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Objectives To elucidate whether fluorine-18-labeled ( 18 F) fluoro-2-deoxy- d -glucose (FDG) accumulation can reflect the extent of periodontal inflammation, periapical inflammation, or dental caries. Study Design 18 F-FDG accumulations on positron emission tomography (PET)-computed tomography (CT) were retrospectively compared with the size of the bone resorption areas caused by periodontal inflammation, periapical inflammation, or dental caries on panoramic radiographs, CT, and magnetic resonance imaging (MRI) in 44 subjects. Results A significant correlation was found between the size of the bone resorption area caused by periodontal ( r = 0.595, P r = 0.560, P 18 F-FDG accumulation. A significant correlation was found between the periodontal ( r = 0.622, P r = 0.394, P 18 F-FDG accumulation. The SUVmax of 18 F-FDG around most teeth with caries was under 1.5. Conclusions 18 F-FDG accumulation reflects the extent of dental inflammation, not dental caries.

医療現場における口腔ケアと摂食・嚥下リハビリテーション（以下，摂食嚥下リハ）の現状と課題を把握し，この分野で貢献するべき人材を育成するための教育プログラムを構築することを視野に入れ，アンケート調査を実施した．調査は平成18年（以下，今回）に，福岡県内の病院，高齢者・障害者施設（以下，施設）および歯科医院を対象として行われた．必要に応じて平成16年（以下，前回）に病院と施設において実施された同様の調査と比較，検討した．今回の調査では病院と保健施設の，それぞれ95.1%，94.9%が口腔ケアを，73.2%，23.3%が摂食嚥下リハを実施していると回答した．また，前回の調査と比べ，口腔ケア担当者の職種として第一位は看護師であったがその割合は減少し，より口腔領域の専門性が高い歯科医師，歯科衛生士，言語聴覚士などの割合が増加していた．一方，摂食嚥下リハにおいては，より多くの医療職が関与して実施されているとの回答が得られた．この結果は，摂食嚥下リハにおけるチーム医療によって実施されていることを反映したものと考えられた．口腔ケアおよび摂食嚥下リハに携わる人材には，「口腔機能管理における専門的知識と技術」と「高齢者に対する知識や介護技術」，ついで「栄養学的知識の習得」の知識と技術が求められた．高齢社会に対応できる口腔保健の専門家が求められると同時に，チーム医療，とくに栄養補給チームの一員として貢献できる人材が求められていると考えられた．以上のことから，口腔ケアと摂食嚥下リハを担当する口腔保健の専門家（とくに歯科衛生士）には，口腔機能管理における専門的知識と技術のみならず，社会的ニーズに伴う高齢者に対する知識や技術，他の医療職との連携がさらに重要になる将来的医療環境に対応できる知識（とくに栄養学的知識）を習得させる教育プログラムが必要であると考えられた．

広汎型侵襲性歯周炎は，歯周炎を除き全身的に健康ではあるが，急速な歯周組織破壊，家族内発現を認めることを特徴とする歯周炎である。本報では，広汎型侵襲性歯周炎と診断された患者に対して，歯周外科，歯周再生療法，歯移植および歯科矯正治療を含めた包括的な治療を行った。患者は21歳の女性で，下顎前歯部の動揺，歯肉の発赤腫脹を主訴に来院した。臨床診査およびX線診査によって，高度なアタッチメントロスと歯槽骨の吸収が多くの部位で認められた。家族歴として，父方叔父が壮年の早い時期から総義歯であったこと，母方従兄弟が患者と同年代で同様な症状を示していた。歯周基本治療終了後臼歯部において歯周外科を行った，その際上顎右側第一大臼歯は抜歯し，同側第三大臼歯を移植した，また上下顎左側臼歯部においてはエナメルマトリックスデリバティブ(EMD)を応用した。その後上顎に歯科矯正治療を行い最終補綴処置を行った。その結果，歯周組織の良好な改善が認められた。術後4年間のメインテナンスを行っているが経過は良好である。

本研究は, 実験的歯周炎によって垂直挺出した歯に対し, ルートプレーニング (RP) が垂直的な歯の変位にどのような影響を及ぼすかを検討した。雄のビーグル成犬8頭の下顎左右第三前臼歯 (P3) に生活歯髄切断法を行った後, レジンキャップを装着した。下顎左右第二, 第四前臼歯に, 歯の垂直挺出量を測定するために計測用ステントを装着した。さらに, 頬舌側の圧の排徐するための装置を計測時以外に下顎左右P3に装着した。炎症群は, 4頭の下顎左側P3を用い, デンタルフロスの結紮を12週間継続した。RP群は, 4頭の下顎左側P3を用い, デンタルフロスの結紮を4週間継続した後, 4・5週目に麻酔下にてRPを行った。並行して, 週3回のTooth cleaningを行った。対照群 (炎症側, RP側の反対側の下顎右側P3) は, 週3回のTooth cleaningを12週間行った。歯の垂直挺出量の測定は, 精密印象採得によって1週間毎に行った。同時に臨床パラメータは, Probing Pocket Depth (PPD), Probing Attachment Level (PAL), 動揺度 (TM), 歯肉溝滲出液 (GCF) の測定も行った。その結果,1. 炎症群, RP群では, 実験期間中, 歯の垂直挺出が認められた。2. RP群では, RP直後に炎症群と同程度の歯の垂直挺出が認められ, 約2週経過すると, 垂直挺出量は低下した。3. RP群におけるPAL, TMは, RP直後一時的に値が増加を示したが, 約2週経過すると, PAL, TMとも炎症群に比較して有意に改善した。PPD, GCFは, RPを行うと数値が減少した。以上より, 炎症の程度とRPは, 歯の挺出に影響することが示唆された。

This study evaluated bone and cementum regeneration following periodontal reconstructive surgery using recombinant human bone morphogenetic protein-2 (rhBMP-2) in six beagle dogs. Surgically created mandibular supraalveolar premolar tooth defects in contralateral jaw quadrants were randomly assigned to receive rhBMP-2 or control vehicle. Clinical defect height was prepared to 5 mm. rhBMP-2 was applied with synthetic bioerodable particles and autologous blood using 20 micrograms rhBMP-2 per 100 microliters implant volume. Flaps were advanced to submerge the teeth and sutured. The dogs were sacrificed 8 weeks postsurgery. Histometric recordings included defect height, height and area of alveolar bone regeneration, height of cementum regeneration, root resorption, and ankylosis. Group means, standard deviations, and P values are shown (Student t test; n = 6). Histometric defect height for rhBMP-2 and control defects was 3.7 +/- 0.3 and 3.9 +/- 0.4 mm, respectively (P = 0.446). Height of alveolar bone regeneration amounted to 3.5 +/- 0.6 and 0.8 +/- 0.6 mm for rhBMP-2 and control defects, respectively (P = 0.000). Corresponding values for bone area were 8.4 +/- 4.5 and 0.4 +/- 0.5 mm2, respectively (P = 0.006). Cementum regeneration was observed in all experimental defects (17/17) and in 15 out of 17 controls, averaging 1.6 +/- 0.6 and 0.4 +/- 0.3 mm for rhBMP-2 and control defects, respectively (P = 0.005). Small amounts of root resorption were seen in rhBMP-2 defects, whereas controls exhibited substantial resorption (0.2 +/- 0.1 and 1.1 +/- 0.3 mm, respectively; P = 0.001).(ABSTRACT TRUNCATED AT 250 WORDS)

To elucidate whether fluorine-18-labeled ((18)F) fluoro-2-deoxy-d-glucose (FDG) accumulation can reflect the extent of periodontal inflammation, periapical inflammation, or dental caries.(18)F-FDG accumulations on positron emission tomography (PET)-computed tomography (CT) were retrospectively compared with the size of the bone resorption areas caused by periodontal inflammation, periapical inflammation, or dental caries on panoramic radiographs, CT, and magnetic resonance imaging (MRI) in 44 subjects.A significant correlation was found between the size of the bone resorption area caused by periodontal (r = 0.595, P.01) or periapical (r = 0.560, P.01) inflammation and the highest standardized uptake value (SUVmax) of (18)F-FDG accumulation. A significant correlation was found between the periodontal (r = 0.622, P.01) or periapical (r = 0.394, P.01) inflammatory findings on MRI and the SUVmax of (18)F-FDG accumulation. The SUVmax of (18)F-FDG around most teeth with caries was under 1.5.(18)F-FDG accumulation reflects the extent of dental inflammation, not dental caries.

One endpoint of periodontal therapy is to regenerate structure lost to periodontal disease. Periodontal regeneration requires both formation of a new connective tissue attachment to the tooth and formation of alveolar bone. Several procedural advances may support regeneration of the attachment, however, regeneration of alveolar bone does not occur consistently. Therefore, factors which stimulate bone repair are areas for research in periodontal reconstructive therapy. Effects of cytokines or growth factors on bone repair are examples of such areas. Another one is electrical stimulation which naturally occurs in bone, and as-such bone may be particularly susceptible to electrical therapy. This overview describes the potential of electrical stimulation for bone regeneration and applications in alveolar and periodontal research. J Periodontol 1995;66:2–6.

Since Yasudea observated that a small amout of electricity stimulates osteogenesis in 1953, this original concept has been verified and considerably expanded by many investigators. We have determined the direct electric currents of 10 microamperes stimulates the bone remodeling and osseous callus formation in the alveolar bone and mandible. This study designed to determine the effect of direct electrical stimulation on new cementum formation during the periodontal wound healing.In three adult mongrel dogs, two pairs of surgical bony defects were made bilateraly in the mandible. A pair of defects was constituted of the cathodic defect between the second premolar and third premolar, and the anodic defect between the third and fourth premolar. The electrodes were stainless wires 0.7 milimeter in diameter, insulated by Teflon tube without one milimeter from top ends, netted in the bottom wall of bony defects on each side of the mandible. A pair of electordes on the left side connected to the implantable power pack unit for the delivery of a constant, continuous direct currents of 10 microamperes, that was constituted of a dual FET, a resister and silver oxide battery.Evalution of the dynamics of appositional cementum was facilitated by the subcutaneous administration of oxytetracycline, that began on Day 15 of the experiental period with the use of a schedule of 3 days on, 7 days off, and 3 days on. The dosage was 200mg/day.Not-stained bony sections (100 microns) were horizontally cutted, and were viewed under the fluorescence microscope. Morphometric measurements were performed with the Nikon's eyepiece type micrometer and the Zeiss's integrating disk type II. We measured 5 cross-sections of the each side of the mandible. The following 5 parameters were measured on 4 quadrants of each root, distal root of the second premolar, mesial root of the third premolar, distal root of the third premolar and mesial root of the fourth premolar.1) Mean ratio of Tc labeled surface to root surface (%)2) Mean ratio of Tc double labeled surface to root surface (%)3) Mean thickness of labeled cementum (μm)4) Mean appositional rate of cementum (μm/day)5) Mean width of periodontal ligament (μm)The ratio of labled surface and double labeled surface were higher valure in cahtode than control site, and not different in anode, in all quadrants. The appositional rate and thickness of the cementum were higher value in cathode and anode than control in all quadrants. The width of periodontal ligament was not different between the electrical stimulated site and control, and was larger value in A quadrant in that new bone formation. The direct electric currents stimulated the cementum formation on root, and expanded the adaptive area, and accelated the adaptive speed in this process.

This study was designed to investigate the effect on new attachment formation using a biodegradable membrane as a barrier to the regeneration of periodontal tissue. One-wall wide periodontal osseous defects with exposed root surfaces were prepared in three adult mongrel dogs. After surgical debridement of the periodontal defects, 3 types of biodegradable membranes, [Poly(L-lactic acid); (P-L-LA)] membrane, [Poly(lactic acid-co-glycolic acid); (PLGA)] (81: 19 mole%) membrane and PLGA (50: 50 mole%) membrane, were arranged to cover the denuded root surfaces. Specimen blocks were removed 8 weeks postoperatively for histological evaluation of their effect on the regeneration of periodontal tissue. The results were as follows: 1. Gingival regions containing P-L-LA or PLGA (81: 19 mole%) membranes showed delayed wound healing macroscopically. 2. Almost all P-L-LA membranes were present in the experimental sites failing to be resorbed during the 8-week experimental period. PLGA (81: 19 mole%) membranes were also present but showed with some degree of resorption and fragility, while PLGA (50: 50 mole%) membranes were completely resorbed. 3. This showed that the membranes used in this experiment are possible barriers to the generation of new attachment. It is important to make sure keeping the membrane. 4. There was no relationship between osteogenesis and cementogenesis. It seems that osteogenesis was depressed by membrane shrinkage and the gingival pressure which limited "the regenerative space of bone." 5. Moderate resorption was observed on the root surface, and new cementum was formed at the resorbed surface. 6. Ankylosis was observed between the new cementum and bone at the experimental sites. Newly formed cementum was seen on coronal sections of this area.