Japan Dental Association

Author(s): Takashi NAKAJIMA１），Susumu ADACHI２），Kaoru KOBAYASHI３）

Affiliation: １）Miho Dental Clinic
２）Adachi Law Office
３）Department of Oral and Maxillofacial Radiology and Diagnosis, Tsurumi University School of Dental Medicine

Title: On the Use of Judicial Precedent for Medical Safety : Legal risk management in dental treatment

Abstract

As medical accident and malpractice suits have become more common, various trends in judicial outcomes have emerged. Compared with medical treatment, events that directly affect a patient’s life or require immediate cardiopulmonary resuscitation are less common in dental treatment. Since dental treatment frequently addresses patients’ chief complaints, e.g., the rehabilitation of masticatory functions or the restoration of esthetics, dental lawsuits often involve matters related to medical interviews, informed consent, or treatment modalities and their indications. Therefore, the establishment of a good relationship between patient and medical professional is critical. On the other hand, there have been many cases of duty of care violations and incidents related to the skill of clinicians. It is necessary for dental professionals to continuously improve the quality of the treatment（including the emergency care）they provide.

Keywords: Medical lawsuits, Medical safety, Quality of medical treatment

Author(s): Osamu KOMIYAMA

Affiliation: Department of Oral Function and Rehabilitation, Nihon University School of Dentistry at Matsudo

Title: Persistent toothache : clinical considerations for chronic toothache

Abstract

Toothache is a frequently encountered in regular dental practice, and primary toothache is relatively easy to diagnose and treat. However, general dentists often find it difficult to recognize non-odontogenic toothache, which is a painful tooth condition that occurs in the absence of any clinically evident cause affecting the teeth or periodontal tissue. The current approach to non-odontogenic toothache often involves ineffective or irreversible dental procedures such as pulpectomy and/or tooth extraction. There are a number of possible causes of non-odontogenic toothache, and they should be treated in a cause-dependent manner. Unnecessary dental treatment should be avoided.

Keywords: Toothache, Peripheral painful traumatic trigeminal neuropathies, Referred pain

Author(s): Mariko NAITO

Affiliation: Department of Preventive Medicine, Nagoya University Graduate School of Medicine

Title: The use of patient-reported outcomes to assess the effects of a dental intervention : Quality of life as a measuring tool

Abstract

Health professionals need to have a precise understanding of the health status of their patients. However, patients may have considerable concerns regarding their health and daily lives that health professionals do not understand sufficiently. Medical and dental interventions can be assessed for patient perception using various measuring scales or instruments, and the results of such assessments can be used to improve them. Understanding the concept of QOL and instruments are essential for introducing QOL assessment as a measurement of health outcome.

Keywords: Quality of life, Patient-reported outcomes, Clinical assessment

Author(s): Akio HARADA１）, Masahiro YAMADA２）, Hiroshi EGUSA２）

Affiliation: １）Tohoku University Hospital, Fixed Prosthodontics
２）Tohoku University Graduate School of Dentistry, Division of Molecular and Regenerative Prosthodontics

Title: Selection of implant superstructure materials : Essential characteristics of crown restoration materials

Abstract

Implant-supported fixed prostheses are often prone to mechanical complications, depending on the structural characteristics of their components and the peri-implant tissue. Recent advances in CAD/CAM technology have led to the development of various brittle materials, including zirconia, that can be used in the superstructures of implant-supported fixed prostheses. However, selection criteria for such materials remain to be established. This paper describes the characteristics of various crown restoration materials and, along with a literature review, considers the selection criteria for crown superstructure materials, focusing on the avoidance of mechanical complications.

Keywords: All-ceramic crowns, Mechanical complications, Zirconia

Author(s): Toshiaki UENO１），Toshikazu YASUI２）

Affiliation: １）Sports Medicine and Dentistry, Graduate School of Medical and Dental Sciences, Tokyo Medical and Dental University
２）Meikai University

Title: Role of sports dentists now and in the future

Abstract

An official certified sports dentistry program was started by the Japan Sports Association in 2013. Sports dentists are expected to play an increasingly active part in various sporting fields. Japan will host the 2019 Rugby World Cup and the 2020 Olympic Games, and sports dentists could make valuable contributions to these events. The purpose of this paper is to look back over the history of sports dentistry in Japan in order to illustrate the contribution made by sports dentists and to discuss how their role is expected to develop in future.

Keywords: Sports dentistry, Sports dentist, Mouthguard

Author(s): Naoyuki TAKAHASHI

Affiliation: Institute for Oral Science, Matsumoto Dental University

Title: How is alveolar bone resorption caused by periodontitis?

Abstract

Periodontitis is characterized by gingival inflammation, which induces alveolar bone loss. Recent advances in bone biology have revealed the cellular mechanisms responsible for the differentiation and functioning of osteoclasts, which are involved in bone resorption. The mechanism responsible for the inflammation induced by pathogenic bacteria has also been elucidated over the last quarter of a century, as has the mechanism by which bacterial components induce osteoclastic bone resorption. This article describes the cellular mechanisms responsible for bone resorption under normal conditions and during bacterial infections. In addition, the utility of anti-bone resorption drugs as treatments for periodontitis is discussed.

Keywords: Periodontal disease, Microbism, Alveolar bone resorption

Author(s): Akibumi OMI

Affiliation: Tokyo Medical University Hachioji Medical Center

Title: Application of the “WHO Surgical Safety Checklist” to Dental Treatment

Abstract

The World Health Organization Surgical Safety Checklist was published in 2008 in an attempt to reduce the occurrence of complications and death from surgery. According to various incident reports about dental treatment, intraoperative medical emergencies are not so rare, and patients whose conditions suddenly turn for the worse are often encountered. The Japanese population is aging rapidly so it is important that dentists are aware of their patients’ medical history and any coexisting complications in order to prevent accidents. The development of a new specialized checklist for dental treatment is required to ensure patient safety and prevent miscommunication of information about patient care among health care providers.

Keywords: World Health Organization（WHO）, Surgical safety checklist, Dental treatment

Author(s): Jun HOSONO

Affiliation: Hosono Dental Clinic

Title: Home dental care within the framework of the integrated community care system : The role of the family dentist

Abstract

In Japan, the number of elderly people who require dental care but are not able to visit a dentist is increasing due to the rapid aging of Japanese society, especially in urban areas. Home dental care could help to solve this issue. Home dental care involves the provision of comprehensive oral healthcare, including dental treatment and other oral management strategies, e. g., for improving hygiene or functional activity including feeding and swallowing rehabilitation. Therefore, it should be performed within the framework of the integrated community care system, which means that a multi-disciplinary approach is essential for successful care provision. This article includes some practical tips for family dentists who are trying to provide home dental care within the community healthcare setting.

Keywords: Home dental care, The integrated community care system, Family dentist

Author(s): Tetsuo OHNISHI

Affiliation: Oral Care Center, Department of Dentistry, Ikeda City Hospital

Title: Perioperative oral management by dental professionals : A Basic Concept

Abstract

In patients who undergo surgery under general anesthesia, perioperative oral management can be provided as a supportive therapy by dental and medical professionals. Perioperative oral maintenance and care can prevent complications including ventilator-associated pneumonia and is expected to facilitate early recovery after surgery. Enumeration of oral bacteria using a chair-side device can be useful for assessing the oral condition of patients in the perioperative period and is expected to be used to aid evidence-based decision making regarding treatment. Mutual understanding among the multidisciplinary perioperative team is key to the success of this management strategy.

Keywords: Perioperative oral management, Oral bacteria, Supportive therapys

Author(s): Kenichi MATSUZAKA

Affiliation: Department of Clinical Pathophysiology, Tokyo Dental College

Title: Pathological consideration of oral cancer and pathological examination

Abstract

Cancer is caused by the accumulation of genetic mutations, and invasion and metastasis have a significant negative effect on the human body. Cancer cells infiltrate and metastasize by weakening cell-to-cell junctions and destroying the extracellular matrix. It is known that oral cancer predominantly arises from the oral epithelium as squamous cell carcinoma. However, precancerous lesions and conditions such as leukoplakia and oral lichen planus should not be overlooked and have to be followed-up in clinical practice. So, this review describes the mechanisms responsible for cancer development, infiltration, and metastasis and also discusses the pathological findings of precancerous lesions, conditions, and oral squamous cell carcinoma.

Keywords: Oral cancer, Squamous cell carcinoma, Pathological examination

Author(s): Yoshiharu NAKAMURA

Affiliation: Tsurumi University, School of Dental Medicine, Department of fixed Prosthodontics

Title: Clinical procedure of direct resin core build-up with fiber core placement

Abstract

Resin core build-up with fiber post placement prevents root fractures for the following reasons : 1）The elastic modulus of fiber posts is similar to that of dentin. 2）Stress concentrates on the post tip using metal core build-up but on the tooth neck using resin core build-up with fiber post placement. 3）The dentin, resin for the core, and fiber post are integrated by adhesion. To maximize these advantages, an appropriate bonding procedure is important.

Keywords: Fiber post, Resin core build-up, Root fracture

Author(s): Yoshio SAITO

Affiliation: Department of Pharmacy, Tsurumi University Dental Hospital

Title: Prevention of drug-induced medical complications : Selection of an appropriate drug in dental practice

Abstract

To prevent drug-induced medical complications in dental practice, it is important to assess the safety of the planned dental treatment and to select appropriate drugs. It is thought that a reference source, if one were available, would aid efficient and appropriate drug selection in cases in which safety evaluations were performed in busy dental practices or in which it was necessary to select an alternative drug because the standard drug could not be used. This paper presents important points that clinicians should bear in mind when selecting a local anesthetic, antimicrobial agent, or analgesic. A list of these drugs is provided for reference.

Keywords: Drug, Medical complications, Reference material

Author(s): Nagakazu KO

Affiliation: Ko Dental Clinic

Title: Clinical Characteristics of Patients with Dental Metal Allergy : The importance of the medical-dental cooperation

Abstract

Of the conditions caused by dental metal allergy, skin allergy is by far the most common. This study suggests that dental metal allergy, to a considerable extent, is a latent disease that arises in patients with treatment-resistant allergic skin diseases. Therefore, medical-dental cooperation during the treatment of dental metal allergy is expected to facilitate the identification of the causative allergen and healing.

Keywords: Dental metal allergy, Lymphocyte stimulation test, Atopic dermatitis

Author(s): Akira KATAKURA

Affiliation: Department of Oral Pathobiological Science and Surgery, Tokyo Dental College

Title: Essential Knowledge and Skills of Systemic Assessment for General Practice Dentists Today

Abstract

New aims of dental treatment in Japan is to prevent a decline in oral function accompanying aging. It is also important to support healthy longevity and to manage the oral function through the life cycle from infant to elder. General dentists need the knowledge and skills to assess not only the oral but systemic conditions of patients accurately in order to meet needs of patients and medical staff in community health care system.

Keywords: Systemic assessment, Community health care system, Medically compromised patient, Clinical examination

Author(s): Takeshi KIKUTANI

Affiliation: Tama Oral Rehabilitation Clinic, The Nippon Dental University

Title: Support for the eating in the region

Abstract

Japan is becoming a super-aged society, with many elderly people who have physical and/or cognitive dysfunctions living in the community. Likewise, this certainly points out that most elderly people suffered from motor masticatory disturbance have been increasing. The strategy for patients with motor masticatory disturbance is not only treatment approach as motor function training but also management of an appropriate modified food type for each patient’s eating function as a compensatory approach. Furthermore, an environmental approach for improvement of accessibility to these modified food in the society are also needed.

Keywords: Motor masticatory disturbance, Modified food, Regional cooperation

Author(s): Kosei MATSUDA

Affiliation: Matsuda dental office

Title: Clinical course of implant-supported partial dentures

Abstract

We considered that, in multiple-tooth defective dentition cases in which pressure-receiving and -applying conditions have deteriorated, it is difficult for conventional partial dentures alone to facilitate favorable postoperative courses. On the other hand, fixed-prosthetic defective treatment using multiple implants requires advanced techniques from clinicians, and causes the marked financial and physical burdens of patients ; therefore, it is considered difficult for both clinicians and patients. Furthermore, in recent years, there have been reports of difficulty in the maintenance of fixed implant prostheses due to the aging of patients. Therefore, with this background, we evaluated the advantages of the incorporation of implants into removable dentures, based on postoperative courses.

Keywords: Modification of defective dentition, Implant, Removable partial denture

Author(s): Yasutaka OKAMOTO１），Junichiro MACHIDA２）

Affiliation: １）Department of Plastic & Reconstructive Surgery and Medical Information Management Group, Toyota Memorial Hospital
２）Department of Oral and Maxillofacial Surgery, Toyota Memorial Hospital

Title: Outcome-oriented clinical pathway to improve medical quality

Abstract

In recent years, many acute care hospitals have been working on CP（clinical pathway）. Rehabilitation hospitals, chronic care hospitals, clinics, and senior care homes have also become involved with CP through the development of liaison CP. This paper describes the history, definition, significance of the introduction, and usage of CP, indicating that CP is a useful tool in the promotion of medical team and quality improvement activities. Also, CP is considered to be a useful tool to promote regional medical cooperation, and, thus comprehensive community health care.

Keywords: Clinical pathway, Outcome-oriented, Medical cooperation

Author(s): Takeyoshi YONEYAMA

Affiliation: Yoneyama Dental Clinic

Title: Dawn of the Era of Geriatric Periodontology and Geriatric Periodontal Treatment : Selection in a Super-aged Society

Abstract

In an integrated community care system, we should shift the idea of functioning only in the dental clinic to functioning in a community support-oriented facility. This is required urgently. After applying this system within a super-aged society, the local community will appreciate our activities in the district. In this context, periodontal treatment in conjunction with support for the oral function is the central tenet of geriatric periodontology and geriatric periodontal treatment.

Keywords: Super-aged society, Aged, Periodontology

Author(s): Haruhiko ONO

Affiliation: ONO Dental Clinic

Title: Application of cone beam computed tomography to periodontal regenerative therapy

Abstract

Cone beam computed tomography（CBCT）is a very effective tool for periodontal regenerative therapy. It allows us to obtain a better understanding of the defects prior to surgery and to plan ahead and reduce complications. It can also provide information about how root surfaces should be debrided, the optimal flap design, and material selection. With the help of CBCT, we can better assess whether a patient is indicated for periodontal regenerative therapy and formulate better strategies.

Keywords: Periodontal regenerative therapy, Treatment strategies, CBCT 16690

Author(s): Yoshihiro YAMADA

Affiliation: Department of Disaster Relief Medicine/Dentistry, Division of Forensic Dentistry, Graduate School of Kanagawa Dental University

Title: Age estimation using the racemization method provides useful information for criminal investigations

Abstract

In recent years, the age estimation of unidentified human bodies has become increasingly important in criminal investigations and large disasters. As such, age estimation is one of the most important functions of forensic dentistry. The conventional method of aspartic acid racemization is based on the estimation of the d-l-aspartic acid ratio in slow turnover tissues, such as tooth tissue, in order to estimate the age of an individual. This method has recently been applied to age estimation in criminal investigations. Herein, we report three cases in which age estimation was performed using the racemization method. It was possible to estimate the age of the corpses using the racemization method. Furthermore, the racemization method was able to determine the influence of heat on the teeth. These results suggest that the racemization method is useful for obtaining information in criminal investigations.

Keywords: Age estimation, Aspartic acid, Racemization

Author(s): Kaoru SAKURAI, Takayuki UEDA

Affiliation: Department of Removable Prosthodontics and Gerodontology, Tokyo Dental College

Title: Key points on relining removable dentures with soft liner

Abstract

This paper outlines key points regarding the relining of removable dentures with soft liner. Specifically, it examines soft liner and its effectiveness, and tips, tricks, and potential pitfalls associated with the usage of such material. Also, the indications for relining removable dentures with soft liner and some clinical cases are discussed.

Keywords: Soft liner, Relining, Removable prosthodontics

Author(s): Yoshitaka KINOSHITA

Affiliation: Kinoshita Dental Clinic

Title: Protection of the oral mucosa in the nasal cavity during malignant melanoma treatment : Experience with a heavy particle beam and DAV therapy

Abstract

In the course of combination therapy for head and neck cancer involving surgery combined with anti-cancer agent treatment, pain-induced dysphagia and oral mucositis occur in almost all cases. Malnutrition and reduced immunity can prevent the desired treatment plan from being accomplished. The author has treated a case of malignant melanoma that occurred at the bottom of the nasal cavity with heavy particle beam（carbon ions）therapy and an anti-cancer agent. The patient was able to continue to ingest normal meals ; i. e., they did not require a liquid diet, and their pain during eating was reduced. Furthermore, it significantly shortened the period of oral mucositis and helped to overcome various side effects. By taking advantage of the knowledge and skills of dentists, the pain caused by oral mucositis can be controlled.

Keywords: Oral mucosa protection device, Oral mucositis, Heavy particle radiotherapy

Author(s): Akira MAKINO

Affiliation: Makino Dental Office

Title: Importance of high quality initial periodontal therapy

Abstract

We often experience treatment cases in which brushing, scaling and root planing results in favorable treatment outcomes including long epithelial attachment. I speculate that, in some cases, the attachment might have been changed to connective tissue attachment during appropriate maintenance care. This can be achieved by improving the quality of initial periodontal therapy. The following factors are important for high quality initial periodontal therapy : 1. Continuous improvement of patient motivation for plaque control. 2. Painless root planing without anesthesia. 3. Selection of the most appropriate time to start root planing. Painless root planing without anesthesia minimizes trauma to periodontal tissue. It is applicable to severe cases in which tooth extraction is generally considered necessary and will be beneficial for the tooth migration to natural positioning and gingival creeping.

Keywords: Root planing without anesthesia, Time to start root planing, Long epithelial attachment

Author(s): Yoshihiro YAMADA

Affiliation: Department of Disaster Relief Medicine/Dentistry, Division of Forensic Dentistry, Graduate School of Kanagawa Dental University

Title: DNA typing plays a conclusive role in personal identification and criminal investigations

Abstract

The condition of DNA obtained under forensic conditions is often unsuitable for analysis other than that by the polymerase chain reaction（PCR）. Variable numbers of tandem repeats, short tandem repeats（STR）, Y-chromosome STR and mitochondrial DNA（mtDNA）at specific regions are potentially useful for forensic practice. Experimental results and forensic casework have shown that the DNA contained in teeth and human remains can be extracted and typed. The genotypes of some nuclear DNA markers and mutations obtained from mtDNA sequences can support positive identification.

Keywords: DNA analysis, short tandem repeat, Y short tandem repeat, Mitochondrial DNA

Author(s): Ken-ichi FUKUDA

Affiliation: Division of Special Needs Dentistry and Orofacial Pain, Department of Oral Health and Clinical Science, Tokyo Dental College

Title: Management of elderly patients using visiting care in dentistry

Abstract

Japan is becoming a super-aging society, with one in three individuals expected to be elderly in the near future. Consequently, the incidence of diseases such as dementia and cerebrovascular disease has increased, as has the need for visiting care. The difficulties and risks associated with dental care are also expected to be more prevalent, and, as a result, safer dental treatment modalities will also become more necessary. Therefore, clinicians need to assess in detail the condition of elderly patients. The management of elderly patients using visiting care in dentistry is discussed herein.

Keywords: Management of patients, Dental care for aged, Visiting care in dentistry 38802

Author(s): Yutaka SUGIYAMA

Affiliation: Sugiyama Dental Clinic

Title: The challenge for “zero cavities” : Analyzing patterns of development to determine causes of dental caries

Abstract

The prevalence of dental caries is decreasing. However, new caries can form in some patients regardless of receiving regular maintenance by dental professionals. Evaluations of teeth and tooth surfaces with such lesions revealed specific patterns. Interventions based on analyses of these patterns markedly reduced the development of new caries. This report describes representative cases and interventions.

Keywords: Plaque control, Eating habits, pH

Author(s): Mitsuharu INOKO

Affiliation: Inoko Dental Clinic

Title: An innovative releasing incision using an upward motion scissors technique

Abstract

Flap management is a key factor for the success of periodontal surgery and bone regeneration for dental implants. A safe and effective approach to adequately releasing incised flaps using scissors, upward motion scissors technique, was demonstrated in anatomical challenging areas where two types of bone augmentation proceeded. This technique can avoid potential complications with exposure during bone regeneration therapy and allows secure and reliable primary flap closure for predictable outcomes.

Keywords: Guided Tissue Regeneration（GTR）method, Guided Bone Regeneration（GBR）method, Release incision

Author(s): Tetsutaro YAMAGUCHI，Kotaro MAKI

Affiliation: Department of Orthodontics, School of Dentistry, Showa University

Title: Recent advances in gene discovery for malocclusion

Abstract

The term “malocclusion” refers to a number of conditions including crowding, mandibular prognathism, edge-to-edge occlusion, maxillary protrusion, spacing, open bite, and deep bite. These abnormal conditions typically occur due to abnormalities in teeth, the underlying craniofacial components, or both. Genetic and environmental factors play important roles in the etiology of malocclusion. The relative influences of genetic and environmental factors on the etiologies of most types of malocclusion have not yet been clearly defined. On the other hand, recent studies and advances in human genetics have provided a better understanding of the role of gene（s）in the etiology of malocclusion. The elucidation of genetic factors is expected to contribute to dental practices by providing more detailed information on the etiology of malocclusion, estimating the risk of developing malocclusion（genetic diagnosis）, or establishing prevention methods. This study discusses current knowledge on and the evidence-based impact of human genetics as a review of the etiological factors of malocclusion.

Keywords: Malocclusion, Gene, Human genome

Author(s): Haruya OGAWA１），Yasushi NISHII２），Junji OHTANI３）

Affiliation: １）Ogawa Orthodontic Office
２）Department of Orthodontics, Tokyo Dental College
３）Ohtani Dental & Orthodontics

Title: MTM force system and application of orthodontic anchor screw

Abstract

Minor Tooth Movement（hereinafter “MTM”）has become indispensable to high quality comprehensive dental treatment. Understanding the diagnosis, treatment planning and force system is more critical rather than applying treatment, because it could be difficult to rebuild a failed MTM. The effectiveness of the orthodontic anchor screw （hereinafter “anchor screw”）to clinical applications has recently become widespread. The anchor screw is very effective because MTM cannot secure sufficient anchorage. Here, we explain the force system of conventional MTM and MTM with an anchor screw.

Keywords: MTM, Force system, Anchor screw

Author(s): Takashi NISHIOKA

Affiliation: Ministry of Health, Labour and Welfare

Title: The future of the social security system in Japan

Abstract

The “Social security reform national conference report”, which was published in August 2013, has become the cornerstone for reforms in the social security system in Japan. This report describes the direction of reforms in medical and nursing care as well as pensions, and summarizes concepts for the financing method for the pension scheme and mutual support between generations. We herein describe its contents, particularly those related to the pension scheme, reflect on the factors that led to the national conference report, and consider ways to organize the social security system in Japan.

Keywords: Social security reform national conference report, Financing method for the Pension scheme, Mutual support between generations

Author(s): Hirohisa ARAKAWA

Affiliation: Division of Oral Health, Department of Oral Science, Graduate School of Kanagawa Dental University

Title: Self-care fluoride application to prevent root caries

Abstract

Root caries in adults including the elderly represents one of the main health problems in the field of dentistry. Root caries needs to be detected at the softening stage before the loss of the root surface structure, and managed using noninvasive measures. The application of fluoride has been demonstrated to prevent and control dental caries. Fluoride toothpaste and mouthwash, which are available as self-care measures in Japan, can effectively prevent and control root caries. It is important for patients to be properly advised on the use of fluoride toothpaste, including post-brushing rinsing with a small amount of water.

Keywords: Root caries, Fluoride toothpaste, Fluoride mouthwash

Author(s): Shoji NAKASHIMA

Affiliation: （Former affiliation）Department of Cariology and Operative Dentistry, Division of Oral Health Sciences, Graduate School of Medical and Dental Sciences, Tokyo Medical and Dental University

Title: Understanding the roles of materials in dentifrice and fluoride action for dentists and hygienists

Abstract

Daily oral care including a dentifrice is significantly important for sustaining oral health. This article describes the characteristics and roles of materials used to prepare dentifrices and relationships between heath claims for dentifrices such as caries prevention and their active ingredients from the viewpoint of governmental regulations. The mechanisms of action of caries prevention and promotion of remineralization by fluoride contained in dentifrices are explained, although most fluoride in dentifrice is removed by rinsing after brushing the teeth for a short period.

Keywords: Dentifrice, Ingredient, Fuoride

Author(s): Takamichi MORIKAWA, Takahiko SHIBAHARA

Affiliation: Department of Oral and Maxillofacial Surgery, Tokyo Dental College

Title: Current status of and task for medication-and bisphosphonate-related osteonecrosis of the jaw

Abstract

Bisphosphonates（BP）specifically act on osteoclasts, which inhibits bone absorption. BP have been widely used to treat osteoporosis and the bone metastasis of malignancies. The incidence of BP-related osteonecrosis of the jaw （BRONJ）has rapidly increased in recent years. In Japan, BRONJ is characterized by osteoporosis in many cases. We have necessitated investigations on BRONJ on anti-resorptive agents-related ONJ（ARONJ）of BP and denosmab, medication-related ONJ（MRONJ）of anti-resorptive agents and angiogenesis inhibitors.. Position papers in Japan concerning it have also been modified in 2016. With enhanced medical cooperation among dentists, medical doctors, and pharmacists in performing appropriate dental treatments, it is important to obtain a clearer understanding of and prevent MRONJ.

Keywords: Bisphosphonate（BP）, BRONJ・ARONJ・MRONJ, Medical cooperation

Author(s): Tadahiro YANAGAWA１），Takashi USHIJIMA２），Daisuke TANOUE２），Shigeru OHYAMA３）， Koichi NAKAKUKI４），Koichi NISHI５）

Affiliation: １）Japan Dental Association, ２）Kumamoto Dental Association, ３）Kyushu District Dental Federation, ４）Maxillofacial Surgery, Graduate school of Medical and Dental Sciences, Tokyo Medical and Dental University, ５）Kagoshima Dental Association

Title: How Dental Associations reacted to the Kumamoto Earthquakes

Abstract

The tremor which occurred at 09 : 26 on April 14 was just a foreshock of the Kumamoto Earthquakes in 2016. The main shock struck the region at 01 : 24 on the 16th of the same month. “Natural disasters happen when we forget” - it is said that the deceased Professor Torahiko Terada of the University of Tokyo, who specialized in geophysics and conducted studied and surveys on the Great Kanto Earthquake in 1923, warned with this epigram. In recent years, prefectural dental associations throughout Japan have developed plans to specify actions to be adopted in the event of a disaster, and organize systems to appropriately manage major disasters. Furthermore, in disaster medicine-related sections of healthcare and medical plans, an increasing number of administrative bodies define the provision of emergency dental services, identification of individuals, and management of victims’ health through oral care as tasks to be accomplished by dental associations. This paper examines the measures implemented by the Kumamoto Dental Association, as well as the Japan Dental Association and Kyushu District Dental Federation, to manage the situation following earthquakes in a region where major disasters had not previously been expected.

Keywords: Interprofessional Collaboration, Kyushu District Dental Federation, JMAT operation 52996

Author(s): Tatsuya MORIMOTO

Affiliation: Morimoto Dental Office

Title: Clinical observation of the influence of occlusal force

Abstract

After graduating, I learnt the importance of following up at the study group. Clinical observations are made using materials such as intraoral and X-ray photographs. When investigating the prognosis of a case, a phenomenon was identified in which the influence of occlusal force was suspected ; therefore, we focused our attention on this phenomenon. The type of and mechanisms underlying this force currently remain unclear. There are presently no strategies or approaches by which to investigate this force, it is a rather ambiguous judgment of inference from the phenomenon. However, in spite of this, I would like to present it as a clinical question.

Keywords: The influence of force, Bruxism, Occlusion

Author(s): Katsunari HIRABA，Takumi MORITA，Tomoko MATSUNAGA

Affiliation: Department of Physiology, School of Dentistry, Aichi-Gakuin University

Title: Anterior dislocation of the articular disk from a physiological point of view : muscle activity of the lateral pterygoid muscle and occlusion

Abstract

Two hypotheses are herein proposed for the development of anterior dislocation of the articular disk. Both of these theories are applicable to mastication and based on our previous findings of the EMG activity of the lateral pterygoid muscle and condylar movement in humans and rabbits. One hypothesis is the “joint space expansion theory”, which predicts postero-inferior movement of the working-side condyle during the occlusal phase of mastication, indicating that the space lying between the condyle and articular eminence expands in order for the posterior band of the disk to slide anteriorly more easily. The other hypothesis is the “compressive load development theory”, which predicts the development of a compressive load on the working-side condyle due to the loss of molar teeth on the same working side.

Keywords: Triangle of support of the mandible, Postero-inferior condylar movements, Dislocation of the articular disk

Author(s): Kaoru KOIDE１，２），Fumi MIZUHASHI１，２），Toshihide SATO１），Naoki ASANUMA３），Atsuko KONDO４）

Affiliation: １）Department of Removable Prosthodontics, The Nippon Dental University School of Life Dentistry at Niigata
２）Functional Occlusal Treatment, The Nippon Dental University Graduate School of Life Dentistry at Niigata
３）The Nippon Dental University College at Niigata
４）Comprehensive Dental Care, The Nippon Dental University Niigata Hospital

Title: Diagnosis of stomatognathic function and treatment of temporomandibular disorder

Abstract

The diagnostic criteria for temporomandibular disorder established by The Japanese Society for the Temporomandibular Joint are consistent with DC/TMD, which represent the international standard for temporomandibular disorder. A method involving palpation of the temporomandibular joint and muscle to fully evaluate the type and degree of pain （including familiar pain）is also effective for the diagnosis and treatment of temporomandibular disorder. Additionally, a simple stomatognathic function inspection of the temporomandibular joint and muscle, which may be performed within a short time period, needs to be conducted in conjunction with an oral examination at the initial visit. In order to treat temporomandibular disorder, it is important to clinically understand the disease state and then treat it with effective manipulation or splint treatment.

Keywords: Diagnosis of stomatognathic function, Temporomandibular disorder, Manipulation technique

Author(s): Takeo FUJII

Affiliation: Department of Oral Health Promotion, Graduate School, Matsumoto Dental University

Title: Basic strategy for periodontal examinations of patients with periodontal diseases

Abstract

Clinical periodontal examinations include a comprehensive oral evaluation that is specific to periodontal tissues. The objective of this procedure is to assess the following :
1. Whether the patient’s periodontium is healthy or diseased.
2. The activity and extent of tissue damage if pathological changes are present.
3. The characteristics of the patient’s disease that influence a diagnosis, etiology, prognosis, and treatment plan.
Diagnostic procedures need to be systematic and organized for specific purposes. The findings obtained are combined in order to provide a meaningful explanation of the patient’s periodontal conditions.

Keywords: Periodontal disease, Periodontal tissue, Examination

Author(s): Kyoko KUROIWA

Affiliation: Murata Dental Clinic

Title: Preventing deterioration of the oral conditions of patients receiving care in their homes / facilities

Abstract

In Japan’s super-aging society, the numbers of the elderly, labor force participants, those with dementia, other impairments caused by other diseases, and cancer patients, who experience face feeding difficulty in chewing and swallowing due to oral problems, are increasing more rapidly than expected. The oral conditions of such individuals tend to markedly deteriorate. With the oral cavity and pharynx covered by high-viscosity saliva, secretions（phlegm/nasal discharge），and dried, exfoliated epithelial cells/tissue, they frequently face breathing difficulty, and many of them are diagnosed with dysphagia. To prevent the deterioration of their oral conditions, we are charged with the task of disseminating oral care and rehabilitation, as well as pharyngeal care, by helping multiple professionals learn appropriate methods for these approaches, and perform them through collaboration with dental professionals.

Keywords: Super-aging society, Oral care and rehabilitation, pharyngeal care, Multi-professional collaboration

Author(s): Masataka KASAHARA

Affiliation: Department of Pharmacology, Tokyo Dental College

Title: Knowledge of herbal medicine

Abstract

The traditional herbal medicine is effective for chronic diseases. It may be useful for difficult diseases such as intractable stomatitis, periodontitis, temporomandibular disorder, or trigeminal neuralgia. The objective of this report is to increase knowledge of herbal medicines that can be used for diseases of the oral and maxillofacial regions. I regard this as the first step in expanding the use of herbal medicine in the field of dentistry.

Keywords: Herbal medicine, Prescription, Disease

Author(s): Takehiro ARISAKA１，２，４），Hitoshi TAGA３，４），Morio TONOGI１，４）

Affiliation: １）Department of Oral and Maxillofacial Surgery, Sleep Surgery Unit, Nihon University School of Dentistry
２）Ota Memorial Sleep Center, Sleep Surgery Center, Ota General Hospital
３）Dentistry and Oral Surgery, JR Tokyo General Hospital
４）The Japanese Academy of Dental Sleep Medicine

Title: The dentistry approach to obstructive sleep apnea Your snoring may be cured at a dental clinic!

Abstract

Appropriate cooperation between medical and dental care is key to the success of obstructive sleep apnea（OSA） care. Currently, the leading OSA therapies are nasal continuous positive airway pressure（CPAP）and oral appliance （OA）. OA is the most used therapy in dentistry, widely used to treat mild to severe cases of OSA. Here, we will consider how dentists should approach OSA, how medical-dental cooperation can be established, the various types of sleep tests, how they should be viewed, indications for OA therapy, and how OAs should be made.

Keywords: Obstructive Sleep Apnea（OSA）, Oral Appliance（OA）, Snoring

Author(s): Tetsuro IKEBE

Affiliation: Department of Oral and Maxillofacial Surgery, Fukuoka Dental College

Title: Back to the basics of tooth extraction, focusing on gingival incision and patient management in the perioperative period

Abstract

Tooth extraction is a general dental therapeutic method required to prevent odontogenic infection from progressing. It must never be forgotten that tooth extraction is a surgical procedure. Dental extraction as a surgical procedure consists not only of elevator and forceps handling techniques, but also of general surgical approaches such as use of the mucoperiosteal flap and management in the perioperative period. In particular, there must be cooperation between dentists and medical doctors if extraction is to proceed safely.

Keywords: Tooth extraction, Muco-periosteal flap, Perioperative management

The Journal of the Japan Dental Association

ENGLISH

2016

NO.1 April

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NO.2 May

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NO.3 June

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NO.4 July

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