Reported here is a patient with a mucous retention cyst in the sinus for which maxillary sinus floor elevation surgery was performed after aspiration of the cyst interfluid. A 49-year-old man had requested implant treatment and was referred to our department by his dentist. Results of our initial examination, showed that the upper jaw was edentulous, while no abnormal findings were noted in the alveolar mucosa. X-ray findings revealed a retention cyst in the right maxillary sinus as well as significant vertical bone resorption in the bilateral maxillary molar alveolar bone. Under a diagnosis of abnormal absorption of the maxillary ridge, bilateral maxillary sinus floor elevation was performed under general anesthesia at 7 months after the first visit. A bony window was formed on the right side, then mucus from the retention cyst was aspirated with a syringe (18G). After elevating the maxillary sinus mucosa, a mixed graft consisting of bone grafting material and blood was tightly packed into the raised sinus floor. The postoperative course was good and 3yeas and 4months have passed without any complications.

【Case Summary】 A 54-year-old female patient presented with a chief complaint of widening interdental spaces. The patient had generalized moderate periodontitis in the maxilla and mandible, and there was significant bone loss around the upper left incisor, and pathologic tooth migration (PTM) caused the interdental space and esthetic disturbance.【 Treatment plan and course of treatment】The patient requested orthodontic treatment, but we decided to perform basic periodontal treatment first and then reevaluate the overall condition of the dentitions and scrutinize the validity of the orthodontic treatment option. As a result, the patient's PTM was successfully corrected without orthodontic treatment, surgery, or prosthodontic treatment by thorough control of inflammation. 【Discussion】The proportion of PTM in patients with periodontitis is estimated to be about 33% to 55%, and many of them complain of esthetic problems. The cause of PTM is considered to be multifactorial, but inflammation and occlusal force are considered to be the major problems. In the present case, we did not resort to orthodontic or prosthodontic treatment, but provided SRP along with thorough OHI and eventually shifted to SPT. PTM is not localized to a single tooth, but occurs in relation to and as a result of conditions of the entire dentition. The improvement of PTM through periodontal treatment resulted not only in the closure of the void, but also in the restoration of continuity of the dentition and changes in occlusion.

In occlusal reconstruction, it is often the case that horizontal overlap of the anterior teeth is excessive in Angle II and insufficient in Angle III, which makes it difficult to obtain anterior guidance. Considering the occlusal function, it is important whether the anterior guidance mechanism works properly and allows disocclusion to the molars during lateral movement. Inadequate anterior guidance is likely to cause tooth wear and excessive load on the TMJ, and long-term stability of the dentition would be a bleak picture1) . In this study, we report a case of a Class II skeletal patient with generalized severe chronic periodontitis, in which strategic tooth extraction and prosthodontic treatment were combined to achieve sound anterior guidance.

In order to match the color tone of the prosthesis to the natural tooth, it is necessary not only to mimic the tooth structure, but also to match the three attributes of color: value, chroma, and hue. Light is absorbed, reflected, scattered, or transmitted when it enters an object, and humans perceive the reflected light as color, in fact as a specific color by the interrelation of value, chroma, and hue1) . Value, in particular, requires attention because it can be easily identified visually. It is extremely difficult to read these complex color tones from the shade data, and the finishing quality heavily relies on the experience and skill of the fabricator. In recent years, however, universal shade composite resins have been introduced to solve these problems and have been attracting attention. Although the dental composite resins are originally intended for direct method, the results of this study show that the same color reproducibility as that of conventional CR inlays can be achieved using the indirect method.

In cases of root fracture or other problems adjacent to implants that lead to tooth extraction, it is often difficult to restore oral function afterward. Since the connection between implants and natural teeth is not recommended, the treatment options are generally limited to placement of additional implants, refabrication of a superstructure, or a partial denture. The 68-year-old male patient with supragingival fracture underwent restorative treatment after orthodontic extrusion and extraction of #13-#12, transplantation of #12 into the extraction socket of #13, and transplantation and orthodontic attachment of a portion of the root of #13 into the extraction socket of #12.

キーワード：歯科恐怖症，ナラティブベイスド・メディスン，歯周基本治療 A 44-year-old female patient with dental phobia was treated with a narrative-based approach and was successfully transitioned from periodontal treatment to stable SPT. The patient had been avoiding dental visits for many years due to a fear of dental treatment, despite her anterior teeth being on the verge of exfoliation. Based on the patient's complaints, we concluded that she had a strong inferiority complex about her teeth and had been avoiding dental visits even though she was aware of the need for dental treatment. At the initial visit, the patient was extremely nervous and did not voluntarily speak out and seemed to have difficulty in speaking due to embarrassment. Over the course of six sessions of basic periodontal therapy, the patient gradually became less tense, and her eye contact and spontaneous conversation increased while some signs of comfortableness were seen in changes in speaking speed and voice volume. This was accompanied by a marked improvement in plaque control and the ability to transition to periodontal surgery. The author was taught the importance of gaining the patient's trust through a respectful attitude, as well as the importance of narrative-based approach and nonverbal communication.

We report a case of an elderly patient who came to our department with a chief complaint of denture nonconformity, and we obtained good results by fabricating a denture with consideration for oral function. The patient was an 81-year-old woman. She came to our hospital with a complaint of denture nonconformity and difficulty in food intake. In 2015, a maxillary partial denture and a mandibular full denture were fabricated, and she had been using them without any problem for some time, but over time the dentures became unfit and she started experiencing difficulty in eating and eventually visited our department. At the time of her initial visit, the mandibular full-base denture was unstable and not well supported. Oral examination revealed poor oral hygiene, decreased tonguelip motility, decreased masticatory force, and decreased tongue pressure. Based on the above, we diagnosed her as hypofunction with mandibular denture incompatibility and performed oral function management including fabrication of a full mandibular denture. The mandibular denture was considered to be unstable due to the pressure from the lower lip, and the mandibular anterior teeth were aligned in consideration of the neutral zone to improve the stability of the denture. In addition, the outline of the denture base was set so that there would be no space between the tongue and the lingual mucosa of the mandibular denture. After the new dentures were fitted, the patient underwent a reevaluation of the oral function examination, and all the examination values improved.