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


Association between motivation scale score and oral condition on receiving basic periodontal therapy


Relationship between Volatile Sulfur Compounds and the Oral Environment in Patients Complaining of Oral Malodor

口臭症患者に認められる揮発性硫黄化合物と 口腔環境との関連性


Production of YouTube Videos Linked to Toothbrushing Habits and Verification of Educational Effects

歯磨き習慣と関連付けたYouTube動画の制作と視聴による教育的効果の検討


Factors associated with diabetes control: 2-Year cohort study in outpatients with type 2 diabetes

Type 2 diabetes is a typical lifestyle disease. We aimed to identify the factors affecting glycemic control in 64 outpatients with type 2 diabetes over a 2-year period. We defined poor glycemic control using a change in glycosylated hemoglobin (?HbA1c) of ??0.5% over 2 years and/or HbA1c ??7.5% at the end of the study period. We used a questionnaire to collect information on oral health behavior and lifestyle, including eating and smoking habits, and analyzed the relationships between indices of diabetes control and responses to the questionnaire. The mean (SD) HbA1c of the participants was 6.87% (0.77%) at a baseline, and 6.93% (0.69%) after 2 years. Twenty-three participants (36.0%) had poor glycemic control. ?HbA1c and the change in body mass index (?BMI) correlated (Spearman's rank correlation, r?=?0.350, p?<?0.01). The HbA1c at baseline was associated with eating slowly?/?chewing well, and ?BMI was associated with perceived oral symptoms. Binominal logistic regression analysis revealed that poor glycemic control was associated with ?BMI and a smoking habit (odds ratio : 1.62, 95% confidence interval : 1.08?2.42?;?and 4.01, 1.12?14.36, respectively). These findings imply that weight gain and a smoking habit are associated with poor glycemic control in patients with type 2 diabetes. J. Med. Invest. 70 : 28-33, February, 2023.

The Journal of Medical Investigation : JMI


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


Association between Onset of Fever and Oral Care Assessment Items in Older Adults Requiring Nursing Care Who Are Capable of Oral Ingestion

経口摂取要介護高齢者の発熱発生と口腔ケアアセスメント項目との関連性

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


Factors influencing dental caries in 3-year-old children: Effectiveness through prenatal oral health examination on the behavioral change


Analysis of Factors Related to Periodontal Condition in Pregnant Women

妊婦の歯周状態に関連する因子の分析


Oral care tablet containing kiwifruit powder affects tongue coating microbiome


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


Anti-Inflammatory and Protective Effects of Juncus effusus L. Water Extract on Oral Keratinocytes

Periodontitis is a chronic inflammatory disease caused by periodontopathogenic bacteria that form biofilms in periodontal pockets. The gingival epithelium acts as the first physical barrier in fighting attacks by periodontopathogenic pathogens, such as the primary etiological agent , and various exogenous chemicals, as well as regulates the local innate immune responses. Therefore, the development of novel oral care products to inhibit inflammatory reactions caused by bacterial infection and protect the gingival epithelium is necessary. L. has generally been used as an indigenous medicine, such as a diuretic, an antipyretic, and an analgesic, in ancient practice. In this study, we examined the effects of a water extract from L. on the inhibition of the inflammatory reaction elicited by bacterial infection and protection of the oral epithelium by chemical irritation. Pretreatment of oral epithelial cells with the water extract from L. significantly reduced or its lipopolysaccharide- (LPS-) mediated production of chemokines (interleukin-8 and C-C-chemokine ligand20) in a concentration-dependent manner with comparable to or greater effects than epigallocatechin gallate and protected oral epithelial cells from injury by chemical irritants, cetylpyridinium chloride, and benzethonium chloride. Moreover, the water extract from . L. in the presence of antimicrobial agents or antifibrinolytics already used as ingredients in mouthwash could significantly reduce the production of chemokines from LPS-stimulated oral epithelial cells in a concentration-dependent manner. These findings suggest that the water extract from . L. is potentially useful for oral care to prevent oral infections, such as periodontal infections, and maintain oral epithelial function.


糖尿病患者における間食習慣および口腔保健行動と口腔環境との関連性

糖尿病患者における間食習慣および口腔保健行動と口腔環境との関連性


歯科衛生士学生における摂食嚥下リハビリテーション臨床実習の有効性

歯科衛生士学生における摂食嚥下リハビリテーション臨床実習の有効性

The Journal of Japan Society for Dental Hygiene


Association between Diabetes-related Clinical Indicators and Oral Health Behavior among Type-2 Diabetes Patients

Objective : The aim of this study was to evaluate the association between diabetes-related indicators and oral health behavior among patients with type 2 diabetes. Methods : Seventy-four outpatients were included. We administered a questionnaire and divided the patients into two groups according to oral health behavior and eating habits. We then compared diabetes-related clinical records between the groups and performed logistic regression analysis. Results : Participants who brushed their teeth before bedtime every night had lower BMIs than those who did not. Participants who reported eating slowly and chewing well every day had significantly lower HbA1c than their counterparts. Participants who reported gum bleeding had significantly higher LDL-cholesterol than their counterparts. Binominal logistic regression analysis revealed that BMI < 25 was associated with not brushing teeth before bedtime every night, HbA1c < 7.5 with not eating slowly or chewing well every day, and LDL-cholesterol < 120 with gum bleeding (odds ratio : 0.140, 95% confidence interval : 0.036-0.540 ; OR : 0.085, 95% CI : 0.010-0.736, OR : 0.275, 95% CI : 0.077-0.979, respectively). Conclusions : Our findings suggest that toothbrushing before bedtime every night is associated with reduced risk of obesity and that eating slowly and chewing well are advantageous for glycemic control in patients with type 2 diabetes.J. Med. Invest. 68 : 140-147, February, 2021.


There is an association between gingival inflammation and obesity in Japanese male adolescents


Involvement of oral bacteria and oral immunity as risk factors for chemotherapy- induced fever with neutropenia in patients with hematological cancer

The aim of this study is to investigate the association between chemotherapy-induced fever with neutropenia less than 1500/μL (FwN) and oral bacteria and/or oral immunity in patients with hematological cancer. Thirty-two patients with hematological cancer were enrolled in the study. Secretory immunoglobulin A (sIgA) in saliva and the anaerobic bacteria in tongue coating of each subject were assessed before the first chemotherapy. Eleven subjects had an onset of FwN and 21 subjects did not during the observation periods. It was revealed by the Cox-proportional hazard model analysis that the levels of sIgA were low (HR 0.98, p < 0.05) and the rate of Fusobacterium nucleatum [F. nucleatum count per total bacterial count (%)] was high (HR 1.65, p < 0.05) in patients with FwN onset. Using ROC curve analysis, the optimal cutoff point based on the AUC in the F. nucleatum/sIgA ratio was 0.023, and this model had a 78.4% probability (p < 0.01). The risk of FwN onset was also significantly higher among the group of ≥ 0.023 F. nucleatum/sIgA ratio (HR 66.06, p < 0.01). These results suggest that the rate of F. nucleatum and the levels of sIgA at baseline might be related to FwN onset as risk factors.


Relationship between smoking habits of mothers and dental health behavior or the oral health condition of their children

母親の喫煙習慣と歯科保健行動および子どもの口腔状態との関連性

Objective: It is known that secondhand smoke exposure is associated with dental caries in children, and it is also speculated that mothers with smoking habits may have little awareness of their dental health and their children. The purpose of this study was to analyze the relationship between smoking habits of mothers and dental health behavior or the oral health condition of their children, and to clarify the factors involved in dental caries of deciduous teeth.Methods: The subjects enrolled in this study were mothers and their children who received health checkup for both 18-month-old children and 3-year-old children in N City, Tokushima Prefecture, Japan. One hundred sixty-five subjects (mothers) were divided into two groups, non-smoker group (n=152) and smoker group (n=13). The results of dental examinations for 3-year-old children and the questionnaire surveys from mothers were collated and analyzed.Results: Dental caries prevalence of deciduous teeth was 46.2% in children of the smoker group, which was significantly higher than that of 21.1% in children of the non-smoker group (p<0.05). Among the questionnaire survey items regarding the regular dental checkup of mothers, the percentage of "no visit" in the smoker group was 76.9% and 46.1% in the non-smoker group, and it showed a significant difference (p<0.05). In the item of the dental examination for pregnant woman, the percentage of "did not receive" in the smoker group was 76.9% and 43.7% in the non-smoker group, and it showed a significant difference (p<0.05). There were significant differences between the presence and absence of smoking habits of mothers regarding the age of mother (p<0.01) and smoking habits of the other families (p<0.05). In addition, the binomial logistic regression analysis showed that oral hygiene condition (OR=2.92, p<0.05), regular between meal eating (OR=3.99, p<0.01) and smoking habits of mothers (OR=4.13, p<0.05) were significantly corelated with the presence of dental caries in 3-year-old children.Conclusions: These results suggest that the mothers in the smoking group was younger and higher rate that included smoker families, in addition to poor regular dental check-up during pregnancy and currently. It was also suggested that smoking habits of mothers were associated with dental caries in 3-year-old children.

小児の受動喫煙とう蝕罹患との関連性が報告されている．また，喫煙習慣を持つ母親は自身や子どもに対する歯科健康意識が低いと推察される．そこで本研究では，母親の喫煙習慣と歯科保健行動および子どもの口腔状態との関連性を分析し，乳歯う蝕罹患に関わる因子を明らかにすることを目的とした．徳島県N市にて実施した1歳6か月児健康診査および3歳児健康診査を両方受診した母子を対象とした．調査対象児165名の母親を，非喫煙者(152名)と喫煙者(13名)の2群に分け，3歳児の歯科健診結果および母親からのアンケート調査結果を突合して分析した．乳歯う蝕罹患率は喫煙者群では46.2%で，非喫煙者群の21.1%と比較して有意にう蝕罹患の割合が高かった(p<0.05)．アンケート調査項目の母親の現在の定期歯科健診において，「受診なし」の者の割合が喫煙者群では76.9%，非喫煙者群では46.1%で，2群間に有意な差が認められた(p<0.05)．妊婦中の歯科健診の項目において，喫煙者群の「受診なし」の者の割合は76.9%，非喫煙者群では43.7%で有意な差が認められた(p<0.05)．また，喫煙者群では非喫煙者群に比べて，母親の年齢において若年層の割合が有意に高く，母親以外の家族の喫煙習慣ありの割合も高かった(各々p<0.01，p<0.05)．さらに，3歳児のう蝕経験の有無を目的変数として二項ロジスティック回帰分析を行った結果，「清掃状態」(オッズ比:2.92，p<0.05)，「間食時間の決定」(オッズ比:3.99，p<0.01)，「母親の喫煙習慣」(オッズ比:4.13，p<0.05)において有意な関連が認められた．以上の結果より，喫煙習慣を有する母親は，年齢が低い者の割合が高く，他の家族の喫煙率も高く，そして，妊娠期および現在も歯科健診受診の割合が低いことが示された．また，母親の喫煙習慣が3歳児の乳歯う蝕罹患に関連することが示唆された．

Japanese Journal of Smoking Control Science


Association between Oral Health Status and Diabetic Nephropathy-Related Indices in Japanese Middle-Aged Men


Effectiveness of an oral care tablet containing kiwifruit powder in reducing oral bacteria in tongue coating: A crossover trial

The aim of this study was to investigate the effect of an oral care tablet containing kiwifruit powder on oral bacteria in tongue coating compared with tongue brushing. Thirty-two healthy, young adults were enrolled, and a crossover clinical trial was conducted. The volatile sulfur compound (VSC) concentration, Winkel tongue-coating index (WTCI), and the number of total bacteria in addition to Fusobacterium nucleatum in tongue coating were measured. We instructed subjects to remove tongue coating by tongue brush for Intervention I, to keep the oral care tablet containing kiwifruit powder on the tongue dorsum and to let it dissolve naturally for Intervention II, and three oral care tablets 1 day before the measurement for Intervention III. There were significant differences in terms of the level of H S, VSC, and WTCI at Intervention I and all evaluation values at Intervention II. There were significant differences in terms of the level of H S, VSC, WTCI, the number of total bacteria, and F. nucleatum at Intervention III. The value of WTCI, the number of bacteria, and F. nucleatum decreased significantly after taking the oral care tablets than after tongue brushing. When compared with Interventions I and III, Intervention III showed the effective results; there were significant differences in the number of total bacteria and F. nucleatum between tongue brushing and taking tablets. These results suggested that the oral care tablet containing kiwifruit powder could be effective in reducing total bacteria and F. nucleatum in tongue coating when compared with tongue brushing.

Clinical and Experimental Dental Research


Assessing the oral health of in-patients with diabetes using a clinical version of the diabetes oral health assessment tool© and its association with dental examinations

The Journal of Medical Investigation : JMI


食道がん化学療法患者に対するがん支持療法としての専門的口腔ケアの有用性

食道がん化学療法患者に対するがん支持療法としての専門的口腔ケアの有用性


Impact of the use of Kampo medicine in patients with esophageal cancer during chemotherapy: a clinical trial for oral hygiene and oral condition

The aim of this study was to investigate the impact of the use of two Kampo medicines on oral mucositis, tongue coating bacteria, and gingiva condition in patients with esophageal cancer undergoing chemotherapy. Twenty-three esophageal cancer patients who receive chemotherapy at Tokushima University Hospital, were included. The participants, who received professional oral healthcare, were randomly divided into three groups:7 subjects received Daiokanzoto sherbets, 7 subjects received Hangeshashinto sherbets, and 9 subjects received nothing (control). The numbers of total bacteria and specific periodontopathogenic bacteria in tongue coating were determined in addition to clinical parameters. No difference on the onset of oral mucositis was found among the three groups. However, tongue coating index, gingival index (GI), plaque index, the number of total bacteria, Fusobacterium nucleatum and Campylobacter rectus were decreased during chemotherapy. More specifically, GI as well as the number of F. nucleatum and C. rectus were decreased significantly in the Daiokanzoto group when compared to the control group (psize 8 < 0.05). No such differences were observed for the group receiving Hangeshashinto. This clinical trial showed that Daiokanzoto might be effective in attenuating gingival inflammation and reducing the levels of periodontopathogenic bacteria in patients with esophageal cancer. J. Med. Invest. 65:184-190, August, 2018.


A review of evidence for a therapeutic application of traditional Japanese Kampo medicine for oral diseases/disorders.

Kampo medicines prescribed by specialized medical practitioners and Japanese physicians have gradually reemerged in Japan as alternatives to Western medications. Kampo formulations are composed of several plant extracts and, as such, the broad variety of phytochemicals they contain likely act synergistically to provide their beneficial effects. Kampo medicines have traditionally been prescribed for a number of health conditions, including chronic hepatitis, bronchial asthma, anemia, etc. The aim of this article is to review the beneficial effects of Kampos with respect to oral health. Pertinent papers published between 1970 and 2017 were retrieved by searching in PubMed, ScienceDirect, Web of Science, and Scopus using key words followed by evaluation of the relevant articles. In vitro studies have identified a number of properties that give credence to the potential of Kampos for treating or preventing oral diseases/disorders. Given their anti-microbial and anti-inflammatory properties, they may be promising agents for controlling periodontal diseases, oral mucositis, xerostomia, and drug-induced gingival overgrowth. Since some oral diseases have a complex etiology that involves microbial pathogens and the host immune response, agents with dual functionality such as Kampo phytochemicals may offer a therapeutic advantage.


Relationship among Health Related Quality of Life, Quality of Sleep, and Oral Health Condition


血液透析患者における現在歯数および咬合支持状態と栄養状態との関連性

血液透析患者における現在歯数および咬合支持状態と栄養状態との関連性


Comparison of oral malodor and oral microbiome in smokers and non-smokers

Japanese Journal of Smoking Control Science


透析患者の歯科受診を推進するためのツールとしての医療職および患者向けリーフレットの開発


血液透析患者における口腔衛生管理に対する意識

血液透析患者における口腔衛生管理に対する意識

Journal of Shikoku Public Health Society


徳島県内の回復期病院における看護師の口腔ケアに対する認識ーアンケート調査結果からー


幼児のフッ化物配合歯磨剤利用に関する口腔保健行動

幼児のフッ化物配合歯磨剤利用に関する口腔保健行動


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


Factors associated with regular dental visits among hemodialysis patients.

To investigate awareness and attitudes about preventive dental visits among dialysis patients; to clarify the barriers to visiting the dentist. Subjects included 141 dentate outpatients receiving hemodialysis treatment at two facilities, one with a dental department and the other without a dental department. We used a structured questionnaire to interview participants about their awareness of oral health management issues for dialysis patients, perceived oral symptoms and attitudes about dental visits. Bivariate analysis using the (2) test was conducted to determine associations between study variables and regular dental check-ups. Binominal logistic regression analysis was used to determine factors associated with regular dental check-ups. There were no significant differences in patient demographics between the two participating facilities, including attitudes about dental visits. Therefore, we included all patients in the following analyses. Few patients (4.3%) had been referred to a dentist by a medical doctor or nurse. Although 80.9% of subjects had a primary dentist, only 34.0% of subjects received regular dental check-ups. The most common reasons cited for not seeking dental care were that visits are burdensome and a lack of perceived need. Patients with gum swelling or bleeding were much more likely to be in the group of those not receiving routine dental check-ups ((2) test, P < 0.01). Logistic regression analysis demonstrated that receiving dental check-ups was associated with awareness that oral health management is more important for dialysis patients than for others and with having a primary dentist (P < 0.05). Dialysis patients should be educated about the importance of preventive dental care. Medical providers are expected to participate in promoting dental visits among dialysis patients.


Problems on oral healthcare in convalescent hospitals : Questionnaire survey for non-dental professionals

回復期病院職員が抱える口腔ケアについての悩み-他職種へのアンケート調査より-


Analysis of the educational effect of OSCE performed at the college of dental hygienist course

歯科衛生士養成校におけるOSCE導入の教育学的効果に関する解析

The Journal of Japan Society of Dental Hygiene Education

日本歯科衛生教育学会雑誌


妊娠期の歯周状態と低体重児出産のリスクに関する観察研究

妊娠期の歯周状態と低体重児出産のリスクに関する観察研究


The Daiokanzoto (TJ-84) Kampo formulation reduces virulence factor gene expression in Porphyromonas gingivalis and possesses anti-inflammatory and anti-protease activities

Kampo formulations used in Japan to treat a wide variety of diseases and to promote health are composed of mixtures of crude extracts from the roots, bark, leaves, and rhizomes of a number of herbs. The present study was aimed at identifying the beneficial biological properties of Daiokanzoto (TJ-84), a Kampo formulation composed of crude extracts of Rhubarb rhizomes and Glycyrrhiza roots, with a view to using it as a potential treatment for periodontal disease. Daiokanzoto dose-dependently inhibited the expression of major Porphyromonas gingivalis virulence factors involved in host colonization and tissue destruction. More specifically, Daiokanzoto reduced the expression of the fimA, hagA, rgpA, and rgpB genes, as determined by quantitative real-time PCR. The U937-3xκB-LUC monocyte cell line transfected with a luciferase reporter gene was used to evaluate the anti-inflammatory properties of Daiokanzoto. Daiokanzoto attenuated the P. gingivalis-mediated activation of the NF-κB signaling pathway. It also reduced the secretion of pro-inflammatory cytokines (IL-6 and CXCL8) by lipopolysaccharide-stimulated oral epithelial cells and gingival fibroblasts. Lastly, Daiokanzoto, dose-dependently inhibited the catalytic activity of matrix metalloproteinases (-1 and -9). In conclusion, the present study provided evidence that Daiokanzoto shows potential for treating and/or preventing periodontal disease. The ability of this Kampo formulation to act on both bacterial pathogens and the host inflammatory response, the two etiological components of periodontal disease, is of high therapeutic interest.


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


Development of the Diabetes Oral Health Assessment Tool © for Nurses


歯科併設のない人工透析実施医療機関における医科歯科連携

歯科併設のない人工透析実施医療機関における医科歯科連携


Education of tobacco use interventions for undergraduate dental students


Current status of collaborative relationships between dialysis facilities and dental facilities in Japan: results of a nationwide survey

Recent studies have reported an association between periodontal disease and mortality among dialysis patients. Therefore, preventive dental care should be considered very important for this population. In Japan, no systematic education has been undertaken regarding the importance of preventive dental care for hemodialysis patients--even though these individuals tend to have oral and dental problems. The aim of this study was to investigate the current state of collaborative relationships between hemodialysis facilities and dental services in Japan and also to identify strategies to encourage preventive dental visits among hemodialysis outpatients. A nationwide questionnaire on the collaborative relationship between dialysis facilities and dental facilities was sent by mail to all medical facilities in Japan offering outpatient hemodialysis treatment. Responses were obtained from 1414 of 4014 facilities (35.2%). Among the 1414 facilities, 272 (19.2%) had a dental service department. Approximately 100,000 dialysis outpatients were receiving treatment at these participating facilities, which amounts to one-third of all dialysis patients in Japan. Of those patients, 82.9% received hemodialysis at medical facilities without dental departments. Only 87 of 454 small clinics without in-house dental departments (19.2%) had collaborative registered dental clinics. Medical facilities with registered dental clinics demonstrated a significantly more proactive attitude to routine collaboration on dental matters than facilities lacking such clinics. Our nationwide survey revealed that most dialysis facilities in Japan have neither an in-house dental department nor a collaborative relationship with a registered dental clinic. Registration of dental clinics appears to promote collaboration with dental facilities on a routine basis, which would be beneficial for oral health management in hemodialysis patients.


学校給食における残食の要因調査

学校給食における残食の要因調査


Preventive effect of Daiokanzoto (TJ-84) on 5-fluorouracil-induced human gingival cell death through the inhibition of reactive oxygen species production

Daiokanzoto (TJ-84) is a traditional Japanese herbal medicine (Kampo formulation). While many Kampo formulations have been reported to regulate inflammation and immune responses in oral mucosa, there is no evidence to show that TJ-84 has beneficial effects on oral mucositis, a disease resulting from increased cell death induced by chemotherapeutic agents such as 5-fluorouracil (5-FU). In order to develop effective new therapeutic strategies for treating oral mucositis, we investigated (i) the mechanisms by which 5-FU induces the death of human gingival cells and (ii) the effects of TJ-84 on biological events induced by 5-FU. 5-FU-induced lactate dehydrogenase (LDH) release and pore formation in gingival cells (Sa3 cell line) resulted in cell death. Incubating the cells with 5-FU increased the expression of nucleotide-binding domain and leucine-rich repeat containing PYD-3 (NLRP3) and caspase-1. The cleavage of caspase-1 was observed in 5-FU-treated cells, which was followed by an increased secretion of interleukin (IL)-1β. The inhibition of the NLRP3 pathway slightly decreased the effects of 5-FU on cell viability and LDH release, suggesting that NLRP3 may be in part involved in 5-FU-induced cell death. TJ-84 decreased 5-FU-induced LDH release and cell death and also significantly inhibited the depolarization of mitochondria and the up-regulation of 5-FU-induced reactive oxygen species (ROS) and nitric oxide (NO) production. The transcriptional factor, nuclear factor-κB (NF-κB) was not involved in the 5-FU-induced cell death in Sa3 cells. In conclusion, we provide evidence suggesting that the increase of ROS production in mitochondria, rather than NLRP3 activation, was considered to be associated with the cell death induced by 5-FU. The results also suggested that TJ-84 may attenuate 5-FU-induced cell death through the inhibition of mitochondrial ROS production.


The Kampo medicine Rokumigan possesses antibiofilm, anti-inflammatory, and wound healing properties.

Periodontal diseases, which are inflammatory diseases of bacterial origin affecting the tooth-supporting tissues, are characterized by inflammation and destruction of gingival connective tissue and alveolar bone, and may lead to tooth loss. The aim of the study was to investigate Rokumigan, a Kampo Japanese traditional medicine made of six different plants, for its capacity to prevent biofilm formation by Fusobacterium nucleatum, to inhibit interleukin-6 (IL-6) and interleukin-8 (IL-8) secretion by mucosal cells, and to promote wound healing in a fibroblast model. Using a microplate colorimetric assay, Rokumigan prevented biofilm formation by F. nucleatum, while it had no effect on bacterial growth. Rokumigan inhibited IL-6 secretion in both epithelial cells and fibroblasts stimulated with lipopolysaccharide. However, it caused no significant inhibition of IL-8 secretion by both cell types. Rokumigan significantly increased proliferation and migration of gingival fibroblasts in a wound healing assay. In conclusion, the Kampo formulation Rokumigan, through suppression of biofilm formation by F. nucleatum, inhibition of IL-6 secretion by gingival epithelial cells and fibroblasts, and promotion of wound healing in a fibroblast model, may have potential application for periodontal diseases.


Subinhibitory concentrations of tetracyclines induce lipopolysaccharide shedding by Porphyromonas gingivalis and modulate the host inflammatory response.

Antibiotics at below minimal inhibitory concentrations (MICs) may induce various biological responses in bacteria. In this study, we hypothesized that subinhibitory concentrations (subICs) of tetracycline and doxycycline induce the shedding of lipopolysaccharide (LPS) by Porphyromonas gingivalis and, as a consequence, may contribute to enhancing the host inflammatory response associated with periodontitis.

Our study showed that growing P. gingivalis in the presence of subICs of either tetracycline or doxycycline induces LPS shedding. Shed LPS may in turn increase cytokine secretion in a macrophage model.


Effects of Japanese traditional herbal medicines (Kampo) on growth and virulence properties of Porphyromonas gingivalis and viability of oral epithelial cells.

Kampos containing rhubarb and its anthraquinone derivatives may represent promising molecules for controlling periodontal diseases through their capacity to inhibit P. gingivalis growth and virulence properties.

Of the 27 Kampos tested, 7 were found to inhibit the growth of P. gingivalis. The lowest minimal inhibitory concentration (MIC) (250 µg/ml) was obtained with TJ-113. Analysis of the composition of the seven active Kampos showed that they contain Chinese rhubarb as a common ingredient. Therefore, additional growth inhibitory assays on P. gingivalis were carried out with purified anthraquinones known to be present in rhubarb. Aloe-emodin and rhein possessed the strongest antibacterial effects towards P. gingivalis with an MIC of 0.78 µg/ml. The seven Kampos containing rhubarb and purified anthraquinones also exhibited the capacity to decrease the adherence of P. gingivalis to oral epithelial cells and to reduce its proteinase activity. The most important anti-adherence effect of Kampo was obtained with TJ-126; at 250 µg/ml it reduced adherence of P. gingivalis to epithelial cells by 83%. Purified anthraquinones were found to be less active than Kampos. Kampo TJ-113 was found to be the most effective for inhibition of gelatin degradation (49% inhibition at 62.5 µg/ml). Again, purified anthraquinones inhibited gelatin degradation to a lesser extent. Lastly, none of the tested compounds showed cytotoxicity towards oral epithelial cells at the effective concentrations.


Relationship between halitosis and periodontal disease - associated oral bacteria in tongue coatings.

These results suggested that periodontal disease-associated oral bacteria in TCs are closely related to halitosis and that tongue cleaning may be an effective method for improving halitosis.

There was a significant correlation between TC scores and OR values, methylmercaptan (CH3 SH) concentrations and VSC concentrations (Spearman's rank-correlation coefficient test, P < 0.01). There was also a positive correlation between the clinical parameters of halitosis and total bacterial numbers and Prevotella intermedia, Fusobacterium nucleatum and Campylobacter rectus concentrations in the TC samples. However, there was no similar correlation with respect to the saliva samples. The participants were sub-divided into two groups based on whether they had the habit of tongue cleaning or not. The participants with the habit of tongue cleaning had significantly lower OR scores, VSC concentrations and P. intermedia, F. nucleatum and C. rectus levels than the other participants (Mann-Whitney U-test, P < 0.05).


The usefulness of the educational management network system for promoting "dental education program with community-rearing"

地域育成型歯学教育を推進するための教育管理ネットワークシステム導入の有用性

The Journal of Japan Society of Dental Hygiene Education

日本歯科衛生教育学会雑誌


Relationship between Subjective Oral Health Status and Lifestyle in Elderly People: A Cross-Sectional Study in Japan.

Objective. The aim of this study was to assess the relationship between subjective oral health status and lifestyle in elderly people living in Japan. Methods. Subjects were 5383 inhabitants of the Kagawa Prefecture, Japan, at the age of 75-100. Records of the number of remaining teeth and the data from self-reported questionnaire were analyzed statistically. Results. Remaining teeth were significantly correlated to "no current smoking," while not related to other lifestyle. On the other hand, "subjective masticatory ability" defined as a condition allowing chewing all foods well was related to favorable lifestyles. "Subjective masticatory ability" was also related to "not feeling stress," "no deviated food habit" as well as to other good oral health conditions. A logistic regression analysis for "remaining teeth more than 20" revealed a significant relationship between "no current smoking" (OR = 1.582) and "no alcohol drinking" (OR = 0.851). Regarding "subjective masticatory ability," all favorable lifestyles analyzed in this study were found to be significant positive factors. Conclusions. "Subjective masticatory ability" seems to be strongly associated with favorable lifestyles. Therefore, it can be suggested that "subjective masticatory ability" might be a good landmark for quality of life of elderly people in addition to the number of remaining teeth.


Alteration of the oral environment in patients undergoing esophagectomy during the perioperative period

During the perioperative period, oral ingestion is changed considerably in esophagectomy patients. The aim of this study was to investigate oral environment modifications in patients undergoing esophageal cancer treatments due to changes in dietary intake and swallowing functions. Thirty patients who underwent operation for removal of esophageal cancer in Tokushima University Hospital were enrolled in this study. It was found that 1) the flow rate of resting saliva decreased significantly at postoperative period by deprived feeding for one week, although it did not recover several days after oral ingestion began, 2) the accumulation of dental plaque and the number of mutans streptococci in saliva decreased significantly after operation, while both increased relatively quick when oral ingestion began, and 3) the swallowing function decreased significantly in the postoperative period. These results suggest that dental professionals should emphasize the importance of oral health care and provide instructions on plaque control to patients during the perioperative period of esophageal cancer treatment.


病院における専門的口腔ケアへの認知度と期待ー急性期脳卒中患者家族のアンケート調査よりー

Journal of Shikoku Public Health Society


Effect of Taking Supplementary Food for Swallowing on the Intraoral Food Residue

嚥下補助食品摂取が食品の口腔内残留量に及ぼす影響


PKR plays a positive role in osteoblast differentiation by regulating GSK-3b activity through a b-catenin-independent pathway

Double-stranded RNA-dependent protein kinase (PKR) is involved in various cellular functions. We previously reported that PKR regulates osteoblast differentiation, but the specific mechanisms by which this occurs remain unclear. In this study, we investigated the role of PKR in Glycogen synthase kinase 3 (GSK-3) regulation of osteoblast differentiation. Lithium chloride (LiCl), a GSK-3 inhibitor, increased GSK-3 phosphorylation in MC3T3-E1 and MG-63 cells. LiCl also inhibited Runx2 and expression of its regulated genes, causing inhibition of Alkaline phosphatase activity and mineralization. LiCl injection to the calvaria in mice suppressed bone formation. Further, GSK-3 phosphorylation was increased in osteoblasts, by Akt-independent mechanisms, in which PKR was constitutively inactivated. A PKR inhibitor, 2-aminopurine, also induced GSK-3 phosphorylation in MC3T3-E1 and MG-63 cells. Further, Runx2 and its regulated genes were inhibited in PKR-inactivated osteoblasts, and differentiation was suppressed through a -catenin-independent pathway. PKR positively regulates the differentiation of osteoblasts by mediating GSK-3 activity through a -catenin-independent pathway.


Evaluation of collaborative learning program with aged people in dental hygienist education

感情指標を用いた歯科衛生士教育における高齢者交流学習効果


Interaction between PKR and PACT mediated by LPS-inducible NF-kB in human gingival cells

The double-stranded RNA-dependent protein kinase (PKR) is a serine/threonine kinase expressed constitutively in mammalian cells. PKR is activated upon virus infection by double-stranded RNA (dsRNA), and plays a critical role in host antiviral defense mechanisms. PKR is also known to regulate various biological responses, including cell differentiation and apoptosis. However, whether PKR is involved in the progress of periodontitis is not clear. The present study explained the phosphorylation of PKR by LPS in the human gingival cell line, Sa3. Expression of genes encoding LPS receptors was detected in Sa3 cells and treatment of cells with 1 µg/mL LPS for 6 h caused PKR phosphorylation. LPS elevated the expression of the protein activator of PKR (PACT) mRNA and protein, followed by the enhanced association between PACT and PKR within 3 h. In addition, LPS treatment induced the translocation of NF-κB to the nucleus after 30 min, and inhibition of NF-κB decreased the PACT-PKR interaction induced by LPS. The level of pro-inflammatory cytokine mRNA, including interleukin-6 (IL-6) and tumor necrosis factor alpha (TNFα), appeared within 45 min and reached at the maximal levels by 90 min after the addition of LPS. This induction of pro-inflammatory cytokines was not affected by RNAi-mediated silencing of PKR and a pharmacological inhibitor of PKR, whereas the inhibition of NF-κB decreased it. These results indicated that LPS induces PKR phosphorylation and the PACT-PKR association in Sa3 cells. Our results also suggest that NF-κB is involved in the PACT-PKR interaction and the production of pro-inflammatory cytokines in periodontitis.


地域高齢者との福祉体験学習の教育効果と地域貢献事業としての評価

地域高齢者との福祉体験学習の教育効果と地域貢献事業としての評価

The purose of this study is to evaluate the educational effect by the welfare-experience learning program with aged people in community，and to evaluate this program as the regional contribution. This program is to aim at having a consciousness of becoming the dental professional in the University of Tokushima，Faculty of Dentistry，and they were carried out with 16 institutions (a total of 28 times).This program makes students accompany the oral health guidance"long-life oral healthy classroom"，and they carried out the experience study as on auxiliary person of the variaus functional oral-training for elderly people.By the investigation of the student's report, there are students who recognized the achievement objectives which are roles of the way concerning regional contribution as dental professionals in community. On the other hand，the questionnaire to the participating persoonnel was conducted in order to evalaote this program as the regional contrtbution. As a result，this program is useful to elderly people and the understanding of institution personnel is also deepened this practice. As mentioned above，the result of having is suitable for the educational goal "to have a consciousness of becoming the dental professional". Furthermore，this program was considered that future continuation is also expected by deepening of an understanding to the personnel's functional oral-training program.本研究の目的は，地域高齢者との福祉体験学習における学生への教育効果と，地域貢献事業としての評価をすることである．徳島大学歯学部では，医療人を志すものとしての自覚を持つことを目的とした取り組みを県内16カ所の施設で合計28回実施した．これは，学生が口腔保健指導「お口の健康長寿教室」において，高齢者を対象とした口腔機能訓練の補助者として体験学習するものである．学習後のレポートから， 到達目標とした地域貢献の在り方や歯科専門職としての役割を認識する学生が多くを占めた．一方，地域貢献事業として評価するため，参加職員への調査を行った結果，利用者への役立ちに加え，多くの施設職員の理解も深まったとのアンケート結果が得られた．以上から，本取り組みは学生への教育目標「医療人としての自覚を持つ」に沿った成果が得られており，また，施設職員の口腔機能向上プ口グラムへの盤解の深まりから，今後の継続が期待される．

Journal of University Education Research


Levels of salivary stress markers in patients with anxiety about halitosis

To investigate the relationship between salivary stress markers and mental stress states in patients complaining of oral malodour. The utility of the salivary stress markers in assessment of mental conditions of those patients was also investigated. The study population included 74 patients, aged 20-59 years, who complained of oral malodour and were referred to the Breath Odor Clinic at Tokushima University Hospital. Patients were classified into two groups, genuine halitosis (GH) and psychosomatic halitosis (PH), according to the results of organoleptic rating measurement. All patients were subjected to examination by the Cornell Medical Index (CMI) Health Questionnaire. Resting saliva was collected and levels of salivary IgA, cortisol and chromogranin A were determined by ELISA. Twenty-three volunteers not complaining of halitosis were included as the control group. Kruskal-Wallis test and Mann-Whitney's U-test were used for statistical analysis. A significant increase was observed in the concentrations of salivary cortisol in the PH group as compared with GH and control groups (p<0.05). Concentrations of IgA and chromogranin A in saliva were not significantly different among the three groups. In addition, higher salivary cortisol concentrations were found in CMI scale III and IV (tendency towards neurosis) than in scale I and II (normal) (p<0.05). Since salivary cortisol reflects a status of chronic stress condition, psychosomatic halitosis might be closely related to this state of chronic stress. Determination of cortisol levels in saliva may provide useful information for evaluating the mental status of patients complaining of halitosis.


The study of oral health promotion for pregnant women at Tokushima University Hospital

徳島大学病院における妊婦の口腔保健向上に関する研究

The Journal of Japan Society for Dental Hygiene


徳島県における妊婦歯科健診受診者の口腔保健の現状および低体重児出産との関連性

徳島県における妊婦歯科健診受診者の口腔保健の現状および低体重児出産との関連性

Recent studies have suggested that periodontal diseases in pregnant women may be a significant risk factor for low-birth-weight deliveries (less than 2,500g). The aim of this study was to investigate the relationships between the oral health condition, health behavior of pregnant women, and low-birth-weight outcome. We performed oral examinations and conducted a survey of pregnant women to investigate their oral health status and behavior in Tokushima Prefecture. Among 739 pregnant women that received oral examinations, 454 (61.4%) reported complaints and inconvenience related to their oral cavities, 380 women (51.4%) reported gingival bleeding on brushing, while 406 women (54.9%) had teeth which needed treatment. Three hundred and one women (40.7%) harbored periodontal pockets with a depth ≥4mm, and were assigned a Community Periodontal Index (CPI) code of 3 or 4. On the other hand, there were only 136 women (18.4%) who received regular dental checkups. The percentage of pregnant women with a CPI of 3 or 4 was higher than that of women in the same age group based on the Comprehensive Guide to the Survey of Dental Diseases (2005). The percentage of subjects with a CPI of 3 or 4 among pregnant women with a smoking habit was higher than in a group of non-smoking pregnant women (p<0.05). All pregnant women with a smoking habit had a CPI≥1. In addition, we examined the relationship between the oral health status of the pregnant women and a low-birth-weight outcome. Stepwise logistic regression analysis of the 227 pregnant women who signed the informed consent document for this study showed that a smoking habit (OR 5.96, 95% CI 1.16-30.53, p=0.03) and periodontal pocket depth ≥4mm (OR 3.34, 95% CI 1.18-9.42, p=0.02) were significantly associated with low-birth-weight deliveries. In conclusion, efforts should be made to motivate pregnant women to undergo regular dental checkups for periodontal disease prevention and quit smoking.

近年,妊娠期の歯周病が低体重児出産(2,500g未満での出産)の危険因子として注目されている.徳島県では,平成17年度8020運動特別推進事業の一環として妊婦歯科健診が実施された.本研究では,妊婦歯科健診で得られた739名の健診結果ならびにアンケート結果より,妊婦の口腔保健の現状を調査した.その結果,口腔内に不満や不自由を覚える者は454名(61.4%),ブラッシング時に出血を認める者は380名(51.4%),未処置歯または楔状欠損歯を有する者は406名(54.9%),4mm以上の歯周ポケットを有する者は301名(40.7%)と高い値が示された.一方,定期的に歯科医院を受診している者は136名(18.4%)と低い値であった.さらに,産後に出生児の出生時体重を郵送法にて調査し,回答が得られた227名について,口腔保健の現状と低体重児出産との関連性について検討を行った.ロジスティック回帰分析の結果,喫煙習慣(OR 5.96, 95%CI 1.16-30.53, p=0.03)および4mm以上の歯周ポケットを有する状態(OR 3.34, 95%CI 1.18-9.42,p=0.02)が低体重児出産に有意に関連していた.今後,妊婦に対しては,歯科医院の定期受診率を上げることに加え,さらに充実した禁煙支援を含めた歯周状態の管理が必要であると考えられる.


PKR-mediated degradation of STAT1 regulates osteoblast differentiation

The double-stranded RNA-dependent protein kinase (PKR) plays a critical role in various biological responses including antiviral defense, cell differentiation, apoptosis, and tumorigenesis. In this study, we investigated whether PKR could affect the post-translational modifications of STAT1 protein and whether these modifications regulate osteoblast differentiation. We demonstrated that PKR was necessary for the ubiquitination of STAT1 protein. The expressions of bone-related genes such as type I collagen, integrin binding sialoprotein, osteopontin, and osterix were suppressed in osteoblasts lacking PKR activity. In contrast, the expressions of interleukin-6 and matrix metalloproteinases 8 and 13 increased in PKR-mutated osteoblasts. The expression and degradation of STAT1 protein were regulated by PKR in a SLIM-dependent pathway. Inhibition of SLIM by RNA interference resulted in the decreased activity of Runx2 in osteoblasts. Stimulation of interleukin-6 expression and suppression of alkaline phosphatase activity were regulated through by SLIM-dependent pathway. However, expressions of bone-related genes and MMPs were regulated by SLIM-independent pathway. Our present results suggest that the aberrant accumulation of STAT1 protein induced by loss of PKR regulate osteoblast differentiation through both SLIM/STAT1-dependent and -independent pathways.


徳島大学パイロット事業支援プログラム「歯科医療系学生の口腔保健・福祉体験実習による健康長寿支援」


教育GP「高齢社会を担う地域育成型歯学教育」(第1報) 高齢者交流学習による教育効果

歯学部1年生22名(口腔保健学科16名，歯学科6名)を対象に，平成20年度に実施した高齢者交流学習の教育効果について考察した．交流前には同施設長より生と死，老いについて特別講義を受け，4回目の交流後及び最終回の交流後にふり返り授業を実施した．交流学習の教育効果については毎回の学習記録と共に自己評価を10点満点で記載させた．養護老人ホームにおいて高齢者との1対1の交流からコミュニケーションを養う交流学習を実施した結果，交流後の学習記録に認められる心に深く感じた内容や自己評価点数の上昇，更に四つの到達目標に沿った表現の記載が参加学生から認められたことから，1年次に実施した取り組みは人間力の向上という一般目標に適した有効な教育カリキュラムであると思われた．


急性期病院の脳神経疾患患者に対する口腔ケアニーズの分析

急性期病院の脳神経疾患患者に対する口腔ケアニーズの分析

The purpose of the present study was to identify factors related to oral health care among inpatients with neurological disorders. For each of the 143 inpatients included in our study, the oral as well as general health (level of consciousness, feeding style, etc.) conditions were investigated using an assessment sheet at their first visit. The study revealed that 80% of the hospitalized patients showed "dysfunction of oral periphery muscle and/or tongue movement", 60% of them presented "dry mouth" and/or a "reduced level of consciousness", and 25% exhibited "constant open mouth with no intention". By logistic regression analysis of the data, it was strongly suggested that "severe debris accumulation" could be attributed to "dry mouth". Furthermore, "dry mouth" was found to be significantly correlated with several features, including "constant open mouth", "impaired mouth rinse", "dysfunction of oral periphery muscle and/or tongue movement", and "reduced level of consciousness", which are conditions often observed in patients with neurological disorders. These results suggest that inpatients with both a "reduced level of consciousness" and "constant open mouth" should receive professional oral care in order to prevent "dry mouth", and undergo a careful follow-up to promote the maintenance of good oral hygiene and functions.

われわれは,平成16年より徳島大学病院栄養サポートチームの一員として病棟における専門的口腔ケアを展開してきた,当初より,脳神経疾患をもつ患者の占める割合が多く,平成20年2月までの間,計143名の当該患者の口腔ケアを行った.本研究では,これらの患者の初診時における口腔内状態および全身状態について調査し,口腔ケアのニーズにかかわる要因について統計学的に検討した.その結果,約80%の人が「口腔周囲筋や舌の動き」が十分でなく,約60%の人に「口腔乾燥」の発現や「意識レベル」の低下を認め,約25%の人に「不随意の常時開口」がみられた.ロジスティック回帰分析の結果,「口腔乾燥」の強さが多量の「不潔物付着」に強く寄与することが示唆された.また,「口腔乾燥」の強さは「常時開口」がみられる,「うがい」が不可能あるいは不十分,「口腔周囲筋や舌の動き」が低下,「意識レベル」が低下,といった脳神経疾患患者で高頻度にみられる所見と有意な関連を示すことが確かめられた.これらのことから,意識レベルの低下および常時開口がみられる患者に対しては,急性期から口腔乾燥を予防するとともに良好な口腔衛生状態の保持に努め,口腔機能にも配慮した専門的口腔ケアを行っていく必要性が示唆された.


Relationship between Campylobacter rectus and periodontal status during pregnancy.

In a previous study, we showed that the growth of Campylobacter rectus is stimulated by the presence of female sex hormones in the culture medium. In the present study, we examined the relationship between C. rectus levels in the saliva and the periodontal status of pregnant women. Unstimulated whole saliva was collected from 22 pregnant and 15 non-pregnant women. Periodontal pocket depth (PD) and bleeding on probing (BOP) were recorded. A quantitative real-time polymerase chain reaction was performed to determine the concentrations of suspected periodontopathogenic bacteria in the saliva samples. In addition, the concentration of estradiol in the saliva samples was measured by enzyme immunoassay. The average age, number of teeth, and total number of bacteria in the saliva of subjects in both groups were similar. The percentage of sites with a PD = 4 mm and the salivary estradiol concentrations were significantly higher in pregnant women than in non-pregnant women. In addition, the percentage of BOP sites and the C. rectus levels in the saliva of the pregnant women tended to be higher than in non-pregnant women, although these differences were not statistically significant. There were positive correlations between C. rectus levels and estradiol concentrations, and between C. rectus levels and the percentage of sites with PD = 4 mm in the pregnant women. These results indicate that C. rectus levels are higher in the oral flora of pregnant women and that this may be associated with increased salivary estradiol concentrations. This may contribute to periodontal disease progression during pregnancy.


Salivary immunoglobulin A directed to oral microbial GroEL in patients with periodontitis and their potential protective role.

The aim of this study was to identify salivary immunoglobulin A (IgA) directed to oral microbial GroEL in patients with periodontitis and to demonstrate their potential protective role through a reduction of inflammatory cytokine production induced by microbial GroEL. Using five different proteins belonging to the heat-shock protein 60 family, Western immunoblot analysis of salivary IgA from 63 subjects revealed immunoreactivities with Campylobacter rectus GroEL and Porphyromonas gingivalis GroEL in subjects with periodontitis (P < 0.05) compared to control subjects. Using the BIACORE 1000 to measure the salivary IgA titers directed towards C. rectus GroEL, high resonance unit (RU) values were observed in the saliva samples from patients with periodontitis (P < 0.01). Furthermore, the number of teeth with deep pocket depth (>or=5 mm) showed a high correlation coefficient with the RU value (r = 0.50, P < 0.01). C. rectus GroEL possessed the ability to stimulate the production of interleukin-6 by gingival fibroblasts. Interestingly, salivary IgA antibody directed to C. rectus GroEL caused a partial inhibition of interleukin-6 production. This study showed a relationship between high levels of salivary IgA directed to GroEL and periodontal disease severity. Although additional investigations are required, salivary IgA to GroEL may have a protective role by reducing the inflammatory response induced by GroEL derived from periodontopathogenic bacteria.


Effect of saliva collection method on the concentration of protein components in saliva

In order to clarify how we collect saliva for analyzing salivary protein in aged subjects who can not eat well, we compared the effects of suction, spitting and the swab saliva collection method on the yield of protein components in saliva samples from normal volunteers. The saliva collected by suction, spitting and the swab method were designated as, Saliva I, II and III, respectively. The saliva volume collected by Saliva I was about 2-fold greater than that by of Saliva II and III. This is mainly due to the fact that saliva secretion was stimulated by the suction itself. The content of total protein, S-IgA, trypsin-like activity and human airway trypsin-like protease (HAT) were almost the same in Saliva I and II, and significantly lower in Saliva III than in Saliva I and II. Kallikrein activity was almost the same in Saliva I, II and III. The concentration of each total protein, S-IgA, kallikrein activity, trypsin activity and HAT in Saliva I were significantly positively correlated with that in Saliva II. These results indicate that we can obtain information of change of salivary protein by analyzing saliva collected by suction method, although this method caused the stimulation of saliva to some extent.

The Journal of Medical Investigation : JMI


The Effects of Supervised Fluoride Mouth Rinsing on Dental Caries Development : Analyses of Caries Development by Tooth Type and of the Relationship between Deciduous Tooth Caries and Permanent Tooth Caries --- 歯群別分析および乳歯う蝕と永久歯う蝕の関連性についての分析

フッ化物洗口実施校におけるう蝕予防効果 --- 歯群別分析および乳歯う蝕と永久歯う蝕の関連性についての分析

In 1993, a daily fluoride mouth rinsing program and biannual oral examination were started at the nursery school, elementary school and junior high school of the K District, Tokushima Prefecture. In this study, the longitudinal change of caries development in elementary school students was evaluated. Caries development by tooth type in schoolchildren of the 6th grade was evaluated, and furthermore, the relationship between deciduous tooth caries in 1st grade students and caries development in permanent teeth in 6th grade students was also elucidated. After starting the daily fluoride mouth rinsing program, caries development in the permanent teeth of the low grade children of the elementary school began to decrease first, followed by that of the high grade children, and then, the junior high school students. It was revealed that the strong suppression of caries development in the 1st molar was reflected in a decrease in total caries development in the 6th grade schoolchildren. In addition, a significant relationship between DMFT in the 6th grade schoolchildren and the number of deciduous tooth caries or the number of deciduous teeth in the 1st grade schoolchildren was detected. These results suggest that a fluoride mouth rinsing program before school age is effective for caries prevention in the 1st molar, but, in order to effectively prevent permanent tooth caries, a high risk strategy is needed for children with deciduous tooth caries.

徳島県の山間部に位置するK村では, 平成5年度より村内の保育園, 幼稚園, 小中学校において週5回のフッ化物洗口と年度2回の歯科健康診断を実施している.本研究では, フッ化物洗口を開始してからの児童生徒のう蝕有病状況の経年的変化をまとめ, 特に, 小学校6年生での歯群別のう蝕有病状況について詳しく調べた.さらには, 小学校1年生での乳歯う蝕の状況, 歯の萌出状況と6年生での永久歯う蝕経験との間の関連性について調べた.以上の結果, フッ化物洗口開始後のう蝕有病状況の経年的変化において, 永久歯う蝕は小学校低学年で早期に減少傾向が現れ, 次いで高学年, 中学生へと移行していることがわかった.小学校6年生での歯群別のう蝕有病状況から, 第一大臼歯のう蝕有病率が大幅に抑制されたことが, 全体のう歯数低下につながっていることが示唆された.一方, フッ化物洗口開始後も小学校1年生での乳歯未処置う歯の本数や乳歯の現在歯数が小学校6年生でのDMFTと有意に関連することがわかった.このことは, 就学前からのフッ化物洗口は第一大臼歯のう蝕罹患を抑制するのに効果的なう蝕予防施策であるが, さらに永久歯う蝕の抑制効果を期待するためには, 乳歯う蝕を指標としたう蝕リスクの高い幼児への介入が必要であることが示唆された.


Effect of female sex hormones on Campylobacter rectus and human gingival fibroblasts

Recent studies have suggested a relationship between maternal Campylobacter rectus infections and preterm low birth weight. The purpose of this study was to investigate the effect of female sex hormones, estradiol and progesterone, on C. rectus and human gingival fibroblasts (HGF). The growth of C. rectus was significantly enhanced by incorporating either estradiol or progesterone in the culture medium. The production of vascular endothelial growth factor (VEGF), interleukin (IL)-6 and IL-8 by HGF increased following stimulation with estradiol or progesterone, at concentrations comparable to those present in the plasma of pregnant women. In addition, a significantly higher secretion of VEGF by HGF treated with the combination of C. rectus and estradiol was observed in comparison with a treatment with C. rectus alone. Stimulation of HGF with VEGF resulted in production of IL-6 and IL-8 in a dose-dependent manner. The capacity of female sex hormones to enhance both C. rectus growth and VEGF, IL-6, and IL-8 production by HGF has the potential to contribute to periodontal disease progression during pregnancy.


即時荷重インプラントに関する臨床的検討: 臨床術式と1年経過時の臨床成績

即時荷重インプラントに関する臨床的検討: 臨床術式と1年経過時の臨床成績

Journal of Japanese Society of Oral Implantology

日本口腔インプラント学会誌


Clinical Examination of Immediate Loading Implants --- Procedure and 1-year Clinical Results

即時荷重インプラントに関する臨床的検討 --- 臨床術式と1年経過時の臨床成績

日本口腔インプラント学会誌


官能試験の結果および質問票による口臭患者の分析

官能試験の結果および質問票による口臭患者の分析

The aim of this study is to analyze the characteristics of patients suffering from malodor using organoleptic rating and questionnaires. Patients who were examined for halitosis at the Clinic of Preventive Dentistry, Tokushima University Medical and Dental Hospital, were classified into 4 groups based on the results of organoleptic measurement using plastic air bag. Aa group; obvious malodor beyond a socially acceptable level is neither perceived by dentists nor the patient. Ab group; obvious malodor is not perceived by dentists, although the patient complains of its existence. Ba group; obvious malodor is perceived by dentists only. Bb group; obvious malodor is perceived by both dentists and the patient. The profile of the Cornell Medical Index (CMI) Health Questionnaire and the questionnaire about a general attitudes toward halitosis were analyzed in each category. Patients in Ab group, who are supposed to have psychosomatic halitosis, showed a stronger tendency toward neurosis. More patients in the Ab group responded in the questionnaire that "I'm always anxious about malodor", and that "I feel malodor stronger than before", than in the other groups. Furthermore, patients in Aa and Ab group seemed to be interested in oral hygiene since many patients in these groups habitually used inter-dental brushing instruments daily. These results suggest that the sell-evaluation of breath by patients might provide useful information about the psychological conditions of patients.

本研究の目的は, 官能試験や質問票の結果を用いて口臭患者の特性を分析することである.徳島大学医学部・歯学部附属病院歯科・予防歯科において口臭検査を受けた患者を, におい袋を用いた官能試験の結果をもとに分類し, 各群における患者のCMI健康調査表のプロファイルと口臭に関する質問票の答え方について分析した.すなわち, 複数の歯科医師(パネル)による官能試験の結果, 社会的容認限度をこえる不快な口臭が認められなかった群と認められた群をそれぞれA群, B群とし, 患者自身による評価で不快な口臭を認めなかった群と認めた群をそれぞれa群, b群として, クロス集計し, Aa群, Ab群, Ba群, Bb群の4群に分類した.CMI健康調査表の結果を各群別にみてみると, 自臭症傾向が強いと考えられるAb群では, ほかの群に比べて神経症傾向が強い人が多く含まれていた.また, Ab群では, 質問票のなかで「常に口臭を気にしている」, 「口臭の感じ方が強くなった」と答えた人の割合が多かった.また, Aa群, Ab群では, 歯間清掃用具を日常的に使用している率が高く, 口腔衛生に対して強い関心をもっていることが明らかとなった.これらの結果は口臭検査時に患者自身に口気を評価させることが, 患者の心理的状況の特性を把握するために有用な情報をもたらす可能性を示唆するものである.


The effects of vitamin C and E intake on blood antioxidative activity in smokers

喫煙者の血中抗酸化能に対するビタミンCおよびビタミンE含有製剤摂取の影響

Journal of Japan Society of Health Sciences


Effect of Surface Topography on Ssseointegration Establishment of Dental Implant --- Comparison between Smooth and Rough Surfaces

インプラントの表面性状がオッセオインテグレーション獲得に及ぼす影響 --- 滑面と粗面(陽極酸化面)フィクスチャーの比較

日本口腔インプラント学会誌


Antigenic cross-reactivity and sequence homology between Actinobacillus actinomycetemcomitans GroEL protein and human fibronectin

The immunologic cross-reactivity between human fibronectin and Actinobacillus actinomycetemcomitans GroEL was examined. Analyses by SDS-PAGE/Western immunoblotting and ELISA showed that a polyclonal antibody directed against the purified GroEL protein of A. actinomycetemcomitans, but not against the Escherichia coli GroEL, cross-reacts with human fibronectin. No antigenic cross-reactivity was observed between anti-A. actinomycetemcomitans GroEL antibody and type IV collagen, another important constituent of the basement membrane. A comparative analysis of the amino acid sequences of A. actinomycetemcomitans GroEL and human fibronectin revealed eight instances of four-amino acid sequence homology between the two proteins. Six of these tetrapeptide sequences were also shared with E. coli GroEL, suggesting that the remaining two tetrapeptides, GQLI (Glycine-Glutamine-Leucine-Isoleucine) and TGLE (Threonine-Glycine-Leucine-Glutamic acid), may be associated with the epitope that the anti-A. actinomycetemcomitans GroEL antibody specifically recognizes. Reactivity between TGLE, but not GQLI, with anti-A. actinomycetemcomitans GroEL antibody was confirmed by a biospecific interaction analysis using a biosensor technology. Although additional investigations are required, the observed phenomenon may lead to an autoimmune response and thus contribute to tissue destruction during periodontitis.


Relationship between tongue coating and secretory-immunoglobulin A level in saliva obtained from patients complaining of oral malodor

The aim of this study was to confirm the relationships between oral malodor and periodontal condition, oral malodor and tongue coating, and to investigate the secretory-immunoglobulin A (S-IgA) level in saliva in relation to the accumulation of tongue coating. Fifty-four patients complaining of oral malodor were included in the study. Their periodontal conditions, tongue coating status and salivary characteristics (flow rate, protein and S-IgA concentrations) were assessed in addition to the level of volatile sulfur compounds (VSC) in oral cavity. The patients were divided into three groups according to their tongue coating level. There are significant relationships between oral malodor and specific periodontal parameters used. The degree of tongue coating was also significantly correlated with the amount of H2S, CH3SH and the total amount of VSC determined. The concentration of S-IgA in the group identified as slight tongue coating was significantly higher than in the moderate or the severe group. By Western immunoblotting analysis, a high level of S-IgA specific to Streptococcus species was recognized in all groups, whereas the reactivity of Porphyromonas gingivalis and Fusobacterium nucleatum with S-IgA was very weak in both the slight and the moderate groups. Data herein indicate that tongue coating is closely related to oral malodor. Furthermore, S-IgA in saliva may influence the accumulation of tongue coating, and S-IgA antibodies directed to Streptococcus species may play a role in protective immunity against the initial colonization of tongue plaque.


Effect of vitamin C and vitamin E supplement on periodontal disease in smokers

喫煙者の歯周病に対するビタミンCおよびビタミンE摂取の有効性の検討

Smoking habit has been reported as a risk factor for periodontal disease and low vitamin C intake has been associated with periodontal status. In this randomized controlled trial, we investigated the efficacy of dietary supplementation with antioxidative vitamins, vitamins C and E, on suppression of the progression of periodontal disease in smokers. A total of 65 patients who were current smokers were randomly assigned to one of the following groups : 1) VC (1,000 mg/day) ; 2) VE (135 mg/day) ; 3) combination of VC and VE ; 4) placebo. Plaque index (PI), clinical attachment level (CAL), pocket depth (PD) and cross-linked carboxyterminal telopeptide of type I collagen (I CTP) from gingival crevicular fluid (GCF) as a biomarker of periodontal disease, were measured at baseline, 12 and 24 weeks following the start of supplementation. CAL and PD in VC, VE and the combination groups showed significant improvements during this trial comparing with the placebo group (p<0.05). Furthermore, in the combination group, the rate of GCF samples in which I CTP was decreased or maintained was significantly greater than that in the placebo group at 24 weeks (p<0.05). On the other hand, VC levels in blood samples from VC and the combination groups (p<0.01) and VE levels from VE and the combination groups significantly rose from each level at baseline (p<0.05). These results suggest that supplements of VC and VE may maintain the periodontal health status in smokers by controlling oxidative status and other mechanisms.

喫煙習慣は,歯周病の危険因子の1つとして認識されてきている.本研究では,喫煙習慣を有する歯周病罹患者において,ビタミンC(VC)とビタミンE(VE)の摂取が歯周病に及ぼす作用を検討することを目的とし,無作為化比較対照試験を実施した.65名(平均年齢49.5±10.5歳,女性3名を含む)の被験者はVC群,VE群,その併用群およびプラセボ群の4群に分かれ,24週間タブレット状の試験製剤の摂取を行った.その結果,VC群,VE群およびその併用群は,プラセボ群と比較して,歯周病の臨床パラメータである臨床的アッタチメントレベル(CAL)と歯周ポケット深さ(PD)において,有意な進行の抑制作用を示した(p<0.05).また,歯周組織破壊の生化学的マーカーである歯肉溝滲出液中のI型コラーゲンC末端テロペプチド(I CTP)についても測定を行った.ベースライン時と比較して24週時点でI CTPの改善・維持が認められた部位の割合を群間で比較検討したところ,併用群はプラセボ群と比べ有意に高かった(p<0.05).一方,血中のVCレベルはVC群と併用群(p<0.01)で,VEレベルはVE群と併用群で,それぞれ有意に上昇していた(p<0.05).これらの結果は,VC,VEおよびその併用摂取が,喫煙者の歯周病のリスクを低減し,歯周組織の維持に効果を及ぼす可能性を示唆している.


Effect of hydroxamic acid-based MMP inhibitors on human gingival cells and Porphyromonas gingivalis

Matrix metalloproteinases (MMPs) are considered to play key roles in tissue destruction during periodontitis. In this study, we evaluated the cytotoxicity of hydroxamic acid-based MMP inhibitors (ONO-4817, ONO-MI1-514, and ONO-MI1-570), and their inhibitory effects on MMP-2 and -9 activities and growth of Porphyromonas gingivalis. Human gingival fibroblasts (HGF) and human gingival epithelial cells (HGE) were incubated with test inhibitors prior to investigating cell viability, cell proliferation, and mRNA expression for MMP-2 and -9. Gelatin zymography and a colorimetric MMP assay were performed to study the inhibitory effects on MMP-2 and -9 activities derived from HGF and HGE, respectively. The effect of MMP inhibitors on keratinocyte migration and P. gingivalis growth was also tested. Cell viability was not affected by any of the inhibitors at a final concentration of 50 microM, nor was cell proliferation at 20 microM. All inhibitors clearly inhibited MMP-2 produced by HGF and MMP-9 produced by HGE in a dose-dependent manner. No change was found in mRNA expression of MMPs by gingival cells treated with the inhibitors. ONO-4817 and ONO-MI1-514 inhibited keratinocyte migration. ONO-4817 showed a slightly inhibitory effect on the growth of P. gingivalis. Data obtained in this study support the potential use of the three MMP inhibitors for the prevention and treatment of periodontal disease.


Evaluation of Risk Factors Concerning Loss of Osseointegration of Dental Implant

歯科インプラントのオッセオインテグレーション喪失に関与するリスクファクターの検討

日本口腔インプラント学会誌


Helicobacter pylori and Campylobacter rectus share a common antigen


Evaluation of Clinical Factors Conserning Osseointegration Establishment of a Dental Implant

歯科インプラントのオッセオインテグレーション獲得に関与する臨床的要因の検討

Journal of Japanese Society of Oral Implantology

日本口腔インプラント学会誌


Purification and characterization of arginine carboxypeptidase produced by Porphyromonas gingivalis

Arginine carboxypeptidase was isolated from the cytoplasm of Porphyromonas gingivalis 381 and purified by DEAE-Sephacel column chromatography, followed by high-performance liquid chromatography on DEAE-5PW and TSK G2000SW(XL). Sodium dodecyl sulfate-polyacrylamide gel electrophoresis of the purified enzyme revealed the presence of three major bands at 42, 33, and 32 kDa with identical N-terminal sequences. By Western blotting analysis and immunoelectron microscopy, the arginine carboxypeptidase was found to be widely distributed in the cytoplasm and on the surface of the outer membrane. The open reading frame corresponding to the N-terminal amino acids of the arginine carboxypeptidase was detected by a search of the sequence of the P. gingivalis W83 genome. This sequence showed homology with mammalian carboxypeptidases (M, N, and E/H) and included a zinc-binding region signature, suggesting that the enzyme is a member of the zinc carboxypeptidase family. The purified enzyme was inhibited by EGTA, o-phenanthroline, DL-2-mercaptomethyl-3-guanidinoethylthiopropanoic acid, and some metal ions, such as Cu(2+), Zn(2+), and Cd(2+). On the other hand, Co(2+) activated the enzyme. The enzyme released arginine and/or lysine from biologically active peptides containing these amino acids at the C terminus but did not cleave substrates when proline was present at the penultimate position. These results indicate that the arginine carboxypeptidase produced by P. gingivalis is an exo type of metallocarboxypeptidase. This enzyme may function to release arginine in collaboration with an arginine aminopeptidase, e.g., Arg-gingipain, to obtain specific amino acids from host tissues during the growth of P. gingivalis.


Antigenic properties of the GroEL-like protein of Campylobacter rectus

The purpose of this study was to clarify the antigenic properties of the GroEL-like protein of Campylobacter rectus using a specific polyclonal antibody directed to the purified 64-kDa GroEL-like protein (pAb-CrGroEL), a polyclonal antibody directed to the Actinobacillus actinomycetemcomitans GroEL-like protein (pAb-AaGroEL) and a monoclonal antibody against the recombinant human HSP60 (mAb-HuHSP60). In SDS-PAGE/Western immunoblotting analysis, mAb-HuHSP60, pAb-CrGroEL and pAb-AaGroEL were found to react with the GroEL-like protein (64-kDa) present in all C. rectus strains. A 150-kDa protein in C. rectus ATCC 33238 also reacted strongly with pAb-CrGroEL. This 150-kDa protein was found to be present on the surface-associated material of bacterial cells, as determined by transmission electron microscopy and immunogold labelling of cells with pAb-CrGroEL. Analysis of the first 20 N-terminal amino acids of the sequence of the 150-kDa protein revealed a strong homology (80%) with the C. rectus surface layer (S-layer) protein. Investigation of the biochemical nature of antigenic determinants using periodic acid and proteolytic enzymes showed that the C. rectus GroEL-like protein possessed immunodominant epitopes in both peptide and carbohydrate chains, and that the immunoreactive determinants of the 150-kDa protein belonged to carbohydrate. These results suggest that the GroEL-like protein and the S-layer protein of C. rectus may share the same carbohydrate epitopes.


Consumption of Peptide-derived Arginine by a Periodontopathogenic Bacterium, Porphyromonas gingivalis


歯周病原性細菌のプロテアーゼに対するモノクローナル抗体を利用した歯周病診断の試み


Subcellular localization and cytotoxic activity of the GroEL-like protein isolated from Actinobacillus actinomycetemcomitans


The GroEL-like protein from Campylobacter rectus: immunological characterization and interleukin-6 and -8 induction in human gingival fibroblast


Three Cases of Application of Osseointegrated Implant to Surgical Reconstructive Area in Oral Cancer Patients --- Discussion of the Management of Reconstructive Soft Tissue Surrounding Implants

口腔癌切除後の外科的再建部へオッセオインテグレーテッドインプラントを応用した3例 --- インプラント周囲の外科的再建組織の処理法に関する考察

日本口腔インプラント学会誌


Cross-reactivity of specific antibodies directed to heat shock proteins from periodontopathogenic bacteria and of human origin


カナダ·ケベック州における衛生行政機構と地域歯科保健活動

カナダ·ケベック州における衛生行政機構と地域歯科保健活動


A general procedure for the isolation of heat-shock proteins from periodontopathogenic bacteria


Selection and Phenotypic Characterization of Nonhemagglutinating Mutants of Porphyromonas gingivalis


Biological and antigenic characterization of three BApNA-hydrolyzing proteases from the culture supernatant of Porphyromonas gingivalis


Purification and Characterization of a DnaK-like and a GroEL-like Protein from Porphytomonas gingivalis


Immunological characterization and localization of a Porphyromonas gingivalis BApNA-hydrolyzing protease possessing hemagglutinating activity


Purification of an Extracellular Soluble Protease Possessing BApNA Hydrolytic Activity from Culture Supernatants of Porphyromonas gingivalis


Aggregation of Human Gingival Fibroblasts by Porphyromonas gingivalis


Analysis of Factors Influencing the Prevalence of Gingival Inflammation in First-Year Junior High School Students

中学1年生の歯肉炎の罹患に関する調査·分析


Participation of an arginyl residue of insulin chain B in the inhibition of hemagglutination by Porphyromonas gingivalis


Generation of Plasma Kinin by Three Types of Protease Isolated from Porphyromonas Gingivalis 381


Survey of a receptor protein in human erythrocytes for hemagglutinin of Porphyromonas gingivalis


Adhesion of Porphyromonas gingivalis to human gingival fibroblast and collagen.


Porphyromonas gingivalis のヒト培養歯肉線維芽細胞に対する細胞毒性について


Cytotoxicity of Porphyromonas gingivalis toward cultured human gingival fibroblasts


Degradative Specificity of Three Proteases from Porphyromonas Gingivalis on Mammalian Protein


Purification and Characterization of Three Types of Proteases from Culture Supernatants of Porphyromonas gingiivaliis


Trypsin-like Enzyme Activity and Free Amino Acid Levels in Gingival Crevicular Fluids from Adult Periodontitis Patients

成人型歯周炎患者の歯肉溝滲出液中トリプシン様酵素活性と遊離アミノ酸含量について


Isolation of a Collagenase Inhibitory Substance from Soybeans Which is Specifically Active on the Enzyme from Bacteroides gingivaliis and Its Effect on the Cell Culture of Human Gingival Fibroblast

大豆中に存在する Bacteroides gingivalis 由来のコラゲナーゼ阻害剤の抽出とヒト歯肉線維芽細胞の培養系に及ぼす影響


Analysis of Factors Influencing the Caries Prevalence of Deciduous Teeth in Children of Three Years Old

3歳児の乳歯う蝕罹患に関する要因の分析


Inhibition of Bacterial and Mammalian Collagenolytic Activities by Tetracyclines

テトラサイクリン系抗生物質による Bacteroides gingivalis およびヒト由来コラゲナーゼ活性の阻害について

Journal of the Japanese Association of Periodontology


Purification of Thiol-Dependent Collagenolytic Enzyme Isolated from Culture Supernatant of Bacteroides gingivalis 381 and Its Inhibition by Some Serum Components

Bacteroides gingivalisの培養上清中に存在する SH-依存性のコラーゲン溶解酵素の精製と血清成分による阻害


Isolation and characterization of protease from culture supernatant of Bacteroides gingivalis


Salivary IgA Antibody to Bacteroides gingivalis and Actinobacillus actinomycetemcomitans in Patients with Adult Marginal Periodontitis

成人型歯周炎患者のBacteroides gingivalisおよびActinobacillus actinomycetemcomitans抗原に対する唾液中 IgA 抗体価


A Report of Activity in a Short-term Study Abroad to Helsinki Metropolia University of Applied Sciences

ヘルシンキ・メトロポリア応用科学大学への短期留学における活動報告


キャリア形成支援教育プログラムの開発と教育効果の評価-「チーム医療体験学習」の実践的研究を通して-

We prepared career advancement program "Experience learning in medical team treatment" towards the second，third and fouth year students of dental school. This program consits of prior learningconcerned with 'Team treatment and Dental profession' and experience learning in medical team treatment at Tokushima University Hospital.The purpose of this program was to rouse career conciousness as a dentalprofession. This program provided students with career image which they want to be in the future. Besides，they were motivated to study more widely to approach their own image. In this paper，we evaluated theeffects of the program"The experience learning in medical team treatment" on career advancement ofdental school students. As a result，it is suggested that this program might be fruitful as career advancement on dental students.我々は歯学部学生のキャリア形成支援のための教育プログラム「チーム医療体験学習」を開発し，歯学部の2，3，4年次の学生を対象として実施した．本プログラムは，グループワークによる事前学習とチーム医療の現場体験を2つの柱とし，学生の歯科医療職としてのキャリア意識を強化することを目的とした．プログラム終了時のアンケートから，学生には歯科専門職としての将来の姿勢や目指す方向性が具体化すると同時に幅広い知識を身につけたいといった学習に対する動機付が強化されるなど明らかな教育成果が認められた．プログラム実施前後のアンケートの分析結果から， 「チーム医療体験学習」が歯学部学生のキャリア形成支援教育の手法として有効なプログラムである可能性が示唆された．

Journal of University Education Research