慢性関節リウマチ (以下RA) は, 関節周囲組織さらに皮下組織, 心血管, 肺, 脾, 骨格筋などに非化膿性の慢性関節炎を主症状とする広く全身の結合組織を侵す自己免疫応答が関与した膠原病のひとつである.RAは特に手や足の関節あるいは頸部などを中心に運動機能障害と強い痛みが出現することで良く知られているが, 顎関節に関しては口腔内のさまざまな要素が複雑に絡み合うため, この分野の研究は決して多くはない.著者らはリウマチの専門診療科を持つ沢渡温泉病院におけるリウマチ患者の歯科治療において, リウマチが原因していると思われる顎関節機能障害を持った患者に多く遭遇した.そこで, RAと顎関節機能障害の関係, あるいは歯科的見地に立った両者の診断を, 特に原因の明確であった症例をとおし報告し, 加え, 現在のRA患者の顎関節機能障害に対する治療方法の現状を考察したい.

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It is important to consider occlusal effect upon the other parts of the human body. It should be emphasized that harmony of stomatognathic system and the entire body with a single tooth is not overlooked.
In this article, typical case suffered from uvra-tongue malposture syndrome (U.T.M.S.) was reported. In order to treat such syndrome, neurodontical myodontics therapy was applied. Providing optimum occlusion, patient was relieved from the symptoms and U.T.M.S. was cured.
It was assured that edentulous patients with U.T.M.S. may be treated by neurodontical myodontics therapy, with establishing correct occlusion.

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The higher the margin of the restoration is above the gingival margin, the better for the periodontal tissues. However, when such factors as retention and contour are taken into consideration, it cannot always be said that supragingival margins are best. In particular, since the axis of the mandibular molars is often inclined to the lingual, undercuts tend to occur at the margin in the lingual cervical region when it is supragingival, thus making brushing difficult. Consequently, unless there is severe gingival recession, the lingual margins in the mandibular molar region are often placed near the gingival margin.
Subgingival mrgins are unavoidable in the anterior teeth where esthetic demands are very important. However, in these cases probing should be carried out and even though the margin is subgingival, care must be taken to place it as far as possible from the bottom of the gingival sulcus. Furthermore, whenever possible the margin should be placed in the enamel when treating teeth where the root has been exposed, since a gap will often appear between the margin and the root during maintenance in case where the margin has been placed on the root surface.

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