補綴歯科はインプラント治療で何を見ているのか．

補綴歯科はインプラント治療で何を見ているのか．

日本顎顔面インプラント学会誌

日本顎顔面インプラント学会誌


Effect of Palatal Augmentation Prosthesis on Speech and Swallowing in Tongue Dysfunction:A Literature Review

Purpose: Palatal augmentation prosthesis (PAP) is used on patients with dysphagia and dysarthria. While several studies have evaluated the effects of PAP, evidence regarding the adaptation criteria, effects, and limitations of PAP are not well organized. This review aims to summarize its functions, limitations, and applications. Procedure: To investigate the adaptation criteria, effects, and limitations of PAP, we searched the English language literature published in PubMed from its inception through April 20, 2022. The leading search terms included ``palatal augmentation prosthesis.'' Main findings: The primary search used keywords that reflected 31 studies. Finally, nine cross-sectional studies and nine case reports were selected for full-text assessment after applying the inclusion criteria. Eleven studies described the efficacy of speech function: two for motility factors and nine for organic factors (with overlap). Thirteen studies described the effectiveness of swallowing function, four related to motility factors, and ten for organic factors (with overlap). Several studies have demonstrated that PAP effectively restores articulation and swallowing in patients with impaired tongue function after glossectomy for oropharyngeal cancer, sequelae of cranial nerve disease, or neuromuscular disease. However, few papers describe the scope of glossectomy and tongue movement restrictions, so it is impossible to describe the adaptation criteria, effects, and limitations. In this review, most case reports and cross-sectional studies did not provide information on the fabrication methods of PAP or the dentistsʼ experience. Thus, the effect of bias on palatal morphology in PAP patients remains unclear. Conclusions: The number of patients with dysarthria and dysphagia is increasing worldwide, similar to what is already occurring in Japan. Therefore, additional high-quality studies on the effects of PAP are required.


2-methacryloyloxyethyl phosphorylcholine polymer treatment prevents Candida albicans biofilm formation on acrylic resin

We aimed to evaluate the effectiveness of photoreactive 2-methacryloyloxyethyl phosphorylcholine (MPC) in inhibiting Candida albicans biofilm formation on polymethyl methacrylate (PMMA) and assess its mechanism and need for re-application by evaluating its interaction with salivary mucin and durability during temperature changes. PMMA discs were used as specimens. The MPC coating was applied using the spray and cure technique for the treatment groups, whereas no coating was applied to the control. The MPC treatment (MT) groups were further differentiated based on the number of thermal cycles involved (0, 1000, 2500, and 5000). The optical density was measured to assess mucin adsorption (MA). Contact angle (CA) was calculated to evaluate surface hydrophilicity. The presence of MPC components on the PMMA surface was assessed using X-ray photoelectron spectroscopy (XPS). C. albicans biofilms were evaluated qualitatively (scanning electron microscope images) and quantitatively (colony-forming units (CFUs)). Statistical analysis was conducted using two-way analysis of variance and Tukey's multiple comparison test. MA rate and CA increased significantly in the MT groups, which exhibited significantly fewer CFUs and thinner biofilms than those of the control group. Based on the XPS, MA, and CFU evaluations, the durability and efficacy of the MPC coating were considered stable up to 2500 thermal cycles. Additionally, a significant interaction was observed between mucin concentration and MPC efficacy. The photoreactive MPC coating, which was resistant to temperature changes for approximately 3 months, effectively prevented C. albicans biofilm formation by modifying surface hydrophilicity and increasing mucin adsorption.


A case of oral rehabilitation using an oral appliance for open bite caused by rheumatoid arthritis

顎関節リウマチに起因した開咬に対して可撤性補綴装置によって機能回復を行った症例


Novel Magnetic Attachment System Manufactured Using High-Frequency Heat Treatment and Stamp Technique: Introduction and Basic Performance

Recently, a novel magnetic attachment with extremely low cost and high performance was developed. This article aims to introduce a novel magnetic attachment and to evaluate its basic eligibility for denture retention in clinical practice. The novel magnetic attachment system used in this study was the direct-bonding root-keeper-type Magteeth™ MT800 (MagneDesign, Nagoya, Japan). The retentive force without displacement (position 0) and after horizontal displacement to positions 0.5, 1, 1.5, 2, 2.5, and 3 mm were measured. The values relative to the retentive force without displacement were gradually decreased to 82.7 ± 16.3%, 68.8 ± 17.1%, 62.4 ± 15%, 47.2 ± 13.1%, 35.7 ± 9.9%, and 20.7 ± 6.5%, respectively. The retentive force and magnetic field strength did not change significantly after the load test (100 N load, 10,000 times). No new gap between the metal and resin was found in the root keeper- and magnet assembly-embedded blocks after the load test. Some scratches on magnetic assembly and root keeper surface, while no change in the resin texture after the load test were observed. Based on the findings of this preliminary study, this novel low-cost magnetic attachment exhibited favorable retention, strength, and durability for clinical use.


Does Prosthodontic Treatment Improve the Nutrition Status in the Elderly? Literature Review


Treatment outcomes of implant-assisted removable partial denture with distal extension based on the Kennedy classification and attachment type: a systematic review

Implant-assisted removable partial dentures (IARPDs) have recently become popular, but little information is available on the treatment outcomes based on the Kennedy classification and attachment types. The objective of this review was to evaluate the treatment outcomes of IARPD delivered for distal extension edentulous areas based on the differences in the Kennedy classification and attachment type. English-language clinical studies on IARPD published between January 1980 and February 2020 were collected from MEDLINE (via PubMed), the Cochrane Library (via the Cochrane Central Register of Controlled Trials), Scopus online database, and manual searching. Two reviewers selected the articles based on pre-determined inclusion and exclusion criteria, followed by data extraction and analysis. Eighty-one studies were selected after evaluating the titles and abstracts of 2410 papers. Nineteen studies were finally included after the perusal of the full text. Fourteen studies focused on Class I, 4 studies investigated both Class I and II, and only 1 study was conducted on Kennedy's class II. Eight types of attachments were reported. The ball attachment was the most frequently used attachment, which was employed in 8 of the included studies. The implant survival rate ranged from 91 to 100%. The reported marginal bone loss ranged from 0.3 mm to 2.30 mm. The patient satisfaction was higher with IARPD than with conventional RPDs or that before treatment. The results of prosthetic complications were heterogeneous and inconclusive. IARPD exhibited favorable clinical outcomes when used as a replacement for distal extension edentulous areas. The comparison between the clinical outcomes of Kennedy's class I and II was inconclusive owing to the lack of studies focusing on Kennedy Class II alone. The stud attachment was the most commonly used type in IARPDs. Overall, the different attachment systems did not influence the implant survival rate and patient satisfaction. Further high-quality studies are needed to investigate the attachment systems used in IARPD.

International Journal of Implant Dentistry


Reliability of screening methods to diagnose oral dryness and evaluate saliva secretion


Effect of polishing protocols on the surface roughness of polyetheretherketone.

The purpose of this study was to evaluate the influence of various polishing protocols on the surface roughness of polyetheretherketone (PEEK) and identify an effective polishing method of dental prostheses at the chairside. The PEEK specimens were assigned to seven groups with different protocols: no additional polishing (NT); polishing using a rubber point (C); polishing using "silky shine" (S); polishing using "aqua blue paste" (A); protocol C followed by protocol S (CS); protocol C followed by protocol A (CA); and protocol C followed by protocols S and A (CSA). The surface roughness (Sa and Ra) of the polished surfaces was measured. The surface roughness decreased in the following order of groups: NT, C, S, CS, CSA, CA, and A. In Groups C and S, wide deep pits formed by abrasive grains of SiC paper were observed, whereas only fine linear structures were observed on the surface in other groups. With respect to the polishing protocol of PEEK, clinically acceptable surface roughness was obtained using a soft polishing brush and agent for more than 3 min.


Use of a Polyetheretherketone Clasp Retainer for Removable Partial Denture: A Case Report

Clasp retainers made of metal alloys may be esthetically unappealing or cause allergic reactions. To investigate alternative materials, we used the nonfiller polyetheretherketone (PEEK) to fabricate the clasp retainer of a removable partial denture for the mandibular bilateral distal free-end abutment of an 84-year-old female. Two years later, few color and texture changes of PEEK were found macroscopically. The rest part and the clasp arm fitted well without any deformation. There were no particular occlusal or periodontal problems. Subjective satisfaction was expressed by both the practitioner and the patient.


Calprotectin and cross-linked N-telopeptides of type I collagen levels in crevicular fluid from implant sites with peri-implant diseases: a pilot study

Peri-implant crevicular fluid (PICF) contains calprotectin and NTx, which are markers for inflammation and bone resorption, respectively. The aims of this pilot study were to compare calprotectin and NTx levels in PICF from implant sites with or without peri-implant diseases and to evaluate the usefulness of calprotectin and NTx as diagnostic markers for peri-implant diseases. Thirty-five patients with dental implants participated in this pilot study. PICF samples were collected from peri-implant disease sites (n = 40) and non-diseased (healthy) sites (n = 34) after clinical indicators including probing depth (PD), bleeding on probing (BOP), gingival index (GI), and bone loss (BL) rate were investigated. Calprotectin and NTx amounts in PICF were measured using their respective ELISA kits and then compared between diseased and healthy samples. The relationship between PICF calprotectin or NTx levels and clinical indicator levels was investigated. A receiver operating characteristic (ROC) curve analysis of calprotectin and NTx was performed to predict peri-implant diseases. Calprotectin and NTx levels in PICF were significantly higher from peri-implant disease sites than from healthy sites. PICF calprotectin amounts correlated with PD, and its levels were significantly higher in the GI-1 and GI-2 groups than in the GI-0 group. PICF NTx amounts correlated with PD and the BL rate. ROC curves indicated that PICF calprotectin and NTx are useful biomarkers for peri-implant diseases. Calprotectin and NTx in PICF have potential as biomarkers for the diagnosis of peri-implant diseases.


Duplication of complete dentures using general-purpose handheld optical scanner and 3-dimensional printer: Introduction and clinical considerations

To introduce a new clinical procedure for fabricating duplicates of complete dentures by bite pressure impression using digital technology, and to discuss its clinical significance. The denture is placed on a rotary table and the 3-dimensional form of the denture is digitized using a general-purpose handheld optical scanner. The duplicate denture is made of polylactic acid by a 3-dimensional printer using the 3-dimensional data. This procedure has the advantages of wasting less material, employing less human power, decreasing treatment time at the chair side, lowering the rates of contamination, and being readily fabricated at the time of the treatment visit.


An innovative masticatory efficiency test using odor intensity in the mouth as a target marker: a feasibility study

A large number of studies have reported the findings for masticatory efficiency tests; however, some objective masticatory efficiency tests have a drawback, in that subjects are required to spit out the test material. This study examined the possibility of a masticatory efficiency test that evaluates the intensity of odours released when chewing an odour compound-containing material. A total of 20 volunteers were used in this study. The odour intensity in the breath after chewing a gum was measured by portable odour sensor device. The odour intensity after chewing the gum was measured over four chewing durations and at four intervals between spitting out and measurement of the odour intensity. The volume of stimulated saliva was measured by calculating the difference in the weight of the gauze before and after chewing to examine the effect of saliva flow. With an increase in chewing duration, odour intensity reduced. The odour intensity was the highest immediately after chewing. There was a positive correlation between odour intensity and gummy jelly-related masticatory efficiency test value (G-METV), which was significant for 10-s chewing. The regression equation was calculated from three objective variables of odour intensity and G-METV as dependent variable. Pearson's correlation coefficient between G-METV and the odour intensity-related masticatory efficiency value (O-METV) was 0·68. The coefficient of variation of O-METV was significantly lower than that of G-METV. These results suggest that the masticatory performance can be estimated by measuring the odour intensity immediately after chewing food containing odour compounds for 10 s.


Magnet-retained two-mini-implant overdenture: Clinical and mechanical consideration.

Two-implant overdentures have become the accepted treatment for restoring mandibular edentulism. The dimensions of regular implants sometimes limit their use, such as in the case of narrow ridges. Mini-implants with reduced diameters (less than 3.0 mm) enable insertion into narrow ridges. A magnet-retained two-mini-implant overdenture system was developed and is described in this paper. Additionally, we describe a clinical mandibular procedure using the system and evaluate its biomechanical performance.


Hardness, cohesiveness, and adhesiveness of oral moisturizers and denture adhesives: selection criteria for denture wearers.

The mechanical properties of seven denture adhesives and eight oral moisturizers, all of which are commercially available, were evaluated using a texture pro le analysis. A new assessment chart is proposed for the selection criteria of denture adhesive and oral moisturizers using a radar chart with three axes: hardness, cohesiveness, and adhesiveness.


Glass-fiber Reinforced 3-unit Metal-less Bridge: Short-term Preliminary Results

グラスファイバーで補強された高強度コンポジットレジンを用いた3ユニットブリッジ治療について(原著論文)

Mechanical strength to withstand occlusal force is required to the crown restorations of molars. Ag-Pd-Au alloy has been used as the acceptable material of the National Health Insurance system in Japan. However, the metallic color of prosthesis does not meet the aesthetic requirements of the patients, and there is also a problem to the provider side of the treatment that the price fluctuation is large by soaring material costs. A fiber reinforced metal-less bridge is proposed to resolve these problems and we began clinical application of this prosthetic treatment from September, 2012 on the approval of Tokushima University Hospital ethics committee. So far, six patients have been treated with 8 fiber reinforced bridges, and this treatment in Tokushima University Hospital was approved in Shikoku Regional Bureau of Health and Welfare as the advanced medical. We have followed the treatment for a maximum of more than two years, and it has been passed successfully with patient's satisfaction. Slightly problems which were caused in the hybrid resin material, could be easily solved by the direct procedures. This clinical results in short term suggested that the fiber reinforced metalless bridge have a sufficiently high therapeutic effect as a prosthetic method.


審美歯治療のエンドポイントと評価方法

審美歯治療のエンドポイントと評価方法


End points and assessments in esthetic dental treatment.

There are two key considerations for successful esthetic dental treatments. This article systematically describes the two key considerations: the end points of esthetic dental treatments and assessments of esthetic outcomes, which are also important for acquiring clinical skill in esthetic dental treatments. The end point and assessment of esthetic dental treatment were discussed through literature reviews and clinical practices. Before designing a treatment plan, the end point of dental treatment should be established. The section entitled "End point of esthetic dental treatment" discusses treatments for maxillary anterior teeth and the restoration of facial profile with prostheses. The process of assessing treatment outcomes entitled "Assessments of esthetic dental treatment" discusses objective and subjective evaluation methods. Practitioners should reach an agreement regarding desired end points with patients through medical interviews, and continuing improvements and developments of esthetic assessments are required to raise the therapeutic level of esthetic dental treatments.


Influence of female attachment installation load on movement and resultant forces in implant overdentures

This in vitro study investigated the effect of attachment installation conditions on the load transfer and denture movements of implant overdentures, and aims to clarify the differences among the three types of attachments, namely ball, Locator, and magnet attachments. Three types of attachments, namely ball, Locator, and magnetic attachments were used. An acrylic resin mandibular edentulous model with two implants placed in the bilateral canine regions and removable overdenture were prepared. The two implants and bilateral molar ridges were connected to three-axis load-cell transducers, and a universal testing machine was used to apply a 50 N vertical force to each site of the occlusal table in the first molar region. The denture movement was measured using a G(2) motion sensor. Three installation conditions, namely, the application of 0, 50, and 100 N loads were used to install each attachment on the denture base. The load transfer and denture movement were then evaluated. The resultant force decreased with increasing installation load for all attachments. In particular, the resultant force on implants on the loading side of the Locator attachment significantly decreased when the installation load was increased from 0 to 50 N, and that for magnetic attachment significantly decreased when the installation load was increased from 50 to 100 N. For the residual ridges on the loading side, the direction of the forces for all attachments changed to downward with increasing installation load. Furthermore, the yaw Euler angle increased with increasing installation load for the magnetic attachment. Subject to the limitations of this study, the use of any installation load greater than 0 N is recommended for the installation of ball and Locator attachments on a denture base. Regarding magnetic attachments, our results also recommend installation on a denture base using any installation load greater than 0 N, and suggest that the resultant force acting on the implant can be decreased by increasing the installation load; however, a large installation load of 100 N should be avoided when installing the attachment on the denture base to avoid increasing the denture movement.


Blue-violet laser modification of titania treated titanium: antibacterial and osteo-inductive effects

Many studies on surface modifications of titanium have been performed in an attempt to accelerate osseointegration. Recently, anatase titanium dioxide has been found to act as a photocatalyst that expresses antibiotic properties and exhibits hydrophilicity after ultraviolet exposure. A blue-violet semiconductor laser (BV-LD) has been developed as near-ultraviolet light. The purpose of this study was to investigate the effects of exposure to this BV-LD on surface modifications of titanium with the goal of enhancing osteoconductive and antibacterial properties. The surfaces of pure commercial titanium were polished with #800 waterproof polishing papers and were treated with anatase titania solution. Specimens were exposed using BV-LD (λ = 405 nm) or an ultraviolet light-emitting diode (UV-LED, λ = 365 nm) at 6 mW/cm(2) for 3 h. The surface modification was evaluated physically and biologically using the following parameters or tests: surface roughness, surface temperature during exposure, X-ray diffraction (XRD) analysis, contact angle, methylene blue degradation tests, adherence of Porphyromonas gingivalis, osteoblast and fibroblast proliferation, and histological examination after implantation in rats. No significant changes were found in the surface roughness or XRD profiles after exposure. BV-LD exposure did not raise the surface temperature of titanium. The contact angle was significantly decreased, and methylene blue was significantly degraded. The number of attached P. gingivalis organisms was significantly reduced after BV-LD exposure compared to that in the no exposure group. New bone was observed around exposed specimens in the histological evaluation, and both the bone-to-specimen contact ratio and the new bone area increased significantly in exposed groups. This study suggested that exposure of titanium to BV-LD can enhance the osteoconductivity of the titanium surface and induce antibacterial properties, similar to the properties observed following exposure to UV-LED.


Should Occlusal Pressure be Applied in Fixing Magnet Assenmlies to Denture? An Evaluation using the Delphi Technique

The Journal of the Japanese Sociaty of Magnetic Applications in Dentistry


Long-term follow-up case reports on the use of magnetic attachment as intracoronal/extracoronal attachments


Telescopic Magnetic Attachment for Implant-Supported Denture: Evaluation of Splint Effect

Retrievability, connecting strength, and ease of laboratory work are important but conflicting prerequisites for the success of an implant superstructure, particularly with regard to immediate function. To resolve this issue, a telescopic magnetic attachment system has been developed for implant-supported removable dentures. The splinting effect of the attachment was evaluated for stress distribution and elevation with an in vitro model of three implants in an edentulous mandible. Two types of telescopic magnetic attachments were prepared; the inclination angles of the axial wall of the abutment were 2.5 and 6.0 degrees. Three types of three-unit superstructures--a screw-retained superstructure and two telescopic magnet-retained superstructures--were fabricated. Static loads of 24.5, 49, and 98 N were applied vertically at three loading points on one side of each occlusal table. The elevation was measured as the height at which the magnet-retained superstructure detached from the abutment (on the other side of the prosthesis). In addition, by means of strain gauges, the stress distribution around the implants was evaluated and compared among the superstructures with the same three loads applied at six different points. The magnet-retained superstructure with the axial wall inclined at 2.5 degrees did not detach from the abutment. The differences in stress distribution between the screw-retained and magnet-retained superstructures with a 2.5-degree inclination were found to be statistically insignificant. The magnet-retained superstructure with a 6-degree inclination detached from the abutment, and the stress was concentrated during loading to a cantilever site. Because of its stress distribution and elevation, the new telescopic magnetic attachment, which has properties such as splinting the implants, ease of fabrication, and retrievability, is expected to be a viable alternative for the retention of implant-supported removable dentures.

The International Journal of Oral & Maxillofacial Implants


Survival of immediate implant restoration: A retrospective study through 9-year-observation

The purpose of this retrospective study was to assess the implant survival rate and the risk factors associated with implant failure in patients who had undergone immediate implant restoration. We performed a retrospective review and an outcome assessment of all patients who received immediate implant restoration between 2000 and 2010 in our department at Tokushima University Hospital. The patients were divided into groups on the basis of the predictor variables: age, gender, implant location, and number of implants per jaw. The cumulative implant survival rate in the paired groups was determined by using Kaplan-Meier analysis and the log-rank test. Cox proportional hazards model was subsequently used to identify exposures associated with implant failure. Using the Kaplan-Meier method, the survival rates at 1, 3, and 9 years were calculated to be 98.8%, 98.0%, and 94.7%, respectively. No statistically significant association was observed between the implant survival rates and the predictor variables: gender, age, location, and number of implants. Immediate implant restoration is a reliable prosthetic procedure with an acceptable survival rate compared to the conventional implant procedure.


Devalopment and Evaluation of a Computer-assisted Navigation System Equipped with a Motion Sensor in Implant Dentistry

姿勢検出センサを用いたインプラント埋入ナビゲーションシステムの開発

本研究では，3次元的な角度変化を計測できる姿勢検出センサを用いて開発を行った簡易的なインプラント埋入ナビゲーションシステムを開発した．本稿では，本システムの概要について紹介する．また，インプラント埋入の経験のない歯科医師を対象として，外科用ガイドプレートと本ナビゲーションシステムを用いてインプラント窩の形成を行う実験の結果について報告し，本システムの有用性と将来性について述べる．

Journal of Japanese Society of Oral Implantology

日本口腔インプラント学会誌


New glass polyalkenoate temporary cement for cement-retained implant restoration: Evaluation of elevation and retentive strength

The purpose of this study was to evaluate four luting agents for cement-retained implant restorations in two aspects: post-cementation elevation of the superstructure and the retentive strength before and after thermocycling and mechanical cycling. The four evaluated luting agents were: new glass polyalkenoate hard-type (GH) and soft-type (GS) cements, polycarboxylate hard-type (HH) and soft-type (HS) cements. Elevation and retentive strength were measured using a CCD laser displacement sensor and a universal testing machine respectively. Elevation increased in this order: GH, GS, HH, and HS. Thermal and mechanical stresses significantly decreased retentive strength, and the mean values exhibited by GH were significantly higher than the other luting agents. The novel glass polyalkenoate cements (hard- and soft-type) experimentally prepared in the present study augured well as luting agents by virtue of their reduced film thickness and their excellent post-cementation retention and elevation.


磁石固定式上部構造におけるインプラント支持歯槽骨の光弾性応力解析

磁石固定式上部構造におけるインプラント支持歯槽骨の光弾性応力解析

The Journal of the Japanese Society of Magnetic Applications in Dentistry