In this study, we investigated the profile of patients visiting an outpatient clinic for oral malodor and assessed the relationship between the responses to an oral malodor questionnaire and the diagnosis made with an odor-measuring device. An attempt was also made to gain an understanding about the predisposition of patients with psychological malodor to anxiety disorders. The data of 363 patients who visited the special clinic for oral malodor at the Tokyo Dental College Chiba Hospital from January 2009 to December 2011 were analyzed in this study. The patients were asked to complete the oral malodor questionnaire that contained items to determine the demographic variables, the presence/ absence and duration of the perceived oral malodor, the possible causes for the perceived malodor, and its influence on the social and home lives of the individual, and the presence/ absence of a person(s) to whom the individual could communicate his/her concerns. Oral malodor was measured using the Oral Chroma^TM gas chromatograph, targeting the CH₃ SH concentrations. Patients were divided into oral malodor-positive and -negative groups, based on the need for treatment to reduce the malodor. Although the prevalence of subjects who were conscious of oral malodor exceeded 80%, half of the individuals were subsequently diagnosed as not having oral malodor. No significant association was found between oral malodor perception and the presence/ absence of malodor. The findings from the present study indicate that a multidimensional approach, including from the psychological aspect, is necessary for the diagnosis and treatment of oral malodor. In patients with psychological oral malodor, it may be possible to capture a predisposition to anxiety disorders without performing other analyses, such as with Egogram, by evaluating the results from the oral malodor questionnaire and the objective measurement. Nihon Shishubyo Gakkai Kaishi (J Jpn Soc Periodontol) 55(1):15-23, 2013.

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Tissue engineering using living cells is emerging as an alternative to tissue or organ transplantation. The purpose of the present study was to fabricate cell sheets of a thickness sufficient for transplantation, and shortening of the fabrication periods. Human alveolar bone periosteal cells (HABPCs) were seeded at a density of 3.6×10⁴ cells/ml on to the 24 wells of temperature-responsive cell culture dishes at 1, 7,and 11 days. Fourteen days after the first seeding, the HABPC sheets were harvested from 15 of the temperature-responsive culture dishes and stacked one over the other to fabricate HABPC multilayered sheets. The HABPC multilayered sheets were cultured for 1, 3, or 5 days and examined by histological and immunohistochemical analyses. Alkaline phosphatase staining and immunohistochemical staining for anti human type I collagen, osteopontin, osteocalcin, and runt-related transcription factor 2 showed HABPC differentiation occurring from the outer layers of the HABPC multilayered sheets. The results suggested an increase in new bone formation from 3 to 5 days. Mineralized-like tissues were observed in the HABPC multilayered sheets with von Kossa staining at three days. In this study, we were able to shorten the fabrication period of the HABPC multilayered sheets by using a higher cell density for the initial cell seeding into the temperature-responsive cell culture dishes. In addition, we have reported a method for the preparation of HABPC multilayered sheets of sufficient thickness for transplantation. Nihon Shishubyo Gakkai Kaishi (J Jpn Soc Periodontol) 55(1):24-36, 2013.

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We report two cases of gingival overgrowth associated with nifedipine treatment that were successfully treated by periodontal initial therapy, without changing the prescribed drugs or resorting to periodontal surgery. Case 1:A 49-year-old woman visited us with the chief complaint of gingival swelling and pain of the maxillary molar teeth on the right side. She had been diagnosed as having hypertension (185/115 mmHg) in 1998, and been under treatment with a Ca-channel blocker since 1998. At her first visit to us, gingival overgrowth was observed on the gingiva of the region of the mandibular anterior teeth. Case 2:A 63-year-old man visited us with the chief complaint of loose teeth and pain of the maxillary molar teeth on the left side. He had been diagnosed as having hypertension (200/110 mmHg), arrhythmia, and cerebral infarction and had been taking Ca-channel blockers and other drugs since 2001. At his first visit to us, we noticed gingival overgrowth around the mandibular anterior teeth and maxillary molar teeth on the left side. In both cases, it was not possible practicable to change the types of drugs administered ; therefore, the patients were started on periodontal initial therapy while being continued on treatment with the Ca-channel blocker and other drugs, which resulted in apparent improvement of the gingival overgrowth. Thereafter, the patients were maintained under the supportive periodontal therapy in every three months. It has been reported that gingival overgrowth associated with drug intake may be caused not only as a side effect of the drug, but also because of poor oral hygiene and formation of plaques. Through the treatment of these cases, we have found that it is possible to successfully control gingival overgrowth by periodontal initial therapy, without changing the drugs prescribed to the patients or resorting to periodontal surgeries. In future, with the expected increase in the prevalence of lifestyle-related diseases, increase in the number of patients taking multiple drugs, including Ca-channel blockers, can easily be expected. It is therefore important to support self-care according to the life stage and systemic condition, and provide appropriate professional care for long-term health support. Nihon Shishubyo Gakkai Kaishi (J Jpn Soc Periodontol) 55(1):43-53, 2013

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