Fracture risk increases substantially with age due to decreased bone density and muscle mass, and also problems with vision and balance. In the elderly, medication used to treat non-skeletal disorders is one of the causes of bone fracture accompanying decreased QOL. Increased fracture risk by medication is based on either adverse drug reactions on bone metabolism or adverse drug events such as falls. The use of fall risk-increasing drugs (FRIDs), such as opioids, dopaminergic agents, anxiolytics, antidepressants and hypnotics/sedatives, have been demonstrated to increase risk of fracture. Furthermore, in addition to FRIDs, many drugs have been found to affect bone mass and fracture risk as a result of the side effects on bone metabolism. The present article reviews the current understanding of several drugs influencing fracture risk. In particular, drugs affecting fracture risk through sympathetic neuronal activity are also discussed.

In only 30 years after the discovery of hepatitis C (HCV), the treatment of HCV has advanced rapidly, and now the era has entered the age of eradication of HCV with the advent of DAA (Direct Acting Anti-viral agents). However, HCV should never be disregarded even in the era of eradication. It is necessary to update the knowledge of HCV and to implement correct infection control. For example, anti-HCV antibodies remain positive even after the disappearance of HCV RNA. This knowledge is important to consider the medical safety in the context of cost-effectiveness. Moreover, the end of HCV infection does not mean immediately eradicating HCV liver cancer. Even in the age of eradication, patients with infected with mutant virus remain refractory to treat. Moreover, reactivation of hepatitis virus might occur when administering anticancer drugs. In this paper, I outline the knowledge to which dentists should update in the HCV eradication era.

Oral antibiotics are generally prescribed for the odontogenic infection such as periodontal inflammation and pericoronitis or the postoperative infection of extraction in dental medication. Even in this hospital, oral antibiotics especially third generation cephalosporins trend to be frequently prescribed.

As a first step to antimicrobial stewardship, we conducted survey on the type and prescription amount of oral antibiotics for specified treatment including prophylactic prescription after extraction using hospital database. Prophylaxis antibiotics after extraction were prescribed for about 90% of patients and 43% of the prescribed antibiotics were third generation cephalosporins. Moreover, almost 70% of oral antibiotics in treatment for infected root canal, pulpectomy and flap operation were third generation cephalosporins, and it was higher than that for prophylactic prescription after extraction. We need consideration of antimicrobial stewardship about the oral third generation cephalosporins and standardization for prophylaxis oral antibiotics usage according to infectious risks in this hospital.

The alveolar bone is very important for tooth retention. However, periodontitis or trauma can cause loss of the alveolar bone, which is not spontaneously regenerated. Therefore, bone regeneration therapy for alveolar bone loss is necessary to retain the teeth and to maintain proper occlusion. Currently, alveolar bone loss is treated with surgery using bone grafts or artificial bone, which carries the risk of complications such as post-operative infection. To improve patient safety and treatment success, a new non-surgical therapy would be extremely useful. In this study, we focused on gene therapy using the bone morphogenetic protein (BMP) gene. The BMP protein is strongly osteogenic, but BMP gene delivery to the periodontal tissues would obviate the need for carrier matrices or surgical intervention required for direct application of BMP. The periodontal ligaments and periosteum connected to the alveolar bone are well-known sources of mesenchymal stem cells. BMP induces the differentiation of these cells into osteogenic cells. In this study, we attempted gene transfer to the periodontal tissues via in vivo electroporation to induce alveolar bone formation in rats. Our results indicated that we successfully performed gene transfer to the periodontal tissues using a non-viral vector and in vivo electroporation. Moreover, two weeks after gene transfer, additional alveolar bone was formed in the original bone tissue. We concluded that this technique could serve as a model for a new pharmacotherapy for alveolar bone regeneration.

[Purpose] The purpose of this study was to clarify the effectiveness of HI-ZAC oral rinse in reducing oral malodor．

[Patients and Methods] The study population included seven patients whose volatile sulfur compound (VSC) levels exceeded the reference values (hydrogen sulfide [H₂S] >112 ppb or methyl mercaptan [CH₃SH] >26ppb) at the first measurement using an Oral Chroma^TM device. Patients were advised to omit their usual oral hygiene practice, and to not ingest any food or drink on the day of assessment. To evaluate the effects of tooth brushing in reducing oral malodor, the subjects' VSC levels were measured after tooth brushing (the second measurement). After the second measurement, the subjects rinsed their mouths with 5mL of HI-ZAC oral rinse；the VSC levels were measured immediately after rinsing (the third measurement) to evaluate the effects of HI-ZAC oral rinse on halitosis.

[Results] The results showed that tooth brushing did not reduce the VSC levels to a statistically significant extent. A Friedman test followed by multiple comparison testing using a Wilcoxon signedrank test with Bonferroni correction was performed to evaluate the changes in VSC levels. This revealed significant changes in the H₂S value from the first to third measurements (P<0.05) and from the second to third measurements (P<0.05), confirming that the HI-ZAC oral rinse was highly effective for reducing VSC levels. All of the subjects showed a CH3SH level of 0 ppb after rinsing with HI-ZAC oral rinse.

[Conclusion] HI-ZAC oral rinse was therefore found to be useful for reducing halitosis.

Historically, chronic oral pain with unknown origin had been treated as a “psychogenic” condition in dentistry. Although tricyclic antidepressants have been widely used to treat chronic oral pain such as glossodynia or atypical odontalgia, the mechanisms on how they work is not precisely elucidated still now. Strong evidences have been accumulated on pathophysiological interactions between chronic pain and psychosocial factors. Dopamine system has been found to play a key role for bridging chronic pain and psychosocial factors. To treat chronic oral pain better, we dentists should search for a new pharmacotherapy based on brain function, especially with a focus on the relationship between chronic oral pain and dysfunction of mesolimbic dopamine system.