A survey was carried out to determine the relation between eating ability and physical activities/nutritional condition in institutionalised elderly persons with a mean age of 80.9yr. Assessment of eating ability was made using the test jelly method. Physical activities assessed were grip strength, equilibrium, and activities of daily living (ADL).
Those that kept their eating ability also retained physical activities, and vice versa. Therefore, eating ability is related to physical activities. However, nutritional condition was not affected by eating ability bacause of the good nutritional managemement in this nursing home.

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フッ化ナトリウム (NaF) やモノフルオロリン酸ナトリウムなどのフッ化物のう蝕抑制効果に関する研究は, 20世紀初期の斑状歯の研究に始まって以来, 枚挙に暇がない。我々は, これらの従来のフッ化物よりもさらに優れたう蝕予防効果を有する物質を検索する目的で, NaFとの併用によりその効果を増強させる作用を有する物質について, 合成ハイドロキシアパタイト (合成HA) および牛歯エナメル質を用いて検討した。まず, NaF (0.2%) と16種の物質をそれぞれ等モルずつ混合したフッ化物溶液 (pH4.5) を作製し, 合成HAに作用させた結果, NaFに塩酸ピリドキシン (VB₆・HCl) 他数種の物質を併用したフッ化物溶液にて処理した合成HAでは, 顕著なフッ素 (F) 取り込み量の増加と粉末の耐酸性の向上が認められ, NaFの効果の増強作用が認められた。それらの組合せのうち, 我々はNaFとVB₆・HClの組合せを選択し, より詳細に検討した結果, VB₆・HClの濃度を対NaFモル比0～3まで変化させると, NaF: VB₆・HClのモル比が1: 1 (NaF 0.2%に対してVB₆・HCl 0.97%) まではVB₆・HClの濃度にほぼ比例して作用が増加した。また, NaFとVB₆・HClを併用したフッ化物溶液は, pHが小さい (minimum pH4.5) ほどF取り込みと耐酸性の向上が認められたが, pHが大きくなるに従ってNaF単独との差は小さくなり, pH7.0において併用の効果はまったく認められなくなった。NaFとVB₆・HClの併用溶液 (pH4.5) を作用させた合成HAをX線回折分析した結果, NaF単独溶液 (pH4.5) を作用させた場合に比べて, 合成HAの結晶性が明らかに向上しており, またフルオロアパタイトの生成がより顕著に認められた。一方, フッ化カルシウムの生成は検出されなかった。次に, 牛歯エナメル質より作製したエナメルブロックにNaFとVB₆・HClの併用溶液 (pH4.5) を作用させ, 酸生検法にて検討した。その結果, エナメル質最表層部 (脱灰1回目) のF濃度ではNaF単独溶液を作用させたエナメル質と有意差は認められなかったが, 脱灰2回目以降の深層では, 有意に高いF濃度を示した。以上のin vitroにおける検討結果より, NaFとVB₆・HClの組合せは, う蝕予防に関して非常に有用であると考えられた。

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An attempt was made to measure the volume of saliva in the mouths of 121 young subjects by the modified simple method of J.A. Wheatherell (1992).
Immediately after swallowing, a small volume of fluoride solution (F: 100ppm) was placed in the mouth. The subjects mixed this with their saliva and expectoated. The fluoride concetration of the expectorate was measured and the volume of saliva in the mouth at the time of fluoride administration was calculated from the fluoride dilution. The results are as follows;
The nonstimulated volume was 2.44 (mean) ±0.14 (S.E.) ml. The stimulated volume was 3.96 (mean) ±0.14 (S.E.) ml. Significant difference was observed between the unstimulated and the stimulated volumes (p<0.01). There was a significant positive linear correlation between the stimulated and unstimulated volumes (r=0.59; p<0.01).

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感染の成立にはまず菌の標的組織への定着が重要な要因である。本研究では, 成人性歯周炎の原因菌と考えられているPorphyromonas gingivalis (P. gingivalis) のヒト歯肉線維芽細胞 (HGF) 及びコラーゲンに対する接着性をin vitroで調べた。
用いた6株のP. gingivalisのなかでは, 381株がHGF及びコラーゲンに対して最も高い接着率を示した。P. gingivalis 381の接着性は菌体を加熱処理 (60℃, 15min) することにより殆ど消失した。また, 菌体をペプシンで処理するとHGFに対する接着率の著しい低下がみられ, このとき菌体表層の被膜様構造物及びfimbriaeが消失していることが, 電子顕微鏡像で確認された。従って, 本菌の接着には易熱性の物質が関与しており, 特にHGFに特異的な接着因子が菌体表層の被膜様構造物あるいはfimbriae上に存在することが推察された。
菌体とHGF及びコラーゲンとの接着に伴う形態学的変化を調べるために, HGFをP. gingivalis 381と共に2時間培養すると, 菌はHGFの細胞膜と緊密な接着帯を形成し, 接着部位ではHGFの細胞膜の陥入や多くの細胞質内小胞が観察された。さらに長時間 (22時間) 培養を続けると, 菌はHGFモノレイヤーを通過し, その下のコラーゲンゲル内に到達しており, HGFの細胞質内では数個の大きな空胞が認められた。またP. gingivalis 381の培養上清から分離精製した外膜小胞標品は, コラーゲン線維に高い親和性を示し, 同時にコラーゲン分解能も示した。
以上の所見より, 成人性歯周炎においてP. gingivalisは, 歯周結合組織の主要な構成要素であるHGFやコラーゲンに結合して, 様々な病的変化をもたらし歯周組織を破壊していく可能性が示唆された。

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Epidemiological analyses using the Ramfjord Periodontal Disease Index (PDI), Calculus Index (CI) and Plaque Index (PI) were performed on 881 mental retardates possessing one or more subject teeth at 15-48 years of age. They were among a group of 1107 subjects who were admitted to the Niigata Prefectural Institute of Total Training for the Mentally Retarded, Colony Niigata Shiroiwa-no-Sato, during the years 1971-1988.
(1) The PDI was 1.14-1.87 for the 15-19-year-olds in the periods 1971-1975, 1976-1981 and 1982-1988, and 3.88 and 3.09 for 45-54-year-old males and females in 1982-1988; it increased with the age of the newcomers of all 3 periods with regard to the time of admission. The CI also gradually increased with age, to 1.25 and 1.16 in 45-54-year-old males and females in 1982-1988, from 0.27-0.73 in 15-19-year-olds in the same 3 periods. The PI tended to increase very gradually with age, within the range of 1.19-1.83 both for males and females of the same age group and admission period settings.
(2) A decrease of PDI, CI and PI was found between males admitted in the years 1971-1975 and those admitted during 1982-1988. Though there was a difference in the 3 indices by gender and by intelligence quotient in 1971-1975, no difference was recognized in 1976-1981 and 1982-1988. Institutional and non-institutional comparison revealed no difference as far as a newcomer's history before the admission to the Colony was concerned.

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The purpose of this study was to examine plaque formation and dental caries occurrence in hamsters and rats fed a cariogenic diet containing confectioners' sugar and white sugar.
Eighty-one golden hamsters were divided into two groups: Group I fed on Diet-2000 containing confectioners' sugar and Group II fed on Diet-2000 containing white sugar. In hamsters of Group I there was more plaque accumulation and more destruction of molars by caries than in Group II.
One hundred sixty-five rats were divided into four groups: Group I fed on Diet-2000 containing confectioners' sugar; Group II fed on Diet-2000 containing white sugar; Group III fed on 6PMV containing confectioners' sugar; and Group IV fed on 6PMV containing white sugar. In Groups I and III there was more plaque accumulation than in Groups II and IV.
For dental caries in rats the outer third fissure and the inner third fissure were assessed. Rats of Groups I and II showed higher caries scores than those of Groups III and IV in both fissures. Rats of Group I had higher caries scores than those of Group II in the outer third fissure but the differences were not significant. There was no difference in the caries scores in the inner third fissure between Groups I and II.
In rats of Group III the caries scores were higher than in rats of Group IV in both fissures.

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我々は, 従来のフッ化物よりもさらに優れたう蝕予防効果を有する物質を検索する目的で, フッ化ナトリウム (NaF) との併用によりその効果を増強させる作用を有する物質について検討した。その結果, 酸性条件下 (pH4.5) でNaFと塩酸ピリドキシン (VB₆・HCl) とを併用すると, 合成ハイドロキシアパタイト粉末 (synthetic HA) へのフッ素取り込み, 耐酸性, 結晶性が向上し, 牛歯エナメル質へのフッ素取り込みも向上することを明らかにした。そこで次に, NaFとVB₆・HClの併用によるう蝕抑制効果をラット実験う蝕系において検討した。う蝕原性Streptococcus sobrinus 6715株を定着させたラットをう蝕誘発性飼料Diet #2000で63日間飼育した。実験期間中を通じてNaF+VB₆・HCl水溶液, NaF水溶液, 生理食塩液を1日1回, 週5回ラットの上下顎臼歯部に塗布し, プラークスコア, カリエススコア, う蝕裂溝数, 臼歯へのフッ素の取り込みについて比較検討した。
結果の概要は次の通りである。
1) NaF+VB₆・HCl溶液塗布群およびNaF溶液塗布群はコントロール群 (生理食塩液塗布) に比べプラークスコアは有意に低かった。
2) NaF+VB₆・HCl溶液塗布群およびNaF溶液塗布群はコントロール群に比べカリエススコアは有意に低かった。
3) NaF+VB₆・HCl溶液塗布群およびNaF溶液塗布群はコントロール群に比べう蝕裂溝数は有意に少なかった。さらに, NaF+VB₆. HCl溶液塗布群はNaF溶液塗布群に比べう蝕裂溝数は有意に少なかった。
4) NaF+VB₆・HCl溶液塗布群およびNaF溶液塗布群の臼歯歯冠部はコントロール群に比べ有意に高いフッ素濃度を示した。さらに, NaF+VB₆・HCl溶液塗布群の臼歯歯冠部はNaF溶液塗布群に比べ有意に高いフッ素濃度を示した。
以上のin vivoにおける検討結果より, NaFとVB₆・HClの組み合わせはう蝕予防に対して非常に有用であると考えられた。

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The purpose of this study was to examine the acid resistance of remineralized enamel after laser irradiation that could not be defined by microradiograph (MR). Forty-five human premolar enamel slabs were prepared for this study. The enamel slabs were ground down to about 400μm. Forty enamel slabs were divided into four groups, i, e., sound, demineralized (Dem), remineralized after laser irradiation (Lased) and remineralized (Rem) groups. The Other five slabs were used for MR. The Dem, Lased, and Rem groups were exposed to 0.1M lactic acid buffer (3.0mM Ca, 1.8mM P, 1.0% carboxymethylecllulose, pH 4.5, 37°C) for 12hours. The Lased group was irradiated with a Q switch Nd-YAG laser with 50J/cm² of total energy density. The Lased and Rem. groups were exposed to remineralizing solution (3.0mM Ca, 1.8m MP, 1.0% carboxymethylcelluse, 150mM NaCl, 3.0ppm F, pH 7.0, 37°C) for 10 days. The surface of the slabs for MR was divided into four, for all treatment. All slabs were exposed to 0.1M lactic acid solution (pH 4.5, 37°C, 5ml) for 12 hours. The dissolved calcium in the lactic acid solution was measured, and the disolved calcium per 10mm² was evaluated. The slabs for MR were sectioned their MRs were evaluated using the calculated mineral content. The Dissolved calcium of the Lased and Rem groups was significantly lower than in the Sound and Dem groups. Acid resistance for remineralization could be defined. However, there was no statistically significant difference between the lased and Rem group. The results were the same as the results of the MR evauation. The Lesions of the lased remineralized area were deeper than in unlased the remineralized area, but there was not statistic difference between these areas. It was thought that permeability of the enamel was increased by laser irradiation. However, the lesion depth was not related to the amount of dissolved calcium. It was thought that dissssolved calcium from the deep layer of the remineralized enamel after laser irradiation was not diffused easily because of reaction to each layer.

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The effects of the application of various fluorides on the remineralization and fluoride (F) incorporation of root surfaces with or without cementum were evaluated in vitro. Clinincally sound proximal root surfaces of premolars extracted from patients aged 9-14 years were used for experiments and divided into two categories: (1) a dentin group, where cementum was removed by abrasion, and (2) a cementum group, where the cementum was preserved. In both groups, two types of specimens were prepared: (1) sandwich specimens, for assessing mineral volume by a single section technique, and (2) block specimens, for the determination of F incorporation by biopsy.
After demineralization by immersion in 0.01M (for sandwiches, pH 5.1, 6mM Ca, 3.6mM P, 1% CMC, 37°C) or 0.1M (for blocks, pH 5.0, 3mM Ca, 1.8mM P, 1% CMC, 37°C) lactate buffer, specimens were treated with one of the following four fluorides during 14-day immersion in remineralizing solution (Rem solution: 3mM Ca, 1.8mM P, 150mM NaCl, 3ppm F, 1% CMC, pH 7.0, 37°C). The fluorides were APF solution (APF), APF gel (FG), F rinse solution (FR) and MFP dentifrice (FD). Control group (immersion in 3ppm F containing Rem solution only) and negative control group (immersion in F free Rem solution only) were also studied. APF and FG were applied for 4 minutes once just before remineralization, and FR and FD were applied for 1 minute every 24-hour remineralizing period. Sandwinch specimens were microradiographed before and after remineralization. The film density of lesions was convereted to aluminum thickness (Ta; μm) and the mineral volume of lesion (Ma; μm·μm) was defined as integrated values of Ta profiles. F content was determined by acid etch biopsy with 0.5M HClO₄.
The Results were as follows:
Remineralization of early root caries lesion in vitro was
(1) promoted by the application of fluorides, and accelerated more by the treatment with APF or FG than the treatment with FR or FD, and
(2) not significantly different between the cementum and the dentin groups.
(3) Cementum had no inhibitory effects on the remineralization of root surfaces.
F incorporation in remineralized root surfaces were
(1) different between various F treatments, and specimens treated with APF or FG showed significantly higher F uptake level, and
(2) greater in the cementum group than that in the dentin group and this fact indicates that cementum would be important tissue for demineralization and remineralization of root sufaces as a source of F ion supply.
According to the analysis of correlation coefficient, the degree of remineralization was obviously dependent on F incorporation in lesion surfaces.
In conclusion, these findings suggested that F application was effective for the remineralization of root surfaces and F incorporation into root surfaces did not depend on cementum. Thus, professional or self application of fluorides was considered to be higly suitable for the prevention of root caries in the elderly.

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感染に対する抵抗力が糖尿病患者において一般に低下していることは, よく知られている。しかしながら, 口腔の二大疾患の一つである齲蝕と糖尿病との関連性については, いまだ明らかでない。そこで本研究では, 3週齢雄性golden hamsterにstreptozotocinで誘発した糖尿病 (Diabetes mellitus) を発症させ, 実験的糖尿病モデルを作成し, この動物を用いて齲蝕の発症状況を検索した。さらにこの動物からpilocarpine刺激唾液を採取し, 唾液の分泌量, pH, lysozymeおよびチオシアン酸化型peroxidase活性を調べた。また糖尿病発症時における唾液中および血液中のglucose並びにlactate量の変動について観察し, 併せて歯牙エナメル質の酸脱灰に対する抵抗性についても検索した。
その結果, SZ投与量を65mg/kg体重とし, 腹腔内に一回投与することにより, 生存率が高く, かつ糖尿病が明確に発症する実験モデルを作成することができた。齲蝕発症実験には, 高蔗糖含有の齲蝕誘発飼料の投与と, Streptococcus sobrinus K1-R株を接種した。その結果, 糖尿病動物の齲蝕スコアーはSZ非投与動物のそれに比して著しく高く, 齲蝕の重症化が認められた。しかしながら, 糖尿病動物におけるこの齲蝕の重症化は, SZ投与後2日から実験期間中に亘りlente insulinを投与することにより有意に抑制された。また糖尿病動物の唾液の分泌量およびpHに関しては, SZ非投与動物との間に有意差は認められなかった。なお唾液抗菌因子であるlysozymeおよびチオシアン酸化型peroxidase活性は, 糖尿病動物において有意に低下したが, 唾液中のglucoseおよびlactate量については, 著明な増加が認められた。エナメル質の酸脱灰に対する抵抗性に関しては, 糖尿病動物とSZ非投与動物の間に統計学的有意差は示されなかった。

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Streptococcus mutansのH⁺ (F₁F₀)-ATPaseが細胞内のpH調節を担うか否かが明らかではない。そこで, S. mutans GS-5を, 異なる培地pHあるいはイオノフォア (グラミシジンD) 存在下で培養した時, S. mutans GS-5のF₁F₀-ATPase活性がどのように変化するかを明らかにすることにより, 同酵素のもつS. mutans細胞内pH調節・補償機構の意義を考察することを試みた。
細胞壁溶解酵素 (Mutanolysin) により調製したS. mutans GS-5の膜結合性ATPaseの主体が, DCCDおよびN_aN₃で選択的に阻害されるF₁F₀-ATPaseであることを確かめたのち, 培養初期pHの変化 (pH 5.5-7.5), およびグラミシジンD (2μg/ml) 存否の条件下でS. mutans GS-5を培養し, 同菌の増殖およびF₁F₀-ATPase活性の異同を検討した。なおEnterococcus hirae ATCC 9790を比較の為の対照とした。一方, 細胞内pHとF₁F₀-ATPaseの関連性を, S. mutans GS-5の対数増殖期初期 (培地pH 7.0) にグラミシジンDを添加・培養後, 同菌の細胞内pHおよびATPase活性を測定することにより調べた。
培養初期pHの低下が, S. mutans GS-5およびE. hiraeのF₁F₀-ATPase活性を2-3倍上昇させた。グラミシジンD存在下の培養で, E. hiraeのF₁F₀-ATPase活性の上昇 (1.8-3倍) をみたが, S. mutans GS-5では長時間 (8-20時間) の遅滞期 (lag phase) が発現するのみで, F₁F₀-ATPase活性の上昇は認められなかった。この遅滞期前後の細胞内pHとF₁F₀-ATPaseの関連性を, 対数増殖期初期 (培地pH 7.0) にグラミシジンDを添加した実験により検討した。その結果, グラミシジンDの添加によりS. mutansの細胞内pHが7.5から6.9に低下し, 同菌の増殖が約10時間停止した。一方, 再増殖後の細胞内pHは, 7.3に回復しており, この間F₁F₀-ATPase活性変化およびグラミシジンDの失活は認められなかった。
これらの成績から, S. mutans GS-5のF₁F₀-ATPaseは, E. hiraeとは異なりS. mutans GS-5の細胞内pH調節機構に関与する度合いが少ないのではないかと考えられた。

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The purpose of this study was to extract some factors from a 1.5-year-old dental health examination which affect the caries prevalence at 3 years of age in order to make dental health guidance more effective.
The subjects analyzed were 875 children who received a 3-year-old dental health examination at a certain public health center in Hiroshima City from April 1990 to March 1991. The dietary habits, tooth brushing habits and oral conditions at 1.5 years of age were surveyed and their relationships with dental health conditions at 3 years of age were examined.
The results were as follows.
1) The factors associated with caries prevalence in 3-year-olds were ‘Caries prevalence at 1.5 years of age’, ‘Order of birth’, ‘Regularity of snacks’, ‘Presently bottle feeding’, ‘Brushing by mother’ and ‘Drinking sweet beverages’.
2) The importance of giving dental health guidance to mothers before a 1.5-year-old dental health examination is discussed.

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The purpose of this study was to analyze the relation between oral conditions and caries activity tests (CAT) as a means of comprehending the oral conditions of outpatients.
We analyzed the data obtained from 116 patients (aged 11 to 71, who were examined by dental students and recalled from April, 1987 to March, 1988). The indices for multivariate analysis were age, sex, caries severity index (CSI), Ramfjord's periodontal disease index (PDI), missing teeth (MT), bleeding index (BI), debris index (DI), salivary flow rate (SFR), buffering capacity test (BCT), pH of saliva (SPH), lactobacillus colony count (LCC), and cariostat (CAR). The multivariate analysis was done with a program called ANALYST, which was developed for statistical analysis at the Educational Center for Information Processing, Kyushu University. The method of analysis was Kendall's ranking correlation.
A statistical significant correlation was shown between CSI and SFR, LCC, and CAR. The measurement of SFR was easy and effective for CAT in a general clinical examination. In addition, there was significant correlation between PDI and LCC and CAR. The examinations of LCC and CAR were useful as a means of comprehending oral conditions. Moreover, CSI had a significantly higher correlation to MT than to PDI. It was seen that the reason for missing teeth was still dental caries and then conditions that follow caries, such as pulpitis, apical foci, and so on.

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The interaction of sodium monofluorophosphate (MFP) with artificial plaque and the underlying enamel was investigated. Streptococcus mutans Ingbritt (serotype c) and Streptococcus sobrinus 6715 (serotype g) cells were grown on windowed human enamel blocks to form artificial plaque. Plaque-covered enamel and clean enamel samples were incubated anaerobically with 5 ppm (as F^-) of MFP or sodium fluoride (NaF) for 48 hr.
Fluoride concentration in the enamel was significantly increased in plaque-covered enamel in the presence of both MFP and NaF. More than 60% of the acquired fluoride from MFP in the enamel at a depth of 5μm was KOH-soluble fluoride. More fluoride was acquired from MFP in the enamel covered with the plaque of S. sobrinus 6715 than in that covered with the plaque of S. mutans Ingbritt.
Significant degradation of MFP was detected during the growth of S. sobrinus 6715 concomitant with the fall of broth pH around 5.4 within 48 hr incubation. Optimum MFP hydrolysis by S. sobrinus 6715 and S. mutans Ingbritt occurred at approximately pH 5.0, but no detectable MFP hydrolysis was found at alkaline pH. MFP hydrolyzing activity (MFPase) was sharply inhibited by low F^- concentration and was not activated by Mg²⁺. These data indicated that acid phosphatase, and not alkaline phosphatase, is responsible for MFP hydrolysis in mutans streptococci.

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