In order to identify the risk factors of tooth loss in relation to dental check-ups and maintenance visits, we conducted a comparative analysis of two cohorts, “maintenance” and “non-maintenance” with a total of 201 patients who visited a dental clinic in Kobe for the first time between the beginning of 1991 and the end of 1994 and visited at least once after January 1st 2010. The maintenance cohort is comprised of 155 patients who visited the clinic for maintenance at least six times in the last 6 years at intervals of visits being no longer than one year (data from the initial visit—age 46.7 ± 10.83; male 24.5% female 75.5%; DMFT 16.2 ± 6.36; remaining teeth 26.1 ± 3.0; moderate to severe periodontitis 44.7% ); all other 46 patients make up the non-maintenance cohort (data from the initial visit—age 41.9 ± 11.53; male 34.8% female 65.2%; DMFT 15.7 ± 6.12; moderate-severe periodontitis 25%). Setting an extraction event after re-examination as the objective variable, odds ratios are calculated via logistic regression analysis with age, sex and other relevant factors as predictor variables. In the maintenance cohort, the odds ratio 1.12 (95% confidence interval 1.037-1.201) against one (tooth) increase in DMFT. In the non-maintenance cohort, “female” and “remaining teeth” at the first visits are significant factors for lowering the risk of extraction while gingivitis is a strong risk factor.

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This research looks into the tooth extraction data (of 8880 extraction events) gathered from 12 member clinics of the Japan Health Care Dental Association (JHCDA) and made a comparative analysis against that of average dental clinics in Japan. The comparative data is taken from Report on the causes of extraction of permanent teeth (Feb 2005) by 8020 Promotion Foundation originally derived from the questionnaires on one week's extraction records collected from 2001 clinics (9,350 teeth extracted; 7,499 patients). The findings peculiar to the data of 12 JHCDA member clinics include: The ratio of extractions due to tooth fracture was higher at the member clinics than the control and there was a clear trend in the kind of teeth most extracted at the member sites, namely, the second molars and in particular mandibular second molars; There are different trends in the causes of extractions between anterior teeth and molars (multi-rooted); The cause of extractions of mandibular anterior teeth is mostly periodontitis; In the elderly group, extractions due to caries become more common than in the younger age groups.

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The purpose of this study is to scrutinize clinical applicability of disinfection approach in endodontic treatment devised by Hoshino et al. Despite its sound principle, clinical records and reports are scarce. As such, this report presents a summary of cases of disinfection endodontic treatment based on anaerobic culture system at the chair-side. This procedure aims to preserve as much carious dentin as possible, by locally applying to the infected sites antibiotic mixture of minocycline, metronidazole and ciprofloxacin and in order to enhance operability and osmosis, macrogol and propylene glycol are added to the antibiotic mixture (hence, 3Mix-MP® procedure). Due to prolongation of consultation time, application of this procedure was limited to advanced cases with at least one of the four conditions: 1) periapical lesion; 2) prolonged endodontic treatment; 3) acute symptoms; 4) difficult to perform root canal enlargement. For most of cases the antibiotic mixture proved effective against bacterial culture. When cultivatable bacteria was no longer detected in the sample of infected root canal content incubated at the chairside, the root canal was filled. With this approach out of 95 (including 30 unknown) cases only two resulted in adverse prognosis. This suggests clinical utility of the procedure, considering the selection criteria, though confirmation by further clinical researches is imperative.

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In my previous report is presented a summary of treatment results of 3Mix-MP procedure in conjunction with anaerobic culture systems at the chairside. The present study looks into some of the long-term cases included in my previous report (J Health Care Dent. 2012; 13: 20-23). The author started employing 3Mix-MP and the anaerobic culture system after seeing some patients returning with recurring endodontic problem. In a case of patient with recurring endodontic problem, infection was no longer detected 3 years after the disinfection treatment based on anaerobic culture system. There are still some challenges in clinical application of 3Mix-MP and anaerobic culture system such as prolongation of consultation time and inaccurate sampling of bacteria in root apex. Endodontic treatment based on anaerobic culture system is often well received by patients going through prolonged treatments, for it directly deals with the cause of endodontic problem.

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Patients with palmoplantar pustulosis who show neither reaction to metal allergy testing nor improvement after replacing the dental materials with the non-allergen are not uncommon. Refractory cutaneous manifestations of these patients are sometimes remedied after treatment of a periodontal abscess. This is thought to be due to dental focal infection. This paper presents two such cases.

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The purpose of this study was to identify possible challenges upon implementation of ICDAS into clinical procedures. The survey was conducted in collaboration with five regional dental associations. Of 1092 in the area, 117 clinics participated in the workshop voluntarily. On the one raising concerns for ICDAS integrated clinical procedure such as: prolongation of consultation time, stuff training, national insurance coverage, etc, many still showed an interest in ICDAS integration into caries management system at their clinics. On the other hand, answers from the participants suggested that there need considerable improvement and update in knowledge concerned with non-invasive caries management; some half participants underrated efficacy of toothbrushing twice a day with fluoride toothpaste. As such, introduction of ICDAS alone may not turn around caries management in Japan over night, but through the process of ICDAS implementation into caries management more questions may be raised about every day clinical practice, which hopefully in the end lead to more up-to-date dental care. *The summary of this research was presented in the poster presentation session at ORCA 59th ORCA Congress from June 27–30th 2012 in Cabo Frio, Brazil.

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This paper is to present a survey on ICDAS implementation status, conducted at the same time as ICDAS Awareness Survey and Challenges upon its Clinical Application (2011). The target of this survey is 160 dental clinics with purchase record of the panel, of which 35 clinics relied. 3 out of the 35 clinics replied, “Not planning to integrate ICDAS into caries management system”. The rest of them are either considering or already integrating the ICDAS into their caries management. All clinics have less than one year of clinical experience with ICDAS; this survey at an early stage of ICDAS implementation hopefully helps us identify merits and challenges at the clinical level as well as necessary preparations for ICDAS integrated system. As for merits of integration of ICDAS, more than a half of clinics answered “has become more attentive in inspecting tooth surfaces.” In the coding test, the Code 4 question had the lowest rate of correct answers. Between dentists and dental hygienists, the latter scored higher on average in every coding question. The recording format need be standardized to improve inter-clinical exchanges of information.

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Amongst the developed countries Japan was well behind in dissemination of fluoride toothpaste. On the one hand even now some 40 years after establishment of the consensus on effect of fluoride toothpaste, dental professionals in Japan often underrate the effect of fluoride toothpastes. On the other hand, many toothpastes for children, despite the known risks of fluorosis due to excessive intake of fluorides, lack a description of fluoride content (concentration) on their packages.

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It's been almost 13 years since the introduction of “Wistaria” (dental clinical database system) to the members of Japan Health Care Dental Association (JHCDA) in September 1999. This survey is based on replies to questionnaires from 79 clinics (32.6% of the 242 clinics with purchase record of Wistaria ver.3.0 and later). Among those who have not started using Wistaria in every day clinical practice, many felt that the initial set up (including the network part) and data entry were complicated. Those who are well acquainted with Wistaria can utilize the data by the search and extract function to examine and analyze their daily practice and effect relevant improvement in many ways. Given the number of clinics which have been discouraged by complication of data entry and update process, introduction of touch panel entry system and improvement of user support are longed for.

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