下顎大臼歯欠損症例における小臼歯歯周組織の応力と歪みの分析

The purpose of this study was to investigate the stress/strain distributions around the mandibular premolar teeth in patients with loss of molar support. Subjects included female patients with loss of bilateral mandibular molar teeth that were restored with removable dentures (n=7, age from 51 to 69) and controls with complete dentition (n=7, age from 50 to 68). Occlusal contacts and bite forces were recorded under the maximum clenching with and without denture wearing. Finite element model of the mandibular first and second premolar teeth, periodontal ligament and bone was constructed for each patient based on radiographs and study models. The bite forces were applied on corresponding locations in the models to calculate the stress/strain of the periodontium. The forces, the maximum strain and stress of the molar loss group ranged widely among subjects, but they were all significantly higher than those of control group (p<0.05), and they were not prevented by denture wearing. Three subjects demonstrated high compressive cortical bone strain exceeding the estimated threshold of micro-damage of bone. The results suggest that the periodontium of the most posteriorly-located occluding premolars may become sensitive to bilateral loss of molar support if patients exhibit higher maximum bite forces

Effect of Surface Treatment of Multi-Directionally Forged (MDF) Titanium Implant on Bone Response

Multi-directional forging (MDFing) of titanium drastically improved its mechanical properties due to the evolution of an ultrafine-grained structure. Forging strain was repeatedly applied while changing the forging axis during MDFing. Of note is the decreased elastic modulus of MDFed titanium (MDF-Ti) as compared to conventional coarse-grained pure Ti (Ti). In the present study, we evaluated bone&rsquo;s response toward surface-treated MDF-Ti after implantation into the extraction sockets of rat maxillary molars. As surface treatments, acid (Acid, sulfuric acid at 120 &deg;C for 75 s), alkali without post-heat (Alkali, NaOH at 60 &deg;C for 24 h), and alkali with post-heat (Alkali-heat, subsequent heating at 600 &deg;C for 1 h) treatments were employed. The presence of minute nanoscale dimples in the microscale dimples to form regular fractal structures on MDF-Ti surfaces was observed after Acid treatments. Structures of sponge-like porous networks after Alkali treatments and submicron fiber networks after Alkali-heat treatment were produced on the surfaces of both Ti and MDF-Ti. Surface-treated specimens were superhydrophilic. More crystal deposition was clearly observed on each surface-treated specimen after immersion in simulated body fluid for both Ti and MDF-Ti. The bone-to-implant contact (BIC) ratios of the Acid and Alkali-heat specimens were significantly higher than those of the untreated control (p &lt; 0.05). Moreover, Acid and Alkali-heat treatment for MDF-Ti caused significantly greater BICs than that for Ti (p &lt; 0.05). In conclusion, Acid or Alkali-heat treatment of MDF-Ti is useful for improving bone response

Dose constraints in the rectum and bladder following carbon-ion radiotherapy for uterus carcinoma: a retrospective pooled analysis

Abstract Background Carbon-ion radiotherapy (C-ion RT) provides better dose distribution in cancer treatment compared to photons. Additionally, carbon-ion beams provide a higher biological effectiveness, and thus a higher tumor control probability. However, information regarding the dose constraints for organs at risk in C-ion RT is limited. This study aimed to determine the predictive factors for late morbidities in the rectum and bladder after carbon-ion C-ion RT for uterus carcinomas. Methods Between June 1995 and January 2010, 134 patients with uterus carcinomas were treated with C-ion RT with curative intent; prescription doses of 52.8–74.4 Gy (relative biological effectiveness) were delivered in 20–24 fractions. Of these patients, 132 who were followed up for > 6 months were analyzed. We separated the data in two subgroups, a 24 fractions group and a 20 fractions group. Late morbidities, proctitis, and cystitis were assessed according to the Radiation Therapy Oncology Group/European Organisation for Research and Treatment of Cancer criteria. The correlations of clinical and dosimetric parameters, V10–V60, D5cc, D2cc, and Dmax, with the incidence of ≥grade 1 morbidities were retrospectively analyzed. Results In the 24 fractions group, the 3-year actuarial occurrence rates of ≥grade 1 rectal and bladder morbidities were 64 and 9%, respectively. In addition, in the 20 fractions group, the 3-year actuarial occurrence rates of ≥grade 1 rectal and bladder morbidities were 32 and 19%, respectively. Regarding the dose–volume histogram data on the rectum, the D5cc and D2cc were significantly higher in patients with ≥grade 1 proctitis than in those without morbidity. In addition, the D5cc for the bladder was significantly higher in patients with ≥grade 1 cystitis than in those without morbidity. Results of univariate analyses showed that D2cc of the rectum was correlated with the development of ≥grade 1 late proctitis. Moreover, D5cc of the bladder was correlated with the development of ≥grade 1 late cystitis. Conclusions The present study identified the dose–volume relationships in C-ion RT regarding the occurrence of late morbidities in the rectum and bladder. Assessment of the factors discussed herein would be beneficial in preventing late morbidities after C-ion RT for pelvic malignancies. Trial registration Retrospectively registered (NIRS: 16–040)

Dose constraints in the rectum and bladder following carbon-ion radiotherapy for uterus carcinoma: a retrospective pooled analysis.

Carbon-ion radiotherapy (C-ion RT) provides better dose distribution in cancer treatment compared to photons. Additionally, carbon-ion beams provide a higher biological effectiveness, and thus a higher tumor control probability. However, information regarding the dose constraints for organs at risk in C-ion RT is limited. This study aimed to determine the predictive factors for late morbidities in the rectum and bladder after carbon-ion C-ion RT for uterus carcinomas

Intensity-Modulated Radiation Therapy with Simultaneous Integrated Boost for Clinically Node-Positive Prostate Cancer: A Single-Institutional Retrospective Study.

This study aimed to evaluate clinical outcomes and the toxicity of intensity-modulated radiation therapy with simultaneous integrated boost (SIB-IMRT) combined with androgen-deprivation therapy for clinically node-positive (cN1) prostate cancer. We retrospectively analyzed 97 patients with cN1 prostate cancer who received SIB-IMRT between June 2008 and October 2017 at our hospital. The prescribed dosages delivered to the prostate and seminal vesicle, elective node area, and residual lymph nodes were 69, 54, and 60 Gy in 30 fractions, respectively. Kaplan-Meier analysis was used to determine 5-year biochemical relapse-free survival (bRFS), relapse-free survival (RFS), overall survival (OS), and prostate cancer-specific survival (PCSS). Toxicity was evaluated using the Common Terminology Criteria for Adverse Events ver. 4.0. Over a median follow-up duration of 60 months, the 5-year bRFS, RFS, OS, and PCSS were 85.1%, 88.1%, 92.7% and 95.0%, respectively. Acute Grade 2 genito-urinary (GU) and gastro-intestinal (GI) toxicities were observed in 10.2% and 2.1%, respectively, with no grade ≥3 toxicities being detected. The cumulative incidence rates of 5-year Grade ≥2 late GU and GI toxicities were 4.7% and 7.4%, respectively, with no Grade 4 toxicities being detected. SIB-IMRT for cN1 prostate cancer demonstrated favorable 5-year outcomes with low incidences of toxicity

In-room computed tomography-based brachytherapy for uterine cervical cancer: results of a 5-year retrospective study.

Herein, we investigate the long-term clinical outcomes for cervical cancer patients treated with in-room computed tomography-based brachytherapy. Eighty patients with Stage IB1-IVA cervical cancer, who had undergone treatment with combined 3D high-dose rate brachytherapy and conformal radiotherapy between October 2008 and May 2011, were retrospectively analyzed. External beam radiotherapy (50 Gy) with central shielding after 20-40 Gy was performed for each patient. Cisplatin-based chemotherapy was administered concurrently to advanced-stage patients aged ≤75 years. Brachytherapy was delivered in four fractions of 6 Gy per week. In-room computed tomography imaging with applicator insertion was performed for treatment planning. Information from physical examinations at diagnosis, and brachytherapy and magnetic resonance imaging at diagnosis and just before the first brachytherapy session, were referred to for contouring of the high-risk clinical target volume. The median follow-up duration was 60 months. The 5-year local control, pelvic progression-free survival and overall survival rates were 94%, 90% and 86%, respectively. No significant differences in 5-year local control rates were observed between Stage I, Stage II and Stage III-IVA patients. Conversely, a significant difference in the 5-year overall survival rate was observed between Stage II and III-IVA patients (97% vs 72%; P = 0.006). One patient developed Grade 3 late bladder toxicity. No other Grade 3 or higher late toxicities were reported in the rectum or bladder. In conclusion, excellent local control rates were achieved with minimal late toxicities in the rectum or bladder, irrespective of clinical stage