A case of anterior open bite associated with idiopathic condylar resorption treated with miniscrew-assisted orthodontics


術後に顎関節に疼痛を訴えた顎偏位を伴う骨格性上顎前突症例

術後に顎関節に疼痛を訴えた顎偏位を伴う骨格性上顎前突症例

The Journal of Chu-Shikoku Orthodontic Society

中·四国矯正歯科学会雑誌


上顎左側第二小臼歯先天欠如を伴う片側性唇顎口蓋裂患者に対して下顎左側第二小臼歯を移植した一症例．

中·四国矯正歯科学会雑誌


Nonsurgical orthodontic treatment for a patient with Sotos syndrome.

Sotos syndrome is a genetic disorder characterized by overgrowth in childhood, specific facial manifestations, advanced bone age, and mental retardation. The purpose of this article is to describe the nonsurgical orthodontic treatment of a 10-year-old boy with a skeletal mandibular protrusion, unilateral posterior crossbite, and Sotos syndrome. After maxillary lateral expansion, the skeletal Class III relationship with an anterior crossbite improved because of mandibular clockwise rotation, whereas the facemask had a marginal effect. After growth at 16 years, he had a skeletal Class I relationship, and thus, conventional orthodontic treatment with preadjusted edgewise appliances was initiated. After 41 months of multibracket treatment, acceptable occlusion with a functional Class I relationship was obtained. One year postretention, few changes in occlusion and facial features were observed. Our results demonstrate that considering the maxillofacial vertical growth during the peripubertal period associated with Sotos syndrome, more attention should be paid to the early orthopedic treatment with the facemask and/or chincap.

American Journal of Orthodontics and Dentofacial Orthopedics (AJO-DO)


Characteristics of Oral Dysfunction in Pediatric Patients with Malocclusion

小児不正咬合患者の小児患者における口腔機能障害の特徴

To clarify the characteristics of oral dysfunction in pediatric patients with malocclusion, we compared oral function between individuals with normal occlusion and those with malocclusion.A total of 108 participants, including 41 boys and 67 girls (mean age ± standard deviation, 9.4 ± 2.2 years), were recruited from outpatients who visited the Departments of Orthodontics and Pediatric Dentistry of Tokushima University Hospital. They were classified according to their occlusal status into normal occlusion, crowding, maxillary protrusion, mandibular protrusion, open bite, and others.This study revealed that patients with malocclusion had more functional problems (e.g. tongue thrust, low tongue posture and another oral habits) than subjects with normal occlusion and that the functional problems were associated with various types of malocclusion. Especially, patients with open bite showed the characteristic features of oral function and their maximum lip closure force was significantly weaker than that of subjects with normal occlusion (p < 0.05).We found the characteristic features of oral dysfunction in each malocclusion. It is thought that it is necessary to make an individual training program to the characteristic feature of oral function.


矯正歯科治療の経過予後からみた埋伏下顎大臼歯の歯科用CB-CT画像の特徴と牽引可否との関連性

【目的】埋伏下顎大臼歯は，発生率は低いものの骨性癒着が認められた際は重大な不正咬合の原因となる．その治療予後の予測は未だ困難であり，重要な臨床課題の一つである．本研究では臨床的に牽引が不可能であった下顎大臼歯のエックス線画像を見直し，牽引可能であった例と比較することで，牽引の可否を鑑別するための特徴的な画像所見を検討した． 【方法】資料として徳島大学病院矯正歯科を受診した第三大臼歯を除く下顎大臼歯の埋伏を有する患者5 名の歯科用コーンビームCT (以下CB-CT) 画像とパノラマエックス線画像を用いた．Ducommun らの骨性癒着歯の評価項目である歯根膜腔消失・歯根吸収・組織置換に加え，置換性歯根吸収(歯根吸収により生じた歯根表面の凹凸部の骨硬化像)，歯根彎曲の有無を評価した． 【結果】パノラマエックス線画像では5 例全てで歯根膜腔の消失を認めたが，歯根吸収や組織置換像は観察されなかった．一方，CB-CT 画像では牽引が不可能であった3 例全てで歯根膜腔の消失と置換性歯根吸収像を認めた．牽引が可能であった2 例でも歯根膜腔の消失がみられ，うち1 例では歯根吸収像も認めたがその近傍に骨硬化像はなかった． 【考察】Ducommun らの評価項目のみでは，牽引可能であった1 例が偽陽性となったが，置換性歯根吸収の評価項目への追加により偽陽性はなくなった．このことから置換性歯根吸収の評価が埋伏下顎大臼歯の牽引の可否の鑑別に極めて重要であると考えられた． 【結論】埋伏下顎大臼歯の診断において，CB-CT 画像での当該歯の周囲組織の詳細な観察により，牽引が可能であるかを非常に高い精度で診断できる可能性が示唆された．

中·四国矯正歯科学会雑誌


Establishment of a new rehabilitation program using masticatory training food for jaw deformity patients.

The rehabilitation using this training food may become a useful method for postoperative hypofunction in patients with jaw deformities.

Compared with the non-training group, the training group showed a trend toward greater recovery amount of MBF from Pre to T3, and a significantly greater recovery amount in MP (p < 0.05) from Pre to T3. When the time-series change of MP was evaluated in both groups from T0 to T3, a significant difference was observed in the interaction terms (p = 0.03). This result indicates that the effectiveness of the training may be demonstrated by following the postoperative course further.


Thread shape, cortical bone thickness, and magnitude and distribution of stress caused by the loading of orthodontic miniscrews: finite element analysis.

Cortical bone thickness is assumed to be a major factor regulating miniscrew stability. We investigated stress distribution in two miniscrews with different thread shapes (type A and B) and in cortical bone of three different thicknesses using three-dimensional (3D) finite element (FE) models. More specifically, 3D FE models of two different miniscrews were created and placed obliquely or vertically into a cylindrical bone model representing different cortical bone thicknesses. When force was applied to the miniscrew, the stress distribution on the screw surface and in the peri-implant bone was assessed using FE methodology. Miniscrew safety was evaluated using a modified Soderberg safety factor. Screw head displacement increased with a decrease in cortical bone thickness, irrespective of screw type. The smallest minimum principal stresses on the screw surfaces remained constant in type A miniscrews on changes in cortical bone thickness. Minimum principal stresses also appeared on the cortical bone surface. Lower absolute values of minimum principal stresses were seen in type A miniscrews when placed vertically and with upward traction in obliquely placed type B miniscrews. Both miniscrews had acceptable safety factor values. Taken together, orthodontists should select and use the suitable miniscrew for each patient in consideration of bone properties.


Effect of immersion in NaCl solution on the electrical conductivity and the reduction of the shear bond strength of resin-modifi ed glass-ionomer-cements after current application


Treatment decision of camouflage or surgical orthodontic treatment for skeletal Class III patients based on analysis of masticatory function.

The study subjects were 45 patients with skeletal Class III malocclusion (15 cases with camouflage orthodontics and 30 cases with orthognatic surgery) and 12 individuals with normal occlusion. We analyzed the pre-treatment records of electromyographic activities of masseter and temporalis muscles and jaw movements.

Camouflage orthodontic treatment is inappropriate for patients with relatively severe dentoskeletal discrepancies. Wits appraisal of -6.0 mm is a potentially useful parameter for treatment decision.


Volume Magnetic Susceptibility Estimation of α- and β-Phases in Titanium Alloys for Biomedical Applications.

Metallic medical devices in the human body cause serious artifacts in magnetic resonance imaging owing to the volume magnetic susceptibility (χν) mismatch between the device and tissue around the device. To reduce artifacts, medical devices produced from alloys with χν values of approximately -9 × 10-6 are required. Controlling the phase constitution is a basic technique used to control the χν value of an alloy, and the χν value of each phase is a fundamental property. In this study, an α+β-type Ti alloy and two β-type Ti alloys were investigated. The estimated χν values of the α-phase of the alloys were similar to or smaller than that of pure Ti. In contrast, the estimated χν values of the β-phase of the alloys were larger than that of pure Ti. Since the χν value of pure Ti is much larger than -9 × 10-6, the χν values of the β-phases suggested that increasing the volume fraction of the β-phase was not appropriate for producing a Ti alloy with a lower χν value.


A Multidisciplinary Approach to Malocclusion Caused by Facial Multiple Fracture.

In the case of multiple facial fractures, a simple open reduction occasionally causes various disorders during healing process after the surgery. Moreover, esthetic disturbance of a facial deformity might be induced. Therefore, the acquisition of facial symmetry and the recovery of occlusal and masticatory functions become increasingly important. This case report presents a successful treatment of facial multiple fracture induced by a car accident. A 20-year-old male was diagnosed with suffered multiple midface and mandibular fractures induced by a car accident. Midface fractures included the LeFort I and II type fractures, as well as sagittal fracture at midline and fractures from right maxillary sinus anterior wall to orbital wall. In the mandible, midline and left body fractures were detected. The patient underwent open reduction and rigid fixation of the fractured left zygoma, comminuted LeFort I and II fractures, and midline and left body of the mandible with intermaxillary fixation by multibracket appliance; maxillary osteotomy with iliac bone grafting; orthognathic two-jaw surgery with coronoid process grafts onto the depressed zygoma; and onlay graft of hydroxyapatite block on mandible. As the result, the multidisciplinary treatments successfully recover functions and esthetics to the satisfactory level of the patient with multiple facial fractures. As treatments for multiple facial fractures are required complexity due to the extent of trauma, multidisciplinary approach under the close cooperation between hospital departments is thought to be important.


Long-term Management of a Patient with Apert Syndrome.

The two-stage operation combining early distraction osteogenesis and postgrowth orthognathic surgery proves to be an effective therapy for correcting midfacial hypoplasia and skeletal mandibular protrusion caused by Apert syndrome.

The Journal of Contemporary Dental Practice


歯科矯正用アンカースクリューの導入に伴う治療方針の変化(第一報) 抜歯・非抜歯および抜歯部位の判定に関する検討

【目的】近年，歯科矯正用アンカースクリュー(以降アンカーと明記する)の普及により，臼歯の固定や移動が容易に行えるようになり，抜歯，非抜歯，抜歯部位の選択についても変化が起きている．今回，アンカーの導入前後での治療方針の変化について，とくに臼歯抜歯の適応に関する調査を行ったので報告する．【方法】徳島大学病院矯正歯科を受診した初診時年齢12歳以上の患者を対象とし，2002年以前にマルチブラケット治療の診断を受けた100名(Pre群)と2008年以降に診断を受けた100名(Post群)を無作為に抽出した．先天性疾患および歯牙欠損症例，顎変形症は除外した．診断内容における臼歯抜歯(第三大臼歯は除く)の有無，抜歯部位等に関する比較検討を行った．【結果および考察】Pre群とPost群の間で抜歯症例数および抜歯部位に違いは認められなかった．一方，skeletal Class IIの症例はPre群では上顎片顎小臼歯抜歯によるカムフラージュ治療が多かったのに対し，Post群ではその割合は減少していた．また，skeletal Class IIIの症例ではアンカーを用いた非抜歯治療の割合が増加していた．High mandibular plane angle caseにおいてはアンカーの使用により，上顎第一大臼歯の挺出防止ならびに圧下が可能となり上下顎第一小臼歯を抜去する割合が増えた．【結論】アンカー導入で，臼歯の移動や挺出の防止および圧下が可能となり抜歯部位の選択基準に変化が生じたと考えられた．(著者抄録)

The Journal of Chu-Shikoku Orthodontic Society

中·四国矯正歯科学会雑誌


A Long-term Follow-up of Mandibular Deviation Caused by Congenital Cervical Lymphangioma Treated with an Orthodontic Approach.

The hybrid technique combining functional appliance and intermaxillary elastics proves to be an effective therapy for correcting occlusal cant and mandibular deviation caused by cervical lymphangioma.


Effects of water immersion on shear bond strength reduction after current application of resin-modified glass-ionomer-cements containing and not containing an ionic liquid.

The enhancement in the bonding strength of advanced dental cements has enabled long-lasting dental restorations. However, the high bonding strength can cause difficulty in removing these restorations. Therefore, "smart" dental cements with simultaneous strong bonding and easy on-demand debonding ability are required. A resin-modified glass-ionomer-cement (RMGIC) with an ionic liquid (IL) has demonstrated significant reduction in the bonding strength with current application (CA). This research investigates the effect of immersion in distilled water on the electric conductivity and bonding strength of RMGIC with and without an IL and CA. The RMGIC without the IL exhibited significant electric conductivity after immersion, and a significant decrease in bonding strength with CA. In comparison, the electric conductivity after immersion and the decrease in bonding strength with CA were greater for RMGIC with the IL. Thus, the feasibility of smart dental cements capable of electrically debonding-on-demand is indicated.


徳島大学病院矯正歯科における保険診療に関する実態調査-先天性疾患における裂奇形の併発について

矯正歯科治療に健康保険が導入されて約40年が経過し，唇顎口蓋裂と顎変形症の他に2018年現在53項目が保険治療の対象になっている．今回，我々は当科における矯正歯科治療の保険適用患者の実態を調査し，特に唇顎口蓋裂と他の先天性疾患との関連性について臨床統計学的検討を行ったので報告する．徳島大学病院病院情報システム・データウェアハウスを用い，2008年1月から2018年12月までの11年間に当院矯正歯科を受診した患者から保険治療を受けている患者を抽出し，顎変形症単独症例を除く先天性疾患患者について，電子カルテ全文検索システムを用いて臨床統計学的検討を行った．研究対象期間に当科にて保険治療を受けた矯正患者は345人で，そのうち，本研究対象患者は，顎変形症単独症例を除く207人であった．患者の内訳は，裂奇形を主徴候とする症例が全体の5割を占め最も多く，次いで，6歯以上の先天性部分性無歯症，ゴールデンハー症候群(鰓弓異常症を含む)，ダウン症候群の順であった．また，症候性疾患の中で裂奇形の併発は，ピエール・ロバン症候群，ダウン症候群，ゴールデンハー症候群の順に多く，その裂型は，口蓋裂(軟口蓋裂を含む)，唇顎口蓋裂，唇裂の順に多かった．以上のことから，当病院は裂奇形を併発した先天性疾患への専門的な対応が不可欠であり，希少疾患にも柔軟に対応できるよう複数の診療科，職種による診療科の枠組みを超えたチーム医療体制の構築が必要であることが示唆された．

中·四国矯正歯科学会雑誌


Effects of functional training after orthognathic surgery on masticatory function in patients with mandibular prognathism.

Our findings suggested that functional training using the gum chewing and patient-education exercise improved masticatory function in patients with mandibular prognathism.

In the training group, the AI value during MVC increased significantly and the EI value during gam chewing decreased significantly after surgical orthodontic treatment (AI: p < 0.01; EI: p < 0.01), indicating the improvement of activity balance of masseter and temporalis muscles and conversion of the jaw movement from abnormal to normal pattern (p < 0.01).


A Clinico-statistical Investigation on Cleft Lip and/or Palate Patients during the Past 10 Years in the Department of Orthodontics and Dentofacial Orthopedics, Tokushima University Hospital

徳島大学病院矯正歯科における過去10年間の口唇裂・口蓋裂患者に関する実態調査．

A clinical-statistical investigation was carried out with cleft lip and/or palate patients in the Department of Orthodontics and Dentofacial Orthopedics, Tokushima University Hospital, during the 10 years from April 2006 to March 2016.
1 The number of cleft lip and/or palate patients was 96, accounting for 6.2% of orthodontic patients during the 10 years. The patients consisted of 55 males and 41 females with a male to female ratio of 1:0.75.
2 The distribution of cleft type was as follows: cleft lip and palate 36.5%, cleft lip and alveolus 33.3%, cleft palate 19.8%, and cleft lip 10.4%. The unilateral cleft lip was more frequently seen on the left side than on the right side, and in males than in females.
3 The peak age of the first visit was 0 years (58.3%). As Hellman's dental developmental stage, the percentage of stage A was 44.8%.
4 As for the resident distribution, 87.5% patients came from Tokushima prefecture.
5 90.6% of patients were referred from the Department of Plastic and Reconstructive Surgery in Tokushima University Hospital.
6 By classification of crossbite, cases of type 4 (anterior crossbite) were most frequent, at 52.9%.

徳島大学病院矯正歯科に来院した口唇裂・口蓋裂患者の実態を把握する目的で，2006年4月から2016年3月までの10年間に当科を受診した口唇裂・口蓋裂患者を対象として臨床統計を行い，以下の結果を得た．
1．過去10年間の口唇裂・口蓋裂患者は96名であり，矯正歯科総患者数の6.16%を占めていた．男女比は1:0.75であった．
2．裂型分類では唇顎口蓋裂(36.5%)，口唇顎裂(33.3%)，口蓋裂(19.8%)，口唇裂(10.4%)であった．披裂部の側性は唇顎口蓋裂，口唇顎裂においては左側に，口唇裂では右側に高い割合でみられた．裂型別性差に関しては口唇裂，口唇顎裂，唇顎口蓋裂においては男子に，口蓋裂においては女子に高い割合で認められた．
3．初診時年齢は0歳(58.3%)が最も多く，次いで1歳(11.5%)，2歳(7.3%)と続いた．初診時におけるHellmanの咬合発育段階で分類すると，乳歯咬合完成前のⅠA期(44.8%)が最も多く，次にⅠC期(32.3)，ⅡA期(7.3%)と続いた．
4．患者の居住地の地域分布は徳島県が87.5%で最も多く認められた．
5．紹介元の医療施設においては，当院形成外科からの紹介が90.6%を占めていた．
6．交叉咬合の分類において，前歯のみが交叉咬合を呈するType 4が52.9%と最も高かった．

Journal fo Japanese Cleft Palate Association


矯正患者における永久歯の先天性欠如に関する臨床統計調査

矯正患者における永久歯の先天性欠如に関する臨床統計調査

中·四国矯正歯科学会雑誌


徳島大学病院矯正歯科における口唇裂・口蓋裂患者の永久歯の歯数異常に関する調査

徳島大学病院矯正歯科における口唇裂・口蓋裂患者の永久歯の歯数異常に関する調査

中·四国矯正歯科学会雑誌


In vitro evaluation of frictional force of a novel elastic bendable orthodontic wire.

These findings demonstrate that the Ti-Nb alloy wire has almost the same frictional resistance as the Ti-Ni alloy wire, although it has a higher elastic modulus.


Effect of pulsed ultrasound toothbrush on Streptococcus mutans biofilm removal.

The sonic vibration with pulsed ultrasound showed more reduction of the biofilm compared to the control and the sonic vibration with and without continuous ultrasound. Thus, pulsed ultrasound action may be beneficial for biofilm removal of interproximal regions.


Effectiveness of presurgical nasoalveolar molding therapy on unilateral cleft lip nasal deformity.

To evaluate the effectiveness of pre-surgical nasoalveolar molding (PNAM) in patients with unilateral cleft lip nasal deformities. Methods: This was a retrospective study involving 29 patients with unilateral cleft lip and palate defects, of whom 13 were treated with palatal devices with nasal stents (PNAM group) and 16 were treated with palatal devices without nasal stents or surgical tapes (control group). Submental oblique photographs and orthodontic models were longitudinally obtained at the initial visit (T1) and immediately before (T2) and after cheiloplasty (T3). Asymmetry of the external nose, degree of columellar shifting, nasal tip/ala nose ratio, nasal base angle, interalveolar gap, and the sagittal difference in the alveolar gap were measured. The study was conducted in the Orthodontic Clinic at Tokushima University Hospital, Tokushima, Japan between 1997 and 2012. Results: At T1, there were no significant intergroup differences in the first 4 asymmetry parameters. At T2, the PNAM group showed a significant improvement in all values compared to the control group. At T3, the PNAM group showed significant improvement in nasal asymmetry and columellar shifting. Model analysis showed significantly greater changes in the inter-alveolar gap and the sagittal difference of the alveolar cleft gap from T1 to T2 in the PNAM group. Conclusion: The use of PNAM is indispensable for pre-surgical orthodontic treatment at the early postnatal age.


Skeletal anchorage for intrusion of bimaxillary molars in a patient with skeletal open bite and temporomandibular disorders.

The treatment of severe skeletal anterior open bite is extremely difficult in adults, and orthognathic surgery is generally selected for its treatment. We report the case of an 18-year-old adult patient with skeletal anterior open bite and temporomandibular disorders who was successfully treated using temporary anchorage devices. She had an open bite of -2.0 mm and an increased facial height. Miniplates were implanted in both the maxilla and mandible, and molar intrusion resulted in counterclockwise rotation of the mandible over a period of 12 months. After active treatment, her upper and lower first molars were intruded by approximately 2 mm and her overbite became +2.5 mm. Her retrognathic profile improved with counterclockwise rotation of the mandible. Orthodontic treatment aided with skeletal anchorage is beneficial for intrusion of bimaxillary molars in patients with anterior open bite.


歯科矯正用アンカースクリューを用いて上下歯列遠心移動を行った三年保定症例

歯科矯正用アンカースクリューを用いて上下歯列遠心移動を行った三年保定症例

The Journal of Chu-Shikoku Orthodontic Society

中·四国矯正歯科学会雑誌


The Effectiveness of Human Parathyroid Hormone and Low-Intensity Pulsed Ultrasound on the Fracture Healing in Osteoporotic Bones.

Osteoporotic fracture has become a major public health problem, and until today, the treatments available are not satisfactory. While there is growing evidence to support the individual treatment of parathyroid hormone (PTH) administration and low-intensity pulsed ultrasound (LIPUS) exposure as respectively systemic and local therapies during osteoporotic fracture healing, their effects have not yet been investigated when introduced concurrently. This study aimed to evaluate the effects of combined treatment with PTH (1-34) and LIPUS on fracture healing in ovariectomized (OVX) rats. Thirty-two, 12-week-old female Sprague-Dawley rats were OVX to induce osteoporosis. After 12 weeks, the rats underwent surgery to create bilateral mid-diaphyseal fractures of proximal tibiae. All animals were randomly divided into 4 groups (n = 8 for each): control group as placebo, PTH group, LIPUS group, and combined group. PTH group had PTH administration at a dose of 30 μg/kg/day for 3 days/week for 6 weeks. LIPUS group received ultrasound 5 days/week for 20 min/day for 6 weeks and combined group had both PTH administration and LIPUS exposure for 6 weeks. Fracture healing was observed weekly by anteroposterior radiography and micro-CT. Five weeks after the fracture, the tibia were harvested to permit histological assessments and at week 6, for mechanical property of the fracture callus. Micro-CT showed that the PTH and combined groups exhibited significantly higher BMD and trabecular bone integrity than control group at weeks 4-6. Radiography, fracture healing score and mean callus area indicated that the combined group revealed better healing processes than the individual groups. Mechanically, bending moment to failure was significantly higher in LIPUS, PTH and combined groups than in control group. These data suggest that the combined treatment of PTH and LIPUS have been shown to accelerate fracture bone healing and enhance bone properties rather than single agent therapy, and may be considered as a treatment remedy for fracture healing in postmenopausal osteoporosis.


Low-intensity pulsed ultrasound rescues insufficient salivary secretion in autoimmune sialadenitis.

These results suggest that LIPUS upregulates expression of AQP5 and inhibits TNF- production. Thus, LIPUS may restore secretion by inflamed salivary glands. It may synergistically activate negative feedback of NF-B signaling in response to inflammatory stimulation. Collectively, LIPUS might be a new strategic therapy for xerostomia in autoimmune sialadenitis with SS.

TNF-α stimulation of NS-SV-AC and NS-SV-DC cells resulted in a significant decrease in cell number and net fluid secretion rate (p < 0.01), whereas LIPUS treatment abolished them (p < 0.05). The expression changes of AQP5 and TNF-α were also inhibited in LIPUS treatment by blocking the NF-κB pathway. Furthermore, we found that mRNA expression of A20, a negative feedback regulator, was significantly increased by LIPUS treatment after TNF-α or interleukin 1β stimulation (NS-SV-AC, p < 0.01; NS-SV-DC, p < 0.05). In vivo LIPUS exposure to MRL/lpr mice exhibited a significant increase in both salivary flow and AQP5 expression by reducing inflammation in salivary glands (p < 0.01).


顎関節内障を有する骨格性下顎前突症に対する矯正歯科治療の一治験例

顎関節内障を有する骨格性下顎前突症に対する矯正歯科治療の一治験例

中·四国矯正歯科学会雑誌


Low-Intensity Pulsed Ultrasound in Dentofacial Tissue Engineering.

Oral and maxillofacial diseases affect millions of people worldwide and hence tissue engineering can be considered an interesting and clinically relevant approach to regenerate orofacial tissues after being affected by different diseases. Among several innovations for tissue regeneration, low-intensity pulsed ultrasound (LIPUS) has been used extensively in medicine as a therapeutic, operative, and diagnostic tool. LIPUS is accepted to promote bone fracture repair and regeneration. Furthermore, the effect of LIPUS on soft tissues regeneration has been paid much attention, and many studies have performed to evaluate the potential use of LIPUS to tissue engineering soft tissues. The present article provides an overview about the status of LIPUS stimulation as a tool to be used to enhance regeneration/tissue engineering. This review consists of five parts. Part 1 is a brief introduction of the acoustic description of LIPUS and mechanical action. In Part 2, biological problems in dentofacial tissue engineering are proposed. Part 3 explores biologic mechanisms of LIPUS to cells and tissues in living body. In Part 4, the effectiveness of LIPUS on cell metabolism and tissue regeneration in dentistry are summarized. Finally, Part 5 relates the possibility of clinical application of LIPUS in orthodontics. The present review brings out better understanding of the bioeffect of LIPUS therapy on orofacial tissues which is essential to the successful integration of management remedies for tissue regeneration/engineering. To develop an evidence-based approach to clinical management and treatment of orofacial degenerative diseases using LIPUS, we would like to be in full pursuit of LIPUS biotherapy. Still, there are many challenges for this relatively new strategy, but the up to date achievements using it promises to go far beyond the present possibilities.


Low-Intensity Pulsed Ultrasound Activates Integrin-Mediated Mechanotransduction Pathway in Synovial Cells.

Low-intensity pulsed ultrasound (LIPUS) suppresses synovial hyperplasia and synovial cell proliferation characterized for rheumatoid arthritis, but the molecular mechanisms remain unknown. The purpose of this study was to examine the mechanotransduction pathway via the integrin/mitogen-activated protein kinase (MAPK) pathway in LIPUS exposure on the synovial membrane cells. Rabbit knee synovial membrane cell line, HIG-82, was cultured with or without FAK phosphorylation inhibitor, PF-573228. One hour after stimulation with PF-573228, the cells exposed to LIPUS for 20 min or sham exposure. A possible integrin/MAPK pathway was examined by immunofluorescence and Western blotting analysis with antibodies targeting specific phosphorylation sites on intracellular signaling proteins. LIPUS exposure increased phosphorylation of FAK, JNK, ERK, and p38, but the phosphorylation was inhibited by PF-573228. In conclusion, LIPUS exposure might be involved in cell apoptosis and survival of synovial membrane cells via integrin/FAK/MAPK pathway.


Torque Ratio as a Predictable Factor on Primary Stability of Orthodontic Miniscrew Implants.

TR might be related with the miniscrew success rates, and it can be used as a predictable factor on primary stability of orthodontic miniscrew implants. Miniscrew implants should be replaced if MRT is significantly lower than MIT at placement surgery.


顎顔面領域における骨治癒に対する低出力超音波パルス照射の使用経験

顎顔面領域における骨治癒に対する低出力超音波パルス照射の使用経験


Fabrications of zinc-releasing biocement combining zinc calcium phosphate to calcium phosphate cement.

Recently, zinc-releasing bioceramics have been the focus of much attention owing to their bone-forming ability. Thus, some types of zinc-containing calcium phosphate (e.g., zinc-doped tricalcium phosphate and zinc-substituted hydroxyapatite) are examined and their osteoblastic cell responses determined. In this investigation, we studied the effects of zinc calcium phosphate (ZCP) derived from zinc phosphate incorporated into calcium phosphate cement (CPC) in terms of its setting reaction and MC3T3-E1 osteoblast-like cell responses. Compositional analysis by powder X-ray diffraction analysis revealed that HAP crystals were precipitated in the CPC containing 10 or 30wt% ZCP after successfully hardening. However, the crystal growth observed by scanning electron microscopy was delayed in the presence of additional ZCP. These findings indicate that the additional zinc inhibits crystal growth and the conversion of CPC to the HAP crystals. The proliferation of the cells and alkaline phosphatase (ALP) activity were enhanced when 10wt% ZCP was added to CPC. Taken together, ZCP added CPC at an appropriate fraction has a potent promotional effect on bone substitute biomaterials.

Journal of the Mechanical Behavior of Biomedical Materials


Novel PAX9 Mutations Cause Non-syndromic Tooth Agenesis.

PAX9 is a transcription factor expressed in the tooth mesenchyme during tooth morphogenesis. In Pax9-null mice, tooth development is arrested at the bud stage. In humans, heterozygous mutations in PAX9 have been associated with non-syndromic tooth agenesis, predominantly in the molars. Here, we report 2 novel mutations in the paired domain of PAX9, a three-nucleotide deletion (73-75 delATC) and a missense mutation (C146T), in two unrelated Japanese patients with non-syndromic tooth agenesis. The individual with the 73-75del ATC mutation was missing all maxillary molars and mandibular second and third molars. The individual with the C146T mutation was missing the mandibular central incisors, maxillary second premolars, and first molars, along with all second and third molars. Both mutations affected amino acids that are highly conserved among different species and are critical for DNA binding. When both mutants were transfected to COS7 cells, nuclear localization of PAX9 proteins was not affected. However, reduced expression of the mutant proteins and almost no transcriptional activity of the target BMP4 gene were observed, suggesting haploinsufficiency of PAX9 as the cause of non-syndromic tooth agenesis.


三次元デジタルモデルを用いた片側性口唇口蓋裂患者の咬合評価に関する検討 第二報 デジタルツールが三次元デジタル模型の評価に及ぼす影響

The Journal of Chu-Shikoku Orthodontic Society

中·四国矯正歯科学会雑誌


Orthognathic and orthodontic treatments for TMJ-osteoarthritis with jaw deformity


Assessment of occlusal relationship in unilateral cleft lip and palate patients using 3-dimensional digital models

三次元デジタルモデルを用いた片側性口唇裂口蓋裂患者の咬合評価に関する検討

Journal fo Japanese Cleft Palate Association


インプラント固定に関する臨床統計学的研究

インプラント固定に関する臨床統計学的研究

中·四国矯正歯科学会雑誌


Reinforcement of bond strength of self-etching orthodontic adhesive.

Abstract Objective: To determine the reinforcement of bond strength of a self-etching system by applying a pretreatment agent. Materials and Methods: Sixty extracted human premolars were used in this study. The enamel surfaces were treated with four pretreatment agents?phosphoric acid, polyacrylic acid, citric acid, and ammonium hexafluorosilicate (SiF)?and were examined under a scanning electron microscope. Afterward, orthodontic brackets were bonded with a self-etching adhesive system (n ?=? 10 for each agent), and shear bond strength was measured through a debonding process. The adhesive remnant index (ARI) was also assessed. Results: Enamel surfaces treated with polyacrylic acid seemed almost the same as intact enamel. Treatment with SiF induced slight shallow depressions compared with the intact enamel. On the other hand, enamel surfaces treated with citric acid and phosphoric acid showed severe etching patterns. All pretreatments increased the bond strength, but SiF-treated specimens revealed the greatest strength (12.201 ? 1.048?MPa), followed by polyacrylic acid (12.030 ? 2.103?MPa). The control group with no pretreatment showed the least strength (9.078 ? 1.678?MPa). All pretreatments increased ARI score compared with the control group. Conclusions: Surface conditioning before bracket adhesion could reinforce the bond strength of the self-etching adhesive system, resulting in a more reliable bonding system.


Three-dimensional finite element analysis of cartilaginous tissues in human temporomandibular joint during prolonged clenching.

OBJECTIVE: Bruxism, the parafunctional habit of nocturnal grinding of the teeth and clenching, is associated with the onset of joint degeneration. Especially prolonged clenching is suggested to cause functional overloading in the temporomandibular joint (TMJ). In this study, the distributions of stresses in the cartilaginous TMJ disc and articular cartilage, were analysed during prolonged clenching. The purpose of this study was to examine if joint degradation due to prolonged clenching can be attributed to changes in stress concentration in the cartilaginous tissues. DESIGN: Finite element model was developed on the basis of magnetic resonance images from a healthy volunteer. Condylar movements recorded during prolonged clenching were used as the loading condition for stress analysis. RESULTS: At the onset of clenching (time=0s), the highest von Mises stresses were located in the middle and posterior areas (6.18MPa) of the inferior disc surface facing the condylar cartilage. The largest magnitude of the minimum principal stress (-6.72MPa) was found in the condylar cartilage. The stress concentrations were relieved towards the superior disc surface facing the temporal cartilage. On the surfaces of the temporal cartilage, relatively lower stresses were found. After 5-min clenching, both stress values induced in the TMJ components were reduced to 50-80% of the stress values at the onset of clenching, although the concomitant strains increased slightly during this period. CONCLUSIONS: It is suggested that both the condylar and temporal cartilage layers along with the TMJ disc, play an important role in stress distribution and transmission during prolonged clenching due to tissue expansion. Furthermore, our study suggests that a development of stress concentrations in the TMJ during prolonged clenching and risk factors for the initiation of TMJ degeneration could not be confirmed.


A case of maxillofacial saggital fracture reducted by a reverse-activated rapid palatal expander

顔面骨骨折による咬合不全に対し，急速拡大装置を逆回転することで整復した1症例

中·四国矯正歯科学会雑誌


Antibacterial activity of composite resin with glass-ionomer filler particles

The purpose of this study was to examine the antibacterial activity of composite resin with glass-ionomer filler particles versus that of contemporary commercial composite resins. Three composite resins were used: Beautifil II (containing S-PRG filler), Clearfil AP-X, and Filtek Z250. Resin blocks were bonded to maxillary first molars, and plaque accumulation on the resin block surface was examined after 8 hours. For the antibacterial test, the number of Streptococcus mutans in contact with the composite resin blocks after incubation for 12 hours was determined, and adherence of radiolabeled bacteria was evaluated. Less dental plaque was formed on Beautifil II resin block as compared to the other two materials. Antibacterial test revealed that there were no significant differences in the number of Streptococcus mutans among the three composite resins. However, the adherence of radiolabeled bacteria to the saliva-treated resin surface was significantly (p>0.01) lower in Beautifil II than in the other two materials. These results suggested that Beautifil II could reduce dental plaque formation and bacterial adherence, leading to prevention of secondary caries


過去10年間に徳島大学病院矯正歯科を受診した顎顔面骨骨折患者の実態調査

過去10年間に徳島大学病院矯正歯科を受診した顎顔面骨骨折患者の実態調査

中·四国矯正歯科学会雑誌


PLLAスクリュー固定による下顎枝矢状分割術を施行した骨格性下顎前突症の一症例-長期観察例-

中·四国矯正歯科学会雑誌


Stress analysis in the mandibular condyle during prolonged clenching: a theoretical approach with the finite element method.

Parafunctional habits, such as bruxism and prolonged clenching, have been associated with functional overloading in the temporomandibular joint (TMJ), which may result in internal derangement and osteoarthrosis of the TMJ. In this study, the distributions of stress on the mandibular condylar surface during prolonged clenching were examined with TMJ mathematical models. Finite element models were developed on the basis of magnetic resonance images from two subjects with or without anterior disc displacement of the TMJ. Masticatory muscle forces were used as a loading condition for stress analysis during a 10 min clenching. In the asymptomatic model, the stress values in the anterior area (0.100 MPa) and lateral area (0.074 MPa) were relatively high among the five areas at 10 min. In the middle and posterior areas, stress relaxation occurred during the first 2 min. In contrast, the stress value in the lateral area was markedly lower (0.020 MPa) than in other areas in the symptomatic model at 10 min. The largest stress (0.050 MPa) was located in the posterior area. All except the anterior area revealed an increase in stress during the first 2 min. The present result indicates that the displacement of the disc could affect the stress distribution on the condylar articular surface during prolonged clenching, especially in the posterior area, probably leading to the cartilage breakdown on the condylar articular surface.

Proceedings of the Institution of Mechanical Engineers. Part H, Journal of engineering in medicine


Enamel bonding of self-etching and phosphoric acid-etching orthodontic adhesives in simulated clinical conditions: Debonding force and enamel surface

This study aimed to evaluate the effectiveness of self-etching and phosphoric acid-etching orthodontic adhesives for enamel bonding in simulated clinical conditions. By using two self-etching (Transbond Plus, TP; Beauty Ortho Bond, BB) and two acid-etching (Transbond XT, TX; Superbond Orthomite, SB) adhesives, orthodontic brackets were bonded on human premolars (n=10 for each adhesive). Ten teeth without bracket bonding, i.e., intact enamel surfaces, were used as control for SEM observation. After 7-day storage in lactic acid solution, bracket debonding force by means of debonding pliers, adhesive remnant index (ARI), and enamel surface morphology were examined. All the tested adhesives exhibited sufficient bond strength for clinical use. The ARI scores were almost the same among the four adhesives. In terms of SEM observation, the enamel surfaces in the control and TP groups showed a slight change after immersion in lactic acid solution, while the BB group showed less change on the enamel surface compared with the TP group. Meanwhile, the two acid-etching adhesives caused considerable demineralization. Taken together, these findings indicated that the action of self-etching systems was evidently more conservative.


Development of a novel cement by conversion of hopeite in set zinc phosphate cement into biocompatible apatite

Synthetic bone cement that has zinc oxide core particles covered with hydroxyapatite (HAP) was developed; that is, the conversion of hopeite, the traditional zinc phosphate cement, into HAP was attempted. Here, hopeite is the final product of the reaction between powders and trituration liquid of the traditional zinc phosphate cement. This cement may have many advantages not only in terms of biological functions but also the setting process of the traditional cement and the mechanical properties of the developed compact if the hopeite can be converted into calcium phosphate (CP). In this study, calcium nitrate solutions of various concentrations were used for the conversion of hopeite crystals into CP. The products after the solution treatment were analyzed by X-ray diffractometry (XRD), Fourier transform infrared spectrometry (FTIR), and scanning electron microscope (SEM) observation. These results indicated that the converted scholzite crystals could be partially detected. Several types of set zinc phosphate cement with different P/L ratios were arranged. The surface products of the set cement after the solution treatment were analyzed by XRD. However, the crystal phase such as hopeite was not detected except for zinc oxide. The set cement, which was treated with the calcium nitrate solution, was immersed in simulated body fluid (SBF). HAP-like crystals on the set cement could be detected for the specimens immersed for 4 weeks. These findings suggested that the binding phase in the set cement could be converted into HAP by immersion in SBF.


エナメル質形成不全を伴う空隙歯列症例の一治験例

エナメル質形成不全を伴う空隙歯列症例の一治験例

The Journal of Chu-Shikoku Orthodontic Society

中·四国矯正歯科学会雑誌


A case report of condylar remodeling after orthognathic surgery with a combination of intraoral vertical ramus osteotomy and sagittal split ramus osteotomy

下顎枝垂直骨切り術と下顎枝矢状分割術を併用した外科的矯正治療後に下顎頭のリモデリングを認めた一症例

Journal of the Japanese Society for the Temporomandibular Joint


A case of skeletal class III malocclusion with lateral shift treated by two-jaw surgery

上下顎移動術を行った顎偏位を伴う下顎前突の1治験例

中·四国矯正歯科学会雑誌


Three malocclusion cases with transposition of the maxillary canine

上顎犬歯の移転を伴う不成咬合の3症例

中·四国矯正歯科学会雑誌


Comparison of treatment changes produced by the bite jumping appliance and elastic open activator

上顎前突症患者におけるBite jumping applianceとElastic open activatorの作用機序に関する検討

中·四国矯正歯科学会雑誌


Siblings with spaced arches treated with and without partial glossectomy --- Comparison of occlusal stabilities after orthodontic treatment in a pair of brother and sister

Macroglossia, or enlarged tongue, is thought to be an etiological factor in open bite, bimaxillary protrusion, and dental arch spacing, and it might cause instability after orthodontic treatment. Partial glossectomy to reduce tongue size might be a useful method of solving these problems. In this report, we describe orthodontic treatment of 2 siblings with enlarged tongues and arch-space problems. The sister, whose tongue was larger and spacing problem more severe, was treated with a partial glossectomy; her brother refused surgery and was treated with a tongue-crib appliance. Stability after orthodontic treatment was evaluated.

American Journal of Orthodontics and Dentofacial Orthopedics (AJO-DO)


A clinicostatistical study on the location of the impacted maxillary canines using vertex occlusal radiograhpy

歯軸方向エックス線撮影法を用いた上顎犬歯埋伏位置に関する臨床統計学的調査

With the exception of the maxillary and mandibular third molars, the maxillary canine impaction is the most commonly encountered. In this study, the bucco-palatal localization of the maxillary impacted canine was radiographically evaluated using vertex occlusal radiographs, and then the arch length discrepancy, skeletal morphology using lateral cephalometric radiographs, and surgical management relating with canine impaction were investigated in 59 subjects (20 males and 39 females) with 73 impacted maxillary canines. Palatally located canines occurred in 49.3%, buccally located canines in 39.7% of the subjects, showing a higher incidence of buccally impacted canines compared with previous other reports in Caucasian. In the palatally located group, the upper apical base and basal arch width were significantly less than those in the buccally located group, while no significant difference was demonstrated in the arch length discrepancy between both groups. In cephalometric analysis, ANB angle in the palatally located group was significantly smaller than that in the buccally located group. The majority (73.8%) of the impacted canines were exposed surgically, and the gingival recession was observed in these teeth. These results concerned with the assessment of the maxillary impacted canine using the vertex occlusal radiographs could be useful for treatment planning considerations.

上顎犬歯の埋伏は,埋伏歯の中でも比較的高頻度でみられ,局所的な不正咬合のみならず,審美的,機能的にも問題となることが少なくない.上顎犬歯が埋伏する原因について未だ不明な点も多いが,埋伏の唇舌的位置に人種による相違を認めるという報告もみられ,埋伏位置やこれに関わる要因を検討することは,臨床的指針を得るのみならず埋伏の原因を考える上で非常に有益である.そこで本研究では,当科における上顎埋伏犬歯の唇舌的位置を把握するとともに顎顔面形態,叢生量,治療方法等について臨床統計学的検討を行った.研究対象として,徳島大学医学部・歯学部附属病院矯正歯科を受診した口唇裂・口蓋裂を始めとする先天異常患者を除く上顎犬歯埋伏患者のうち,歯軸方向エックス線写真を撮影した59名73歯(男子20名,女子39名,平均年齢13歳4か月)を用いて埋伏犬歯の位置を詳細に検討したところ,以下の結果を得た.1.白人を対象にした報告と比較し,唇側に埋伏する割合が多い傾向が認められた.2.口蓋側群において,上顎歯槽基底弓長径・幅径および,ANB角が有意に小さかった.3.上顎のアーチレングスディスクレパンシーについては,両群間に有意差は認められなかった.4.開窓牽引処置を行った症例が両群ともに多く,歯肉退縮,歯根彎曲等の弊害がみられた.以上の結果より,歯軸方向エックス線撮影法を用いて埋伏犬歯の位置を検討することは矯正治療計画を立案する上で有用であると考えられた.


Evaluation of condylar position and mandibular stability following sagittal split ramus osteotomy --- comparison of PLLA screw, titanium screw and wire in bone fixation

下顎枝矢状分割術を施行した顎変形症患者における術前·術後の下顎頭の位置と下顎骨の安定性 --- PLLA製スクリュー，チタン製スクリュー，ワイヤーを用いた各種骨片固定法の比較


Oral rehabilitation of an orthodontic patient with cleft lip and palate and hypodontia using secondary bone grafting, osseo-integrated implants, and prosthetic treatment.

OBJECTIVE: Complete skeletal and dental reconstruction of the anterior maxilla is of great importance to patients with cleft lip and palate. Accordingly, osseo-integrated implants have been utilized for dental reconstruction after secondary bone grafting. In this report, the orthodontic management of a patient with unilateral cleft lip and plate with associated hypodontia is described. The patient was treated with comprehensive orthodontic treatment in addition to secondary bone grafting, and dental reconstruction was achieved with a combination of osseo-integrated implants and fixed prosthodontic treatment.


A study of stability of the maxillary dental arch form with secondary bone grafting in unilateral cleft lip and palate patients

顎裂部二次骨移植術を行った片側性口唇口蓋裂患者における上顎歯列弓の安定性に関する検討

Journal fo Japanese Cleft Palate Association


Three cases treated by sagittal split ramus osteotomy with bioabsorptive poly-L-lactoc acid screws.

生体内吸収性ポリ-L-乳酸(PLLA)製ネジによる固定法を用いて下顎枝矢状分割術を施行した3症例．

The Journal of Chu-Shikoku Orthodontic Society

中·四国矯正歯科学会雑誌


An orthodontic case with impaction and transposition of right maxillary incisors and canine

上顎右側3前歯に移転を伴う埋伏のみられた認めた1症例

中·四国矯正歯科学会雑誌


Clinical statistical study of jaw deformity patients at the Department of Orthodontics, Tokushima University Dental Hospital

徳島大学歯学部附属病院矯正歯科における顎変形症患者の臨床統計学的検討


Diagnostic evaluation of three cases with condylar resorption

中·四国矯正歯科学会雑誌


Evaluation for malocclusion of 37 Japanese patients with unilateral cleft lip and palate by Goslon Yardstick.

Goslon Yardstick を用いた日本人片側性口唇口蓋裂患者37症例の咬合評価


Effects of electrochemical polishing on frictional resistance and surface roughness of orthodontic wires --- A study using atomic force microscope

電解研磨が矯正用ワイヤーの摩擦力抵抗および表面性状に及ぼす影響に関する研究 --- -原子間力顕微鏡を用いた解析-


A Case of Micrognathia with Mandibular Asymmetry Treated by Surgical Orthodontic Approach

外科的矯正治療を施行した非対称を伴う小下顎症の一治験例


Fluoridation of hydroxyapatite powder by ammonium hexafluosilicate


A study of the stability after orthodontic treatment in vertical openbite cases

前歯部開咬症例の矯正治療後における後戻りの様相に関する研究

中·四国矯正歯科学会雑誌


Identification of key determinant for predicting feasible mandibular molars distalization