研究者詳細 - 窪木　拓男

論文 - 窪木　拓男

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Rating criteria to evaluate student performance in digital wax-up training using multi-purpose software. 査読国際誌

Takuya Mino, Yoko Kurosaki, Kana Tokumoto, Takaharu Higuchi, Shinichi Nakanoda, Ken Numoto, Ikue Tosa, Aya Kimura-Ono, Kenji Maekawa, Tae Hyung Kim, Takuo Kuboki

The journal of advanced prosthodontics 14 ( 4 ) 203 - 211 2022年8月

記述言語：英語掲載種別：研究論文（学術雑誌）

PURPOSE: The aim of this study was to introduce rating criteria to evaluate student performance in a newly developed, digital wax-up preclinical program for computer-aided design (CAD) of full-coverage crowns and preliminarily investigate the reliability and internal consistency of the rating system. MATERIALS AND METHODS: This study, conducted in 2017, enrolled 47 fifth-year dental students of Okayama University Dental School. Digital wax-up training included a fundamental practice using computer graphics (CG), multipurpose CAD software programs, and an advanced practice to execute a digital wax-up of the right mandibular second molar (#47). Each student's digital wax-up work (stereolithography data) was evaluated by two instructors using seven qualitative criteria. The total qualitative score (0-90) of the criteria was calculated. The total volumetric discrepancy between each student's digital wax-up work and a reference prepared by an instructor was automatically measured by the CAD software. The inter-rater reliability of each criterion was analyzed using a weighted kappa index. The relationship between the total volume discrepancy and the total qualitative score was analyzed using Spearman's correlation. RESULTS: The weighted kappa values for the seven qualitative criteria ranged from 0.62 - 0.93. The total qualitative score and the total volumetric discrepancy were negatively correlated (ρ = -0.27, P = .09, respectively); however, this was not statistically significant. CONCLUSION: The established qualitative criteria to evaluate students' work showed sufficiently high inter-rater reliability; however, the digitally measured volumetric discrepancy could not sufficiently predict the total qualitative score.

DOI： 10.4047/jap.2022.14.4.203

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Prosthodontic treatment can improve the ingestible food profile in Japanese adult outpatients. 査読

Aya Kimura-Ono, Kenji Maekawa, Takuo Kuboki, Kumiko Nawachi, Masanori Fujisawa, Hironobu Sato, Hideki Aita, Shigeto Koyama, Masayuki Hideshima, Yuji Sato, Hiroyuki Wake, Kan Nagao, Yorika Kodaira-Ueda, Katsushi Tamaki, Shinsuke Sadamori, Kazuhiro Tsuga, Yasuhiro Nishi, Takashi Sawase, Hisashi Koshino, Shin-Ichi Masumi, Kaoru Sakurai, Kanji Ishibashi, Takashi Ohyama, Yasumasa Akagawa, Toshihiro Hirai, Keiichi Sasaki, Kiyoshi Koyano, Hirofumi Yatani, Hideo Matsumura, Tetsuo Ichikawa, Shuji Ohkawa, Kazuyoshi Baba

Journal of prosthodontic research 67 ( 2 ) 189 - 195 2022年5月

記述言語：英語掲載種別：研究論文（学術雑誌）

Purpose To investigate the effect of prosthodontic treatment on the ingestible food profile in adult Japanese outpatients, and to identify the related risk factors that can deteriorate the profile.Methods The participants were 277 outpatients who visited university-based specialty clinics in Japan for prosthodontic treatment. The demographic data, number of present teeth assessed via intraoral examination, and oral health-related quality of life assessed by the total Oral Health Impact Profile (OHIP-J54) scores of all participants were recorded before treatment. Ingestible food profile score (IFS) was recorded using a validated food intake questionnaire. Eligible participants who answered the questionnaire before and after treatment were categorized into five groups based on the prosthodontic treatments they received (i.e., crowns, bridges, removable partial dentures, removable complete dentures, and removable complete and partial dentures).Results Multivariate analysis of covariance revealed a statistically significant main effect of prosthodontic intervention (time course: before and after treatment) on mean IFS (p=0.035, F=4.526), even after adjusting for covariates (age, number of present teeth, and treatment modality). Multiple linear regression analysis revealed that the low number of present teeth (r=0.427, p<0.001) and a high OHIP-J54 total score (r=-0.519, p<0.001) of the patients at the baseline were significantly associated with their baseline IFSs, even after adjusting for confounding variables.Conclusions The findings of this multicenter follow-up study indicate the importance of prosthodontic rehabilitation in improving patients' ingestible food profiles.

DOI： 10.2186/jpr.JPR_D_22_00017

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Fixed Partial Denture Designed by Combining the Whole 3D Digital Surface Morphology of the Provisional Restoration and Abutment Teeth Surfaces.

Kana Tokumoto, Takuya Mino, Yoko Kurosaki, Koji Izumi, Kenji Maekawa, Tomohito Nakano, Junichi Sejima, Akihiro Ueda, Aya Kimura-Ono, Tae Hyung Kim, Takuo Kuboki

Acta medica Okayama 76 ( 1 ) 79 - 84 2022年2月

担当区分：最終著者記述言語：英語掲載種別：研究論文（学術雑誌）

We introduce a new digital workflow to fabricate a fixed partial denture (FPD) utilizing the three-dimensional surface morphology of provisional restoration (PR) and abutment teeth. Scanned images of the full maxilla with abutment teeth, full maxilla with PR, and PR alone were superimposed. The surfaces of the final FPD were designed based on the entire morphology of the PR and abutment teeth surfaces. The inner and outer surfaces converged at the margin lines of the abutment teeth. Fine modifications to the final FPD design were performed manually, and the final FPD was fabricated and successfully installed in the patient.

DOI： 10.18926/AMO/63215

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White discharge formation following a subepithelial connective tissue graft for anterior fixed partial denture pontics: A case report based on clinical and histological findings. 査読

Norimi Oda, Mitsuaki Ono, Wataru Sonoyama, Taichiro Morimoto, Ikue Tosa, Shuji Nousho, Keisuke Nakano, Takuo Kuboki

Journal of prosthodontic research 66 ( 1 ) 184 - 192 2022年1月

記述言語：英語掲載種別：研究論文（学術雑誌）

PATIENT: A 54-year-old woman presenting with anterior alveolar ridge resorption was submitted to a connective tissue graft (CTG) for esthetic improvement before rehabilitation with a fixed partial denture. Palate-harvested connective tissue was used as a graft after extra-oral removal of the epithelium. Unexpectedly, complete wound healing was not observed. Moreover, 6 months post-surgery, a white discharge was detected at the grafted site. The adjacent tooth showing a root fracture was initially associated with the symptoms and was then extracted. Concomitantly, the unhealed tissue at the grafted site was also excised, leading to temporary symptom resolution. However, the white discharge reappeared after 2 months. The excision area was expanded to remove the grafted tissue entirely, and the wound was completely healed. Since the alveolar ridge resorption had become larger compared to the preoperative condition, the patient was subjected to a second CTG, now using a connective tissue harvested from the palate by a single incision technique. The wound healed uneventfully, and the final prosthesis was delivered 6 months after soft tissu e stabilization. The patient has been followed-up for more than 28 months without any recurrence of white discharge. DISCUSSION: Histopathological and cytological examination detected keratinized epithelial tissues and cells, respectively, in excised tissues and white discharge specimens. Consequently, a possible relationship between white discharge and residual epithelium in the harvested graft was strongly suspected. CONCLUSIONS: Success of the CTG procedure requires careful method selection for tissue transplantation and treatment execution.

DOI： 10.2186/jpr.JPR_D_20_00115

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Effectiveness of the socket shield technique in dental implant: A systematic review. 査読

Toru Ogawa, Ratri M Sitalaksmi, Makiko Miyashita, Kenji Maekawa, Masahiro Ryu, Aya Kimura-Ono, Takeshi Suganuma, Takeshi Kikutani, Masanori Fujisawa, Katsushi Tamaki, Takuo Kuboki

Journal of prosthodontic research 66 ( 1 ) 12 - 18 2022年1月

記述言語：英語掲載種別：研究論文（学術雑誌）

PURPOSE: Dental implant therapy is a common clinical treatment for missing teeth. However, the esthetic result is not as satisfactory as expected in some cases, especially in the anterior maxillary area. Poor esthetic results are caused by inadequate preparation of the hard and soft tissues in this area before treatment. The socket shield technique may be an alternative for a desirable esthetic outcome in dental implant treatments. STUDY SELECTION: In the present systematic review, PubMed-Medline, Google Scholar, and ScienceDirect were searched for clinical studies published from January 2000 to December 2018. RESULTS: Twenty studies were included, comprising one randomized controlled trial, two cohort studies, 14 clinical human case reports, and three retrospective case series. In total, 288 patients treated with the socket shield technique with immediate implant placement and follow-up between 3-60 months after placement were included. A quality assessment showed that 12 of the 20 included studies were of good quality. Twenty-six of the 274 (9.5%) cases developed complications or adverse effects related to the socket shield technique. Most studies reported implant survival without the complications (90.5%); most of the cases that were followed up for more than 12 months after implant placement achieved a good esthetic appearance. The failure rate was low without the complications, although there were some failures due to failed implant osseointegration, socket shield mobility and infection, socket shield exposure, socket shield migration, and apical root resorption. CONCLUSIONS: The socket shield technique can be used in dental implant treatment, but it remains difficult to predict the long-term success of this technique until high-quality evidence becomes available.

DOI： 10.2186/jpr.JPR_D_20_00054

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Preclinical bioequivalence study of E.coli-derived rhBMP-2/β-TCP and autogenous bone in a canine guided-bone regeneration model. 査読

Shuji Nosho, Mitsuaki Ono, Taishi Komori, Akihiro Mikai, Ikue Tosa, Kei Ishibashi, Yukie Tanaka, Aya Kimura-Ono, Emilio S Hara, Toshitaka Oohashi, Takuo Kuboki

Journal of prosthodontic research 66 ( 1 ) 124 - 130 2022年1月

記述言語：英語掲載種別：研究論文（学術雑誌）

PURPOSE: Bone morphogenetic protein (BMP)-2 is a potent growth factor that is widely used in the orthopedic and dental fields for bone regeneration.However, recombinant human BMP-2 (rhBMP-2) products have not been legally approved in Japan. Recently, our research group succeeded in producing GMP-grade rhBMP-2 using the E. coli system (E-rhBMP-2) at the industrial level and developed E-rhBMP-2 adsorbed onto β-TCP (E-rhBMP-2/β-TCP) as an alternative material to autogenous bone grafts. Previous studies on the toxicity, pharmacokinetics, and optimal doses of E-rhBMP-2 have confirmed its safety and efficiency. However, comparative studies with standard treatment therapies are still necessary before clinical application in humans. Therefore, in this preclinical study, we compared the bone regeneration ability of E-rhBMP-2/β-TCP and autogenous bone grafts in a canine guided-bone regeneration model. METHODS: Following extraction of the maxillary third premolar, box-type bone defects (10 mmL × 4 mmW × 9 mmH) were created in the extraction socket area and transplanted with E-rhBMP-2/β-TCP or autogenous bone graft in a canine. After 8 weeks, micro-CT and histological analyses were performed. RESULTS: Transplantation of both E-rhBMP-2/β-TCP and autogenous bone graft significantly promoted bone formation compared to the non-transplantation control group. The bone formation ability of E-rhBMP-2/β-TCP was equal to that of the autogenous bone graft. Histological analysis showed that excessive infiltration of inflammatory cells and residual β-TCP particles mostly were not observed in the E-rhBMP-2/β-TCP transplantation group. CONCLUSIONS: This preclinical study demonstrated that E-rhBMP-2/β-TCP and autogenous bone have equal potential to promote bone regeneration.

DOI： 10.2186/jpr.JPR_D_20_00226

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A retrospective comparison of the survival of vital teeth adjacent to single, bounded edentulous spaces rehabilitated using implant-supported, resin-bonded, and conventional fixed dental prostheses. 査読国際誌

Shun Okuni, Kenji Maekawa, Takuya Mino, Yoko Kurosaki, Takuo Kuboki

Journal of dentistry 116 103911 - 103911 2022年1月

記述言語：英語掲載種別：研究論文（学術雑誌）

OBJECTIVES: In this study, we aimed to compare the long-term survival of vital teeth adjacent to bounded edentulous spaces rehabilitated using an implant-supported prosthesis (ISP), a resin-bonded fixed partial denture (RBFPD), or a conventional fixed partial denture (CFPD). The risk factors for complications in teeth adjacent to the edentulous space (TAES) were also investigated. METHODS: We followed-up a consecutive series of 514 patients who underwent rehabilitation of a single bounded edentulous space with vital TAES (ISP: 103; RBFPD: 216; and CFPD: 195) from 2008 to 2017. Cumulative survival rates of prosthesis and TAES, and complication-free rates of TAES, were evaluated using the Kaplan-Meier analysis and log-rank test. Risk factors were evaluated using a Cox proportional hazards model. RESULTS: Cumulative complication-free rates of TAES showed no significant differences among the three groups. The cumulative survival rate of TAES in CFPD was significantly lower than that of ISP (p = 0.037); no significant differences were observed between ISP and RBFPD (p = 0.513), and RBFPD and CFPD (p = 0.076). Older age (p = 0.027) was the only independent significant risk factor for complications in TAES. Installation of CFPD (p = 0.019), ceramic prosthesis in edentulous space (p = 0.026), and deeper periodontal probing depth (p = 0.018) of TAES were significant risk factors for non-surviving TAES. CONCLUSIONS: Rehabilitating a single bounded edentulous space with CFPD could increase the risk for TAES loss compared with ISP. Risk of TAES loss remained similar between ISP and RBFPD, which can minimize the loss of coronal tooth structure during tooth preparation. CLINICAL SIGNIFICANCE: Teeth adjacent to edentulous space show equivalent longevity when rehabilitating a single bounded edentulous space with resin-bonded fixed partial dentures or single standing implant-supported prosthesis, at least 10 years post-installation.

DOI： 10.1016/j.jdent.2021.103911

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Risk factors for root caries annual incidence and progression among older people requiring nursing care: A one-year prospective cohort study 査読

Kana Tokumoto, Aya Kimura-Ono, Takuya Mino, Suguru Osaka, Ken Numoto, Eri Koyama, Yoko Kurosaki, Shinsuke Nakagawa, Yuki Amano, Ha Thi Thu Nguyen, Takaharu Higuchi, Kumiko Nawachi, Mitsuaki Ono, Yoshitomo Kobayashi, Michiyo Yamamoto, Kenji Maekawa, Takuo Kuboki

Journal of Prosthodontic Research 66 ( 2 ) 250 - 257 2022年1月

Suppression of Bone Necrosis around Tooth Extraction Socket in a MRONJ-like Mouse Model by E-rhBMP-2 Containing Artificial Bone Graft Administration. 査読国際誌

Yukie Tanaka, Kyaw Thu Aung, Mitsuaki Ono, Akihiro Mikai, Anh Tuan Dang, Emilio Satoshi Hara, Ikue Tosa, Kei Ishibashi, Aya Ono-Kimura, Kumiko Nawachi, Takuo Kuboki, Toshitaka Oohashi

International journal of molecular sciences 22 ( 23 ) 2021年11月

記述言語：英語掲載種別：研究論文（学術雑誌）

Medication-related osteonecrosis of the jaw (MRONJ) is related to impaired bone healing conditions in the maxillomandibular bone region as a complication of bisphosphonate intake. Although there are several hypotheses for the onset of MRONJ symptoms, one of the possible causes is the inhibition of bone turnover and blood supply leading to bone necrosis. The optimal treatment strategy for MRONJ has not been established either. BMP-2, a member of the TGF-β superfamily, is well known for regulating bone remodeling and homeostasis prenatally and postnatally. Therefore, the objectives of this study were to evaluate whether cyclophosphamide/zoledronate (CY/ZA) induces necrosis of the bone surrounding the tooth extraction socket, and to examine the therapeutic potential of BMP-2 in combination with the hard osteoinductive biomaterial, β-tricalcium phosphate (β-TCP), in the prevention and treatment of alveolar bone loss around the tooth extraction socket in MRONJ-like mice models. First, CY/ZA was intraperitoneally administered for three weeks, and alveolar bone necrosis was evaluated before and after tooth extraction. Next, the effect of BMP-2/β-TCP was investigated in both MRONJ-like prevention and treatment models. In the prevention model, CY/ZA was continuously administered for four weeks after BMP-2/β-TCP transplantation. In the treatment model, CY/ZA administration was suspended after transplantation of BMP-2/β-TCP. The results showed that CY/ZA induced a significant decrease in the number of empty lacunae, a sign of bone necrosis, in the alveolar bone around the tooth extraction socket after tooth extraction. Histological analysis showed a significant decrease in the necrotic alveolar bone around tooth extraction sockets in the BMP-2/β-TCP transplantation group compared to the non-transplanted control group in both MRONJ-like prevention and treatment models. However, bone mineral density, determined by micro-CT analysis, was significantly higher in the BMP-2/β-TCP transplanted group than in the control group in the prevention model only. These results clarified that alveolar bone necrosis around tooth extraction sockets can be induced after surgical intervention under CY/ZA administration. In addition, transplantation of BMP-2/β-TCP reduced the necrotic alveolar bone around the tooth extraction socket. Therefore, a combination of BMP-2/β-TCP could be an alternative approach for both prevention and treatment of MRONJ-like symptoms.

DOI： 10.3390/ijms222312823

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Six-year follow-up assessment of prosthesis survival and oral health-related quality of life in individuals with partial edentulism treated with three types of prosthodontic rehabilitation. 査読

Yoko Kurosaki, Aya Kimura-Ono, Takuya Mino, Hikaru Arakawa, Eri Koyama, Shinsuke Nakagawa, Ha Thi Thu Nguyen, Suguru Osaka, Mamiko Saeki, Hajime Minakuchi, Mitsuaki Ono, Kenji Maekawa, Takuo Kuboki

Journal of prosthodontic research 65 ( 3 ) 332 - 339 2021年8月

記述言語：英語掲載種別：研究論文（学術雑誌）出版者・発行元：JAPAN PROSTHODONTIC SOC

PURPOSE: The purpose of the study was to compare the long-term performance of three prostheses for partial edentulism: implant-supported, fixed denture (IFD), fixed partial denture (FPD), and removable partial denture (RPD), in terms of prosthesis survival and oral health-related quality of life (OHRQoL). METHODS: The 138 patients in our previous study (Kimura et al., 2012) received one of the three prosthetic treatments and answered a validated OHRQoL questionnaire before and immediately after treatment. In the present study, the patients were followed up six years after treatment using medical records and OHRQoL examinations to evaluate prosthesis survival and change in OHRQoL. The cumulative survival rates were calculated using the Kaplan-Meier analysis. The Steel-Dwass test was used to compare the median OHRQoL scores at the three time points. RESULTS: For the 105 patients (66.8 ± 10.8 years, IFD/FPD/RPD: 58/27/20 patients) who successfully completed the follow-up assessments, the six-year estimated cumulative survival rates of the IFDs, FPDs, and RPDs were 94.7%, 77.4%, and 33.3%, respectively. The log-rank tests indicated that the survival curves were significantly different (IFDs vs. FPDs: p = 0.01; RPDs vs. IFDs, FPDs: p < 0.01). The median OHRQoL scores of the IFD group immediately after treatment and six years after treatment were significantly higher than those observed before treatment (p < 0.01). There was no significant difference in the median OHRQoL scores among the three time points in the RPD or FPD groups. CONCLUSIONS: IFDs showed significantly longer survival rates than FPDs and RPDs in partially edentulous patients. Only in the IFD patients was the OHRQoL level six years after treatment significantly higher than that b efore treatment.

DOI： 10.2186/jpr.JPR_D_20_00095

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IMPLANT THERAPY これで自信をもって取り組める前歯部インプラント治療診断から埋入、補綴まで Step by Stepでわかる成功のポイント(完)(Step 6) 術後のメインテナンスのポイント査読

岩田光弘, 窪木拓男

日本歯科評論 81 ( 6 ) 115 - 123 2021年6月

口腔インプラント学の2040年に向けたイノベーションロードマップ日本口腔インプラント学会にはこれから20年何が求められるのか? 査読

窪木拓男

日本口腔インプラント学会誌 34 ( 2 ) 115 - 123 2021年6月

記述言語：日本語出版者・発行元：(公社)日本口腔インプラント学会

これまで日本口腔インプラント学会は,オッセオインテグレーションの発見を基に,治療技術の開発と教育に強く携わってきた.今後,本学会の最も重要なミッションとなるのは,口腔インプラント治療により,患者がどのようなメリットを享受でき,負担を強いられるのかを科学的に説明できるようにすることである.一方,治療技術のイノベーションにも率先して取り組むべきで,遠からず,自家骨移植は,間葉系幹細胞,生体材料や成長因子の応用により必要最小限になるだろう.インプラント周囲炎は,予防,もしくは治療可能とならなければならない.また,介護現場の問題や非感染性疾患(NCDs)である歯槽骨減少症や硬化症の問題,ひいては,薬剤関連性顎骨壊死の問題も解決されなくてはならない.もしかすると,歯根膜をもつインプラントや歯の再生が可能となるかもしれない.これらにより,患者が享受できるメリットが最大化され,国民が安心して口腔インプラント治療を受けられるようになるはずである.願わくは,これらのイノベーションがわれらJSOIから生まれてほしいということである.(著者抄録)

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その他リンク： https://search.jamas.or.jp/index.php?module=Default&action=Link&pub_year=2021&ichushi_jid=J02151&link_issn=&doc_id=20210909260002&doc_link_id=10.11237%2Fjsoi.34.115&url=https%3A%2F%2Fdoi.org%2F10.11237%2Fjsoi.34.115&type=J-STAGE&icon=https%3A%2F%2Fjk04.jamas.or.jp%2Ficon%2F00007_3.gif

IMPLANT THERAPY これで自信をもって取り組める前歯部インプラント治療診断から埋入、補綴までStep by Stepでわかる成功のポイント(Step 5) 補綴手技のポイント(2)

岩田光弘, 山本桂輔, 窪木拓男

日本歯科評論 81 ( 5 ) 89 - 97 2021年5月

認知機能低下、認知症と口腔顔面痛文献レビュー

前川賢治, 窪木拓男

日本口腔顔面痛学会雑誌 13 ( 1 ) 1 - 10 2021年5月

記述言語：日本語出版者・発行元：(一社)日本口腔顔面痛学会

目的:高齢者人口の増加に伴う認知症の有病率上昇は、介護、医療の負担を増大させる深刻な社会問題となっている。本疾患による自立低下は、口腔内のセルフケア能力の低下などを介して健全な口腔、咀嚼機能の維持を困難とし、口腔顔面痛疾患罹患のリスクを高めることが予測される。しかしながら両者の関係については不明な点が多い。本総説の目的は、現時点での認知機能低下、認知症と口腔顔面痛の関係に関する知見をまとめ、今後の問題点と展望を考えることである。研究の選択:認知機能低下、認知症と口腔顔面痛をキーワードに、PubMedと医中誌から文献検索を行った。定めた検索式で抽出した原著論文の文献数は少なく、検索から採用した文献の引用文献と、ハンドサーチで得られた文献をもとに文献レビューを行った。結果:認知機能低下、認知症高齢者においては口腔顔面痛の有症状率が高いという報告と、低いことを示す結果を得た報告が存在した。口頭で痛みを訴えることができない状態では、正確な診断につながらず、実際の有症状率より低く検出されている可能性も考えられた。また、口頭で症状を訴えることが不可能なこれらの患者に対する現在の口腔顔面痛の診査、診断方法は、未だ不十分であることが明らかとなった。結論:未曾有の超高齢社会を迎えた現在、認知機能の低下した高齢者に対する適切な口腔顔面痛の診査、診断方法の確立は急務と考えられた。(著者抄録)

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岡山大学病院における放射線治療支援への取り組み

宮崎文伸, 松崎秀信, 松崎久美子, 青山英樹, 宇野弘文, 竹内哲男, 上田明広, 太田圭二, 浅海淳一, 窪木拓男

日本口腔顎顔面技工学会会誌 20 ( 1 ) 44 - 44 2021年4月

食力向上による健康寿命の延伸:補綴歯科の意義補綴歯科治療は生命予後の延伸に貢献できるか?

窪木拓男, 前川賢治

日本補綴歯科学会誌 13 ( 2 ) 117 - 125 2021年4月

記述言語：日本語出版者・発行元：(公社)日本補綴歯科学会

われわれ歯科医は補綴治療を毎日患者に施しているが,その治療がどのような効果を患者に及ぼしているかを十分認識していない.たとえば,自立した地域在住高齢者においては,補綴治療の主目的は,口腔関連QOLの向上に加えて,介護予防,フレイル予防,認知機能低下予防であり,補綴治療による口腔機能の維持は多様な食物や栄養素を摂取するという観点から重要な意味があると言われている.本論説では,近年発表された質の高いシステマティックレビューと原著論文を精読し,地域在住高齢者においては,現在歯数が多いほど,生命予後が良好であること,また,現在歯数よりも機能歯数の方が生命予後に強く関連するという日本補綴歯科学会と東京都健康長寿医療センターの共同研究結果を紹介した.一方,日常生活動作がまだまだ保たれている前期要支援・要介護高齢者においては,歯列欠損の修復に加えて,栄養摂取強化と広義の摂食嚥下リハビリテーションが重要な意味を持つ.また,日常生活動作が著しく低下する後期要介護高齢者においては,食環境や食形態の調整,栄養補助食品の利用,多様な栄養摂取ルートの活用などが必要になる.これらの臨床エビデンスをライフステージに合わせて読み解くことにより,われわれ補綴歯科医の医学的,社会的な責務が,どのライフステージにおいても甚大であることを訴えたい.(著者抄録)

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その他リンク： https://search.jamas.or.jp/index.php?module=Default&action=Link&pub_year=2021&ichushi_jid=J05334&link_issn=&doc_id=20210428220004&doc_link_id=130008031302&url=https%3A%2F%2Fci.nii.ac.jp%2Fnaid%2F130008031302&type=CiNii&icon=https%3A%2F%2Fjk04.jamas.or.jp%2Ficon%2F00003_1.gif

IMPLANT THERAPY これで自信をもって取り組める前歯部インプラント治療診断から埋入、補綴までStep by Stepでわかる成功のポイント(Step 4) 補綴手技のポイント(1)

岩田光弘, 山本桂輔, 窪木拓男

日本歯科評論 81 ( 4 ) 103 - 110 2021年4月

Newly developed data-matching methodology for oral implant surgery allowing the automatic deletion of metal artifacts in 3D-CT images using new reference markers: A case report.

Hiroaki Shimizu, Hikaru Arakawa, Takuya Mino, Yoko Kurosaki, Kana Tokumoto, Takuo Kuboki

Journal of prosthodontic research 65 ( 1 ) 125 - 129 2021年2月

記述言語：英語掲載種別：研究論文（学術雑誌）出版者・発行元：JAPAN PROSTHODONTIC SOC

PATIENTS: The patient was a 55-year-old woman with left upper molar free-end edentulism and 9 full cast metal crowns in her mouth. Three three-dimensional (3D) images were superimposed: a computed tomography (CT) image with the patient wearing the CT-matching template (CTMT) with six glass ceramic markers, which hardly generate any artifacts, on the template surface, and oral plaster model surfaces with and without CTMTs. Metal artifacts were automatically removed by a Boolean operation identifying unrealistic images outside the oral plaster model surface. After the preoperative simulation, fully guided oral implant surgery was performed. Two implant bodies were placed in the left upper edentulism. The placement errors calculated by comparing the preoperative simulation and actual implant placement were then assessed by a software program using the 3D-CT bone morphology as a reference. The 3D deviations between the preoperative simulation and actual placement at the entry of the implant body were a maximum 0.48 mm and minimum 0.26 mm. Those at the tip of the implant body were a maximum 0.56 mm and a minimum 0.25 mm. DISCUSSION: In this case, the maximum 3D deviations at the entry and tip section were less than in previous studies using double CT. CONCLUSIONS: Accurate image fusion utilizing CTMT with new reference markers was possible for a patient with many metal restorations. Using a surgical guide manufactured by the new matching methodology (modified single CT scan method), implant placement deviation can be minimized in patients with many metal restorations.

DOI： 10.2186/jpr.JPOR_2019_429

Web of Science

PubMed

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IMPLANT THERAPY これで自信をもって取り組める前歯部インプラント治療診断から埋入、補綴までStep by Stepでわかる成功のポイント(Step 3) 外科のポイント(2)

岩田光弘, 窪木拓男

日本歯科評論 81 ( 2 ) 131 - 140 2021年2月

Tryptophan and Kynurenine Enhances the Stemness and Osteogenic Differentiation of Bone Marrow-Derived Mesenchymal Stromal Cells In Vitro and In Vivo. 国際誌

Hai Thanh Pham, Mitsuaki Ono, Emilio Satoshi Hara, Ha Thi Thu Nguyen, Anh Tuan Dang, Hang Thuy Do, Taishi Komori, Ikue Tosa, Yuri Hazehara-Kunitomo, Yuya Yoshioka, Yasutaka Oida, Kentaro Akiyama, Takuo Kuboki

Materials (Basel, Switzerland) 14 ( 1 ) 208 - 208 2021年1月

記述言語：英語掲載種別：研究論文（学術雑誌）出版者・発行元：MDPI AG

Aging tissues present a progressive decline in homeostasis and regenerative capacities, which has been associated with degenerative changes in tissue-specific stem cells and stem cell niches. We hypothesized that amino acids could regulate the stem cell phenotype and differentiation ability of human bone marrow-derived mesenchymal stromal cells (hBMSCs). Thus, we performed a screening of 22 standard amino acids and found that D-tryptophan (10 μM) increased the number of cells positive for the early stem cell marker SSEA-4, and the gene expression levels of OCT-4, NANOG, and SOX-2 in hBMSCs. Comparison between D- and L-tryptophan isomers showed that the latter presents a stronger effect in inducing the mRNA levels of Oct-4 and Nanog, and in increasing the osteogenic differentiation of hBMSCs. On the other hand, L-tryptophan suppressed adipogenesis. The migration and colony-forming ability of hBMSCs were also enhanced by L-tryptophan treatment. In vivo experiments delivering L-tryptophan (50 mg/kg/day) by intraperitoneal injections for three weeks confirmed that L-tryptophan significantly increased the percentage of cells positive for SSEA-4, mRNA levels of Nanog and Oct-4, and the migration and colony-forming ability of mouse BMSCs. L-kynurenine, a major metabolite of L-tryptophan, also induced similar effects of L-tryptophan in enhancing stemness and osteogenic differentiation of BMSCs in vitro and in vivo, possibly indicating the involvement of the kynurenine pathway as the downstream signaling of L-tryptophan. Finally, since BMSCs migrate to the wound healing site to promote bone healing, surgical defects of 1 mm in diameter were created in mouse femur to evaluate bone formation after two weeks of L-tryptophan or L-kynurenine injection. Both L-tryptophan and L-kynurenine accelerated bone healing compared to the PBS-injected control group. In summary, L-tryptophan enhanced the stemness and osteoblastic differentiation of BMSCs and may be used as an essential factor to maintain the stem cell properties and accelerate bone healing and/or prevent bone loss.

DOI： 10.3390/ma14010208

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論文 - 窪木 拓男

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論文 - 窪木　拓男