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Acquiring adequate attached mucosa is important in restoring masticatory function with a removable dental prosthesis or dental implant. In patients with inadequate attached mucosa, a free gingival graft (FGG) with a custom stent is used. However, it is challenging to apply the conventional method for fabricating a stent with a reshaped cast in patients with reconstructed mandibles because the reconstructed mandible has limitations due to a titanium mesh, skin flap, and unique bone morphology. In the present report, we have proposed a new design and fabrication process for a mucocompressive splint via medical engineering to acquire the attached mucosa for the prosthodontic treatment of reconstructed mandibles.Three-dimensional (3D) craniomandibular models were reconstructed from a computed tomography dataset after mandibular reconstruction. The dentition region was replaced with highly precise scan data of the dental casts using a 3D scanner. The alveolar ridge mucosa and teeth were ideally designed using the 3D model while referring to the anatomical structures. The jig used to fabricate the working dental cast with artificial gum in real space was designed and fabricated using a 3D printer. The alveolar ridge was altered into a simulated configuration on the articulator using a jig. A mucocompressive splint was fabricated on an altered dental cast. The splint was immediately seated on the mandible without any major adjustments after the FGG.Adequate attached mucosa for the prosthodontic treatment of a reconstructed mandible was obtained by the pre-surgical fabrication of a mucocompressive splint through medical engineering.

RNA-binding proteins (RBPs) play important roles in the posttranscriptional regulation of gene expression, including mRNA stability, transport and translation. Fission yeast rnc1+ encodes a K Homology (KH)-type RBP, which binds and stabilizes the Pmp1 MAPK phosphatase mRNA thereby suppressing the Cl- hypersensitivity of calcineurin deletion and MAPK signaling mutants. Here, we analyzed the spatial regulation of Rnc1 and discovered a putative nuclear export signal (NES)Rnc1 , which dictates the cytoplasmic localization of Rnc1 in a Crm1-independent manner. Notably, mutations in the NESRnc1 altered nucleocytoplasmic distribution of Rnc1 and abolished its function to suppress calcineurin deletion, although the Rnc1 NES mutant maintains the ability to bind Pmp1 mRNA. Intriguingly, the Rnc1 NES mutant destabilized Pmp1 mRNA, suggesting the functional importance of the Rnc1 cytoplasmic localization. Mutation in Rae1, but not Mex67 deletion or overproduction, induced Rnc1 accumulation in the nucleus, suggesting that Rnc1 is exported from the nucleus to the cytoplasm via the mRNA export pathway involving Rae1. Importantly, mutations in the Rnc1 KH-domains abolished the mRNA-binding ability and induced nuclear localization, suggesting that Rnc1 may be exported from the nucleus together with its target mRNAs. Collectively, the functional Rae1-dependent mRNA export system may influence the cytoplasmic localization and function of Rnc1.

RNA-binding proteins (RBPs) play important roles in the posttranscriptional regulation of gene expression, including mRNA stability, transport and translation. Fission yeast rnc1

The purpose of this present study was to improve student knowledge on the semi-adjustable articulator. Following from the insights provided by Ryan and Deci’s review of Organismic Integration Theory (OIT), we attempted to promote student interest in the semi-adjustable articulator. OIT was also utilized to provide guidance in assessing student motivation and its relation between the degree of student knowledge/interest. Finally, the study also aimed at establishing a rationale to evaluate and further develop our classroom practices at the institute. Through this process for raising student awareness, it was suggested that to observe the FGPs was useful to recognize the utility of a semi-adjustable articulator when a bridge at the molar region is made. Moreover, it was suggested that the student motivation helped promote their understanding. This highlights the need to support student motivation in our classroom. Finally, future studies on how professors perceive bureaucratic pressures from Ministry of Health, Labor and Welfare (MHLW) and within the institute could add additional insights to improving our educational practices in the classroom.

The previous reports suggest that obstructive sleep apnoea (OSA) is related to metabolic syndrome, mineral metabolism disorders and cardiovascular disease. In addition, a possible relationship between obesity and the calcification of ligaments has been implied. However, the potential link between OSA and the calcification of ligaments has not been directly studied. In this present study, to investigate the potential link between OSA and the calcification of ligaments, we examined the prevalence of the calcification of ligaments in OSA patients and the relationship between these findings and OSA severity. Eighty consecutive patients (60 males, 20 females) diagnosed as OSA or a heavy snorer based on full-night polyso-mnography were retrospectively recruited from May 2006 to July 2008. Each patient underwent cephalometric imaging examination before the arrangement of an oral appliance. One calibrated observer (YS) reviewed the cephalometric images for the presence of calcification of the nuchal ligament and osteophytes of the cervical spine. The prevalence of calcification of the nuchal ligament in OSA patients and snorers was 46.3% (males: 52%, females: 30%) There was a significant positive correlation between the severity of OSA (AHI) and the calcification of the nuchal ligament before and after adjusting for BMI. The prevalence of the calcification of the nuchal ligament in OSA subjects and snorers was higher than in previous studies with non-OSA subjects. In addition, it is suggested that the severity of OSA correlates with the presence of calcification of the nuchal ligament.

Purpose The purpose of this report is to propose a computer assisted mandibular reconstruction procedure, utilizing a custom-made Ti-mesh tray with particulate cancellous bone and marrow, and a removable denture. This procedure was based on the top-down treatment technique, and reviews the case of a representative patient with mandibular continuity defect. Methods The patient was a 74-year old female with a chief complaint of facial asymmetry and masticatory dysfunction. Due to gingival carcinoma, she underwent a segmental mandibulectomy on the left mandibule. On the VR space, using 3-D reconstructed computer tomography data, the residual right-side mandibular fragment was repositioned based on the condylar position and the occlusal relation. The mandibular fragment was then mirrored for a central sagittal plane. The position of the mirrored object was slightly arranged with the occlusal relation. Through the above operations, the landmark configuration, for the custom-made Ti-mesh tray as a virtual simulation model, was fabricated. On the physical model, we produced a custom-made Ti-mesh tray with a commercial Ti-mesh sheet. Surgical treatment was carried out using the tray. The denture pattern was designed by a dental technician on the VR space, fabricated using a 3D printer, and modified to create an impression tray with resin. Using the impression, the temporary removable denture was fabricated. Conclusions We propose a computer assisted design for a custom-made Ti-mesh tray and a removable denture, based on the Top-down treatment concept. We feel this technique is advantageous in reconstructing functional occlusion, and in accurately regaining dental and facial esthetics.

目的: 1被験例の30年間の記録を通して, 咬合小面と各種下顎位の咬合接触の関係について検討する.方法: 1被験者について, 25, 39, 55歳時の咬合小面および咬合接触を記録した. 咬合接触の記録顎位は, 咬頭嵌合位, 最後方咬合位, 前方滑走運動路上の4顎位, 左右側方滑走運動路上の各4顎位の計14顎位である. これらの接触部と重なった咬合小面を咬合接触小面とし, 得られた咬合小面, 咬合接触小面数を記録した.結果: 1. 咬合小面数は経時的に増加し, 特に大臼歯部での増加数はほかの歯種に比べ多く, 咬頭嵌合位における咬合接触小面数も同様に増加していた. 2. 最後方咬合位における咬合接触小面数は, 各年齢を通じて第二大臼歯に最も多く認められ, 経時的に増加していた. 3. 前方運動における咬合接触小面数は, 前歯や小臼歯では減少していたが, 大臼歯では増加した. 4. 側方運動における作業側の咬合接触小面数は, 右側方運動では一定の傾向は認められなかったが, 左側方運動では経時的に増加した, 平衡側は, 左右側方運動とも大臼歯では咬頭嵌合位から1, 2mmの側方位で増加した.結論: 本被験者の咬合小面数は経時的に増加し, なかでも大臼歯における増加数は, ほかの歯種に比べ多かった. この咬合小面の経時的変化には各種下顎位の咬合接触が関係し, 特に咬頭嵌合位における咬合接触の影響が大きいことが示された.

The purpose of this study was to observe the variations of cervical curvature in patients with infraocclusion, and to compare this with the controls. In this study, the infraocclusion criteria were defined with the Pr-id as

目的: この研究では, 顎関節症患者に顎関節疼痛誘発テストを応用し, その反応を臨床診査時の疼痛所見および関節円板の状態と比較した. 本研究の目的は, このテストの有痛性の円板転位に対する診断精度を明らかにすることである.方法: 対象は本学補綴科あるいは口腔外科を受診し, 顎関節症と診断された患者で, 本研究の趣旨に賛同の得られた47名である. 患者の上下顎第二大臼歯間にプラスチック棒 (厚さ9mm) を介在して片側性に噛みしめさせ, そのときの誘発痛の有無, その部位を記録した. また, これらの知見を同患者の臨床症状およびMRI所見と比較した. すなわち, すべての顎関節を関節円板の状態と診査時の顎関節部の疼痛の有無により関節円板転位なし (N), 無痛性の円板転位 (NP-Dis), 有痛性の円板転位 (PDis) の3群に分類し, 誘発痛との関連性について検討した.結果: 顎関節疼痛誘発テストによる非噛みしめ側の疼痛は主に顎関節部にみられ, その多くで当該関節に有痛性の円板転位がみられた. 顎関節疼痛誘発テストの有痛性の円板転位症例に対する診断精度は有効度83%, 感度71%, 特異度89%, 陽性反応適中率76%, 陰性反応適中率86%であった.結論: 顎関節疼痛誘発テストの有痛性の円板転位に対する診断精度は高く, 臨床的に有用であることが示唆された.

Purpose: There has been a significant number of malocclusion patients who suffer from the osteoarthritis associated with TMJ, and acquired anterior open bites were reported as a representative example. Treatments for patients with malocclusion often prove difficult, as the condyle position is not stable. It remains unknown as to whether this is due to the disease or the condyle position. This case report documents a clinical application of a Digital Gothic Arch Tracer for occlusal diagnosis and subsequent management and treatment of malocclusion with osteoarthritis.Materials and methods: This case report presents the treatment process of a female patient (51 years, 6 months of age) with an acquired dual-bite malocclusion with severe osteoarthritis in the temporomandibular joint (TMJ). The occlusal condition of the patient was examined by a Digital Gothic Arch Tracer (DGAT, Gothic Display: Shofu Inc.). The GDAT was used as it provides an extra-oral tracing of jaw movements. While it is simple and easy to use, the accuracy remains impressively high, as several jaw motions are included into the final calculation.Results: The ensuing treatment plan was as follows: Upon the first examination, the occlusal position was recorded with DGAT. The DGAT data was then evaluated for correlations between the terminal points of the rapid habitual opening-closing movements (tapping points), apex point and speaking position. The gothic arch figure revealed that when approaching the terminal points of the tapping points and the speaking position, there was a separation at the apex point. From this, we reached a conclusion on the new occlusal position for tapping points and the speaking position. Based on the DGAT results, via the occlusal adjustment method, we set the new occlusal position. On their final visit the patient received Prosthodontics treatment. The DGAT was able to provide an avenue of examination that maintained the original occlusal position without raising the vertical dimension. Therefore, it was rather simple and exact to compare the Tapping points and Apex points.Conclusion: Using a Digital Gothic Arch Tracer, we successfully carried out the occlusal examination and treatment of a patient with osteoarthritis and malocclusion.

The purpose of this present study was to investigate the influence of material filler and RGB values' fluctuation on creating a calibration curve, which indicates the relationship between material thickness and transmitted light brightness using the transillumination method. Creating the calibration curves were carried out through the following three methods; 1) the conventional method creates the calibration curve with a formula of thickness, 2) the maximum value method, with samples of a specified thickness, and 3) the actual value method, with a microscope. Furthermore, the reliability of each curve was verified via scanned artificial tooth data. In addition, the characteristics of light decrement were investigated. From our results, it was suggested that the filler diameter must be considered when the calibration curve is created using the bite impression material with a filler. In addition, it was suggested that the RGB values' fluctuation did not influence the calibration curve.

Oral appliance (OA) therapy for obstructive sleep apnea (OSA) has only been part of Japan's National Health care coverage plan since 2004. Subsequently, not enough time has passed to establish the medical trends and characteristics of OSA patients in Japanese Dental Hospitals.The aim of this study was to investigate the medical trends and the characteristics in patients with OSA who visited our clinic, and to compare our findings with previous studies.Epidemiological survey (retrospective study).Two hundred and one patients were recruited at the Internal Medicine Division in the Tsurumi University Dental Hospital from February 2006 to December 2008, consecutively. Patients received a medical interview, and a detailed sleep analysis that included a polysomnography (PSG) to verify the exact nature of their condition. The efficacy of OA was assessed in 49 patients who wore an OA and underwent PSG.Of all subjects, 141 patients visited the Prosthodontic Division to receive OA therapy, 38 patients were treated or received a follow up examination in the Internal Medicine Division. The dropout rate was 10.4% in the all subjects, 17.0% in patients who visited the Prosthodontic Division. The male-to-female ratio was 3.3:1, 3.0:1 in patients who visited the Prosthodontic Division. In addition, females had a lower rate of OAS severity than males. In our patients, the major complication was hypertension and cardiac disease. The success rate of OA was 75.5%.This approach allowed us to reveal some of the trends and characteristics in our patients.

In our clinic, the four-dimensional analysis of mandibular movement has mainly been used to diagnose jaw function disorders. In present, we are considering its application for patients with occlusal issues. Consequently, an improvement in system accuracy is required. However, metal artifacts cause distortions in the 3D-cranio-mandibular model construction process, which leads to accuracy concerns. The purpose of this present study was to grasp the accuracy differences caused by the oral metal restorations in reconstructed 3D-cranio-mandibular models from CT data, and scanned dentition models. The accuracy of the reconstruction was confirmed from comparing the occlusal contacts in VR space and real space. The VR contact areas in the dry skulls without and moderate restoration showed a close similarity to real occlusal contacts. However, the VR contact areas in the dry skull with numerous restorations was not similar to the real contacts. From these results, it is considered that metal artifacts decrease the accuracy of model reconstruction.

Objective The aim was to report the kinetics of masticatory muscles using a 4-dimensional muscle model and kinetically investigate the etiology of square mandible (SQM) in vivo. Study design To ascertain the mandibular movements in patients with SQM, we compared a group of 11 SQM patients with painless limited mouth opening to a matched group of 11 healthy volunteers who acted as control subjects. Mandibular movements were recorded using a 6-degrees-of-freedom jaw-tracking device, with the incisal and kinematic condylar as analytic points. Results For the control group, mean tracking distance for the incisal point was 50.1 ± 6.8 mm, whereas for the SQM group mean tracking distance was 27.1 ± 2.8 mm. With lateral excursions, the control group's mean tracking distance of the incisal point was 9.9 ± 2.01 mm, and the SQM group's was 8.1 ± 1.64 mm. Conclusion Despite a sufficient lateral excursion, motion of the mandible was limited by some factors at opening and suggests that the mode of lateral movements in SQM patients may differ slightly from those in healthy individuals.

PURPOSE: A jaw motion tracking device that measures six degrees of freedom has recently been developed. Understanding jaw motion is useful, but previous measurement methods were impractical for use in dental clinics. The overall aim of this study was to demonstrate the simple operation, low cost, and high precision of a recently developed jaw tracking device. In addition, this study explored its potential clinical applications. METHODS: In this study, we compared two jaw motion tracking devices: a digital system type of device and an optical type of device. First we established a baseline occlusal plane from which to measure jaw motion in the same subject with both devices. The jaw motion signals were sampled at a frequency of 100 Hz. The subjects were three healthy women (mean age +/- SD = 26.3 +/- 1.2 years) who were recruited from among the crown-and-bridge faculty of Tsurumi University of Dentistry. The jaw motions measured were open-close movement, sagittal border movement, and frontal border movement. In addition, the kinematic axis point was calculated from the sagittal border movement. Data from the digital system type of device and data from the optical device were compared. The data were selected to measure rotation and translocation, i.e. jaw position about protrusion, both laterotrusion and maximal opening of the mouth. RESULTS: The root mean square (RMS) error of position measurement was 0.163 mm with MM-JI-E and 0.178 mm with the optical type of device. The RMS error of jaw motion measurement with the optical type of device was maximum at 0.8mm and minimum at 0.1mm. This was similar to that with digital system type of jaw motion tracking device. CONCLUSION: This study showed the possibility of developing clinical applications for this jaw motion device.