Updated on 2024/12/20

写真a

 
TANAKA Yuuki
 
Organization
Faculty of Medicine, Dentistry and Pharmaceutical Sciences Assistant Professor
Position
Assistant Professor
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Degree

  • 博士(歯学) ( 2018.3   岡山大学大学院医歯薬学総合研究科 )

  • 博士(歯学) ( 岡山大学 )

Research Areas

  • Life Science / Prosthodontics  / Evaluation of masticatory ability

Professional Memberships

  • 日本顎口腔機能学会

    2021.9

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  • 一般社団法人 日本顎顔面補綴学会

    2021.3

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  • 公益社団法人日本補綴歯科学会

    2014.5

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Papers

  • 日常生活中の筋電図記録に混入し得るノイズ信号に関する研究

    皆木 省吾, 兒玉 直紀, 中原 龍一, 尾崎 敏文, 古寺 寛志, 北川 佳祐, 萬田 陽介, 田中 祐貴, 杉本 皓, 森 慧太朗, 山田 蘭子, 松岸 諒, 桑原 実穂

    日本顎口腔機能学会雑誌   29 ( 2 )   124 - 125   2023.3

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  • Effect of continuous sweet gustatory stimulation on salivary flow rate over time. International journal

    Ranko Yamada, Yuki Tanaka, Hikaru Sugimoto, Naoki Kodama, Ryusuke Yoshida, Shogo Minagi

    Archives of oral biology   146   105590 - 105590   2022.11

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    OBJECTIVE: This study aimed to determine changes in saliva secretion and subjective taste intensity during a sustained period with continuous gustatory stimulation. DESIGN: Twenty-two healthy adults participated in this study. The selected taste solutions were aspartame, sucralose, and acesulfame potassium, which are nonnutritive sweeteners. The concentrations of sucralose1 and acesulfame potassium were set to show the same sweetness intensity as aspartame. Sucralose2 was twice the concentration of sucralose1. The solution was continuously fed into the oral cavity at a flow rate of 0.04 mL / min through a neck-worn precise infusion system. The salivary flow rate (g/min) after 10 min of intraoral water supply from the device was used as the baseline. Salivary flow rate, subjective taste intensity evaluated by the visual analog scale (VAS), and salivary flow rate relative to the baseline were recorded at 10, 30, 60, and 120 min after the start of the test. RESULTS: In the aspartame, sucralose1, and sucralose2 groups, the salivary flow rate increased significantly from 10 min to 120 min after the start of the test when compared to the rate at baseline (p < 0.05). The relative salivary flow rate increased and the VAS value decreased significantly over time and were affected by the time factor (p < 0.001, p = 0.013, respectively) but not by the sweetener-group factor and the interaction effects. CONCLUSIONS: Continuous gustatory stimulation may maintain increased salivary production for a sustained period.

    DOI: 10.1016/j.archoralbio.2022.105590

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  • 岡山大学病院夢の会話プロジェクト外来における構音障害患者への実態調査

    松岸 諒, 兒玉 直紀, 古寺 寛志, 長塚 弘亮, 佐藤 匡晃, 川上 滋央, 美甘 真, 洲脇 道弘, 田中 祐貴, 北川 佳祐, 足立 れいみ, 市川 知香, 山田 蘭子, 皆木 省吾

    日本補綴歯科学会誌   14 ( 特別号 )   214 - 214   2022.7

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  • 大学病院における口腔ケア 岡山大学病院頭頸部がんセンターにおける顎骨再建後のインプラントと口腔ケアの重要性

    水川 展吉, 武田 斉子, 木股 敬裕, 松本 洋, 安藤 瑞生, 丸山 貴之, 佐々木 禎子, 田中 祐貴, 上田 明広, 飯田 征二

    日本口腔ケア学会雑誌   16 ( 3 )   83 - 83   2022.4

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  • 若手研究者&臨床家に送る 科学英語論文の読み方・書き方(第4回) 科学英語論文を書くための準備 報告ガイドラインを把握する

    兒玉 直紀, 田中 祐貴

    歯界展望   139 ( 1 )   182 - 188   2022.1

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    Language:Japanese   Publisher:医歯薬出版(株)  

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  • ガミースマイルを伴うエナメル質形成不全症に対して包括的アプローチを行った1症例

    兒玉 直紀, 井手口 英隆, 萬田 陽介, 田中 祐貴, 杉本 皓, 森 慧太朗, 皆木 省吾

    岡山歯学会雑誌   40 ( 2 )   38 - 38   2021.12

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  • 呼気流路の容易な制御を目的とした面接触型人工舌の構音改善に関する実験的研究

    長塚 弘亮, 川上 滋央, 古寺 寛志, 佐藤 匡晃, 田中 祐貴, 兒玉 直紀, 原 直, 皆木 省吾

    顎顔面補綴   44 ( 2 )   76 - 76   2021.12

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  • Effects of food particle loss on the evaluation of masticatory ability using image analysis.

    Hikaru Sugimoto, Yuki Tanaka, Naoki Kodama, Shogo Minagi

    Journal of prosthodontic research   66 ( 3 )   484 - 490   2021.11

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    PURPOSE: To examine how particle loss affects the evaluation of masticatory ability using the image analysis method. METHODS: The subjects were divided into two groups:Y-group (healthy young adults: 10 male, 10 female; mean age 27.6 ± 1.9 years), and D-group (denture wearing older adults: 13 male, 9 female; mean age, 75.1 ± 5.3 years). Raw carrots, peanuts, and a combined test food from 5 daily food materials (mixed foods) were selected as test foods. Images of the boluses were captured and processed after the subjects freely masticated the test foods until the point of swallowing or completed half strokes of total chewing cycles. The median particle size (X50) was calculated from the data for each particle. We compared X50 calculated from all particles obtained from the masticatory bolus (as X50N) with the X50 of only selectively larger particles (as X50R). RESULTS: Significant correlations were observed between X50N and X50R (p < 0.01) determined in almost all masticatory conditions. In particular, for particle sizes of 2 mm or more, the correlation coefficient between X50N and X50R was notably strong (r > 0.75). CONCLUSION: The method of analyzing only larger particles makes it possible to evaluate masticatory ability without losing the characteristics of the original particle size distribution of the entire bolus. This finding can be applied for the evaluation of masticatory ability, especially among older adults who have difficulty retrieving the total amount of test food due to decreased activities of daily living.

    DOI: 10.2186/jpr.JPR_D_21_00069

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  • Differences in comminution progress during mastication in healthy dentate and denture-wearing elderly people.

    Hikaru Sugimoto, Yuki Tanaka, Naoki Kodama, Shogo Minagi

    Journal of prosthodontic research   64 ( 3 )   257 - 263   2020.7

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    PURPOSE: This study aimed to investigate the effect of removable denture prostheses on the comminution progress in elderly people. METHODS: Twenty-two denture wearers of Eichner's classification B and C (75.1±5.3 years old) and 20 young fully dentate subjects (27.6±1.9 years old) participated in the masticatory examination, which used a combined test food from 5 daily food materials. Full masticatory cycles lasting until subjects needed to swallow and the half number of the cycles were adopted as masticatory conditions. Digital images of food particles under wet conditions were obtained for each bolus, and particles were analyzed by calculating the homogeneity and particle size indices. RESULTS: The characteristic properties of the food particles were observed using a homogeneity index in the elderly denture group for half masticatory strokes. Their homogeneity index was significantly higher than that of the young dentate group. By contrast, no significant difference was observed in the indices for particles immediately before swallowing between two groups. CONCLUSIONS: The comminuted particle size before swallowing in healthy denture wearers was not significantly different from that in the natural dentate group. The comminution of the first-half process in denture wearers was typical and could be one possible focus for meal property specifications in future studies.

    DOI: 10.1016/j.jpor.2019.08.001

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  • Effects of stage II transport and food bolus sampling methods on the properties of food particles. International journal

    Yuki Tanaka, Hikaru Sugimoto, Naoki Kodama, Shogo Minagi

    Journal of oral rehabilitation   47 ( 2 )   196 - 203   2020.2

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    During mastication, some portion of the food bolus is gradually transported to the oropharynx before deglutition, which is known as stage II transport (STII). Although the importance of STII in mastication and deglutition has been widely acknowledged, food particle properties that are transported into the oropharynx by STII have not yet been fully specified. To reveal the food particle properties that are transported into the oropharynx by STII and to assess the usefulness of new food bolus sampling methods for the evaluation of masticatory efficiency. Twenty-two healthy volunteers participated in this study. Four different bolus sampling conditions were adopted: (a) the whole food particles were expectorated when the subject was aware of the first deglutition, (b) the last bolus to be swallowed at the end of unrestrained food intake was expectorated (aftermost bolus sample), (3) the whole food particles were expectorated when the subject felt ready to swallow after swallow-inhibited mastication (swallow-inhibited sample), (4) the particles were regurgitated from the oropharynx after the first STII (stage II-transported sample). Food particles were analysed using the homogeneity index and particle size index. There was no significant difference between food particles in the aftermost bolus sample and swallow-inhibited sample. The particles in the stage II-transported sample showed significantly more homogeneous and smaller sizes than other sampling conditions (P < .05). The food particles transferred to the oropharynx in the stage II-transported sample were smaller than those broken down by natural mastication.

    DOI: 10.1111/joor.12879

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  • Short-Term Crossover Study on the Effect of Orthogonalized Deep-Grooved Posterior Artificial Teeth on the Masticatory Efficiency of Complete Denture Wearers. International journal

    Yuki Hashimoto, Kyoko Sugimoto, Yuki Tanaka, Hikaru Sugimoto, Shogo Minagi

    The open dentistry journal   12   255 - 264   2018

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    BACKGROUND: Mastication has been regarded to play an important role in achieving quality daily life for the elderly. On the occlusal surface of posterior artificial teeth, parallel grooves of 1 mm depth and 1 mm width with an inter-groove distance of 2 mm have been found to significantly improve masticatory efficiency on a mechanical simulator. MATERIALS AND METHODS: In the present study, the effect of the grooved design on masticatory efficiency in edentulous subjects using a short-term crossover trial was evaluated. Six edentulous participants, 1 male and 5 females, were assigned into two groups. One received duplicated complete dentures with grooved molars first, and the other received duplicated complete dentures with conventional molars first. The design of the teeth was crossover after evaluating masticatory efficiency. Raw carrot, raw lettuce and mixed foodstuffs were used to evaluate masticatory efficiency. Subjects were instructed to masticate 20 strokes and arbitrary strokes until they felt like swallowing. RESULTS: The number of masticatory strokes taken was significantly smaller using the grooved design (p<.05). Masticatory efficiency analysis revealed that the grooved design achieved significantly higher masticatory efficiency at 20 masticatory strokes for raw carrot and mixed foodstuffs (p<.05). CONCLUSION: Results show that compared with conventional lingualized occlusion, the grooved design accomplishes higher masticatory efficiency in vivo. Considering the distinction of this design that it can be applied to any existing denture occlusion, the design might help improve the dietary life of the elderly.

    DOI: 10.2174/1874210601812010255

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  • A new occlusal surface design for artificial posterior teeth to achieve high masticatory performance.

    Yuki Hashimoto, Kyoko Sugimoto, Yuki Tanaka, Kazuhiro Oki, Shogo Minagi

    Journal of prosthodontic research   61 ( 2 )   193 - 201   2017.4

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    PURPOSE: The low masticatory efficiency of denture prostheses impairs the ability of wearers to consume high-fiber foods. Hence, artificial teeth with high masticatory efficiency are required. This study aimed to establish an occlusal surface design for posterior artificial teeth in denture prostheses that is compatible with the existing artificial teeth arrangement and that has high masticatory efficiency for the comminution of raw vegetables. METHODS: A masticatory simulator for occluding complete dentures was used to evaluate the masticatory efficiency of four occlusal surface designs, i.e., with parallel grooves occluding at right angles to the opposing teeth, groove depths of 1 and 0.5mm, and inter-groove distances of 1, 2, and 3mm. Raw carrots, rice, raw lettuce, chicken breasts, and peanuts were used as test foods to evaluate food comminution. RESULTS: Grooved occlusal surface designs with a 1-mm groove depth and a 2- or 3-mm inter-groove distance demonstrated significantly greater masticatory efficiency than the conventional occlusal form (p<0.05). CONCLUSIONS: The superiority of grooved designs over the conventional design was particularly evident for lettuce and raw carrots in this study, both of which are considered difficult foods to chew with complete dentures.

    DOI: 10.1016/j.jpor.2016.05.004

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  • 終日記録咬筋筋電図と歯根膜感覚閾値を利用した顎関節症罹患状態についての検討

    平田 敦俊, 加藤 聖也, 松永 匡司, 熊崎 洋平, 荒木 大介, 美甘 真, 橋本 有希, 萬田 陽介, 田中 祐貴, 清瀧 優也, 原 哲也, 沖 和広, 皆木 省吾

    日本補綴歯科学会誌   7 ( 特別号 )   279 - 279   2015.5

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Books

  • 科学英語論文を書くための準備~報告ガイドラインを把握する~

    ( Role: Joint author ,  情報提供、編集)

    歯界展望 第139巻  2022.1 

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  • 慢性再発性アフタ性口内炎を有する患者に対し,口腔衛生管理を行った一症例

    高橋 麻里子, 田中 祐貴, 藤代 万由, 三浦 留美, 窪木 拓男

    日本歯科衛生学会雑誌   19 ( 1 )   91 - 91   2024.8

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  • 既製NSVの改良開発(第一報) 設計と形状

    庄賀 春生, 宮崎 文伸, 太田 圭二, 松岸 諒, 桑原 実穂, 吉實 舞, 兒玉 直紀, 田中 祐貴, 古西 隆之, 藤田 隼平, 瀬島 淳一, 窪木 拓男

    日本口腔顎顔面技工学会学術大会プログラム・抄録集   25回   28 - 28   2023.11

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  • 日常生活中の筋電図記録に混入し得るノイズ信号に関する研究

    皆木 省吾, 兒玉 直紀, 中原 龍一, 尾崎 敏文, 古寺 寛志, 北川 佳祐, 萬田 陽介, 田中 祐貴, 杉本 皓, 森 慧太朗, 山田 蘭子, 松岸 諒, 桑原 実穂

    日本顎口腔機能学会雑誌   29 ( 2 )   124 - 125   2023.3

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  • ニューラルネットワークを用いた画像解析による咀嚼能力評価

    杉本皓, 田中祐貴, 山田蘭子, 兒玉直紀

    日本咀嚼学会学術大会(Web)   34th ( 2 )   107 - 107   2023

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  • 持続的な甘味刺激が唾液分泌量に及ぼす影響

    山田 蘭子, 杉本 皓, 田中 祐貴, 北川 佳祐, 古寺 寛志, 足立 れいみ, 市川 知香, 松岸 諒, 森 慧太郎, 桑原 実穂, 萬田 陽介, 兒玉 直紀, 吉田 竜介, 皆木 省吾

    日本補綴歯科学会誌   14 ( 中国・四国支部学術大会特別号 )   22 - 22   2022.8

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  • 持続的な甘味刺激が唾液分泌量に及ぼす影響

    山田 蘭子, 杉本 皓, 田中 祐貴, 北川 佳祐, 古寺 寛志, 足立 れいみ, 市川 知香, 松岸 諒, 森 慧太郎, 桑原 実穂, 萬田 陽介, 兒玉 直紀, 吉田 竜介, 皆木 省吾

    日本補綴歯科学会誌   14 ( 中国・四国支部学術大会特別号 )   22 - 22   2022.8

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  • 岡山大学病院夢の会話プロジェクト外来における構音障害患者への実態調査

    松岸 諒, 兒玉 直紀, 古寺 寛志, 長塚 弘亮, 佐藤 匡晃, 川上 滋央, 美甘 真, 洲脇 道弘, 田中 祐貴, 北川 佳祐, 足立 れいみ, 市川 知香, 山田 蘭子, 皆木 省吾

    日本補綴歯科学会誌   14 ( 特別号 )   214 - 214   2022.7

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  • 大学病院における口腔ケア 岡山大学病院頭頸部がんセンターにおける顎骨再建後のインプラントと口腔ケアの重要性

    水川 展吉, 武田 斉子, 木股 敬裕, 松本 洋, 安藤 瑞生, 丸山 貴之, 佐々木 禎子, 田中 祐貴, 上田 明広, 飯田 征二

    日本口腔ケア学会雑誌   16 ( 3 )   83 - 83   2022.4

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  • 持続的な味刺激による唾液分泌量の経時変化に関する研究

    山田 蘭子, 杉本 皓, 田中 祐貴, 北川 佳祐, 古寺 寛志, 足立 れいみ, 才本 大稀, 小室 奈央, 谷地 開, 桑原 実穂, 萬田 陽介, 兒玉 直紀, 吉田 竜介, 皆木 省吾

    日本顎口腔機能学会雑誌   28 ( 2 )   76 - 77   2022.3

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  • 呼気流路の容易な制御を目的とした面接触型人工舌の構音改善に関する実験的研究

    長塚 弘亮, 川上 滋央, 古寺 寛志, 佐藤 匡晃, 田中 祐貴, 兒玉 直紀, 原 直, 皆木 省吾

    顎顔面補綴   44 ( 2 )   76 - 76   2021.12

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  • 食塊粒度解析から判明した義歯装着高齢者の咀嚼の特徴

    杉本 皓, 田中 祐貴, 兒玉 直紀, 皆木 省吾

    岡山歯学会雑誌   37 ( 2 )   85 - 85   2018.12

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  • 義歯装着高齢者と健常者における咀嚼進行に伴う食塊粒度特性の差

    杉本 皓, 田中 祐貴, 杉本 恭子, 皆木 省吾

    日本咀嚼学会雑誌   28 ( 2 )   85 - 85   2018.11

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  • Stage II transportで移送された粒子と咀嚼食塊中の粒子の粒度特性に関する研究

    田中 祐貴

    岡山歯学会雑誌   37 ( 1 )   1 - 7   2018.6

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    咀嚼中にStage II transportで咽頭に移送された食物粒子の粒度特性を明らかにし、日常的な咀嚼を反映させ得る実用的な咀嚼食塊の回収方法について検討した。当院に所属する職員ならびに歯学部の学生計12名(男性8名、女性4名、平均27.2±2.15歳)を対象とした。被験者に対し、咀嚼条件1「自由咀嚼を行わせ、その途中に嚥下運動が1回発生したと自覚した時に口腔内に存在している食材をすべてカップに吐出させて粒子を回収する」などの四つの条件下で咀嚼を行ってもらい、口腔内粒子の除去後、反芻様運動を行うよう指示することで中咽頭の粒子を口腔内に戻させ、その粒子を回収用吸引装置で回収した。その結果、咀嚼条件1の粒子が最も大きく、それ以外の条件下では肉眼的におおむね同様の大きさの粒子が観察される傾向にあった。中咽頭に移送されている粒子は小さく均等であり、咀嚼の完了した粒子が選別されて送り込まれていることが示唆された。

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  • 下顎偏位時における舌の三次元的位置解析

    徳善 貴大, 兒玉 直紀, 長塚 弘亮, 村上 明日香, 田中 祐貴, 松本 卓也, 皆木 省吾

    日本補綴歯科学会誌   10 ( 特別号 )   260 - 260   2018.6

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  • 下顎偏位時における舌の三次元的位置解析

    徳善貴大, 兒玉直紀, 長塚弘亮, 村上明日香, 田中祐貴, 松本卓也, 皆木省吾

    日本補綴歯科学会誌(Web)   10 ( 特別号 )   260 (WEB ONLY) - 260   2018.6

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  • Stage II transportで移送された粒子と咀嚼食塊の粒度は異なるか

    田中 祐貴, 杉本 皓, 橋本 有希, 杉本 恭子, 皆木 省吾

    日本咀嚼学会雑誌   27 ( 2 )   83 - 83   2017.11

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    Language:Japanese   Publisher:(NPO)日本咀嚼学会  

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  • 補綴の底力(第2回) フレイル、サルコペニアを予防、改善する超高齢者の咀嚼と義歯治療 高咀嚼能率で噛める総義歯

    皆木 省吾, 萬田 陽介, 橋本 有希, 田中 祐貴, 前田 直人

    補綴臨床   49 ( 6 )   680 - 690   2016.11

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    Language:Japanese   Publisher:医歯薬出版(株)  

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  • New method of neck surface electromyography for the evaluation of tongue-lifting activity

    Y. Manda, N. Maeda, Q. Pan, K. Sugimoto, Y. Hashimoto, Y. Tanaka, N. Kodama, S. Minagi

    JOURNAL OF ORAL REHABILITATION   43 ( 6 )   417 - 425   2016.6

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    Language:English   Publisher:WILEY-BLACKWELL  

    Elevation of the posterior part of the tongue is important for normal deglutition and speech. The purpose of this study was to develop a new surface electromyography (EMG) method to non-invasively and objectively evaluate activity in the muscles that control lifting movement in the posterior tongue. Neck surface EMG (N-EMG) was recorded using differential surface electrodes placed on the neck, 1 cm posterior to the posterior border of the mylohyoid muscle on a line orthogonal to the lower border of the mandible. Experiment 1: Three healthy volunteers (three men, mean age 37.7 years) participated in an evaluation of detection method of the posterior tongue lifting up movement. EMG recordings from the masseter, temporalis and submental muscles and N-EMG revealed that i) N-EMG was not affected by masseter muscle EMG and ii) N-EMG activity was not observed during simple jaw opening and tongue protrusion, revealing the functional difference between submental surface EMG and N-EMG. Experiment 2: Seven healthy volunteers (six men and one woman, mean age 27.9 years) participated in a quantitative evaluation of muscle activity. Tongue-lifting tasks were performed, exerting a prescribed force of 20, 50, 100 and 150 gf with visual feedback. For all subjects, a significant linear relationship was observed between the tongue-lifting force and N-EMG activity (P &lt; 0.01). These findings indicate that N-EMG can be used to quantify the force of posterior tongue lifting and could be useful to evaluate the effect of tongue rehabilitation in future studies.

    DOI: 10.1111/joor.12389

    Web of Science

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  • 介護老人保健施設入居高齢者の咀嚼能力に関する調査研究

    田中 祐貴, 橋本 有希, 平田 敦俊, 坂本 隼一, 沖 和広, 皆木 省吾

    岡山歯学会雑誌   34 ( 2 )   77 - 77   2015.12

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  • 終日記録咬筋筋電図と歯根膜感覚閾値を利用した顎関節症罹患状態についての検討

    平田敦俊, 加藤聖也, 松永匡司, 熊崎洋平, 荒木大介, 美甘真, 橋本有希, 萬田陽介, 田中祐貴, 清瀧優也, 原哲也, 沖和広, 皆木省吾

    日本補綴歯科学会誌(Web)   7 ( 特別号 )   1‐6‐89 (WEB ONLY) - 279   2015.5

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    Language:Japanese   Publisher:(公社)日本補綴歯科学会  

    J-GLOBAL

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  • 咀嚼能率の向上と義歯疼痛軽減を目指した人工歯咬合面形態の機能的評価

    橋本 有希, 杉本 恭子, 田中 祐貴, 皆木 省吾

    日本咀嚼学会雑誌   24 ( 2 )   96 - 97   2014.11

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    Language:Japanese   Publisher:(NPO)日本咀嚼学会  

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  • 食塊粒度を用いた咀嚼能率評価の行方

    皆木 省吾, 田中 祐貴, 橋本 有希, 杉本 恭子

    日本顎口腔機能学会雑誌   21 ( 1 )   8 - 20   2014.9

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    Language:Japanese   Publisher:日本顎口腔機能学会  

    咀嚼に関する研究の中心となってきた歯科医学に多くの知識が存在するにもかかわらず、現在の高齢者の食に関する決定に対する歯科医師の関与はわずか3.1%にすぎず非常に少ないことが報告されている。摂食には多くの要因が関与するため例えば義歯装着等によって食形態を変更できるかどうかの総合的かつ客観的判断も現時点では困難とされており歯学領域でこれまで蓄積されてきた知識は活用されているとは言い難い。この観点から考えると、日常的に摂取している自然食品の咀嚼評価を、食レベル決定のための臨床判断基準として用いることには重要なニーズがあると考えられる。多種多様な日常食品を咀嚼・嚥下する実際の高齢者の食生活を考慮すれば、咀嚼能率の評価は単純化・普遍化から離れて、個々の患者の嗜好なども含めたオーダーメイド化された評価を目指すことが望まれる。本稿ではこれまでに報告された種々の食品の粒度解析関連の研究を紹介するとともに食レベル決定への関与の可能性という観点からまとめたものである。(著者抄録)

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    Other Link: https://search.jamas.or.jp/index.php?module=Default&action=Link&pub_year=2014&ichushi_jid=J02994&link_issn=&doc_id=20150213300002&doc_link_id=%2Fex2gakuk%2F2014%2F002101%2F002%2F0008-0020%26dl%3D0&url=https%3A%2F%2Fwww.medicalonline.jp%2Fjamas.php%3FGoodsID%3D%2Fex2gakuk%2F2014%2F002101%2F002%2F0008-0020%26dl%3D0&type=MedicalOnline&icon=https%3A%2F%2Fjk04.jamas.or.jp%2Ficon%2F00004_2.gif

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