Removability of a newly developed oral care gel to simulated dry phlegm and debris


Factors involved in picky eating in children with disabilities visiting outpatient clinics to receive feeding therapy

This study aimed to clarify the factors influencing picky eating in children with disabilities based on the hypothesis that primary disease or oral function is involved in picky eating. The subjects were 242 children aged 3-6 years receiving outpatient feeding therapy at our clinic. The subjects' general and oral conditions and picky eating were assessed by their medical recodes. Resultingly, 79 children showed picky eating. Using logistic regression analysis, associated factors of picky eating were primary disease (p = .04), nutritional methods (p = .01), and oral hypersensitivity (p = .04). The relationship with the primary disease suggests the influence of the characteristics of the primary disease. The relationship with oral hypersensitivity may be attributed to avoiding certain sensations. Additionally, the study revealed that the subjects employed tube feeding to compensate for reduced nutritional intake due to picky eating. This study indicated that primary disease and nutritional method as general conditions and oral hypersensitivity as an oral function were possible factors for picky eating. Picky eating was found to occur at varying frequencies depending on the underlying primary disease, especially when the child struggled to tolerate different sensations experienced during meals.


Oral Health-related Factors Involved in the Onset of Pneumonia in Latter-stage Older Adults Receiving Oral Health Examination

後期高齢者歯科健康診査受診者の肺炎発症に関わる口腔保健関連因子の分析


Time-study research on maxillofacial prosthetic treatment

Unreasonable medical fees can cause problems such as increased medical costs, greater medical disparities, decreased medical standards, and physician shortages. To prevent such problems, it is important to set appropriate medical fees, ensure their proper use, and improve the efficiency of medical care. The treatment of patients with maxillofacial defects is generally more expensive compared with general prosthodontic treatment because it involves more materials and requires more frequently follow-ups for longer period. However, the actual time required for maxillofacial prosthetic treatment is unclear. Therefore, in this study, we aimed to clarify the amount of time spent treating maxillofacial prosthetic patients. We analyzed clinical data from patients undergoing routine maxillofacial prosthetic treatment, irrespective of difficulty level, at 8 university hospitals and 2 dental clinics. We also collected data from maxillofacial prosthodontists on the treatment time required for various Japanese health insurance items, including the fabrication of maxillofacial prostheses. The results revealed that some aspects of maxillofacial prosthetic treatment may take longer to perform and are more costly to perform than previously thought, suggesting the need for some adjustments to the health insurance reimbursement system. Maintaining an appropriate balance between expenditures and fees will greatly benefit patients and physicians, ensuring positive health outcomes and a healthy society.


The relationship between subjective oral frailty and adverse health outcomes or medical and dental expenditures in the latterstage older adult: A 6year longitudinal study.

The study aimed to investigate the relationship between subjective oral frailty and adverse health outcomes or medical and dental expenditures in the latter-stage older adult through a 6-year longitudinal study. The participants enrolled in the cross-sectional study were 3564 Tokushima City residents aged 75, 80, 85, and 90 years old who received oral health examinations and who responded to a questionnaire on oral conditions and health behavior at baseline. The data for the occurrence of disability or mortality, and the monthly medical expenditures, dental expenditures, and total medical expenditure of each participant were obtained from the National Health Insurance Database. The total medical expenditure showed significant differences in participants who had difficulties in eating tough foods, difficulties in swallowing tea or soup, and dry mouth when compared to that of healthy participants, in addition to the current medical treatment against the general disease. The 6-year longitudinal study revealed that participants with subjective oral frailty symptoms, including difficulties in eating tough foods and difficulties in swallowing tea or soup at baseline, had significantly higher medical, dental, and total expenditures among 538 participants without certified nursing care. In addition, those with subjective oral frailty or with less than 19 teeth present were shown to have a higher possibility for the occurrence of disability or mortality by the cox proportional hazard analysis. Furthermore, it was found that medical and total expenditures in older adults with adverse health outcomes were higher than that of healthy participants. These results suggest that subjective oral frailty in the latter-stage older adult is related to subsequent adverse health outcomes and an increase in medical and dental expenditures.

Clinical and Experimental Dental Research


Oral health status of pregnant women in the Republic of Kiribati

Prenatal dental examinations were performed from June 2012 to May 2013 in the Republic of Kiribati as a Japan International Cooperation Agency support program. We analyzed the examination data and compared it with Japanese data retrospectively to clarify the oral health condition of pregnant women in the Republic of Kiribati. We recorded the DMF index, gingival status, and calculus attachment, analyzed data of 512 pregnant women. We also compared the city and the rural group data. The average number of present teeth, decayed teeth, missing teeth and filled teeth was 26.9, 2.5, 1.1, 0.2, respectively. Pregnant Kiribati women had significantly more decayed teeth and fewer filled teeth, more severe periodontal condition, more calculus deposition, and more severe gingival swelling than pregnant Japanese women. No significant difference was found in missing and filled teeth, but pregnant women in the city group had significantly more decayed teeth and tooth stumps than those in the rural group. Our findings indicate that pregnant women in Kiribati have more decayed teeth, more missing teeth, fewer filled teeth, and more severe periodontal problems than their counterparts in Japan. Additionally, the oral health status of pregnant women in Kiribati could be subject to regional variations. J. Med. Invest. 70 : 110-114, February, 2023.

The Journal of Medical Investigation : JMI


Use of ATP Bioluminescence Assay to Evaluate Oral Streptococci

The statistical correlation between the number of oral streptococci and the results of ATP bioluminescence assay was examined and compared with the results from Streptococcus plate counts and an oral bacteria quantification system. Because a significant correlation was found between ATP (RLU) and the number of bacteria in the oral bacteria quantification system for all seven types of oral streptococci examined, ATP would reflect a conditions of oral hygiene. However, using this assay, it was observed it may be difficult to correctly evaluate bacteria that form aggregates. Furthermore, even a small number of bacteria (below 10 CFU/mL) , which cannot be measured by the oral bacteria quantification system, could be estimated by using ATP bioluminescence assay. It was suggested that this assay could be used for quantitative evaluation of the effect of oral cleaning.


後期高齢者の口腔状態と要介護認定または死亡発生との関連性

後期高齢者の口腔状態と要介護認定または死亡発生との関連性


Effect of facilitating neurologic intervention on severe dysphagia after the onset of pneumonia in patients with Parkinson's disease: a retrospective study to increase the proportion of oral intake

パーキンソン病患者における肺炎発症後の重度摂食嚥下障害に対する脳神経内科医の介入促進の効果 -経口摂取割合の増加に関する後方視的検討-


Association Between the Swallowing Reflex and the Incidence of Aspiration Pneumonia in Patients with Dysphagia Admitted to Longterm Care Wards

To investigate the association between the Simple Swallowing Provocation Test (SSPT) and the incidence of aspiration pneumonia in patients with dysphagia in long-term care (LTC) wards. The study design was a prospective cohort study. Participants were followed for 60 days from admission. LTC wards. Study participants were patients with dysphagia aged ≥65 years who were admitted to LTC wards between August 2018 and August 2019. In total, 39 participants were included in the analysis (N=39; 20 male, 19 female; mean age, 83.8±8.5y). Participants were divided into 2 groups based on SSPT results: normal swallowing reflex (SSPT normal group) and abnormal swallowing reflex (SSPT abnormal group). The covariates were age and sex, primary disease, history of cerebrovascular disease, Glasgow Coma Scale, body mass index, Geriatric Nutritional Risk Index, the Mann Assessment of Swallowing Ability, Food Intake Level Scale, FIM, and Oral Health Assessment Tool. Not applicable. The outcome was the incidence of aspiration pneumonia during the first 60 days of hospitalization, and the predictive factor was SSPT: 0.4 mL. The incidence of aspiration pneumonia was 33.3% in the SSPT normal group and 76.2% in the SSPT abnormal group. The φ coefficient (a measure of association for 2 binary variables) was 0.43, the risk ratio (the ratio of the probability of an outcome in an exposed group to the probability of an outcome in an unexposed group) was 2.29, and the 95% confidence interval was 1.14-4.58 for the SSPT abnormal group. Our findings suggest that the SSPT provides a valid index for the development of aspiration pneumonia in older patients with dysphagia admitted to LTC wards.

Archives of Physical Medicine and Rehabilitation


特別支援学校と歯科医療機関の連携 中国・四国地区の現状

特別支援学校と歯科医療機関の連携 中国・四国地区の現状


Detection of poststroke oropharyngeal dysphagia with swallowing screening by ultrasonography

There are currently no standard evaluation tools for poststroke neurogenic oropharyngeal dysphagia. We previously suggested calculating the relative movements of the hyoid bone and larynx by ultrasonography to evaluate swallowing movement. Swallowing movement is altered in neurogenic oropharyngeal dysphagia. Therefore, the present study aimed to verify whether an ultrasonographic evaluation of swallowing movement facilitates the detection of neurogenic oropharyngeal dysphagia. Eighteen healthy male elderly participants (the healthy group) and 18 male stroke patients diagnosed with neurogenic oropharyngeal dysphagia (the dysphagia group) were enrolled. Participants swallowed 5 mL of liquid and water with an adjusted viscosity and the movements of the hyoid bone and larynx were visualized by ultrasonography. The results obtained revealed significant differences in laryngeal duration (static phase), laryngeal displacement (elevation phase), and the hyoid bone-laryngeal motion ratio (HL motion ratio) between the two groups. A multiple regression analysis was performed to adjust for confounding factors, and laryngeal duration (static phase) and the HL motion ratios were identified as factors affecting dysphagia. In the receiver operation characteristic curve of the two variations, the area under the curve for laryngeal duration (static phase) was 0.744 and the cut-off was 0.26 sec with 72.2% sensitivity and 88.9% specificity; the area under the curve for the HL motion ratio was 0.951 and the cut-off was 0.56 with 88.9% sensitivity and 88.9% specificity. Therefore, the objective evaluation of hyoid bone and larynx movements during swallowing by ultrasonography facilitated the detection of neurogenic oropharyngeal dysphagia.


Predictive factors associated with poor outcomes for older adult inpatients in the convalescent rehabilitation ward

This study aimed to determine predictive factors associated with poor outcomes among older adult inpatients in the convalescent rehabilitation ward. We also examined the validity of factors that were identified as predictive of poor outcomes. Study subjects were 104 older adult inpatients in the convalescent rehabilitation ward, divided into two groups based on outcome at discharge. Group I included the outcomes of death or transfer to an acute care hospital and Group II included all other outcomes. Data were retrospectively collected from older adults' medical records, including: activities of daily living, swallowing grade, nutritional index, and blood biochemistry data. Logistic regression analysis was used to extract predictive factors associated with poor outcomes. Next, we calculated the Stratum-specific likelihood ratio (SSLR) for each extracted factor. Two items were extracted as predictive factors with AUCs ≥ 0.7 : N-terminal pro-brain natriuretic peptide (NT-proBNP) and days from onset to hospitalization. The SSLRs showed the risk for a poor outcome increased when NT-proBNP was ≥ 2500 pg / ml, and when there were ≥ 35 days from onset to hospitalization. Our findings suggest these predictive factors provide a valid index to predict poor outcomes among older adults from the early stage of admission. J. Med. Invest. 67 : 304-310, August, 2020.


Association between Survival Prognosis and Intraoral Conditions in Cancer Patients Receiving Palliative Care

緩和ケア受療がん患者の生命予後予測と口腔内状況

 目的:緩和ケア受療進行がん患者の口腔内評価を実施し，生命予後予測と口腔内状況の関係を検証した．

 方法:対象は，2017年11月から2018年7月の期間に，聖隷浜松病院に入院中の緩和ケア受療がん患者で，同意が得られた85名とした．基本情報はカルテから抽出し，口腔内の状態はOral Health Assessment Tool日本語版(以下，OHAT-J)と口腔機能評価表を用いて評価した．Palliative Prognostic Index(以下，PPI)を用いて，対象者を生命予後が3週未満と予測される群(以下，予後短期群)と，それ以上(以下，予後長期群)の2群に分け比較した．

 結果および考察:対象者の平均年齢は65.6±13.2歳であり，予後長期群が62名，予後短期群が23名であった．OHAT-Jでは，口唇，歯肉・粘膜，唾液，口腔清掃の項目および合計スコアにおいて予後短期群で有意に悪化が認められた．口腔機能においては，すべての項目において予後短期群で有意な悪化が認められた．口腔粘膜など口腔乾燥が影響する項目に有意な悪化が認められたものと考えられ，口腔機能に関しては，Activities of Daily Living(日常生活動作:以下，ADL)や意識状態の悪化などの結果と推察された．

 結論:生命予後予測と口腔内状況には関連性があり，予後短期群の口腔内状況は予後長期群よりも不良であることが示唆された．PPIによる予後予測は口腔内状況の把握に有用であることが示唆された．


非経口摂取高齢入院患者に対する「水を使わない口腔ケアシステム」実施による口腔細菌数の変化


Evaluation of Swallowing Movement Using Ultrasonography


病棟看護師による「水を使わない口腔ケアシステム」実施の効果

病棟看護師による「水を使わない口腔ケアシステム」実施の効果

咳反射や口腔機能が低下した高齢者に対する口腔ケアは，汚染された洗浄水を誤嚥させるリスクがある．角らが開発した「口腔ケアシステム」を用いて行った先行研究では，口腔ケア用ジェル「お口を洗うジェル」を使用して遊離させた汚染物を絡め取り口腔外へ排除する手法により，口腔細菌数が有意に減少を示した．今回，看護師実施による口腔ケアの効果を口腔細菌数の変化により検証した． 非経口摂取患者を，「口腔ケアシステム」を用いた「新法群」と，従来行っている他社製品の口腔保湿剤と吸引カテーテルを使用する口腔ケア「従来法群」の2群に分け，病棟看護師により1日1回連続28日間実施した．口腔細菌カウンタを用いて，口腔ケア介入開始1日目の口腔ケア直前，5日目口腔ケア後30分，28日目口腔ケア後30分の3回測定し，クロスオーバー比較化試験を行った．統計解析はIBM SPSS version24を用い有意水準は5%とした．新法を従来法と比較した結果有意性が認められ，測定時期も直前とケア5日目，28日目は有意に減少した．


Clinical features predicting oral intake after onset of pneumonia in patients with Parkinsonism

パーキンソニズム患者における肺炎発症後の経口摂取に関わる臨床的特徴


吸い飲み内残余飲料の微生物汚染状況に関する実験的予備調査

吸い飲み内残余飲料の微生物汚染状況に関する実験的予備調査


歯科初診患者の歯周病重症度と口腔関連QOL の関連性

歯科初診患者の歯周病重症度と口腔関連QOL の関連性

Journal of the Japanese Association of Periodontology


INVESTIGATING FACTORS RELATED TO THE ACQUISITION OF MASTICATORY FUNCTION IN DOWN SYNDROME CHILDREN

The International Journal of Orofacial Myology


高齢脳血管疾患患者における摂食嚥下機能と開口力の関係

高齢脳血管疾患患者における摂食嚥下機能と開口力の関係


Use of ATP bioluminescence to survey the spread of aerosol and splatter during dental treatments

Aerosol and splatter produced during dental treatments (ultrasonic scaling and professional mechanical tooth cleaning) are potential sources of infection. Contamination patterns on the mask, goggles, chest and gowned right arm of operators, and on the goggles of patients before and after dental treatments were investigated using ATP bioluminescence analysis. Contamination on every surface tested increased significantly after dental treatment. Maximum contamination was found on the goggles of patients. Aerosol and splatter produced during dental treatments therefore have the potential to spread infection to operators and patients. ATP bioluminescence is a useful tool for monitoring surface contamination.


Subjective evaluation of swallowing screening test by speech therapists

言語聴覚士による4種の嚥下スクリーニングテストの主観的評価

Japanese Journal of Speech, Language, and Hearing Research


Relationship between oral function and food preferences among elderly Japanese

高齢者の咀嚼・嚥下機能と食品嗜好との関連性

Objective: Aging affects the sense of taste, and consequently food preferences change in the elderly. However, preferences might be influenced not only by oral sensory function but also by chewing and swallowing function. This study aimed to clarify the relationship between oral function and food preferences among elderly Japanese.Materials and Methods: Forty patients (mean age, 74.2 years) of the dental hygiene clinic in Tokushima University Hospital were enrolled in the elderly group. Twenty-five university students (mean age, 21.4 years) were enrolled in the young group.Food preferences were assessed using a questionnaire on favorite foods among 35 items, based on mastication score (MS). Chewing function was assessed using a xylitol gum-chewing test (Lotte Co., Ltd.) and MS. Swallowing function was assessed using number of saliva swallows in 30 seconds, water swallow test, maximum voluntary tongue pressure (MVTP) and subjective swallowing evaluation (SSE).The Mann-Whitney U test, X2 test, Spearman's rank correlation coefficient, and stepwise regression analysis were performed for statistical analyses using SPSS ver.21.This study was conducted with the approval of the Ethics Committee of Tokushima University Hospital (Approval number: 1378).Results and Discussion: The scores of the gum-chewing test, MS, number of saliva swallows in 30 seconds, MVTP and SSE of the elderly group were significantly lower than those of the young group. There was a significant correlation between RSST and food preference scores in the elderly group, but not in the young group. Moreover, there were significant correlations between SSE and food preference score, and also between the number of saliva swallows in 30 s and food preference scores in the elderly group with stepwise regression analysis in order to exclude confounding factors between age and oral function.It is considered that the changes of swallowing function with aging affect food preferences among elderly Japanese.Conclusion: Our results indicate that swallowing function influences food preferences among elderly Japanese.

【目的】 わが国の高齢化率は上昇を続けており，高齢者の健康寿命への関心も高い．特に食事は楽しみの一つであり，QOL の向上につながる重要因子とされている．咀嚼や嚥下機能が低下すると摂取する食品が制限され，食品嗜好へ影響を与えることが懸念される．しかし，咀嚼機能や嚥下機能など口腔機能と，食品嗜好との関係に着目した研究はみられない．そこで，本研究は，高齢者の咀嚼および嚥下機能と食品嗜好との関連性を明らかにすることを目的とした．【対象】 徳島大学病院歯科衛生室の65 歳以上の外来受診患者40 名(高齢者群)と，徳島大学歯学部口腔保健学科学生25 名(若年者群)を対象とした．【方法】 対象者の口腔内状況を確認し，平井らの摂取可能食品質問票の食品35 品目を用いて，食品嗜好スコア(好き/ 嫌い)，咀嚼スコア(噛める/ 噛めない)，嚥下スコア(飲み込める/ 飲み込めない)に関するアンケートを行い，口腔機能として咀嚼機能はガム咀嚼，前述の咀嚼スコア，嚥下機能は30 秒間の唾液嚥下回数，最大舌圧，水飲みテスト，前述の嚥下スコアを測定し評価した．高齢者群と若年者群の各パラメータにおける2 群間比較を行い，各群における口腔機能と食品嗜好との相関関係を求めて比較した．さらに，食品嗜好スコアと年齢および口腔機能との間における交絡要因の影響を排除するために，ステップワイズ重回帰分散分析を行った．【結果・考察】 高齢者群のみに30 秒間の唾液嚥下回数と食品嗜好スコアとの間に正の相関が認められた．さらに，多変量解析により，高齢者群のみに嚥下スコアと食品嗜好に，30 秒間の唾液嚥下回数と食品嗜好スコアに正の相関が認められた．高齢者の食品嗜好には，年齢ではなく嚥下機能が影響する可能性が考えられた．【結論】 高齢者の口腔機能，特に嚥下機能と食品嗜好には関連性があることが示唆された．

The Japanese Journal of Dysphagia Rehabilitation

日本摂食·嚥下リハビリテーション学会雑誌


A new oral care gel to prevent aspiration during oral care

口腔ケア時の誤嚥予防の試み ―口腔ケア用ジェルの新規開発―

Aim: Although oral care is important in the prevention of aspiration pneumonia, the different institutions and practitioners employ various oral care methods, some of which are associated with the risk of aspiration. We have developed a new gel with the physical properties needed for waterless oral care. In the present study, we evaluated and investigated the properties and effectiveness of this gel.

Methods: The physical properties of the trial gel and commercial moisturizing gels were compared using a VAS scale. The effects of plaque elimination were evaluated in healthy volunteers. Brushing was carried out by a dental hygienist using the gel and water. The number of throat suctions performed during brushing was also counted, and the difference was evaluated.

Results: In the evaluation of physical characteristics, trial Gel B showed a significantly higher rating than the other gels. In plaque elimination, the rate of decrease in a modified PCR was significantly greater with the gel trial. Suctioning was also performed significantly fewer times with the trial gel.

Conclusions: Good results were obtained with the newly developed trial Gel B with regard to the physical properties and the sensory evaluations. Its effectiveness was also confirmed in plaque elimination and in the evaluated risk of aspiration. The use of Gel B may have the potential to decrease the risk of aspiration during oral care and reduce the occurrence of aspiration pneumonia.

目的:口腔細菌は，誤嚥性肺炎を含めた全身の疾患と密接に関係していると考えられている．誤嚥性肺炎の予防には口腔ケアが極めて重要であるが，その方法は施設や術者により様々であり，中には誤嚥のリスクを伴う口腔ケア方法も存在する．口腔ケア中の誤嚥性肺炎起炎菌を含む洗浄水の誤嚥のリスクを低下させるため，本研究では，水を使わない口腔ケアに必要かつ適正な物性を持つジェルを開発し，その物性およびプラークの除去，咽頭への流入しにくさについて評価・検討を行った．方法:ジェルの物性評価は，医療従事者31名を評価者とし，VASを用いた主観的物性評価と口腔内官能評価から，試作ジェル3種類(A∼C)と市販の保湿ジェル3種類(D∼F)を比較した．プラーク除去効果の評価は，健常者20名を対象とし，物性評価において最も評価が高かったジェルをジェル使用時，水道水を水使用時とし，歯科衛生士によるブラッシングにより評価を行った．評価はModified PCRを用い，ブラッシング前後のプラークの減少率を比較した．また，ブラッシング時の吸引回数をカウントし，咽頭への流入しにくさについてジェル使用時と水使用時における差を評価した．結果:物性評価において，試作ジェルBはその他5種類のジェルに比べ，有意に評価が高かった．プラークの除去効果において，Modified PCRの減少率はジェル使用時の方が水使用時よりも有意に高かった．また，吸引回数はジェル使用時の方が有意に少なかった．結論:新規に開発した試作品ジェルBは物性評価にて良好な結果を得た．さらにプラークの除去効果や咽頭への流入しにくさにて有効性を確認した．洗浄水ではなくジェルBを使用することにより口腔ケア時に流入しにくくなる可能性があるため，今後の臨床試験に期待したい．


Relationship between Chewing Behavior and Oral Conditions in Elementary School Children Based on the "Chewing 30" Program: An Intervention Study


Monitoring of bacterial contamination of dental unit water lines using adenosine triphosphate bioluminescence

Bacterial contamination of dental unit waterlines (DUWLs) was evaluated using ATP bioluminescence analysis and a conventional culture method. Water samples (N=44) from DUWLs were investigated for heterotrophic bacteria by culture on R2A agar, which gave counts ranging from 1.4×10(3) to 2.7×10(5) cfu/mL. The ATP bioluminescence results for DUWL samples ranged from 6 to 1189 relative light units and could be obtained within 1min; these correlated well with the culture results (r=0.727-0.855). We conclude that the results of the ATP bioluminescence assay accurately reflect the results of conventional culture-based testing. This method is potentially useful for rapid and simple monitoring of DUWL bacterial contamination.


A survey of bacterial contamination in Dental Unit Waterlines for clinical training

臨床実習用デンタルユニット給水ライン(DUWLs)における細菌生息状況調査

The Journal of Japan Society of Dental Hygiene Education

日本歯科衛生教育学会雑誌


Molecular analysis for bacterial contamination in dental unit water lines

Bacterial contamination in dental unit waterlines (DUWLs) was evaluated by molecular techniques in addition to the conventional culture method. Water samples (n=8) from DUWLs were investigated for heterotrophic bacteria by culture method using R2A agar. The selected bacterial antibiotic-resistance genes and Legionella species-specific 16SrDNA were identified by PCR. The profiles of bacterial contamination in DUWLs were further identified by PCR-DGGE. In this study, no antibiotic-resistant or Legionella genes were detected. Polycyclic aromatic hydrocarbon-degrading bacterium, Novosphingobium sp. was the most prevalent in DUWLs. Conventional PCR and PCR-DGGE were shown to be potentially useful for monitoring of bacterial contamination in DUWLs.


Effect of oral functional training on changes in resting saliva secretion in older hemodialysis patients

高齢血液透析患者に対する口腔機能訓練の効果 ―安静時唾液分泌量の変化からみた検討―

Introduction: Daily fluid restriction and aging-related atrophy of saliva glands might cause dry mouth in older hemodialysis patients. We hypothesized that greater saliva secretion is needed to relieve dry mouth and that this could be achieved by providing oral functional training to patients. The aim of this study was to investigate changes in resting saliva secretion after performing oral functional training for older hemodialysis patients with mild dry mouth.Materials and Methods: Hemodialysis patients with mild dry mouth at Kawashima Hospital gave informed consent to participate in the study. They were then randomly divided into an intervention group (n=31) and a control group (n=30). The intervention group was provided oral functional training by a dental hygienist, including saliva gland massage for 30 s and tongue lateral movement for 12 weeks during dialysis treatment. The control group did not receive the training. Overall, 54 participants completed the experiment. Oral wetness was measured using a KISO-WeT Tester, and the amount of resting saliva secreted in 30 s was collected in a cotton roll and weighed. Measurements were implemented at baseline and at 2, 4, 8, and 12 weeks after starting the regimen.Results and Discussion: In the intervention group, oral wetness at 4, 8, and 12 weeks was significantly higher than that at baseline (p<0.05, p<0.001, p<0.05, respectively). No statistically significant differences were found in the control group. In the intervention group, the amounts of saliva secreted at 4, 8, and 12 weeks were significantly greater than that at baseline (p<0.05, p<0.001, p<0.001, respectively). In the control group, the amount of saliva secreted at 12 weeks was significantly more than that at 2 and 4 weeks (p<0.05, p<0.05, respectively).Conclusion: We concluded that performing oral functional training, which included salivary gland massage and tongue movement training for 4 or more weeks, could increase the amount of resting saliva secretion in older hemodialysis patients with mild dry mouth.

高齢血液透析患者の口腔乾燥には，日常的な水分摂取の制限と唾液腺自体の加齢性変化が関係していると考えられる．高齢血液透析患者の口腔乾燥改善には，まず十分な安静時唾液の分泌が必要と考え，それを促す手法の一つとして口腔機能訓練に着目した．本研究は，高齢血液透析患者に対して継続的な口腔機能訓練を行い，安静時唾液量の変化から訓練の効果を検証することを目的とした．研究参加の同意が得られた軽度以上の口腔乾燥を有する高齢血液透析患者を，無作為に2群に分けた．歯科衛生士による口腔機能訓練(唾液腺マッサージ，舌運動訓練)を透析中(週3回)に12週間行った群を介入群，行わなかった群を対照群とした．研究開始前，2週後，4週後，8週後および12週後に，口腔内湿潤度と安静時唾液量を測定した．研究を完了した54名(介入群28名，対照群26名)について，群内および群間の比較には二元配置分散分析を，計測回ごとの多重比較にはBonfferoni法を用いて，統計解析を行った．口腔機能訓練の実施による変化を検証した結果，口腔内湿潤度は，介入群の主効果および対照群との交互作用も有意であった(F(1,52)＝22.3，p＝0.03，F(4)＝3.5，p＝0.008)．群内の多重比較の結果，介入群は研究開始時と比較して，4週後以降で有意差が認められた(p<0.05，p<0.001，p<0.05)が，対照群は有意差が認められなかった．安静時唾液は，介入群の主効果および対照群との交互作用も有意(F(1,52)＝18.6，p<0.001，F(3)＝5.3，p＝0.002)であった．群内の多重比較の結果，介入群において，研究開始前と比較して4週後以降(p<0.05，p<0.001，p<0.001)に有意な増加が認められた．一方，対照群において，2週後と12週後，4週後と12週後に有意な増加が認められた(p<0.05，p<0.05)．以上より，高齢血液透析患者に対する長期間(4週間以上)の唾液腺マッサージや舌運動訓練による口腔機能訓練は，安静時唾液分泌量を増加させる可能性が示唆された．

日本摂食·嚥下リハビリテーション学会雑誌


The comparative study of dysphagia screening tests

嚥下障害のスクリーニングテストの比較研究

Objective: In this research, two types (comprehensive evaluation methods and single evaluation methods) of dysphagia screening test were compared effectiveness to confirm more appropriate as the screening test.Methods: Video recordings were made of 3 patients with dysphagia who underwent single evaluation methods (RSST and MWST) or comprehensive evaluation methods (SSA and TOR-BSST) in dysphagia screening tests. These recordings were then used to create a teaching video movie, which was shown to 65 speech therapists with clinical experience (mean years of experience, 5.2±3.6 years); these therapists were then administered a questionnaire. This questionnaire consisted of 10 items, which covered the following aspects of the dysphagia screening tests: simplicity of the tests, confirmation or inference of the site of dysphagia, their safety, severity evaluation, determination of the food types, determination of their usefulness for assessment of swallowing training, evaluation of the effect of swallowing training, evaluation of the changes in swallowing functions over a period of time, ability to diagnose dysphagia, and usefulness of the tests. A 5-point scale was used to answer each question, and the subjective evaluations of the practitioners who used the 4 tests were analyzed. The Kruskal Wallis test was used for analysis of the results and a value less than 5% was considered to be significant.Results: As a result of questionnaire survey, it has become apparent that comprehensive evaluation methods were more appropriate than single evaluation methods as dysphagia screening tests.Conclusion: The result of this study suggested that effectiveness of comprehensive evaluation methods in dysphagia screening test. It might be contribute for the dysphasic patients to introduce the comprehensive evaluation methods in Japan.

【目的】本研究では，嚥下スクリーニングテストの包括的な評価方法の有用性を検討した．【方法】嚥下障害者3例に対して，嚥下スクリーニングとして単一の項目で標準化されたテストであるRSST とMWST，および包括的評価を行うStandardized Swallowing Assessment(以下，SSA)とThe Toronto Bedside Swallowing Screening Test(以下，TOR-BSST)の4つのテストを用いた評価場面をビデオ撮影し，独自に教則ビデオを作成した．その後，言語聴覚士65名(平均臨床経験年数5.2±3.6年)を対象に，作成した教則ビデオを視聴させた後，アンケート調査を実施した．アンケートの質問は10項目で，嚥下障害のスクリーニングテストにおける ① 簡便性，② 嚥下障害における問題の所在の確認と推測，③安全性，④ 重症度の判定，⑤ 食事形態の決定への活用，⑥ 嚥下訓練につながるアセスメントの可否，⑦嚥下訓練の効果判定，⑧ 嚥下機能の経時的変化，⑨ 嚥下障害の検出力，⑩ 総合的な使い勝手，についての ① から ⑩ 項目で構成され，各質問を「思わない」から「そう思う」までの5 件法で尋ねた．解析方法はKruskal―Wallis 検定を用いて，有意水準5%未満として検討した．【結果】単一項目で行う評価方法と包括的に行う評価方法との比較では，今回使用したアンケート調査の10項目中7項目( ②，④，⑤，⑥，⑦，⑧，⑨)において，包括的評価方法の有用性が支持された．【結論】術者の主観的な評価として，今回調査した4つすべての嚥下スクリーニングテストは総合的に使い勝手がよいと判断され，さらにSSAやTOR-BSSTで用いられる包括的な評価方法は，嚥下障害の問題の所在の確認および推測，嚥下障害の重症度の判定，食事形態の決定への活用，嚥下訓練につながるアセスメントの可否，嚥下訓練の効果判定，嚥下機能の経時的変化を捉えていくことへの活用，嚥下障害の検出力において，RSST やMWST を単一項目で評価する場合よりも有用であることが示唆された．

日本摂食·嚥下リハビリテーション学会雑誌


大学歯学部生における口腔健康状態に対する意識および歯科保健行動

大学歯学部生における口腔健康状態に対する意識および歯科保健行動

Journal of Shikoku Public Health Society


Relationships between skeletal muscle mass and strength, and jaw-opening force in Japanese community-dwelling elderly

地域在宅高齢者における骨格筋量・骨格筋力と開口力との関連性

日本摂食·嚥下リハビリテーション学会雑誌


Construction of test design for practical evaluation using OSCE method in the dental hygienist education

歯科衛生士教育におけるOSCE形式実技試験の環境構築

日本歯科衛生教育学会雑誌


Influence of food volume per mouthful on chewing and bolus properties

Behaviors relating to food intake, i.e., speed of chewing, number of chews, and bite size, are important for decreasing energy intake, which might reduce excess body weight and thus metabolic risk. This study aimed at investigating the influence of mouthful volume on the number of chews and food bolus properties in addition to clarifying appropriate eating behaviors related to mouthful volume. Fifteen young Japanese women volunteered to participate. The subjects were asked to spit the food bolus in a glass dish just before swallowing when eating 3 different foods: boiled rice, fish sausage, and peanuts. The 3 physical properties of solidity, adhesiveness, and cohesiveness were measured in the bolus, and the number of chews was noted. The number of chews significantly increased with increasing mouthful volume with all 3 foods; conversely, the number of chews per unit of food weight (g) decreased significantly with boiled rice and fish sausage. Trends were observed for solidity and cohesiveness, which varied with increasing mouthful volumes. Decreased mouthful volume resulted in a greater number of chews per weight of food and more appropriate bolus properties; therefore, a change in mouthful volume could be a useful behavior modification for regulation of energy intake.


Relationship between Gross Motor Function and Oral Parafunction Habits Relavant to Eating in Children with Down's Syndrome

ダウン症候群児の粗大運動能と摂食に関わる口腔以上習癖との関連

Journal of the Japanese Society for Disability and Oral Health


Relationship between mouthful volume and number of chews in young Japanese females

Objective: Modification of eating behavior in Japan is promoted to prevent overweight and obesity, but the effects of such modifications are unclear. This study aimed to clarify the inter- and intra-individual relationship between bite size and number of chews of food. Design and methods: Subjects comprised of 50 young healthy Japanese women (mean age 19.5 years). Food materials were boiled rice and apple. First, the average bite size and the number of chews per mouthful of food were calculated across the study cohort. The number of chews was counted by the subjects themselves and then self-reported. Correlation between the individual one-bite volume and the number of chews per volume was analyzed using Spearman's rank correlation coefficient. Second, the number of chews for three different sized bites of food (half of one bite, one bite, and one-and-a-half bites) were calculated as a prospective observational study. The number of chews for each of the three volumes of food was compared using one way ANOVA with Bonferroni correction. Results: For both food types, there was a negative correlation between individual mouthful volume and number of chews for both food materials. The number of chews per volume decreased as bite sizes increased. Conclusion: This study demonstrated an inter- and intra-individual relationship between bite size and the number of chews and suggested that smaller bite sizes were associated with more chews per volume of food.


要介護高齢者の口腔ケアを支援する簡易版アセスメントシートの開発

要介護高齢者の口腔ケアを支援する簡易版アセスメントシートの開発

日本摂食嚥下リハビリテーション学会誌

日本摂食嚥下リハビリテーション学会誌


Quaritative nutritional change of maxillofacial prosthesis wearers after nutritional guidance by dieticians

顎義歯装着患者に対する専門的栄養指導が質的栄養改善に与える影響

Journal of the Japanese Academy of Maxillofacial Prosthetics


A study of burnout characteristics among dental hygienists in a local city

地方都市における歯科衛生士のバーンアウトに関する研究

The Journal of Japan Society of Dental Hygiene Education

日本歯科衛生教育学会雑誌


Oral Health Care lssues in Nursing Facilities for the Elderly ldentified in a Workshop

介護領域における口腔ケアの問題点 ―ワークショップからの問題点抽出―

 Oral health care is an important and significant facet of nursing and welfare in Japan, but many facilities suffer from problems in delivering this care. The purpose of this study was to define those factors that limit the delivery of oral health care in nursing facilities for the elderly.

 A seminar with a workshop was offered for staff in nursing facilities for the elderly in Fukuoka, Japan on 14 December, 2009. The 67 participants were divided into 11 groups and asked to report the difficulties they experienced in caring for their patients' oral health. We used the KJ method to identify problems in oral health care in these facilities, and the importance and urgency of these problems were then ranked using a two-dimensional expansion method. After analyzing 11 products, 69 codes were defined in decreasing order of relevance. The most relevant were ``rejection of care'', ``lack of experience (knowledge/skills) among staff'', ``dentures'', ``deterioration of oral function'' and the most important and urgent was ``no assessment and no basic manual''. Having identified the major barriers to delivering good oral health care to elderly patients, we encourage dentists and dental hygienists to collaborate with workers in the nursing and welfare fields to formulate strategies to overcome these pressing issues.

 Because the information given by nursing care staff might help dental professionals to understand the problems associated with delivering oral health care in nursing facilities, we consider that workshops for nursing care staff are of significant benefit in promoting the interactive exchange of information, creating an integrated and cooperative relationship between staff in the nursing and dental fields.

 介護領域にも口腔ケアの重要性や必要性は浸透し，実際の現場における口腔ケアの問題点は漠然と把握されているが，明確化されていない．そこで，介護従事者対象の「口腔ケア研修会」においてワークショップを行い，得られたプロダクトから介護の現場における口腔ケアの問題点を抽出し明確化することを目的とした．

 平成21年度福岡市介護保険事業者研修会「口腔ケアについて」にて，全参加者67名を11グループに分け，ワークショップを行った．各グループで口腔ケアの問題点をKJ 法により明確化し，さらに二次元展開法を用いて問題点の重要度と緊急度を検討した．完成したプロダクトを調査対象とし，名札数および重要度と緊急度の順位を解析した．11枚のプロダクトには69枚の名札が表記され，多いものから「ケア拒否・非協力」，「スタッフの知識・技術不足」，「義歯関連」「口腔機能低下」であった．解決の優先順位が高いものは「評価法やマニュアルがない」，次いで「スタッフの知識・技術不足」であった．歯科から介護領域へのこれらの解決法に関する情報提供が有意義であると考えられた．

 以上より，介護従事者がワークショップにおいて作成したプロダクトは歯科関係者にとって介護の現場における口腔ケアの問題点が把握できるよい材料であり，また，ワークショップ自体は歯科からの情報発信だけでなく双方向の情報交換に役立ち，菲薄な両者の関係を緊密化する可能性が推考された．


主機能部位でのストッピング嚙みしめ時の顆頭運動

主機能部位でのストッピング嚙みしめ時の顆頭運動


The Survey on a General Youth's Eating Behavior

一般青年の食行動についての実態調査

Journal of Japanese Society for Mastication Science and Health Promotion


Brain Activation During Oral Exercises Used for Dysphagia Rehabilitation in Healthy Human Subjects: A Functional Magnetic Resonance Imaging Study

Oral exercises, including tongue, lip, and jaw movements, are commonly used in clinical practice as training to improve oral and pharyngeal swallowing in dysphagia patients. These rehabilitation exercises are believed to affect the peripheral and central nervous system at various levels. However, few studies have examined healthy subjects' brain activity while performing oral exercises used in dysphagia rehabilitation. The current study sought to measure brain activation during oral exercises in healthy subjects using functional magnetic resonance imaging (fMRI). Lip-pursing and lip-stretching, tongue protrusion, lateral tongue movement, and oral ball-rolling were selected as tongue and lip exercise tasks. The tasks were performed by eight healthy subjects, and the fMRI data were submitted to conjunction analyses. The results confirmed that head movements during all tasks exhibited translation of <1.0 mm and rotation of <1.0° in x, y, and z coordinates. We found several clear regions of increased brain activity during all four oral exercises. Commonly activated regions during tongue and lip exercises included the precentral gyrus and cerebellum. Brain activation during ball-rolling was more extensive and stronger compared to the other three oral exercises.


A Case Report of Rehabilitation for a Hemi-glossectomy and Treatment Outcome

舌可動部亜全摘症例に対するリハビリテーションとその治療効果―下顎歯槽堤形成術と最大舌圧の経時的変化―


Microfloral characterization of the tongue coating and associated risk for pneumonia-related health problems in institutionalized older adults

To characterize a comprehensive outline of the oral microflora related to pneumonia in older adults. Prospective and retrospective longitudinal study. Community. Long-term hospitalized patients and people in nursing homes (343 subjects, aged > or =65). Subjects were assessed at baseline for pneumonia-related health problems. The flora of the tongue coating was characterized according to terminal restriction fragment length polymorphism (T-RFLP) analysis. All subjects were followed prospectively for 6 months for a diagnosis of pneumonia. The number of febrile days (>37.5 degrees C) was assessed in 299 subjects who were observed for 12 months (retrospectively for 6 months and prospectively for 6 months). The follow-up data were analyzed using multivariate regression analyses in relation to the baseline data, including T-RFLP patterns. RESUTS: T-RFLP patterns outlining the floral composition of the tongue coating were grouped into Clusters A, B, C, and D. According to Cox regression analysis, the subjects in Clusters C (hazard ratio (HR)=4.0, 95% confidence interval (CI)=1.1-15.1) and D (HR=4.9, 95% CI=1.2-21.1) were at a significantly greater risk of pneumonia than those in Cluster A, independent of other confounding factors. Logistic regression analysis adjusting for the same covariates indicated that the number of subjects with more than 9 febrile days per year was significantly lower in Cluster A than in the other clusters. The comprehensive microfloral profile of the tongue coating is closely related to pneumonia-related health problems in institutionalized older adults.

Journal of the American Geriatrics Society


Subjective assessment of chewing function of obturator prosthesis wearers.

Assessments of masticatory performance and occlusal force for wearers of obturator prostheses were performed as clinical objective assessments and reported in an earlier study. The purpose of the present study was to evaluate clinically the chewing function of obturator prosthesis wearers by self-evaluations and to examine their relationship to the objective assessments.

The International Journal of Prosthodontics


Rehabilitation for a partial glossectomy patient : A case report of prosthetic treatment, speech therapy and dysphasia rehabilitation for the patient

舌部分切除症例に対するリハビリテーション : 補綴治療と機能訓練を施行した1症例

Journal of the Japanese Academy of Maxillofacial Prosthetics


Clinical assessment of chewing function of obturator prosthesis wearers by objective measurement of masticatory performance and maximum occlusal force.

Eating, which includes chewing and swallowing, is an oral function that influences quality of life. Though the swallowing ability of maxillectomy patients was reported in our previous study, the chewing function has not been fully reported to date. Thus, the purpose of this study was to evaluate the chewing function of obturator prosthesis wearers by measurement of masticatory performance and occlusal force. The relationship of these 2 measurements was also investigated.


Objective clinical assessment of change in swallowing ability of maxillectomy patients when wearing obturator prostheses.

Evaluation of treatment outcome is important in maxillofacial rehabilitation. Although eating is one of the oral functions that most strongly influences patients' quality of life, only a few reports exist on the objective assessment of swallowing for maxillectomy patients. The purpose of this study was to identify changes in the swallowing ability of maxillectomy patients when wearing obturator prostheses through the use of an objective clinical assessment.


A Case Report of Maxillofacial Rehabilitation for a Maxillectomy Patient with Speech Therapy and Objective Functional Tests

機能訓練と客観的評価を行った上顎欠損に対する顎顔面補綴治療の1例

The Journal of the Japan Prosthodontic Society


A case report of prosthetic treatment after free-tissue transfer reconstruction of a maxillectomy patient : The treatment outcome by objective and subjective assessments

腹直筋皮弁による外科的再建を受けた上顎欠損患者の補綴治療 : 客観的機能評価と満足度による主観的評価


摂食機能療法へのチームアプローチ ―食事前後の血圧測定から―

摂食機能療法へのチームアプローチ ―食事前後の血圧測定から―


悪性腫瘍再発のため二度の軟口蓋補綴を要した症例 —軟口蓋補綴治療の客観的評価—

悪性腫瘍再発のため二度の軟口蓋補綴を要した症例 —軟口蓋補綴治療の客観的評価—


A Report of Diet Therapy for Patients with maxillofacial Prosthesis

顎義歯装着患者に対する食事指導の試み


療養型病床における摂食・嚥下機能療法へのチームアプローチについて

療養型病床における摂食・嚥下機能療法へのチームアプローチについて


上顎欠損に対する補綴治療の客観的評価

上顎欠損に対する補綴治療の客観的評価


Difference in the mechanism of balancing-side disclusion between 1st and 2nd molars.

This study investigates the cusp angle and movement variables related to balancing-side disclusion and compares the characteristics between the 1st and 2nd molar regions. Fifty-six normal young adults were divided into two groups according to balancing-side contact: a disclusion group consisting of 40 subjects (80 excursions), and a non-disclusion group consisting of 16 subjects (20 excursions). Lateral excursions were measured in six-degrees of freedom, and the inclinations of the frontal paths were calculated on the working-side canine, balancing-side 1st and 2nd molars and balancing-side condylar point. The cusp angle was measured using a three-dimensional digitizer. While there were no differences between disclusion and non-disclusion groups in the inclination of the balancing-side condylar path, significant differences were found in the cusp angle and the inclination of the working-side canine path. In the non-disclusion group, the cusp angle of the 2nd molar was markedly greater than that of the 1st molar. It was concluded that the inclination of the anterior guidance and the cusp angle of related teeth have a great effect on the occurrence of balancing-side disclusion and that the mechanism of high frequent balancing-side contacts at the 2nd molar was characterized by its greater cusp angle compared to the 1st molar.


前頭面・矢状面における切歯点と両側大臼歯点の咀嚼運動パターン

前頭面・矢状面における切歯点と両側大臼歯点の咀嚼運動パターン


The Movement Analysis of Gysi Simplex OU Articulator : Part2. The Effect of Lateral Wing

Gysi Simplex OU 型咬合器の運動解析 : 第2報 側方切歯路傾斜度の変化による影響

The mechanism and movement of Gysi Simplex OU articulator was clarified in our previous study. This articulator has optional incisal guide tables with lateral wings. The movements of the articulator with four different angles of lateral wings were measured with Kyushu University 3-D Movement Analyzing System. The results were as follccws : 1. The rotational points existed when the incisal guide tables with the lateral wings were used. 2. Lateral rotational axes were constructed by joining three rotational points at three different heights. 3. As the incisal inclination became steeper, the rotational point wets located more anterolaterally at the height of the condyle guide pin, and was located more anteromedially aL the height of the occlusal plane and incisal guide pin. 4. As the incisal inclination became steeper, the axes changed froun convergent axes to divergent axes.

独特な機構をもつGysiSimplex咬合器は,顆頭間軸の回転と滑走からなる他の咬合器とは異なり,側方運動の実態を単純に把握することは難しい.著者らはGysi軸学説に準じた作図法から各点の動きを求め,本咬合器の運動指導機構について検討,既報した.続いて,九州大学式非接触3次元精密変位計測システムを用い計測した結果,側方咬合軸の存在を明確にした.本報においては,傾斜の付与された切歯指導板を用い,矢状切歯路傾斜度および側方切歯路傾斜度を変化させたときの同咬合器の動きを,前回同様,計測,解析し,新たな知見を得たので報告する.


A Study on 3-Dimensional Condylar Movements in Lateral Mandibular Movements : Part4 The Timing of the Mandibular Side Shift

側方運動における顆頭部三次元動態に関する研究 : 第4報 下顎のサイドシフトのタイミング

The lateral movements of 40 young adults were measured and the timing of the mandibular sideshift was analyzed. The following results were obtained :1. The KA angle-side shift curve was developed to analyze the timing of the mandibular side shift. TheKA angle was defined as the rotation angle of the intercondylar axis for the working condyle during lateralmandibular movement.2. The curves were classified as 5 patterns according to the timing of the side shift :type I ; a side shift occurred proportional to the KA angle (movement of the mandible).type II ', a side shift occurred in the early stage of the movement.type III : the curve is sigmoidal, which means that a side shift occurred in the early and late stage of themovement.type TV : a side shift occurred in the last part of the movement.type V : a side shift occurred in the middle of the movement.And type 0, which has no significant side shift, was added to the timing.3. Type O?III were popular patterns in all 80 condyles, but type IV and V were rare.4. The significant side shift occurred before the middle of the lateral movements for most condyles.

著者らは側方運動時の下顎運動を,作業側顆頭の運動まで含めて検討してきた.第1報では,側方運動解析のため顆頭基準点として側方顆路基準点を提唱し,その妥当性を実証した.第2報では,この側方顆路基準点の運動パターンの分析から,作業側顆頭の運動様式を3つに大別し,歯牙ガイドとの関連を検討した.第3報では,作業側顆頭の運動に対応する平衡側顆頭の運動と,顆頭間軸の運動を解析し,サイドシフトは運動中期までにそのほとんどを終了することが示唆された.そこで本報では,この下顎側方運動に際して起こるサイドシフトのタイミングを明確にするために検討を加え,いくつかの知見を得たので報告する.


A Study on 3-dimensional Condylar Movements in Lateral Mandibular Movements : Part 3. The Movements of Non-working Condyle and Intercondylar Axis

側方運動における顆頭部三次元動態に関する研究 : 第3報 側方滑走運動時の平衡側顆頭と顆頭間軸の運動

The movements of right and left condyles and intercondylar axis were analyzed usingKyushu University 3-D movement analyzing system, and the following results were obtained.l . In the rotation type of working condylar movement, the intercondylar axis rotated mainlyaround the working condyle, and the non-working condyle showed very slight internal sideshift.2. In the shift type and the winding type of that, the lateral mandibular movement was thecombination of the intercondylar axis rotation and the bodily sideshift.3. In the external sideshift type and the winding type, the non-working condyle showedapparent internal sideshift.4. In the internal sideshift type of working condylar movement, the nonworking condyleshowed slight external sideshift, that was as large as the internal sideshift, and almost straightforward movement.5. In all types of working condylar movement, the rotation angle of the intercondylar axisshowed no difference.

下顎運動では,各側顆頭の運動は独立したものではなく,互いに影響を及ぼしあうものである.特に,側方運動では作業側顆頭と平衡側顆頭とは非常に異なった動きをするが,このような見地から側方運動を解析した研究は少ない.著者らは,第1報において,側方運動解析のための基準点として,新たに側方顆路基準点を提唱し,その妥当性を実証した.第2報では,作業側顆頭の運動様式について詳細な検討を加えた.本報においては,側方滑走運動時,作業側顆頭の運動に対応する平衡側顆頭の運動と,顆頭間軸の運動の解析を行い,いくつかの知見を得たので報告する.


A Study on 3-dimensional Condylar Movements in Lateral Mandibular Movements : Part2. The Working Condylar Movements

側方運動における顆頭部三次元動態に関する研究 : 第2報 側方滑走運動時の作業側顆頭運動

We studied the working condylar movement in the lateral movements in 40 normalyoung adults. The following results were obtained :l. The working condylar movements were classified into 3 types :l) rotation type, 2) shift type and 3) winding type2 . The shift type included 1) external side shift, 2) internal side shift and 3) reciprocal sideshift.3. The range of motion was smallest in the rotation type, was largest laterally in the shift type,and was the largest anteroposteriorly in the winding type.4. The difference of movement pattern between rotation type and shift type could not beidentified by incisal movement.5. The rotation type was observed more in the cuspid-guided and the cuspid-premolar-guidedlateral occlusions. The group-functioned occlusion had more shift type than the others.6 . In the winding type, the mandible was guided more posteriorly at the early stage of lateralexcursion in the V-shape, and was guided more flatly and anteriorly in the A-shape.7. It was suggested that the lateral occlusal guidance was one of the most influential factorsfor working condylar movement.

顆頭運動の解析にあたっては,顆頭基準点をどこにとるかによって,同じ運動であっても経路に差異が生じてくる.前後,開閉運動の計測にあたっては,顆路幅径の最も小さくなる全運動軸が,わが国で採用されてきた.側方運動に関しては,顆頭基準点の微妙な位置的違いが運動経路に大きく差異を生じる.そこで著者らは,第1報で側方運動解析を行い,作業側顆路が最小となる側方顆路基準点を新たに顆頭基準点として提唱し,その妥当性を実証した.本報では,下顎側方運動に際して起こる側方顆路基準点の運動解析,特に運動パターンの分析を行い,特徴あるいくつかの運動様式を観察したので報告する.


A Study on 3-dimentional Condylar Movements in Lateral Mandibular Movements : Part1. A New Condylar Reference Point for Analysis of Lateral Mandibular Movements

側方運動における顆頭部三次元動態に関する研究 : 第1報 側方運動解析のための新しい顆頭部基準点について

We researched the point on kinematic axis which had a minimal range of motion in lateral excursive movements. We called that lateral condylar reference point (LCR point). We studied the range of motion, the relative position to the arbitrary point and to the morpho-logical center of the condyle of the following 4 points : kinematic axis point, hinge axis point, cross point and LCR point. 1. The ranze of motion of the LCR noint was O.47 mm (anteroposterior), O.79 mm (lateral), 0.74 mm (vertical) and 0.90 mm (3-D). It was the smallest among the 4 points. 2. The LCR point was located 1.31 rum medial to the morphological center of the condyle. 3. The LCR point was located 3.62 mm anteriorly, 24.18 mm medially and 4. 57 mm superiorly to the arbitrary point. Therefore, the LCR point is a suitable analysing point on the condyle in lateral mandibular nxovements.

側方運動を作業側顆路をも含めて解析するためには,再現性が高く,運動に際して安定した経路をとる基準点を,解析点として選ぶ必要がある. そこで,著者らは本論文において,側方運動解析のための新たな基準点を検索することを目的とした.側方滑走運動時,作業側顆頭付近の全運動軸上に,3次元的最小可動点を求めた.そして,この解析点の運動量,可動範囲および位置を,従来用いられてきた各種顆頭部解析点と比較した結果,この解析点は側方運動解析のための基準点となりうると考えられた.著者らはこれを,側方顆路基準点と命名した.


新型コロナウイルス感染症対策を再考する Withコロナ時代の口腔衛生管理における感染対策