含歯性嚢胞より生じた原発性骨内歯原性癌腫

Malignant tumors arising from dentigerous cysts are classified as primary squamous cell carcinoma derived from an odontogenic cyst or as odontogenic carcinoma according to the 2005 WHO classification and are extremely rare. We report a malignant tumor arising from a dentigerous cyst in the right maxillary anterior teeth , together with a literature review. The patient was a 75-year-old man who visited a hospital with complaining of discomfort in the lingual part of the right maxillary anterior teeth. On panoramic radiography and plain computed tomography (CT), dentigerous cyst, keratocystic odontogenic tumor or ameloblastoma was suspected. The extirpated material was histopathologically diagnosed as an odontogenic carcinoma (in situ) arising from the dentigerous cyst. Postoperative ultrasonography (US) and contrast enhanced CT revealed no metastasis to the cervical lymph nodes. The patient is currently being followed up without resection or anticancer drug administration. Neither local recurrence nor metastases were observed 18 month after surgery.症例は75歳男性で、右上顎前歯の舌部不快感を主訴として受診した。パノラマX線撮影とCT検査により含歯性嚢胞、角化細胞歯原性腫瘍またはエナメル上皮腫が疑われた。切除切片の病理組織学的検査の結果、含歯性嚢胞より生じた歯原性癌腫と診断した。術後超音波検査と造影増強CT画像では頸部リンパ節への転移は見られなかった。抗癌剤投与はせずに経過観察中で、術後18ヵ月時点で再発や転移は見られていない。含歯性嚢胞より生じる悪性腫瘍は2005年のWHO分類によれば歯原性嚢胞由来の原発性扁平上皮癌または歯原性癌腫に分類され、極めて稀である。本症例は右上顎前歯の含歯性嚢胞より生じた悪性腫瘍であった。他の症例についても文献レビューした

Systemic diseases and periodontal disease.

歯周病と全身疾患との相互関係を構築する研究分野は,ペリオドンタルメディシン(periodontal medicine)と総称され,一つの学問体系を確立するに至った.現在まで肥満,糖尿病,心臓血管疾患,骨粗鬆症,誤嚥性肺炎,早産･低体重児出産などと歯周病との関係が報告され,20年になろうとしている.さまざまなエビデンスが提供されるとともに,近年では新たに悪性腫瘍やアルツハイマー病といった老年病との関連も登場し,研究領域の広がりをみせると同時に,若干の混乱も生じている.そこで,本稿では歯周病と腎臓疾患との関連を含めたペリオドンタルメディシンの現状整理を行い,解説する

日本人成人におけるパノラマX線写真上の下顎皮質骨と海綿骨構造との関係：コーンビームCTによる分析

Objectives The purpose of this study was to assess the association between the cortical shape of the mandible, as detected on panoramic radiographs, and trabecular bone structure, as assessed by cone-beam computed tomography (CBCT), in Japanese adults. Methods Panoramic radiographs and CBCT images of the mandibles of 50 subjects (18 men, 32 women), aged 45–86 years, were evaluated. An experienced oral and maxillofacial radiologist categorized the cortical shape of the mandible as detected on panoramic radiographs as normal, mildly to moderately eroded, and severely eroded cortices, respectively. All mandibles were scanned using CBCT. Four bone structure parameters of the basal portion of the mandible were calculated in three dimensions using an image-analysis system: total bone volume (mm3); cortical bone volume fraction (%); trabecular bone volume fraction (%); fractal dimension. One-way analysis of covariance with Bonferroni correction was employed to evaluate differences in the four bone parameters among the three cortical shape groups. Pearson’s correlation coefficient was calculated to examine correlations between age and cortical and trabecular bone volume fractions.Results Progression of cortical bone erosion was significantly associated with increased trabecular bone volume fraction (P\0.001) and increased fractal dimension(P = 0.01). Cortical bone volume fraction decreased significantly with age (P = 0.04). However, trabecular bone volume fraction tended to increase with age (P = 0.06). Conclusions The change in the trabecular bone structure of the mandible may differ from that of the general skeleton in Japanese adults.2013博士（歯学）松本歯科大

The effect of periodontal treatment for atherosclerotic indicator:cardio ankle vascular index(CAVI)

Independent from hyperlipidemia, hypertension, diabetes mellitus, smoking, a classical risk factor for arteriosclerosis, it has been shown that various types of chronic inflammationmay be involved in the development of arteriosclerosis. As a chronic inflammation, theprevalence rate of periodontal disease is reported to be about 80% at the age of 30 to 50years, and about ₉0% at the age of 60ʼs. In this study, cardio ankle vascular index (CAVI),a vascular function test, was measured as an indicator of arteriosclerosis before and aftertreatment of periodontal disease. As a result, it was revealed that CAVI statistically significantly decreased by treatment of periodontal disease. Further studies are needed in th

Comprehensive analysis including the nutritional point of view on the pathogenesis of periodontal disease

To clarify risk factors for periodontal disease from the viewpoints of physiology, blood biochemistry, and nutrition, a survey involving 364 persons (224 males, 140 females) who consulted the Medical Examination Center of Matsumoto Dental University Hospital was conducted. The pathogenesis of periodontal disease was investigated using the maximum Community Periodontal Index (CPI) and Attachment Loss (AL) values, and their distributions with respect to the sex were analyzed using Wilcoxonʼs rank sum test. Based on the CPI and AL values, the subjects were divided into 3 groups: healthy (0), mild (1–2), and severe (3–4). The mean values obtained from the physiological, dental, blood biochemical, and nutritional findings in the 3 groups were analyzed using the multiple comparison test. Furthermore, their distributions with respect to sex and smoking in the 3 groups were analyzed using Fisherʼs direct probability test. A p–value of 0.05 was regarded as significant. Factors influencing the CPI included the sex (male), body mass index (BMI), abdominal circumference, diastolic blood pressure, AL, alanine aminotransferase (ALT), fasting blood glucose, neutral fat, HDL cholesterol, and smoking. Factors influencing the AL included the sex (male), age, current number of teeth, CPI, lipid intake, manganese intake, vitamin C intake, monounsaturated fatty acid intake, polyunsaturated fatty acid intake, n–6 fatty acid intake, fruit intake, and smoking. The results suggest that the physiological, blood biochemical, and nutritional states are involved in the pathogenesis of periodontal disease. The CPI was associated with metabolic error in the presence of metabolic syndrome. There was an association between the AL and diet as an environmental factor

Sardine procalcitonin amino-terminal cleavage peptide has a different action from calcitonin and promotes osteoblastic activity in the scales of goldfish

The nucleotide sequence of a sardine preprocalcitonin precursor has been determined from their ultimobranchial glands in the present study. From our analysis of this sequence, we found that sardine procalcitonin was composed of procalcitonin amino-terminal cleavage peptide (N-proCT) (53 amino acids), CT (32 amino acids), and procalcitonin carboxyl-terminal cleavage peptide (C-proCT) (18 amino acids). As compared with C-proCT, N-proCT has been highly conserved among teleosts, reptiles, and birds, which suggests that N-proCT has some bioactivities. Therefore, both sardine N-proCT and sardine CT were synthesized, and their bioactivities for osteoblasts and osteoclasts were examined using our assay system with goldfish scales that consisted of osteoblasts and osteoclasts. As a result, sardine N-proCT (10− 7 M) activated osteoblastic marker enzyme activity, while sardine CT did not change. On the other hand, sardine CT (10− 9 to 10− 7 M) suppressed osteoclastic marker enzyme activity, although sardine N-proCT did not influence enzyme activity. Furthermore, the mRNA expressions of osteoblastic markers such as type 1 collagen and osteocalcin were also promoted by sardine N-proCT (10− 7 M) treatment; however, sardine CT did not influence their expressions. The osteoblastic effects of N-proCT lack agreement. In the present study, we can evaluate exactly the action for osteoblasts because our scale assay system is very sensitive and it is a co-culture system for osteoblasts and osteoclasts with calcified bone matrix. Both CT and N-proCT seem to influence osteoblasts and osteoclasts and promote bone formation by different actions in teleosts. © 2017 Elsevier Inc.Embargo Period 12 month

Successful conservative treatment of anti–resorptive agent–related osteonecrosis of the jaw in a patient with multiple myeloma:A case report

Summary.Bone resorption inhibitors,such as bisphosphonates and denosumab,are widely used to treat bone lesions caused by disorders of bone metabolism,multiple myeloma,and bone metastases from solid tumors,and the occurrence of antiresorptive agentrelated osteonecrosis of the jaw (ARONJ) is increasing.Currently,surgical treatment is recommended;however,case reports are sparse and there is no established global consensus on treatment.We report the case of a 75–year–old female patient with osteonecrosis of the mandible following bisphosphonate administration for the treatment of multiple myeloma,who was cured by conservative treatment alone.The patient had multiple myeloma and,therefore,had been receiving bisphosphonates for about 24 months prior to her first visit to Matsumoto Dental University Hospital.During periodontal treatment,the patient underwent extraction of the left mandibular wisdom tooth.About 6 months later,bone exposure was observed in the same area,and coexisting osteomyelitis of the jaw was diagnosed.Conservative treatment involving oral hygiene instructions,several doses of antibacterial agents,and frequent rinses was chosen for the bone exposure.About 6 months after the start of such treatment,the decayed bone had disappeared,and after 7 months,the mucosa had completely sealed.Disappearance of the findings of osteomyelitis was assessed by MRI.The infection tended to spread during the clinical course of the disease,but improved with conservative treatment alone,and the exposed area of bone has since epithelialized.We reaffirmed the importance of collaboration and sharing information on the medical history and medications between physicians and dentists while treating patients with primary diseases indicated for bisphosphonates

Oral hygiene instruction based on visual caries risk was effective to reduce salivary SM bacteria levels: A case report

Summary In this case, a high dental caries risk was identified in the initial examination was initiated to reduce and dental plaque control SM bacteria levels in saliva. The effect of reducing SM bacteria levels in saliva was confirmed, and this effect continued even after 6 months. It was suggested that dental plaque control using visual materials such as specific guidance on tooth surface cleaning methods, phase-contrast microscopy, and SM bacteria culture results was effective to maintain patient motivation. It was found that this method has a marked effect not only on grasping the test values but also on the motivation of the patient

Treatment of OPG-deficient mice with WP9QY, a RANKL-binding peptide, recovers alveolar bone loss by suppressing osteoclastogenesis and enhancing osteoblastogenesis.

Osteoblasts express two key molecules for osteoclast differentiation, receptor activator of NF-κB ligand (RANKL) and osteoprotegerin (OPG), a soluble decoy receptor for RANKL. RANKL induces osteoclastogenesis, while OPG inhibits it by blocking the binding of RANKL to RANK, a cellular receptor of RANKL. OPG-deficient (OPG–/–) mice exhibit severe alveolar bone loss with enhanced bone resorption. WP9QY (W9) peptide binds to RANKL and blocks RANKL-induced osteoclastogenesis. W9 is also reported to stimulate bone formation in vivo. Here, we show that treatment with W9 restores alveolar bone loss in OPG–/–mice by suppressing osteoclastogenesis and enhancing osteoblastogenesis. Administration of W9 or risedronate, a bisphosphonate, to OPG–/–mice significantly decreased the osteoclast number in the alveolar bone. Interestingly, treatment with W9, but not risedronate, enhanced Wnt/β-catenin signaling and induced alveolar bone formation in OPG–/–mice. Expression of sclerostin, an inhibitor of Wnt/β-catenin signaling, was significantly lower in tibiae of OPG–/–mice than in wild-type mice. Treatment with risedronate recovered sclerostin expression in OPG–/–mice, while W9 treatment further suppressed sclerostin expression. Histomorphometric analysis confirmed that bone formation-related parameters in OPG–/–mice, such as osteoblast number, osteoblast surface and osteoid surface, were increased by W9 administration but not by risedronate administration. These results suggest that treatment of OPG–/–mice with W9 suppressed osteoclastogenesis by inhibiting RANKL signaling and enhanced osteoblastogenesis by attenuating sclerostin expression in the alveolar bone. Taken together, W9 may be a useful drug to prevent alveolar bone loss in periodontitis

Seismic exploration at Fuji volcano with active sources : The outline of the experiment and the arrival time data

Fuji volcano (altitude 3,776m) is the largest basaltic stratovolcano in Japan. In late August and early September 2003, seismic exploration was conducted around Fuji volcano by the detonation of 500 kg charges of dynamite to investigate the seismic structure of that area. Seismographs with an eigenfrequency of 2 Hz were used for observation, positioned along a WSW-ENE line passing through the summit of the mountain. A total of 469 seismic stations were installed at intervals of 250-500 m. The data were stored in memory on-site using data loggers. The sampling interval was 4 ms. Charges were detonated at 5 points, one at each end of the observation line and 3 along its length. The first arrival times and the later-phase arrival times at each station for each detonation were recorded as data. P-wave velocities in the surface layer were estimated from the travel time curves near the explosion points, with results of 2.5 km/s obtained for the vicinity of Fuji volcano and 4.0 km5/s elsewhere