The role of dental hygienists in the prevention and treatment of periodontal diseases is significant. In order to effectively participate in a team approach to periodontal treatment, it is necessary for dental hygienists to develop abilities to identify clients’ problems within the scope of dental hygiene. The aim of the present study was to elucidate the significance of introducing ‘dental hygiene diagnosis’ into education of periodontics for dental hygiene students. A simulated patient practice focused on periodontics was offered to 3^rd year dental hygiene students as one part of a 3-year dental hygiene curriculum. Students formulated dental hygiene diagnoses within the dental hygiene process of care, and the diagnostic statements were evaluated. As a qualitative analysis, statements were read for their consistencies with human needs deficits of the Dental Hygiene Human Needs Conceptual Model. The results indicated that diagnostic formulation promoted students’ thought processes in identification of patients’ problems with a particular focus on periodontal problems. However, students’ perspectives on dental hygiene problems were limited. Their abilities to identify psycho-social-behavioral problems of clients seemed to be especially limited. It is suggested that the effective utilization of the dental hygiene conceptual model helps in addressing domains that students are less likely to identify and enhance their awareness of those domains. This learning strategy may facilitate the development of multilateral perspectives. The above findings suggested that the introduction of the dental hygiene diagnosis is beneficial in education of periodontics for dental hygiene students.
Nihon Shishubyo Gakkai Kaishi (J Jpn Periodontol) 50 : 21-29, 2008.

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In this study, we examined the plaque removal and gingivitis improving effects obtained using different application methods of the treatment agent for periodontal disease, Hinoporon^TM. We selected 36 fifth grade dental school students with gingivitis, no occlusal problems and normal dental arches at the Tsurumi University School of Dental Medicine, and the six teeth of Ramfjörd were selected. The medicine used was Hinoporon^TM (Showa Yakuhinnkako Co., LTD, Tokyo, Japan). We divided the subjects into three groups of 12 persons each: the medical agent application group, the toothbrush group and the combined use group.The design of the new trial toothbrush for application of the medical agent Hinoporon^TM is as follows: nylon bristles (0.30mm in diameter), 6mm in length, 3 rows, 23 tufts, straight handle. The clinical parameters examined were the plaque index (PlI), gingival index (GI) and bleeding on probing (BOP). Scoring of clinical parameters was performed at the baseline and at the end of the 4-week study period. differences among the groups were analyzed statistically by the t-test. The results were as follows: PlI) medical agent application group, 44.7±14.8%; toothbrush group, 57.3±5.8%; combined use group, 61.9±6.8%. GI) medical agent application group, 78.9±5.0%; toothbrush group, 82.4±3.5%; combined use group, 66.7±11.3%. BOP) medical agent application group, 85.5±4.6%; toothbrush group, 64.4±12.9%; combined use group, 87.9±3.1%. No statistically significant differences in the PlI or GI were observed among the three groups. Statistically significant differences in the BOP were found between the medical agent application group and the toothbrush groups, and between the toothbrush group and the combined use group (p<0.05). The results suggested that the new trial toothbrush is useful for not only plaque removal, but also the prevention of gingivitis.
Nihon Shishubyo Gakkai Kaishi (J Jpn Periodontol) 50 : 30-38, 2008.

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Generalized aggressive periodontitis is characterized by rapid periodontal tissue destruction, with no relationship between the amount of plaque adhesion and the disease severity, a high proportion of Porphyromonas gingivalis, Tannerella forsythia, Treponema denticola and Aggregatibacter actinomycetemcomitans in the total population of bacteria, and slight gingival inflammation. In a 30-year-old male patient diagnosed to have generalized aggressive periodontitis, we monitored the change of the bacterial flora in the periodontal pockets following antimicrobial therapy administered based on the results of antibacterial sensitivity tests after initial periodontal therapy. After the reduction in the number of bacteria and healing of the periodontal tissue, several periodontal regeneration techniques were applied in combination, including use of enamel matrix derivative, guided tissue regeneration techniques, and bone grafting. The patient was then shifted to supportive periodontal therapy (SPT). The periodontal tissue condition remains well 4 years later in the patient on SPT.
Nihon Shishubyo Gakkai Kaishi (J Jpn Periodontol) 50 : 39-49, 2008.

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We report herein on a case of true halitosis caused by oral disease in which the 56-year-old female patient was unaware of her own bad breath and did not wish to undergo any dental treatment. If she had in fact noticed her strong breath odor, she might have reacted positively to the suggestion of dental treatment, but on the other hand, she may have become over-aware of the possibility of her own halitosis with a negative impact on her social life. We tried to motivate her to have dental treatment without inducing any halitosis-related anxiety. From two years before the first visit, her family members began to comment on her bad breath, of which she was not aware but finally her husband recommended her to visit our breath clinic. The breath odor examination at the first visit revealed that she had a "strong bad breath" in all tests. Her oral hygiene was bad and she had a thick tongue coating. She had perioral periodontitis together with noted root fracture and tooth decay. We explained the causes of her bad breath and advised her to have dental treatment to avoid any worsening of her halitosis, whereafter she began to positive participation in a dental treatment program whereafter she voluntarily attended our clinic consistently and the treatment proceeded without trouble. We performed basic periodontal treatment including tooth extraction. Dental hygienists also tried to maintain her high motivation through oral hygiene instruction and also removed the patient's halitosis-related anxiety. After the treatment, the patient achieved stability in her periodontal conditions no bad breath was detected in an examination. Her good periodontal environment and low breath odor were maintained in the long-term, which may have been due to the high motivation of the patient including home-based plaque control. The role of the dental hygienists in the success of this treatment must be recognized.Nihon Shishubyo Gakkai Kaishi (J Jpn Periodontol) 50 : 50-57, 2008.

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