The Bulletin of Tokyo Dental College
Print ISSN : 0040-8891
最新号
選択された号の論文の8件中1~8を表示しています
Original Article
  • Tadashi Kogou, Takashi Takaki, Takahiko Shibahara
    2018 年 59 巻 3 号 p. 147-161
    発行日: 2018年
    公開日: 2018/09/14
    ジャーナル フリー

    Two-dimensional cephalometric analysis is commonly used in planning and evaluating the outcome of orthognathic surgery. It is difficult to arrive at an accurate evaluation with this method, however, as the jaw bones overlap in profile. Therefore, the purpose of this study was to use 3-dimensional (3-D) orthognathic treatment planning software for measurement of distances and angles to evaluate change in dentofacial morphology and stability after orthognathic surgery in patients with jaw deformity and facial asymmetry. Computed tomography with SimPlant O&O® (Materialize Dental, Belgium) was used to obtain data at before surgery (T1) and at 1 month (T2) and 1–2 years postoperatively (T3). Reference points, reference planes, and evaluation items were set to measure angles and distances. The average values at T1, T2, and T3 and the standard deviations were obtained. The analyses of change in distance and angle between T1 and T2 in both the maxilla and mandible revealed that the amount of postoperative deviation and change was greatest in the mandible (p<0.05). These findings showed a correlation between postoperative change in position of the chin and symmetry. Only a minimal amount of change was observed between T2 and T3 in both the maxilla and mandible. The results also revealed a correlation between positional change in both the proximal and distal bone segments and stability. It was found to be possible to determine change in horizontal, vertical, and anterior/posterior angle in both the maxilla and mandible by such 3-D analysis. The results suggest that the chin is the most appropriate facial element for evaluation of symmetry after orthognathic surgery.

  • Koichiro Ogami, Takayuki Ueda, Masahiro Ryu, Sayaka Tajima, Kaoru Saku ...
    2018 年 59 巻 3 号 p. 163-169
    発行日: 2018年
    公開日: 2018/09/14
    ジャーナル フリー

    The tongue surface in older people requiring nursing care is often coated with a layer believed to comprise, keratinized products of degeneration, food residue, bacteria, and leukocytes attached to the tongue papillae. Which factors affect the status of this tongue coating remain to be elucidated, however. The purpose of this study was to evaluate factors related to tongue coating status in older people requiring nursing care. The study participants comprised 41 individuals admitted to special nursing homes for the elderly. After undergoing tooth brushing and tongue cleaning by the facility staff, the participants were required to refrain from oral cleaning until evaluation of tongue coating status, which was performed just after lunch. The moisture level of the tongue surface was measured and total number of oral microbes determined. Food type, care level, and sex were determined by a questionnaire given by the attending nurses. Correlations between the tongue coating status and various factors were analyzed using Spearman's rank correlation coefficient. The participants were divided into 2 groups according to the median value of the tongue coating status. Factors related to tongue coating were analyzed using binomial logistic regression analysis (α=0.05). Tongue coating status showed a significant correlation with the total number of oral microbes on the tongue surface (rS=0.449, p=0.003), type of food (rS=0.388, p=0.012), and care level (rS=−0.308, p=0.050). Logistic regression analysis revealed that the food type of the side dish significantly affected tongue coating status. These results showed a correlation between tongue coating status and type of food of the side dish in older people requiring nursing care.

  • Tetsuhide Makiguchi, Hiroki Imai, Aiko Arakawa, Ayako Tashiro, Takuro ...
    2018 年 59 巻 3 号 p. 171-181
    発行日: 2018年
    公開日: 2018/09/14
    ジャーナル フリー

    The purpose of the present study was to investigate change in the size of the jaw and deciduous teeth in Japanese children over the past 40 years by performing measurements on plaster models of the dental arch obtained from children born between 2007 and 2009 (2000s group) and children born between 1968 and 1974 (70s) group. A total of 61 children were enrolled in the 2000s group, comprising 25 boys (average age, 4 years 5 months) and 36 girls (average age, 4 years 4 months), and 93 children in the 70s group, comprising 45 boys (4 years 6 months) and 48 girls (4 years 4 months). The mesiodistal width of the crown, dental arch width, dental arch length, dental arch height, and available arch length in these groups were measured using a 3D measurement system and the sums of the mesiodistal width of the crown and tooth size-arch length discrepancies calculated. The results of the two groups were statistically compared and the following conclusions reached: the size of deciduous teeth has not changed statistically over the last 40 years; the size of the dental arch has decreased in boys (p<0.01), while remaining approximately the same in girls; and the tooth size-arch length discrepancy has decreased, especially in boys (p<0.01). These results indicate that the interdental spaces of the deciduous dentition have decreased, increasing the risk of crowding in Japanese children.

  • Masashi Eriguchi, Akira Watanabe, Kenichirou Suga, Youko Nakano, Teruo ...
    2018 年 59 巻 3 号 p. 183-191
    発行日: 2018年
    公開日: 2018/09/14
    ジャーナル フリー

    The purpose of this study was to investigate the long-term effects of two-stage palatoplasty on the morphology of the maxillary alveolar arch and occlusion using plaster models of the maxilla and mandible obtained from patients with unilateral complete cleft lip and palate who also underwent orthodontic treatment. A total of 20 patients undergoing two-stage palatoplasty by Perko's method (Group T) were enrolled. Plaster models of the maxilla and mandible were obtained from each patient at Time 1, on commencement of orthodontic treatment in the mixed dentition period; at Time 2, on that of orthodontic treatment in the permanent dentition period; and at Time 3, on completion of active orthodontic treatment. Analysis of occlusion and morphological analysis were performed using a 3-dimensional measuring system. The results were compared with 15 patients who underwent one-stage palatoplasty by the push-back method using a mucoperiosteal flap (Group P). Alveolar morphology and the relationship between the maxilla and mandible were satisfactory in Group T. The palates in Group T were deeper and larger than those in Group P. Alveolar collapse in Group T was milder, and impairment of the alveolar morphology less notable than in Group P, as surgical invasion to the anterior alveolar region was avoided during the palatal growth period. These results suggest that two-stage palatoplasty is advantageous for jaw development.

Case Report
  • Takeshi Onda, Kamichika Hayashi, Naoki Shiraishi, Nobuo Takano, Takahi ...
    2018 年 59 巻 3 号 p. 193-200
    発行日: 2018年
    公開日: 2018/09/14
    ジャーナル フリー

    Verruciform xanthoma (VX), a papillary or wart-like lesion of the mucosa, is histopathologically characterized by papillary projection of the epithelium and an aggregation of foam cells in the lamina propria. Here, we describe a case of VX in the posterior mandibular gingiva, initially suspected to be a benign lesion based on clinical findings and cytology prior to an excisional biopsy. The patient was a 62-year-old man who had visited a local dentist approximately 1 year earlier, presenting with a white lesion in the left posterior mandibular gingiva that resisted removal by scraping. The lesion was left untreated as there were no subjective symptoms. Thereafter, the surface of the lesion roughened and the patient was referred to our department for a comprehensive examination. A circumscribed, granular mass, 15-mm in diameter, with a red and white surface was observed in the left posterior mandibular buccal gingiva. Exfoliative cytology was performed. The diagnosis was a class III lesion. Excisional biopsy was performed under local anesthesia. Histopathological examination led to a diagnosis of VX. At 1 year postoperatively, the patient is making satisfactory progress without recurrence. Verruciform xanthoma is difficult to diagnose preoperatively, and is commonly resected under a clinical diagnosis of papilloma or benign tumor. A benign lesion was also initially suspected in the present case and cytological analysis performed to confirm absence of malignancy. The lesion could not be diagnosed as VX preoperatively. Verruciform xanthoma can be over-diagnosed based solely on cytological examination because it often involves cellular atypia reflecting its characteristic extension of rete pegs and keratinization of surface cells, indicating the need for care in arriving at a definitive diagnosis.

  • Gentaro Mori, Takafumi Kobayashi, Taichi Ito, Yasutomo Yajima
    2018 年 59 巻 3 号 p. 201-206
    発行日: 2018年
    公開日: 2018/09/14
    ジャーナル フリー

    Sjögren's syndrome (SS), an autoimmune disorder, affects the exocrine glands, including the lacrimal and salivary glands. It is characterized by symptoms of dry eye and dry mouth. As secretion of saliva decreases, patients with SS experience rampant caries, pain in the oral mucosa, inflammation and hardening of the salivary glands, abnormal taste, dysphagia, and loss of teeth earlier than healthy individuals. A removable partial denture is often used as a prosthesis after tooth loss. Compromised salivary lubrication, however, can produce traumatic ulceration of the mucosa, making use of a removable prosthesis in SS patients painful. In such cases, a dental implant is likely to be requested as an alternative. This report describes dental implant treatment in an SS patient, a 50-year-old woman who presented with the chief complaint of masticatory dysfunction and pain due to a removable partial denture. Eight implants were placed in the maxillary and mandibular first molar tooth and second molar tooth regions. Following a 4-month non-loading period, second-stage surgery and provisional restoration with a screwretained implant temporary crown were performed. Screw-retained superstructures were fitted by means of a customized titanium abutment and zirconia crown as the final restoration. No complications, including inflammation of peri-implant soft tissue or resorption of peri-implant bone, were observed at 3 years following placement of the superstructures.

  • Mika Otonari-Yamamoto, Kei Nakajima, Junichiro Sakamoto, Kenichi Imoto ...
    2018 年 59 巻 3 号 p. 207-212
    発行日: 2018年
    公開日: 2018/09/14
    ジャーナル フリー

    On images, a dermoid cyst is often described as resembling a “sack of marbles” or “marbles in a bag”. Typically, it comprises an inhomogeneity filled with multiple nodules in a fluid matrix on both computed tomography and magnetic resonance imaging (MRI). How it appears, however, will vary depending on its histological contents, which may cause confusion in arriving at a diagnosis. This report describes a dermoid cyst in the floor of the mouth of a 55 year-old woman that showed an atypical internal appearance on MRI. Most of the lesion showed homogeneous high signal intensity on T1 - and T2-weighted images, suggesting that it was derived from fat. A small area within the mass, however, showed moderate signal intensity almost equal to that of muscle on T1-weighted images and high signal intensity on fat-suppressed T2-weighted images. Given the location of the lesion, a dermoid cyst was one possible diagnosis. A lipoma or lipoma variants were also considered, however, based on signal intensity. Histopathological section of the excised specimen revealed a dermoid cyst with sebaceous glands in its walls and keratin in its cavity. Dermoid cysts show variation in their internal structures and contents. Since MRI can reflect such histological variation, signal intensity requires careful interpretation.

Clinical Report
  • Mai Ohkubo, Takayuki Ueda, Hiroki Sugito, Akira Watanabe, Fumi Seshima ...
    2018 年 59 巻 3 号 p. 213-221
    発行日: 2018年
    公開日: 2018/09/14
    ジャーナル フリー

    A working group established at Tokyo Dental College Suidobashi Hospital considered how to manage patients experiencing difficulties with food intake during the process of dental treatment. This resulted in the opening of an in-hospital booth dedicated to providing advice on such problems. A survey was performed to determine the number of patients utilizing this facility and the department which they were attending with the aim of investigating factors involved in eating-related problems. The results revealed that patients were being referred to the booth from the departments of dental prosthetics, conservative dentistry, oral and maxillofacial surgery (by both dentists and dietitians), oral implantation, and orthodontics. Patients were provided with information on the booth by their dentist or dietician, either by means of introductory materials or verbally. These patients were requested to complete a questionnaire, with informed consent, over a 2-year period. The participants were classified according to age and original dental problem on attending this hospital and the results analyzed. The inability to eat hard foodstuffs, difficulty in chewing, inability to open the mouth, insufficient nutrition, unbalanced nutrition, intraoral pain, and difficulty in swallowing were all identified as problems related to eating. A total of 1,948, 413 visitors had received introductory materials, while 156 had learned of the facility verbally. Looking at department as a factor, the inability to eat hard foodstuffs and difficulty chewing occupied a large percentage of the reported problems for all departments. Taken together, these results revealed that many patients experienced difficulties in eating during the process of treatment. This indicates that it is necessary to give the appropriate eating instructions to each patient according to their specific needs and stage of dental treatment.

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