Ryoji MATSUSHIMA
Matsushima Dental Clinic, Meguro-ku, Tokyo
Starting up for oral hypofunction
Oral hypofunction is when functions such as chewing, swallowing, and salivating decline. If left untreated, this can lead to dysphagia, causing frailty from the lowered nutrition levels body-wide, and subsequent increased risk of mortality.
Oral hypofunction was recognized as a new disease in 2018, and incorporated into the health insurance system. However, the insurance calculation rate is an issue. This is why this paper explains how the author’s clinic has incorporated oral hypofunction into clinical practice, based on its track record of managing the disease in some 700 patients over the last six years.
Chewing does not equal swallowing, Aspiration pneumonia, Oral function training
Shintaro KONDO
Nihon University School of Dentistry at Matsudo
Morphological characteristics and developmental models of maxillary premolars
Three-dimensional surface homologous modeling, which quantitatively analyzes the structure of teeth with few anatomical landmarks, has made it possible to objectively analyze the structures of cusps. With this method, the maxillary first premolars (P1) were shown to be larger than the second premolars (P2): in P1 the buccal cusp was well developed than the lingual cusp, but in P2 the prominences of the buccal cusp and the lingual cusp were similar. These variations in the premolar structures can be explained by two molecular models: the inhibitory cascade model, and the patterning cascade model. This paper explains the method for quantifying shapes and the molecular developmental models for teeth and cusps.
Homologous modeling, Inhibitory cascade model, Patterning cascade model
Naoya KAKIMOTO1), Akira TAKAHASHI2), Kohtaro TAKISAWA3), Tsuyoshi FUJITA4)
1)Department of Oral and Maxillofacial Radiology, Graduate School of Biomedical & Health Sciences, Hiroshima University
2)Takahashi Dental Office, Ainan-cho, Ehime
3)Takisawa Dental Clinic, Aomori-shi, Aomori
4)Fujita Dental Clinic, Ise-shi, Mie
Essentials of digital x-ray imaging in oral radiology
Digital imaging in oral radiology is spreading, becoming a mandatory diagnostic tool in clinical dentistry.
Understand the system and resolution of digital imaging, then using the correct projection in dentistry, leads to correct image diagnosis. Using cases of dental caries, apical periodontitis, and chronic periodontitis, which are all encountered in daily dental practice, this paper explains the features of the imaging methods and the key points of diagnostic imaging.
Digital x-ray images, Intraoral x-ray imaging, Image diagnosis
Hiromitsu KISHIMOTO
Department of Oral and Maxillofacial Surgery, School of Medicine, Hyogo Medical University
Changes in MRONJ position paper 2023 :prevent fragility fractures caused by osteoporosis, and extreme shortening of healthy life span and life expectancy after fractures as well as osteonecrosis of the jaw in osteoporotic patients
The position paper on medication-related osteonecrosis of the jaw (MRONJ) was revised in July 2023, emphasizing the importance of medical, dental, and pharmacological cooperation. In addition, the paper points out the following as important points: the number of MRONJ patients is still increasing in Japan; warning about the risk factor of "persistent infection" such as periapical lesions, periodontal disease, and peri-implantitis, which may lead to tooth extraction, rather than invasive procedures such as tooth extractions; and to suggest no prophylactic withdrawal of antiresorptive agents at the time of tooth extraction.
Medication-related osteonecrosis of the jaw, Osteoporosis, medical, dental, and pharmacological cooperation
Riho KANAI, Takashi I, Yoshinori SUMITA
Department of Medical Research and Development for Oral Disease, Graduate School of Biomedical Sciences, Nagasaki University
Salivary gland regeneration via utilization of immune cell function:new therapeutic strategy for xerostomia
Aging as well as radiation therapy or Sjögren's syndrome cause clinically irreversible atrophic damage to the salivary glands. This atrophic disorder not only causes xerostomia due to decreased salivary secretion but also promotes oral frailty and dysphagia, leading to aspiration pneumonitis. To lead the functional recovery from morbid aged tissues caused by such disorders, it may be critical to eliminate chronic sterile inflammation and then develop therapeutic techniques that strongly induce the tissue regeneration from remaining normal tissues. This article discusses the potential usefulness of cell-based therapies that utilizes the functions of immune cells such as macrophages to regulate both sterile inflammation and tissue regeneration.
Xerostomia, Salivary gland regeneration, Immune cells
Yasuaki KAKINOKI
Kyushu Dental University
Tongue diagnosis is useful in clinical dentistry
The tongue is said to be a mirror of the whole body, and since ancient times it has been a source of information on the state of the whole body during medical examinations. In particular, in Kampo medicine, tongue diagnosis has been considered important as a form of inspection.
Tongue diagnosis is a method of examination that does not require special instruments, and in clinical dentistry, where the tongue is frequently observed, it is a method of gathering information on the general condition of the patient.
Pathophysiological analysis of information from observation of the tongue is useful in selecting treatment, correspondence, and lifestyle guidance. With the advent of an aging society, living environments and medications taken are becoming more diverse, and their effects on the general condition and oral functions can no longer be ignored. It is also possible for dentistry to take on the role of a primary care provider.
Tongue diagnosis, Oriental medicine, Dental Kampo medicine
Hiroshige MATSUI
Matsui Dental Clinic, Hiratsuka-shi, Kanagawa
Clinical utilization of periodontal ligament regeneration capability
The regenerative ability of healthy periodontal ligament tissue is well known and recognized in orthodontic migration, tooth replantation, and tooth transplantation. In recent years, regenerative therapy has been clinically utilized for periodontal diseases, and good results have been reported. Emdogain®, a periodontal tissue regeneration therapy, has already been clinically proven for more than 20 years, and various other periodontal regeneration therapies have also been clinically utilized. This article presents periodontal tissue regeneration through periodontal tissue movement and regenerative therapy in orthodontic migration and tooth transplantation/regeneration, as well as introducing the possibility of clinical use of periodontal ligament regeneration capability that could change the limits of preservation as a future vision.
Periodontal ligament tissue, Regenerative therapy, Tooth movement
Yoshihito NIKI
School of Medicine, Showa University
An overview of the novel coronavirus pandemic and preparing for the next pandemic
The SARS-CoV-2 (COVID-19) novel coronavirus pandemic appeared to be contained by spring 2023, three years after it ran rampant. However, the virus is by no means extinct, and is still mutating, leaving behind some numbers of patients and fatalities. It is not clear how humanity will coexist with this disease in the future. In the 21st century, pandemics have continued to plague us. Their cause might lie in rapid population growth, the various environmental changes, or climate change. At any rate, they are not an issue that will be solved quickly, and we may be faced with the next pandemic before we know it. We have learned a lot from the last pandemic. Unlike in the past, where we did not understand about infectious diseases and lost huge numbers of people, today we can and should analyze and reflect on the lessons, and make use of what we learned to serve as a good experience for the next pandemic.
COVID-19, Pandemic, Infectious control
Tomoaki KIKYO
Kikyo Dental Clinic, Setagaya-ku, Tokyo
Dental management for developmental disorder patients with mild or no intellectual disabilities
In recent years, the words “developmental disorder” have been featured a lot in the media. There are numerous “special needs dentistry” papers or books which discuss dental management for developmental disorder patients who have intellectual disabilities. However, there are few papers or books describing how to deal with developmental disorder patients with mild or no intellectual disabilities. This paper will reaffirm what developmental disorder are and discuss dental management for developmental disorder patients with mild or no intellectual disabilities.
Developmental disorder, Special needs dentistry, Behavior modification method
Koyo TAKIMOTO
Takimoto Endodontics, Mitaka-shi, Tokyo
Endodontic management for young patients
Endodontic management for young patients is very important for the development and maintenance of natural permanent dentition. Specialized care provided by endodontists to young patients includes vital pulp therapy, endodontic treatment for immature teeth, and treatment for traumatized and transplanted teeth. Since these treatment options are closely related to each other, it is necessary for all dentists to acquire basic knowledge of their diagnosis and treatment. It is important to build a network of regional dental care systems for the development and maintenance of long-term oral function for young patients. It can be achieved through cross-disciplinary collaboration between family dentists, endodontists, oral surgeons, orthodontists, and pediatric dentists.
Vital pulp therapy, dental trauma, tooth autotransplantation
Kenji MAEKAWA
Department of Removable Prosthodontics and Occlusion, School of Dentistry, Osaka Dental University
The importance of maintaining number of functional teeth on an impact of life expectancy.
Previous epidemiological studies have shown that tooth loss increases the risk of mortality and shortens life expectancy. It has also been postulated that dietary and nutritional disorders mediate the link between tooth loss and shortened life expectancy, and if this hypothesis is true, it may be possible to attenuate the effects of tooth loss through prosthodontic treatment. This article discusses, the importance of maintaining the number of functional teeth, focusing on the influence of the number of functional teeth, which represents the number of present teeth plus the number of teeth restored to the missing area, on life expectancy, as revealed in a follow-up study of community-dwelling older people.
Furthermore, intervening factors between the number of functional teeth and life expectancy are also discussed based on recent findings.
Functional teeth, life expectancy, food and nutritional intake
Nobuo YOSHINARI
Department of Cariology, Endodontology, and Periodontology, School of Dentistry, Matsumoto Dental University
The new classification of periodontal and peri-implant diseases and conditions
In 2017, the American Academy of Periodontology and the European Federation of Periodontology took the lead in developing a new classification based on the latest evidence. This new classification is characterized by the clarification of gingival health and mucogingival status, the first reference to peri-implant tissue disease, and the introduction of stage and grade classifications for periodontitis. In Japan, both the Japanese Society of Periodontology and the Japanese Academy of Clinical Periodontology have adopted a format in which this new classification is provisionally combined with the older classification. This paper explains the current world-standard periodontal disease classification.
New classification of periodontal diseases, peri-implant conditions, classification of periodontitis based on stages, grades
Tetsuhiro KAJIKAWA, Satoru YAMADA
Department of Periodontology and Endodontology, Tohoku University Graduate School of Dentistry
New frontiers in neutrophil research: re-evaluating their roles in periodontal disease and recent insights
Periodontitis is a complex disease involving bacterial, host and environmental factors, with neutrophils playing crucial roles in its pathogenesis and progression. Neutrophils eliminate bacteria through phagocytosis, degranulation and the formation of NETs, but excessive activation can also lead to tissue destruction. Recent studies have revealed that OSM and NETs produced by activated neutrophils contribute to this process. Additionally, mechanisms by which trained innate immunity (TII) and clonal hematopoiesis of indeterminate potential (CHIP) exacerbate periodontitis via neutrophils have been reported. This paper re-evaluates the roles of neutrophils in periodontitis in light of these new insights.
Neutrophil, Periodontitis, Innate trained immunity and clonal hematopoiesis of indeterminate potentia
Hiroshi MURATA
Department of Prosthetic Dentistry, Graduate School of Biomedical Sciences, Nagasaki University
Effective soft linings for difficult denture cases
Our super-aging society is seeing an increasing number of elderly denture patients with thin basal seat mucosa and severe residual ridge resorption. Soft-lined dentures fabricated through dynamic impression using tissue conditioners and indirect lining methods are effective for such difficult denture cases. Application of the denture intaglio surface fitting method (when using soft denture liners), now covered by insurance, leads to ample functionality of soft denture liners due to being able to ensure adequate lining thickness.
Soft denture liner, tissue conditioner, denture intaglio surface fitting method
Kazunori HAMAMURA
Department of Pharmacology, School of Dentistry, Aichi Gakuin University
Involvement of the carbohydrate chain in homeostasis maintenance and disease onset
Called the “third chain of life,” the carbohydrate chain is composed of various sugars linked together. The carbohydrate chain is involved in the maintenance of homeostasis and the onset of diseases such as infectious diseases, neurodegenerative diseases, endocrine diseases, and cancer. This review will cover how the carbohydrate chain is involved in the maintenance of homeostasis and the onset of diseases, and discuss the prospects for clinical application of carbohydrates in the oral cavity.
Glycosylation, glycoconjugate, disease
Jun KANEKO
Department of Oral Health Sciences, School of Health Sciences, Meikai University
Medical tooth whitening: outline, considerations for clinical examinations, and diagnosis
In medical tooth whitening, dentists or dental hygienists under a dentist’s supervision perform everything from diagnosis and treatment plan determination, selection of tooth whitening methods and agents, management during treatment, professional color management from preoperative to postoperative, and postoperative maintenance and touch-ups. This article focuses on the dental knowledge required to perform medical tooth whitening, particularly the action mechanism of tooth whitening and points to consider in its clinical examination and diagnosis.
Medical tooth whitening, action mechanism, clinical examination and diagnosis
Yuka SUMITA
Primary Lecture Professor, Prosthodontics Department, The Nippon Dental University School of Life Dentistry
To contribute to the prevention, early detection, and supportive care for medication-related osteonecrosis of the jaw (MRONJ) in prosthetic treatment
The increasing number of MRONJ cases in Japan emphasizes the need for improved prevention, early detection, and supportive therapy. In prosthetic treatment, it is important to focus on the following: 1. Enhance collaboration among medical, dental, and pharmaceutical professionals to thoroughly understand patients' medication histories. 2. Regularly monitor the fit of removable prosthetics and maintain the hygiene of remaining roots and teeth to prevent MRONJ or detect it early. 3. Provide perioperative management during the surgical resection of necrotic bone, and facilitate healing and early functional recovery with appropriate prosthetic treatment.
Medication-related osteonecrosis of the jaw, MRONJ prevention, Early detection and supportive care, Prosthetic treatment
Makoto TOMINAGA
Thermal Biology Laboratory, Nagoya Advanced Research and Development Center, Nagoya City University
The importance of basic research
Detection of ambient temperature is one of the most important and essential functions of living things on this planet, including homeotherms like humans, poikilotherms and even unicellular organisms. This is because all life activities fluctuate depending on temperatures, so living beings have developed a variety of temperature sensing mechanisms and temperature adaptability. The author has been working on thermal biology research since he was involved in the cloning of the first temperature sensor, the TRPV1 capsaicin receptor.
TRP temperature-sensitive channel, thermal biology, TRPV1
Takehiko IIJIMA
Division of Anesthesiology, Department of Perioperative Medicine, School of Dentistry, Showa University
An unique system of dental anesthesiology in Japan and its perspectives
In Japan, anesthesia for dental treatment and surgery is, for historical reasons, generally provided by dentists. This unique system dates back to the early 20th century, and initially aiming to ensure anesthesiologists had specialist knowledge of oral surgery and dentistry. However, anesthesia services for dentistry have not yet met the demands for anesthesia. Japan’s annual total cases do not reach even one-tenth or less of the cases in North America. Better understanding of dental anesthesia and improvement of its infrastructure are necessary to meet the demands of dental patients.
Dental anesthesia, General anesthesia, Pediatric dentists
Masataka SUNAGAWA
Department of Physiology, School of Medicine, Showa University
Oriental medicine as an alternative approach: application of Kampo formulae in dental practice
Oriental medicine can be effective in cases where conventional treatments fail, as well as in treating diseases and symptoms for which established therapies do not exist. Additionally, Oriental medicine can contribute to improving the host’s constitution and addressing conditions before they manifest as diseases. In the field of dentistry, Kampo formulae are utilized for conditions such as xerostomia, glossodynia, temporomandibular joint disorders, nonspecific complaints, stomatitis, and various pain-related disorders. This review discusses the current status of Kampo formulae in dental practice and introduces Kampo formulae that can be used, with a focus on xerostomia, stomatitis, and chronic pain.
Oriental medicine, Kampo formulae, Crude drug
Yoshizo MATSUKA
Department of Stomatognathic Function and Occlusal Reconstruction, Graduate School of Biomedical Sciences, Tokushima University
Management of orofacial pain and analgesic effects of Tranilast
Pain is an unpleasant experience that all of us have had, and is defined by the International Association for the Study of Pain as “An unpleasant sensory and emotional experience associated with, or resembling that associated with, actual or potential tissue damage.” The management of pain is an important aspect of dentistry, but it can be difficult to understand because it is caused by a variety of factors. This paper discusses the definition of pain, what orofacial pain is, and the management of orofacial pain, and then reports on the effects of tranilast on neuropathic pain.
Orofacial pain, Neuropathic pain, Tranilast
Kazumichi YONENAGA
Department of Dysphagia Rehabilitation, Nihon University School of Dentistry
Oral frailty and interprofessional cooperation
The dental community can play a central role in supporting eating in the future, involving not only the medical community but also the retail and restaurant industries. This makes oral frailty control and interprofessional work increasingly important. To this end, we are working on measures to combat “eat-loss” and to encourage "i-shi renkei." “Eat-loss” refers to the continued inability to eat, and “i-shi renkei” refers to cooperation between medical care and citizens (residents), the market (industry), and city government (administration). To promote these efforts, end-of-life dental care, oral palliative care, and measures against frailty, sarcopenia, and eat-loss in children are also key points.
Eat-loss, Pediatric frailty, Oral palliative medicine
Kosuke KASHIWAGI
Department of Fixed Prosthodontics and Occlusion, Osaka Dental University
Face scanner basics
This paper provides an overview of face scanners in dentistry. Face scanners capture 3D facial data, contributing to precise treatment planning and esthetic restoration by considering facial harmony. This paper discusses virtual patient creation, diagnostic digital design, scanning technologies, device types, accuracy, head positioning, and face scanners available in Japan. Face scanners are essential tools for improving the quality of dental care and enabling dentists to provide better treatment.
Face scanner, CAD/CAM, digital dentistry
Fusao KATO, Yukari TAKAHASHI
Center for Neuroscience of Pain, The Jikei University School of Medicine
Nociplastic pain – the newly defined third mechanistic descriptor of pain
Nociplastic pain is a recently introduced third mechanistic descriptor of pain aimed at understanding treatment-resistant pain that cannot be explained by the two previously established mechanisms: nociceptive and neuropathic pain. This nociplastic pain that arises without tissue damage or nerve injury has also been frequently observed in dentistry and oral surgery and is thought to be linked to plastic changes in neural circuits responsible for pain processing and egulation. Here, we discuss the background, characteristics, and clinical implications of this novel pain mechanism.
Primary chronic pain, Neuroplasticity, Descending pain regulatory system
Yoshihiro IWANO
Director, Iwano Dental Clinic
Decision-making in periodontal tissue regeneration therapy
The retention of blood clots is one of the key elements in periodontal regenerative therapy. The Modified Papilla Preservation Technique (MPPT) is a technique that was developed to ensure the retention of blood clots and to secure a space for regeneration. In order to achieve optimal results, it is important to master the basic skills of incision, flap elevation, debridement, and suturing, as well as to select the appropriate technique for each condition. This article will discuss in detail the selection of the appropriate technique for periodontal regenerative therapy in the interdental region.
Periodontal regenerative therapy, Papilla preservation technique, MPPT
Hirokazu KUMANO, Jun TAKEBE
Department of Removable Prosthodontics, School of Dentistry, Aichi Gakuin University
Points about magnetic attachments to be aware of in clinical applications
Magnetic attachments are recognized as retainers highly regarded for their clinical usefulness, and are widely used in day-to-day treatment. Considering the super-aging society of recent years, the demand for plate dentures is only going to increase, which means we can expect a rise in the frequency of magnetic attachment use as well. To maximize the clinical effectiveness of magnetic attachments, it is important to fully understand their characteristics, select the appropriate cases, practice accurate clinical procedures, and carry out regular maintenance.
Magnetic attachments, Clinical procedures, Safety standards
Megumi INOMATA
Division of Microbiology and Immunology, Department of Oral Biology and Tissue Engineering, Meikai University, School of Dentistry
The relationship between aging and autophagy:
Why does pneumonia arise with aging?
Pneumonia and aspiration pneumonia are infectious diseases caused by Streptococcus pneumoniae. Susceptibility to pneumococcus is significantly higher in people aged 65 or older, and the number of both patients and deaths from pneumococcal infections is increasing in Japan, a super-aging society. The mechanism by which pneumococcal infections develop in elderly people was investigated by using young and old mice, and it was found that autophagy/LAP, a mechanism for decomposing and eliminating S. pneumoniae, declines with aging.
Autophagy, Streptococcus pneumoniae, Aging
Hitoshi NIWA
Department of Dental Anesthesiology, Osaka University Graduate School of Dentistry
Allergic Reaction in Dental Practices
Many drugs and dental materials are used in dental practice. Many of them are allergenic. Allergic reactions associated with dental practice are mainly type I (immediate) and type IV (delayed) allergies. Type I allergies are especially severe and can lead to anaphylactic shock. The most common allergens causing allergic reactions are antibiotic preparations, NSAIDs, disinfectants, and latex. Dentists should be aware that they are constantly using allergic substances in their practice.
Drug allergy, Dental materials, Allergic contact dermatitis
Naomi TANOUE
Nagasaki University Graduate School of Biomedical Sciences
The concept of resin-bonded cantilever fixed partial prosthesis
Resin-bonded cantilever fixed partial prostheses, added to Japanese health insurance coverage in 2024, are two-unit prostheses consisting of one abutment and one pontic for a single missing incisor. They are similar to but not the same as conventional resin-bonded fixed partial prostheses, and have different indications, contraindications, and approaches to occlusion. When using these prostheses in clinical practice, it is essential to understand the concepts presented in this paper.
Cantilever, Adhesion, Indications
Takahumi KATO
Department of Oral Physiology, Graduate School of Dentistry, Osaka University
Recent research trends in sleep bruxism pathology
Sleep bruxism (SB) is a critical issue in dental practice. Recent studies have refined the definition and diagnostic criteria of SB, challenging traditional views of its association with stress and TMD. SB is linked to central nervous system phenomena during sleep under the influences of sleep stages, neurotransmitters, and autonomic nervous system changes. As diverse SB phenotypes can exist, individualized approaches based on risk factors and comorbidities are essential. Advancements in technology hold promise for deeper understanding and improved management of SB.
Sleep bruxism, Pathophysiology, Individualized treatment
Akio MITANI
Department of Periodontology, School of Dentistry, Aichi Gakuin University
Possibilities for strategic periodontal treatment using the new AG oral hygiene instruction method
Plaque control is a complex treatment step as it requires patients to carry it out on their own. This is usually done using O'Leary’s PCR chart, but the author has often seen situations in which the phenomenon of inattentional blindness can lead to brushing instruction in areas other than the important target points of treatment. This article will discuss inattentional blindness as a possible pitfall during oral hygiene instruction, and outline a new instruction method that may improve the efficiency of periodontal treatment.
Plaque control, inattentional blindness, agPCR
Takeshi TOYOSHIMA
Director, Toyoshima Dental Clinic, Shinjukai Medical Corporation, Kagawa
Minimally invasive surgery in implant dentistry using absorbable bone substitutes
Minimally invasive surgery in implant dentistry is highly beneficial for both patients and surgeons, and is therefore an important option in implementing implant treatment tailored to each patient's situation. Specifically, alveolar ridge preservation is performed to avoid or reduce GBR procedures during tooth extraction. In addition, for numerous symptoms carrying out internal GBR could ensure a continuous alveolar ridge morphology, leading to a stable oral environment. This article examines the potential of minimally invasive surgery in implant dentistry simplified through using these new absorbable bone substitutes.
Minimally invasive surgery, Absorbable bone substitutes, Simplification
Mitsuko INOUE
Visiting Professor, Department of Pediatric Dentistry, School of Dentistry, Showa University
Support for oral function in school-age children
Recently, with the decline in pediatric caries, issues of pediatric oral function are under the spotlight. There are high ratios of school-age children with lip incompetence (gaping mouths) or who are mouth-breathers. These tend to increase readily with age, and have been reported as being readily correlated with the development of malocclusion. This paper examines the process of the development and acquiring of lip and tongue functions among children, as well as factors that could influence these, and also provides an outline of responses and support for oral function issues in school-age children. However, it is thought that support for function development starting from before children start school (ideally, when weaning) is important.
Oral function development, Lip incompetence, Tongue thrusting
Yasuo FUJIWARA
Director, Ikuta Dental Clinic, Amakusa-shi, Kumamoto
The cutting edge of oral development starting in infancy: the origins of malocclusion revealed through breastfeeding
Causes of overbite, underbite, and crowding revealed in a survey of daycare centers for infants under the age of one
While cavities are fewer, there are increasing cases of child crowding and malocclusion. A survey by Ikuta Dental Clinic showed that four out of five middle school children have malocclusion. To find the cause, oral surveys starting from less than one year old have begun. The results show that oral development during the lactation period is important, and the period and method of breastfeeding affect future oral health. Initiatives to encourage understanding of correct breastfeeding methods and periods are required in order to protect child oral health.
Malocclusion, Breastfeeding, Oral development