フッカ ジアミンシリケート オ リヨウ シタ ゾウゲシツ チカク カビンショウ チリョウホウ ノ カイハツ

Dentin hypersensitivity is a common disease, the incidence is approximately 30% in the general population. However, knowledge is limited regarding the etiology of dentin hypersensitivity, and there is no consistent treatment method. Therefore, relationship between the etiology of dentin hypersensitivity and condition of plaque control was evaluated in vivo using the vital teeth of dogs. In the plaque control group, the average diameter of dentin tubules decreased over time. In contrast, the diameter of the dentin tubules increased in the non-plaque control group. These results demonstrate that the spontaneous recovery of hypersensitive teeth would be expected if proper plaque control is carried out. Therefore, it was concluded that plaque control plays a key role in the etiology of dentin hypersensitivity, as in the prevention of dental caries. From the above results, an ideal treatment method for dentin hypersensitivity seems to be to occlude dentin tubules with a calcium phosphate similar to natural calcification at the tooth surface by mineral deposition from saliva. Ammonium hexafluorosilicate [SiF: (NH4)2SiF6] solution was prepared to overcome the defect of diamine silver fluoride. Dentin tubules after SiF treatment were completely occluded with the silica-calcium phosphate precipitate, similar to natural remineralization; therefore, SiF treatment is useful for the treatment of dentin hypersensitivity. In addition, SiF treatment significantly increased acid resistance and improved the crystallinity in both enamel and dentin. It is concluded that SiF treatment is useful for the prevention of dental caries as well as dentin hypersensitivity

ゾウゲシツ チカク カビンショウ ノ ビョウタイ ト チリョウホウ

The prevalence of dentin hypersensitivity ranges from 4 to 74%, and approximately 20-30% adults patient have complaints such as cold, air, and tactile pain. The pathogenesis of dentin hypersensitivity and pain transmission system in teeth are still unclear. The hydrodynamic theory is widely accepted as a mechanism to explain tooth pain. Many open dentinal tubules exist at the surface of hypersensitive teeth. In contrast, most dentinal tubules are occluded with minerals in nonhypersensitive teeth. Therefore, the treatment method for dentin hypersensitivity aims to occlude open dentinal tubules and reduce fluid flow within the tubules. Several treatment methods have been developed and applied to hypersensitive teeth, such as desensitizing agents, resins, and lasers. The representative treatment method to occlude open dentinal tubules with inorganic materials is applying potassium oxalate. Unfortunately, the duration of potassium oxalate occlusion was reported to be relatively short-lived in the oral environment. Aside from inorganic materials, several organic materials (e.g. / resin) for coating the dentin surface have recently been commercialized. Resin materials can seal not only at the dentin surface but also deep in the dentinal tubules. In addition, several kinds of dental laser have recently been used for the treatment of dentin hypersensitivity. The action mechanism of lasers in dentin hypersensitivity is still not clearly understood, although some clinical studies have reported the effectiveness of laser therapy. However, no consistent treatment regimen has been established for dentin hypersensitivity; therefore, we should choose the optimum therapy after understanding the characteristics of each treatment method

ニホン ダイガク マツド シガクブ リンショウ ジッシュウ シサツ ホウコク

Clinical training inspection at Nihon University School of Dentistry at Matsudo was carried out on February 15, 2013, and useful information for clinical training was collected. The clinical training begins in April of the fifth grade, and it ends in June of the sixth grade. The patients are handed over from sixth- to fifth-year students in pair-policlinic training, which is carried out in the first month of clinical training. The number of patients is approximately 20 per student. Objective structured clinical achievement tests (OSCAT) are conducted at a later stage of the fifth grade, and subjects of OSCAT perform a medical interview, composite resin filling, root canal therapy, SRP, muscle trimming, tooth extraction, and vital sign checks. OSCAT is carried out in the testing time from 4 to 20 minutes. Subjects which are difficult to evaluate with such a practical test such as case analysis and treatment strategy development are tested by the written examinations. We are discussing the adoption of OSCAT at the end of the clinical training in our university, serving as a useful and helpful reference. The clinical training is completed by June of the sixth grade, and then classroom lectures are started to prepare for the graduation examination with multiple choice questions (MCQ) in December

ニホン シカ ダイガク リンショウ ジッシュウ シサツ ホウコク

We made a field trip to Nippon Dental University Hospital to observe its clinical training practices on February 16, 2011. Distinctive features of the clinical training system were as follows. 1) Clinical training is given to fifth-year students. Students in the sixth-year are intent on their studies. 2) There is a one-month overlap in the training periods between these two groups, as patients are handed over from the fifth- to the fourth-year students. This handover is a student-led event. 3) After this period, pre-clinical training is given to the fifth-year students for three months, and then clinical training begins. 4) Patients are requested to evaluate and give feedback to the students treating them. Each student should receive five or more evaluations. 5) A mentor system was introduced in 2005. According to our findings and the results of the“ World Café” held on the same day with trainee dentists and fifth-year students, we identified the following means of improving our clinical training system. First, students under clinical training are now permitted to participate in case-report conferences of trainee dentists, as of 2011. This program was introduced based on the concept of top-down processing to help students form perceptions about cases and treatment. Second, the necessity of a faculty-development program focused on clinical training is recognized, to standardize and improve the guidance given to students by advising doctors. Third, the mentor system and the“ World Café” need more attention as elements of clinical training to support students and motivate improvement

先天性血友病患者の移行期の実態

【Introduction】Congenital hemophilia is a category of hemorrhagic disease caused by a genetic defect in the production of coagulation factors. It is treated by administering regular coagulation factor injections on an ongoing basis. Hemophilia is a hereditary illness, often causing social and psychological problems as a result of the disease. To analyze the objective effects of hemophilia, we conducted a retrospective analysis in Tokushima University Hospital. 【Result】All ２３ cases were men between the ages of２０and７２. Hemophilia A was present in１７cases, and hemophilia B was present in six. Nineteen out of ２３ cases were severe, and the others were intermediate. Medical assessments were conducted at pediatrics in seven cases and hematology in １６ cases. Adoption of the self-injection technique was not realized in five cases. Seventeen cases were complicated by hemophilic arthropathy, seven with human immunodeficiency virus（HIV）, and １２ with hepatitis C virus. Eight participants were unemployed, and１７were unmarried. 【Discussion】 Many adult hemophilia patients still visit pediatrics in our hospital. Hemophilia in the period of growth between adolescence and young adulthood is often accompanied by life-altering events such as entering higher education, marriage, and work experience. Therefore, collaboration among professionals of multiple occupations, such as doctors, nurses, pharmacists, medical social workers, and clinical psychologists, is essential. Furthermore, there are many cases of HIV and hepatitis C virus infections complicating hemophilia study due to the stigma surrounding HIV-tainted blood. 【Conclusion】It is imperative that we establish a long-term, sustainable, and multi-disciplinary transitional care and medical support system for patients and their families

HIV感染症およびAIDS患者の臨床的特徴

【Introduction】The survival rate in patients with HIV infection and acquired immunodeficiency syndrome （AIDS） has been improved dramatically due to the advances in anti-HIV drug therapy, while aging-associated complications become a critical issue. The incidence of sudden occurrence of AIDS without prior detection of HIV infection, so called “Ikinari AIDS”, still remains high. 【Objective】We retrospectively analyzed the incidence and clinical characteristics of HIV/AIDS patients in both Tokushima University Hospital and Tokushima Prefectural Central Hospital. 【Results】Eighty four patients （74 males and 10 females） with a median age of 39 years old （range 16 - 85） were enrolled. Thirty-four patients （40.5％） were diagnosed with “Ikinari AIDS” from 2001 to 2020. All 4 patients were diagnosed with “Ikinari AIDS” after 2020. AIDS-defining illnesses were diagnosed as follows ; pneumocystis pneumonia in 21 cases, CMV infection in 8 cases and candidiasis in 6 cases. All patients over 60 years old were suffered from AIDS. Other complications included syphilis in 17 cases, hepatitis B infection in 12 and herpes zoster in 7. 【Discussion/Conclusion】In Tokushima, the incidence rate of “Ikinari AIDS” appeared to be higher than that of national average. COVID - 19 pandemic hampered the public health care services of awareness-raising activity for HIV infection and telephone consultations about HIV, which may become more lease asymptomatic HIV patients without diagnosis. For early diagnosis of HIV/AIDS, it is becoming more important to share information to make early screening of HIV infection among medical staffs, such as medical doctors, dentists, nurses, pharmacists and MSWs

Clinical Key Points of Class II Direct Composite Restoration

Direct composite restorations have been widely accepted as a reliable bonded restorative option to achieve minimal intervention with improved physical properties of resin composite and advancement of adhesive systems. Recently, relatively complicated Class II composite restorations have been more frequently performed because they are esthetically pleasing and easily accepted by patients. In these years, auxiliary instruments such as matrix retainers and wedges for restoring Class II cavities have been enhanced. Using these instruments appropriately brings a promising clinical outcome restoring functions and esthetics of even posterior teeth in Class II cavities. This article will introduce instruments and techniques that can be easily incorporated into daily practice for Class II direct composite restorations, where it is difficult to restore the contact tightness and the anatomy of the proximal surfaces