muscles and protects temporomandibular joint, and it makes the mandibular position stable. This study examined the influence of occlusal splint on mandibular movement using gothic arch tracing device.
We concluded that occlusal splint gave a little influence on gothic arch.

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There are complicated cases in which mobility is noted in multiple teeth caused by the comprehensive progress of destruction of dental support tissues due to periodontal diseases and secondary biting injuries; in addition, a pathologic deviation of the lower jaw and an abnormal displacement of the positions of teeth are noted. To those cases, it is essential to design a therapeutic plan based on the comprehensive diagnoses.In order to achieve this, it is most important to use diagnosis waxing up and provisional restoration.

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The stability of lower jaw grade is influenced by dental occlusion contact and the position relation of condail of a jaw joint, the stable lower jaw grade is according to the state of the tooth which serves as occlusion support is especially decided.
Therefore, when support of occlusion is once lacked, it is complicated, for stabling the lower jaw joint, in addition a functional disorder is further produced at a jaw joint, and the case where various obstacles and condition in whole body are caused the stability of lower jaw grade.
The case is accompanied by sift of lower jaw grade pass, the lower jaw is guided to main grade comparative simply, and the sprint is use of the short of time, which can reproduce desirable lower jaw grade, is considered this time.

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With regard to implant treatment patients, to whom HA-coated implants were clinically applied, the clinical course of implant bodies was observed, and periodontal parameters of the remaining teeth in the oral cavity, such as plaque index, probing values, presence of gingival bleeding during probing, and amounts of alveolar hone loss at the time of implantation, were investigated.
Long-term prognostic bone resorption around HA-coated implant bodies, and dislodgment of HA-coated implant bodies were more frequently observed in cases with larger amounts of alveolar bone loss in the remaining tooth area and larger number of inflammatory periodontal pockets in the same oral cavity at the first examination, although the periodontal pocket values and inflammation improved by the periodontal treatment performed before implant treatment.
These results suggested the influence of previous presence of periodontal disease in the remaining tooth area on implantitis around implant bodies in the same oral cavity, and the possibility that previous presence of periodontal disease could be used as a clinical parameter of preoperative diagnosis before starting implant treatment, to which HA-coated implants were applied.

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It is well known fact that osseointegrated dental implants carry out the new situation for resent prosthetic restoration. However, it has had various problems when clinicians treated implant prosthesis during not only chewing movement but also esthetic viewpoint with severely alveolar ridge resorption.
Therefore, in the severely atrophic jaw which caused by severe periodontal disease, prosthetic rehabilitation using dental implant has been very difficult.
In the cases of thease problems. the reconstruction with bone grafting, distraction osteogenesis, GBR (Guided Bone regeneration) and the substructure (*) may resolve this problems. This is a case of Severely atrophic edentulous maxilla was reconstructed with substructure (*) which was made by tooth crown and gingiva individually.
(*) substructure
new ways of designing suprastructures for fixed implant-supported prosthesis.⁴⁾
Reconstruction with implementing suprastructure that has separating crown parts from gingival parts.

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[in Japanese]

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A patient was 19-year 5-month-old female who had the chief complaint of crowding on maxilla and mandible and right side posterior buccal cross bite, had not complaint as regards mandibular asymmetry. After the close examination, vertical discrepancy on the left side condyle in CO-ICP sliding was confirmed. Forward discrepancy was added in this sliding while the orthodontic treatment was performing without much changing of the right side condylar position, and more, the deformity of the left side condyle was advanced, hence the surgical orthodontic treatment was necessary to achieve the morphological and functional treatment goal for her was obvious. The patient was fully informed about surgical orthodontic treatment and she gave her informed consent to the treatment smoothly by the explanation using the articulator and CPI data, nevertheless her chief complaint was merely the crowding on the maxilla and mandible, and the right side posterior buccal cross bite. The deformity of the condyle was not advance after the surgical orthodontic treatment. It was suggested that using the articulator and CPI data as one of the examinations was also useful to inform the patient the problem except the chief complaint in some cases resulting in giving the patient the higher quality of the treatment. We will apply the articulator positively to gain more informations from the patient and 'informed consent' in the orthodontic and the surgical orthodontic cases.

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