To make clear the characterization of first-appointed patients at the clinic of 1 st conservative dentistry, Kyushu Dental Collage Hospital, we investigated the data of those patients who came here during the three years from April, 1994 to March, 1996, and sorted them by age, sex, residing area, present complaint, introduction, diagnosis, and treatment. Results were as follows : 1. The total number of first-appointed patients during the three years was 1, 218 persons, which consists of 470 males (38.6%) and 748 females (61.4%). 2. By age, the largest group was patients in fifties (20.9%), and groups of patients at ages from 20 to 69 were 85.2% of total number. 3. Patients from Kokurakita-ward showed 26.3% of this total, and patients from the whole wards of Kitakyushu-city showed 76.4% in all. 4. The ratio of introduction from outside of this hospital and other clinics of this hospital were 14.9%, 15.0%, respectively. These patients without introduction showed 70.0% of all. 30.8% of these patients (nonintroduced), had a family dentist. 5. Patient diagnosed as having a disease related to operative dentistry, endodontics or periodontics was calculated to be 23.9%, 40.3%, and 26.0%, respectively. 6. During the three years period, the total endodontic treatments were 34.2%, and restorative treatments and periodontic treatments were 19.4%, 19.2%, respectively. Retreatment ratio was as high as 66.5%, which meant that the dental treatments should be reconsidered for a better result in the near future.

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顎関節症患者が来院した際に行われる顎運動距離の計測項目としては, 最大開口距離, 側方運動限界距離, オーバージェットおよびオーバーバイトなどが挙げられるが, 性差や個体差のためにどの程度の距離をもって正常あるいは異常とみなすかはいまだに議論されている.さらにこれらの計測が顎関節症の診断に貢献しているか否かについても疑問視されているにも関わらず, 初診時の診査として一般的に行われているのが現状である.本研究の目的は, 顎運動計測により得られたデータを比較することにより, 顎関節症患者の原因が疼痛に起因するものか, あるいは機能障害に起因するものかをスクリーニングできるか否かについて検討することにある.41名の顎関節症患者をアンケートにより疼痛群, 機能障害群, および疼痛+機能障害群の3グループに分類し各グループ間の顎運動距離について検討したところ以下の結果を得た.無痛性最大開口距離と有痛性最大開口距離の差について比較したところ, 機能障害群では他の2群よりも有意に小さな値を示した(p<0.05).有痛性最大開口距離と受動性最大開口距離の差について比較したところ, 疼痛群では機能障害群よりも有意に小さな値を示した(p<0.05).患側に関して, 患者の主観的な症状側と側方限界距離の大きな側との一致率について検討したところ, 疼痛群が61.5%, 機能障害群が60.0%, 疼痛+機能障害群が61.5%であり, 患者全体としては61.1%の一致率が得られた.以上のことから, 初診時における顎関節症患者に対する顎運動計測は, 疼痛が主因の患者か機能障害が主因の患者かをスクリーニングするためには非常に有用であることがわかった.また初診時における患側を決定するためにある程度補助的な役割を果たすことがわかった.

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Many attempts have been made in the past to develop indices for malocclusion. The Index of Orthodontic Treatment Need (IOTN) was developed in the United Kingdom to assess both aesthetics and dental health primarily for clinical purpose. The IOTN attempts to rank malocclusion in terms of the significance of various occlusal traits for an individual's dental health and perceived aesthetic impairment. The IOTN incorporates an Aesthetic and Dental Health Component. The first purpose of this investigation is to evaluate the effectiveness of IOTN in the assessment of malocclusion in the Japanese. The second is to evaluate the difference between the IOTN and the Dental Aesthetic Index (DAI). The orthodontic treatment needs of 681 sets of study casts of high school students aged 15 to 18 (396 males and 285 females) in Kyushu were assessed using the IOTN. And 200 sets of study casts (100 males and 100 females) were randomly chosen for the evaluation of the difference between the DAI and the IOTN. The results were as follows : 1. Allocated to the Aesthetic Component (AC) of IOTN, 19.3% of adolescents needed the orthodontic treatment. Allocated to the Dental Health Component (DHC) of IOTN, 55.1% of adolescents needed the orthodontic treatment. No sex difference is noted. 56.0% of adolescents needed orthodontic treatment. 91.2% of those who needed of orthodontic treatment had Crossbite or Displacement of Teeth or both. 2. The results of DAI was correlated to the results of IOTN and each components of IOTN. (p<0.001) Both IOTN and DAI are useful, but IOTN is more useful for the clinical screening of malocclusion, however, DAI is more useful for the epidemiological screening of malocclusion.

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Lipopolysaccharide (LPS) is one of the candidates for the alveolar bone loss accompanied with periodontal disease. The purpose of this study is to assess the effect of LPS on cell proliferation and the differentiation of osteoblastic cells in cell culture. Osteoblastic cells were prepared from rat calvaria, and the cells were cultured with LPS in the presence and the absence of ascorbic acid. After the culture, the cell proliferation was examied by scoring colony formed or estimating cell number using cell counting kit. The osteoblastic differentiation was examined by measuring ALP activity of cell lysate. The results obtained were as follows : 1. In osteoblastic cell culture at low cell density, many colonies were formed. More than half of these colonies were ALP positive from the histochemical stainning. Mineralized nodules were appeared in the culture adding ascorbic acid and β-glycerophophate. 2. LPS (0.1, 1, 10μg/ml) increased cell number of osteoblastic cells in colony assay and in the assay cell counting kit. 3. LPS greatly affected ALP activity of osteoblastic cells. The activity was also positively and negatively influenced by the addition of ascorbic acid and cell density. Thus, LPS increased osteoblastic cell proliferation and affected ALP activity of osteoblastic cells. These results suggest that LPS modulate alveolar bone loss accompanied with periodontal disease.

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Recent reports showed that the tonsillar application of sheep red blood cells (SRBC) is an effective method to induce specific IgA in saliva. In the case of tonsillar application, the level of anti-SRBC antibody in saliva of the rabbits was much higher than those in the case of oral and nasal administration. The purpose of this study is to examine the efficiency of the salivary antibody induction using formalin-killed Streptococcus mutans or Streptococcus sobrinus, instead of SRBC. Sixth week after the immunization by tonsillar and nasal application, anti-S. mutans or anti-S. sobrinus agglutination titers of saliva and blood plasma greatly increased. Anti-S. mutans or anti-S. sobrinus IgA concentration in saliva after the application also increased at the sixth week. In the case of tonsillar application, both the level of agglutination titer and IgA concentration in saliva against S. mutans and S. sobrinus were four times higher than those in the case of nasal application. The numbers of IgA-producing cells against S. mutans and S. sobrinus were the highest in submandibular glands among those in the lymphoid tissues including parotid glands, intestinal mucosa, nasal mucosa, and spleen. In the case of nasal application, the number of these cells was the highest in nasal mucosa. The results show that tonsillar application is more effective method to induce anti-mutans streptococci IgA in saliva than nasal application.

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In the present study, we investigated the clinical and histopathological effects of CP therapy by combined use of cisplatin (CDDP 50 mg/m^2) or carboplatin (CBDCA 300 mg/m^2) and Peplomycin (PEP 5 mg/day) for 24 cases with oral squamous cell carcinoma. The effect of treatment and associated complications were as follows : 1. Complete response (CR) was achieved in 8 and partial response (PR) in 13 of the 24 cases. The overall clinical response rate was 87.5%. The histological response rate was 62.5%. 2. The clinical effects did not always agree with the histopathological effects. There were discrepancies between clinical and histopathological effects, especially in PR determined by clinical findings. 3. The principal adverse reaction was gastrointestinal disturbances, but symptoms were able to be controlled. Signs of hematologic toxicity and renal disturbances were mild and did not preclude the continuance of therapy. 4. The results of this study indicated that neo-adjuvant chemotherapy with CDDP and PEP was highly effective for the local control of oral squamous cell carcinoma.

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韓国人青年の不正咬合の有病状況を調べることを目的に, 18歳以上の韓国人対象者149名(男性78名, 女性71名)についてDiscrepancy Index (DI), Malalignment Index (MI)ならびにOcclusal Feature Index (OFI)を用いて石膏模型上で評価を行った結果, 男性ではDI, MI, OFIの順に12.68, 9.32, 3.45, 女性ではそれぞれ10.58, 9.51, 3.34で, 有意な性差は認められなかった.また, この結果について, これまで報告された日本人, 中国人, 台湾原住民, アメリカ人男性の結果と比較したところ, 韓国人青年は全ての指数において日本人と同程度の値を示した.また, 台湾原住民を除くモンゴロイド集団はアメリカ人男性に比べてMIの値が比較的高く, 逆にOFIの値は小さいことから, 韓国人, 日本人, 台湾の中国人には叢生や歯の位置異常が共通して多く認められることが特徴的であった.

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The electrolyzed strong acid water is characterized by its excellent bactericidal activity, low production costs and no drainage pollution. The authors previously reported that the bacteriologically contaminated impression surface could be sufficiently sterilized by only one-minute immersion in this acid water. In the present study, the side effects of the immersion treatment on the impression and the subsequently fabricated cast were compared with those in several disinfectant chemicals, using alginate impression materials which may be the most susceptible to the environmental changes. The alginate impression showed expansion with time by immersion in any chemical as in water. The expansion rate was the smallest in 10% ethanol-added Isodin^[○!R] (povidon-iodine), the next in the acid water, and the largest in Sterihyde^[○!R] (glutaraldehyde) similarly in water. In a practical sense, however, it was found that the expansion of the impression could be minimized in the acid water, considering that it takes only one-minute immersion while the chemicals require 15 to 60-minute immersion for enough sterilization. It was reflected in the little deformed configuration of the resultant edentulous gypsum cast when the impression was treated with the acid water. Although the surface hardness of the cast generally tended to decrease by the immersion of the impression in water and the chemicals, it rather increased by a short-time immersion in the acid water. The surface roughness of the cast decreased by immersion of the impression in water, acid water and any chemical except for buffer-added Sterihyde^[○!R] in which the cast showed increased roughness. The foregoing results suggest that the electrolyzed strong acid water can be safely applied to the sterilization of the impression showing superior advantages such as significantly rapid treatment and no adverse effects on the resultant gypsum cast.

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The excellent bactericidal activity of the electrolyzed acid water has recently been noticed in dentistry. The authors previously demonstrated the validity of the strong acid water as a disinfectant for impression showing rapid and reliable sterilization effect. In the present study, the applicability of the electrolyzed water to sterilization of dental metallic instruments was examined. The contamination bacteria tested were Streptococcus salivarius (IFO 13956). As the problem with the acid water is that it is potentially corrosive to metals, corrosion tests were also carried out. The instruments having simple configuration such as reamer and explorer could be sterilized by one-minute immersion in the strong acid water, while those of comlicated configuration such as diamond stones and burs required much longer time for equivalent sterilization. When the ultrasonic cleaning action was added in the strong acid water, all the instruments were sufficiently sterilized by one-minute treatment although such a cleaning itself could give little effect of removing bacteria from the instruments even by 20-minute treatment in distilled water. Another type of electrolized water, the week acid water 5.2 in pH showed almost the same effects as the strong acid water. The reamer and diamond stone showed no corrosion in 24-hour immersion in the acid water. The working end of the explorer was also sound while many corrosion pits were observed on its handle. A marked corrosion was found on the overall surface of the steel burs, and a localized loss occurred at the brazed area between the blade and shank of the carbide burs without the blade being harmed. It was confirmed that the week acid water was less corrosive than the strong. Significant damages of the burs by corrosion appeared after 3-hour immersion in the acid water. The term corresponds to 180-time repetitions of one-minute immersion treatment, indicating that such a corrosion behavior may not result in any practically serious problem because it may far exceed the mechanical lives in service of their blades. These findings suggest that both the electrolyzed strong and week acid waters may well be available as the disinfectant for dental instruments.

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The most apparent changes take place in living organism during childhood, especially the adolescent years. The author reported the results of the study on bone formation, after 3 week of supplementation with calcium-balanced standard diet, of mandibular bone loss derived from 3-week feeding of calcium-deficiency and 20% low-calcium dietary, using male Wistar rats of adolescent age. 1. Body weight The body weight were shown nearly twofold increase at 6th week post-experimentally over at the beginning in control, calcium deficiency, and low calcium group. Calcium-deficiency group showed significantly higher weight than control group (p<0.05). 2. Bone density Control group showed significantly higher density than the experimental groups (p<0.05). Calcium-deficiency group showed decreased value among the experimental groups (p<0.05). 3. X-ray microanalysis findings The area analysis of calcium and phosphorus distribution was done to investigate the characteristic radiographic density. The density of calcium was shown to be higher than that of phosphorus in all the control and experimental groups, by the area analysis of distribution of Ca and P within the mandible. 4. Pathological findings Calcium-deficiency group showed decreased bone thickness. Remodelling layers were identified through all the bone layers, osteocytic lacunae decreased, and undermineralized layers scattered in lamellar bone. 20% Low-calcium group showed markedly increased bone thickness, almost the same as control group, and adundant and regular distribution of osteocytic lacunae, in contrast to calcium deficiency group. 5. SEM findings Compared with control group, calcium-deficiency group showed more increased resorptive area than rest area. Amorphic osteocytic lancunae increased, and boundary with surrounding matrix was indistinct. In 20% low-calcium diet group, the resorptive areas were overtaken by the bone formative area, which was different from in calcium-deficiency group. Formtive areas of bone matrix, covered superficially with densely arranged collagenogenic fibrils, were demonstrated to expand, with osteocytic lacunae embedded by regularly arranged collagenous fibrils. 6. Hematological findings No significant differences were found among the three group with reference to the electrolytic and biochemical examination. Endocrinal examination showed nonrewarding. As indicated above, the long-term supplementation of standard dietary would help with bone recovery on the bone loss resulted from 20% low calcium intake in adolescence years, as long as the peak bone mass was well obtained before.

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Endochondral ossification in tibial metaphysis was investigated with electronic microscopy using male Wistar rats of four weeks of age, subjected to three kinds of physical exercise, for cellular level study of their effect on longitudinal growth of growing long bones. 1. SEM findings In control group, it is distinctable among the chondral layers such as growing layer, rest layer, hypertrophic layer, erosive layer, and subchondral bone formative layer ; bone formation was mixed with resorption within the trabeculae. Calcified vesicles within the chondral lacunae increased in ascending order of control group, 10 m/min group, 30 m/min group, 40 m/min group ; with vesicles undistinctable. Bone matrix formation was promoted, in trabeculae continuing with subchondral bone formative layer, in ascending order of control group, 30 m/min, 40 m/min group ; the trabeculae were shown thickly and regularly distributed. 2. TEM findings In control group, active osteoblast distributed in single layer or mosaic pattern. The ratio of nucleus and plasma increased, while the organelle decreased in rest osteoblast. A little amount of osteoid was shown between the osteoblast and bone matrix. The young osteocyte in the vicinity of osteoblasts, abundant in organelle, resembling the shape of osteocytes, were shown to be embeded in the organic matrix that was secreted by themselves. The mature osteocytes deep in location, becoming small and lacking in organelle, were surrounded by the lamina limitans with the ratio of nucleus and plasm increased. Cellular network was built up by intercellular connection with plasm processes. Osteoclasts were revealed to absorb bone matrix with ruffled border. The active osteoblasts, osteoblastoid cells and undifferentiated cells and osteocytes in forming stage were shown increased in ascending order of control group, 10 m/min group, 30 m/min group and 40 m/min group. The organellae were shown developed, and mature osteocytes increased in deep location in 40 m/min group. Osteolclasts were shown to get activated in ascending order of control group, 10 m/min group, 30 m/min group, and 40 m/min group. On the basis of the findings mentioned above, the physical exercise facilitated in bone formation of endochandral ossification in metaphysis of tibia.

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The purpose of this study was to evaluate the effect of subgingival mechanical irrigation using ultrasonic scaler tip to periodontitis patients from moderate to advanced severity. The single-rooted teeth from 7 patients with moderately advanced periodontitis were treated with a split-mouth design. The baseline evaluation included probing pocket depth (PPD), probing attachment level (PAL), gingival bleeding index (GBI) and plaque control record (PCR). One site in each quadrant was sampled for the measurement of dark-field microscopic analysis, subgingival microbial sampling and gingival crevicular fluid (GCF). Four quadrants were consisted of : 1) brushing plus water irrigation using ultrasonic scaler tip (mechanical irrigation group), 2) brushing plus water irrigation using syringe (irrigation-water group), 3) brushing plus 0.2% ethacridine lactate (Acrinol^[○!R]) irrigation using syringe (irrigation-chemical agent group), 4) brushing alone (control group). Subgingival irrigation was repeated one time a week for 4 weeks. And then, second clinical measurement was performed 4 weeks later. The results indicated that PPD reductions were observed in all irrigation groups and control group. Water irrigation using ultrasonic scaler tip was effective in reducing GBI and the percentage of motile bacteria (spirochetes and motile rods). Furthermore, 0.2% ethacridine lactate irrigation using syringe was effective in decreasing GBI. It was demonstrated that water irrigation using ultrasonic scaler tip had some effect in the reduction of GBI and also the improvement of reduction in the subgingival environment. Therefore, it was concluded that the application of water irrigation using ultrasonic scaler tip might be useful in routine periodontal treatment.

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In order to construct a stable lower denture, it is important to place posterior artificial teeth to fit functional movements of surrounding tissues. It is also desirable to place the artificial posterior teeth in complete denture causing as little leverage as possible. The purpose of this research was to determine the placement of artificial posterior teeth giving equal weight to both the "flange technique" and "the law of interalveolar crest line". The flange technique gives priority to muscle balance surrounding denture while the law of interalveolar crest line gives priority to occlusal balance. The three-dimensional shapes of denture space, alveolar crest line and Pound's line (cuspid retromolar pad guide line) as anatomical landmarks were measured. The relationship among parameters was examined. The results were as follows : 1. The averages of the mid-point of the denture space at the second premolar, the first molar and the second molar were 2.82mm, 2.57mm, 3.10mm on the buccal side of the interalveolar crest line respectively. 2. In only 2% of all cases in the molar region, the mid-point of the denture space lay on the intersection of the interalveolar crest line and the occlusal plane. 3. The mid-point of the denture space line was on the buccal side of the interalveolar crest line in 86% of all cases. 4. The averages of the inner angle of interalveolar crest line to the occlusal plane at the second premolar, the first molar and the second molar were 88.1° 85.6° and 80.3°, respectively. Therefore the interalveolar crest line became gentler towards the back of the posterior reduced ridge. 5. All the cases were divided into two groups at 80° (the inner angle of interalveolar crest line to the occlusal plane), and their mid-point denture space positions were compared. The below 80° inc. group was on the buccal side more than the over 80° group at the second premolar (significant p<0.05) and the first molar (not significant). On the other hand, the group over 80° tended to be on buccal side at the second molar (not significant). 6. The inside edge of the denture space was frequently within 1 mm of the inside Pound's line on either the buccal or lingual side. Consequently the inside Pound's line is considered a useful anatomical landmark for teeth arrangement. 7. The reduced alveolar ridge rate was measured at the second premolar, the first molar and the second molar. These data were divided into three groups : low (0 inc. &acd;80%), middle (80 inc. &acd;100%) and high (100 inc. &acd;140%). The reduced rates in the three groups were compared with positions of their denture space positions. The denture space position tended to be strongly on the buccal side in the high group. The position of the inside edge of denture space at the second molar was closer to the interalveolar crest line in the high group. In order to ensure muscle balance surrounding denture and occlusal balance when placing the artificial posterior teeth in complete denture, it is suggested that artificial posterior teeth should be placed along the inside edge of the denture space. This is especially relevant, in cases with high reduced alveolar ridge ; that is, in difficult cases, the placement of the second molar should be paid excessive attention.

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We report a rare case of large radicular cyst considered to have occurred from the left maxillary lateral incisor and grown into the left maxillary sinus. The patient was a 29-year-old man. He visited us complaining of swelling on the left buccal region. There were slightly swelling and oppressive pain on left buccal region at the time of initial presentation. On examination of the oral cavity, the mucolabial fold of left upper anterior teeth was found slight swellen. The left upper lateral incisor was a non-vital tooth and moved toward palatal side and had slight percussion pain. The radiograph features showed a well-defined, circular, radiolucent legion in the left maxilla. Computed tomography demonstrated the water-density area in left maxillary sinus. Under general anesthesia, surgical intervation was employed. The dimension of the cyst was 50×45×30mm. Histopathologically, the cyst wall was lined by squamous epithelium and sinusal mucosa was thickened due to edema.

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