Maxillary central incisors with short roots are occasionally encountered during orthodontic diagnosis. From an esthetic point of view, the central incisors occupy the most noticeable position in the maxillary and mandibular arches, and whether or not to extract them marks a major turning point in the planning of orthodontic treatment. In deciding a treatment strategy in this situation, there are two options to be considered: 1) treatment without extraction due to esthetic considerations; or 2) extraction, taking risk and prognosis into account. Whichever strategy is adopted, however, it will still be necessary to bear in mind that the treatment and prognosis will differ from that in normal orthodontic treatment. If no extraction is to be carried out, care must be taken that no further shortening occurs during the course of active treatment and that stable retention is preserved. On the other hand, if the central incisors are to be extracted, care must be taken to ensure that this has no negative esthetic impact, either during or after orthodontic treatment.

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When multiple tooth loss causes loss of occlusal-masticatory function, functional recovery is normally obtained with the help of removable dentures. After resection of the jawbone or tongue because of tumors, the movement of the tongue and its surrounding tissues is limited, and patients exhibit a more pronounced loss of chewing and swallowing than that observed in other cases of multiple tooth loss. In such cases, it is necessary to take extra care in determining the position of the mandible, arrangement of artificial teeth, and morphology of the palate. In the present case, the left lower jawbone was resected because of a gingival tumor, and when the new denture was manufactured, the intercuspal position was based on the resting position of the mandible. The stability of the lower complete denture was a priority and the artificial teeth were partially arranged on the lingual side. The new denture, however, caused insufficient closing of the mouth aperture and insufficient impact between tongue and palate, resulting in dysphagia. Therefore, the vertical dimension of occlusion was reduced multiple times to improve chewing and swallowing function.

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Dental treatment for patients with physical or mental disability is often performed under general anesthesia due to level of cooperation with treatment, type and location of treatment, time required, or number of times patient is required to attend hospital. University hospitals are receiving an increasing number of requests from local private dentists and dental clinics to provide dental care for patients with physical or mental disability which can only be performed under general anesthesia. We carried out a retrospective survey of the routes of referral and types of dental treatment carried out in such patients under general anesthesia at Tokyo Dental College Suidobashi Hospital. The survey covered a 5-year, 9-month period from April 2006 to December 2011, during which 163 patients, comprising 106 men and 57 women, were treated. Their age ranged widely, from 2 to 53 years, with a high proportion (118 patients, 72.4%) being minors aged under 20. Among the total number of patients, 69 (42.3%) had disorders associated with mental retardation. One hundred and two patients (62.6%) had been referred from other medical institutions, with a particularly high number coming from public dental clinics for patients specializing in such patients. Conservative restorative procedures were performed in most cases (59.4%), with composite resin restorations being particularly frequent. After treatment, many patients returned to their referring medical institutions, which were responsible for subsequent management, but information on the posttreatment status was not available for some patients. Tokyo Dental College Suidobashi Hospital frequently collaborates with local medical institutions, and the present results suggest the importance of improving such collaboration.

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This study aimed to investigate retrospectively the outcome of surgical periodontal therapy. Periodontal surgeries implemented at General Dentistry, Tokyo Dental College Suidobashi Hospital during the period of April 2010 through March 2012 were subjected to data analysis. After initial periodontal therapy, 17 clinicians performed a total of 138 periodontal surgeries in 80 patients with moderate to advanced periodontitis (31 men and 49 women; mean age 54). Cases (sites) operated were as follows: open flap debridement=102, periodontal regenerative therapy=29 (17 for intrabony defects, 12 for furcation involvements) and periodontal plastic surgery=7. Enamel matrix derivative or bone graft was used for regenerative therapy. Clinical data were analyzed focusing on the comparison between open flap debridement and regenerative therapy. At 5 months after open flap debridement, mean reduction in probing depth (PD) and gain in clinical attachment level (CAL) was 3.9 mm (range -1.0-9.0) and 2.3 mm (range -1.0-9.0), respectively. The corresponding values with regenerative therapy were 4.0 mm (range 0-8.0) and 2.8 mm (-1.0-6.0), respectively. At sites with initial PD≥8 mm, a significantly greater gain in CAL was obtained with the regenerative therapy than with flap surgery (mean CAL gain 4.3 mm vs. 2.9 mm, p<0.05). Periodontal surgery performed in our clinical setting demonstrated a favorable short-term outcome. Our data suggest the efficacy of regenerative therapy, in particular for the treatment of deep pockets.

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The aim of this study was to determine age- and sex-specific differences in the ratio of occluding pairs (OPs) to number of present teeth (PT). The data were obtained from a periodontal disease examination carried out under a health promotion law in a city located northeast of Tokyo, Japan, in 2005. Data from a total of 5,131 (1,735 male and 3,396 female) 40-, 50-, and 60-year-old participants were analysed in this study. Occluding pairs were counted by analysing dental charts. Sex-related differences in the ratio of mean PT to OPs were found at 30 PT in 40-year-olds, at 22 PT and 28 PT in 50-year-olds, and at 24 PT and 28 PT in 60-year-olds. Age differences were only found at 28 PT in males. These differences in the ratio of PT to OPs were influenced by the presence of third molars and the type of tooth loss pattern. In some cases the PT-to-OP ratio is influenced by age and sex, but these differences are very small. Age and sex need to be considered when using PT to estimate OPs.

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Osteoblasts play a major role in bone formation. Osteoblasts employ intracellular Ca²⁺ as a second messenger to modulate hormonal responses and a cofactor for bone mineralization. Adrenomedullin (ADM) promotes osteoblast growth and proliferation, inducing an increase in bone mass. Voltage-dependent Ca²⁺ channels (VDCCs) mediate the influx of Ca²⁺ in response to membrane depolarization. Voltage-dependent Ca²⁺ channels serve as crucial mediators of many Ca²⁺-dependent functions, including growth of bone and regulation of proliferation. The purpose of this study was to investigate the effects of ADM on VDCC currents in osteoblasts using a patch-clamp recording method. To our knowledge, the data presented here demonstrate for the first time that ADM facilitates VDCCs in osteoblasts.

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Although the International Committee of Medical Journal Editors has announced that masking the eye area in clinical photographs is inadequate for protection of patient anonymity, such examples can frequently be found in the field of oral surgery, indicating a large gap between the ideal and reality. In this study, two internationally and one domestically distributed journal published between 2009 and 2011 were analyzed. All articles containing clinical photographs of a patient's facial area were extracted and assessed based on 3 criteria: 1) extent of facial area visible, 2) necessity of showing eye area, and 3) presence or absence and form of eye masking. Showing the eye area was judged necessary in a total of 69.7% and 72.4% of photographs in the international journals, but in only 34.4% in the domestic journal. No eye masking was observed in 46.0% of photographs in one international journal and in only 4.7% in the domestic journal. Inappropriate masking occurred in 57.8% in the domestic journal. These results indicate that usage of eye masking reflects the editorial policy of a journal, influencing both author and reader consciousness. Although there may be problems in adhering to privacy regulations in a clinical setting, more needs to be done to ensure patient privacy in both journals and an educational setting.

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