A conventional goal of dentistry has been to save natural teeth whenever possible. However, dentists'willingness to attempt to save so-called hopeless teeth seems to have dramatically decreased with advances in implant treatment. I am presenting four successful kinds of treatment of teeth previously diagnosed as hopeless, resulting in the regeneration of periodontal membranes and resuscitation of the teeth. The first treatments were apexifications of apical lesions in undeveloped root apexes. The second treatment was a root canal treatment and replantation to a refractory apical lesion. The third treatment was a transplantation and replantation for periodontitis. A fourth treatment that showed marked improvement used guided tissue regeneration (GTR) and enamel matrix protein derivative (EMD) for severe periodontitis. Lastly, I am proposing five criteria for successful tooth transplantation and tooth implantation: 1) there should be no inflammation in the recipient site; 2) the root apex should be completely closed by root canal filling material; 3) the periodontal the membrane should not be allowed to become dry; 4) the duration of transplantation procedure should be as short as possible;and 5) the splint should reliably hold the implantation tooth.
The purpose of this study was to evaluate thermographic changes in facial temperature before and after irradiation by three kinds of lasers (CO2 laser, diode laser and Nd: YAG laser) to the right TMJ area of 10 healthy subjects with no history of orofacial disorders, including temporomandibular disorders. Each subject had eight thermograms and the changes in facial temperature before and after irradiation were determined.The facial temperatures at 5 min, 10 min, and 10 min after stopping irradiation were significantly higher than before irradiation on both the irradiated side and the opposite side for the diode laser and the Nd: YAG laser and on the opposite side for the CO2 laser. Though the facial temperatures of 10 min. after stopping irradiation were significantly higher than before irradiation on the opposite side with the CO2 laser, no significant differences were found between before irradiation and at 5 min, before and 10 min. in irradiation side. These results suggested that three kinds of low-level laser irradiations had a effect of increase facial temperature of tissues.
Generally, in clinical diagnosis of various conditions, ELISA is used for the immunologic analysis of bioactive substances such as the cytokines. For this reason, immunologic analysis methods are indispensable in dentistry. However, conventional immunoassays such as ELISA have some limitations, such as complicated procedures, extended analysis time, and the quantity of the sample needed. With the development of biomicrosensing technology, an experiment to measure bioactive substance is made possible by using an extremely small sample. The author developed an immunosensor that utilizes dielectric polarization and examined its clinical application in the field of dentistry. A sensor electrode coated with an insulation layer packed with immobilized antibody molecules was fabricated for microsensing. This appliance detects any difference in density as a change in voltage as soon as even an extremely small sample is placed on the sensor cell. The film which shows the change in voltage is called a response film. The author investigated the followings: first, a material with an insulation property that is suitable for placing over the sensor electrode;second, a suitable time and density for antibodies to be immobilized on the insulation layer;third, the detection of mouse IgG antigen with a sensor which has been immobilized by an anti-mouse IgG antibody;fourth, the detection of various cytokines (IL-1α, IL-1β and TNF-α). Firstly, it was revealed that a surface-etched film with SiO2 particles into an insulation layer was most suitable for the response film. Secondly, it was also revealed that an antibody density of at least 100μg/ml, and an immobilization of time at least 30 minutes was best suited for the response film. Under these optimal conditions, the proposed immune sensor immobilized anti-mouse IgG on the insulation layer and exhibited a good electrochemical reaction towards mouse IgG. When the inflammatory mediators IL-1α, IL1-β, and TNF-α were measured, the sensor showed a good electrochemical reaction for each of the cytokines with differing voltages. The present immunosensor utilizing specific polarization is able to evaluate antigen-antibody reactions as a voltage change and shows a strong potential for future use in clinical laboratory procedures.
The transforming growth factor-beta (TGF-beta) super family includes TGF-beta and bone morphogenetic proteins (BMP) which play an important role during fracture healing and distraction osteogenesis. Smads are intracellular signal transmission mediators of BMP and TGF-beta. Smad 1, 5, 8 are receptor-regulated Smads (R-Smad) which transmits signals of BMPs. Smad 2, 3 are receptor-regulated Smads (R-Smad) which transmits signals of TGF-beta. Smad 4 is a common partner Smad (Co-Smad) which combines signal transmissions of R-Smads. Smad 6, 7 are inhibitory Smads (I-Smad) which inhibits signal transmissions of R-Smads. The aim of this study was to evaluate the expression of R-Smads, Co-Smad, I-Smads, BMP-2, 4 and TGF-beta in distraction osteogenesis of rat mandibles. Left mandibular osteotomy was performed and fixed with an external distractor in 30 rats. After a latency period of 5 days, the mandible was lengthened at a rate of 0.4 mm/day for 8 days (total 3.2 mm). Animals were sacrificed immediately after latency, during distraction, immediately after completion of distraction and after 7 days and 14 days of consolidation. Immunohistochemical analysis was performed to investigate the expressions of R-Smads, Co-Smad, I-Smads, BMP-2, 4 and TGF-beta. Expression of Smad 1, 2, 3, 5, 8, BMP-2, 4 and TGF-beta increased during the distraction phase and gradually decreased towards the consolidation period. On the other hand, expression of Smad 6, 7 was low during the distraction phase, while it increased during the consolidation period. Smad 1, 5, 8 showed a spatial and temporal pattern of expression similar to that of BMP-2, 4 during distraction osteogenesis. Similarly, Smad 2, 3 showed a similar expression pattern to TGF-beta. The increase in expression of I-Smads after completion of distraction indicates its role in the bone remodeling and maturation process.
This study assessed the social demand for specialists in oral care and dysphagia rehabilitation in hospitals, healthcare institutions and dental clinics to create an educational program for dental hygienists. Data were obtained from a questionnaire survey of hospitals, geriatric health services facilities, welfare services facilities for persons with disabilities, and dental clinics in Fukuoka Prefecture in 2006, and they were compared to those obtained by the same method in 2004. In 2006, oral care was performed for inpatients in 95.1% of hospitals and for persons in 94.9% of other healthcare institutions. Dysphagia rehabilitation was performed for inpatients in 73.2% of the hospitals and for persons in 23.3% of the other healthcare institutions. Although nurses provided the majority of the oral care, a small number of them were replaced by oral specialists, such as dentists, dental hygienists and speech-language-hearing therapists. Dysphagia rehabilitation was carried out by a wide variety of the specialists in hospitals and other healthcare institutions in 2006, compared to the institution in 2004. The special knowledge and skills for maintenance of oral functions, those for understanding elderly patients and others, and nutritional knowledge as well are necessary for specialists integrating oral care and dysphagia rehabilitation in hospitals and other healthcare institutions. Thus, it is important for dental hygienists as integrated specialists to obtain special knowledge concerning nutrition, in addition to knowledge and skills for maintenance of oral functions and an understanding of elderly patients and others.
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