Gene therapy was born as a causal treatment for hereditary conditions and was a therapy to compensate for defective genes. Today, various clinical applications are being investigated based on the basic concepts of supplementation of normal genes, suppression of gene expression, and repair of abnormal genes. In recent years, applications to oral and maxillofacial diseases have been considered, and research is being conducted. The authors also conducted research on gene therapy for pain caused by oral cancer and dry mouth caused by Sjogren's syndrome, an autoimmune disease. It is expected for gene therapy to be applied to dental caries and periodontal diseases that are routinely diagnosed by general dentists.
Occlusion is the basis of dentistry and required for suitable posture, oral function and morphology. We treat with consideration for balance, not hung up on only the affected part; development of the dentition is the main purpose in pedodontics. Naturally, to guide retouching and adaptation by removing factors impeding good growth development becomes the main theme. If abnormalities found in early stage are left untreated for a long time, it will be virtually impossible to recover. In contrast, early medical examination and treatment can often lead to cure and prevent children from getting serious conditions. Cross bite, eccentric occlusion and impacted tooth are recommended to treat in early stages and improvement of oral habits is also important. Even if there are some deviations from the growth and development determined by genetics, it is not possible to simply distinguish between abnormal and normal based on morphology alone. It is, however, possible and effective to anticipate the future and take timely action. In this way, development will be stimulated by function, and posture will act as an appropriate sustained external force. It is also necessary to respond to the individual differences. In pedodontics, it is important to investigate the cause of the disorder and take preventive measures for habilitation, rather than just repeating symptomatic treatment.
Coronavirus disease 2019 is rampant in many countries around the world. In this study, we conducted a questionnaire survey among members of the Academy of Clinical Dentistry to investigate the impact of the cluster outbreak on dental clinics in the surrounding area. As a result, the psychological impact of the outbreak on the local residents was significant, and it was suggested that anxiety about infection and the spread of misinformation may have led to avoidance of dental visits and discriminatory feelings toward dental professionals. In addition, the shortage of medical supplies and other factors made it difficult for clinics to implement adequate infection prevention measures. In order to maintain an oral environment patientsʼ oral health, we, dental professionals, recognize the need to disseminate correct information on the new coronavirus infection and to develop a medical environment in which safe and secure treatment can be provided.
We verified a laser fluorescence spectroscopy (DIAGNOdent) was an effective and simple equipment to measure mutans streptococci (MS). DIAGNOdent provides was developed by KaVo Dental and it was launched as a tactile detection device. Since the reflected light excited by the laser light is also generated from healthy tooth material and altered by certainty of postprandial brushing, this wavelength was considered to be a reaction related to MS in dental plaque and biofilm. In the patientʼs mouth irradiation of DIAGNOdent to all tooth surfaces to evaluate the reaction was measured using OralCare Dentocult® SM. By measurement and examing the correlation between the DIAGNOdent measurement values and them, the possibility of using DIAGNOdent was examined. Results showed that 22 of 37 patientʼs with positive Dentocult® SM values in plaque on teeth was positive DIAGNOdent values. Twenty-five out of 29 Dentocult® SM negatives had DIAGNOdent values it was negatives. Plaque in In saliva 21out of 31 people who were positive the Dentocult® values were positive the DIAGNOdent values. Seventeen out of 23 who were negative the Dentocult® SM values had negative DIAGNOdent varues. DIAGNOdentʼs reaction and Dentocult® SM values are significantly correlated. We found the DIAGNOdent was useful as an inspection device for convenient screening of MS in mouse. In daily clinical practice this device intends to facilitate the treatment of causal therapy.
Case summary: It is common to perform esthetic restorations of maxillary anterior teeth using different prosthetic materials for the left and right sides, but it is often difficult to match their color tones. In this paper, we report a case of esthetic restoration using a cement that can reproduce color tones focusing on luminosity. Treatment strategy: The patient, a 59-year-old woman, came to our clinic because of dehiscence of resin prosthetic crown in #11. After obtaining the patient's explanation and consent, it was decided to place an implant and all-ceramic crown on #11 and porcelain laminate veneers on #21 tooth after extraction. Course of treatment: After orthodontic extrusion of #11 to facilitate the alignment of the right and left cervical lines, the implant was placed immediately after extraction. After confirming the osseointegration of the implant, a provisional restorations were fabricated based on the diagnostic wax-ups of #11 and #21, and a porcelain laminate veneer was prepared using the flowable resin technique. After the veneer preparation, the remaining enamel was checked using a chairside SEM observation system, and the veneers were bonded using dental resin cement. Considerations and conclusions: The additional fabrication of a diagnostic wax-up made it possible to reduce the volume of the wax model, thus allowing more enamel to remain and improving long-term bonding expectancy of porcelain laminate veneer. The color tone of all-ceramic crowns is also affected by the color tone of the supporting teeth and bonding materials. Porcelain laminate veneers may be more affected by the cement color because of their thinness. Since luminosity affects color tone, a cement allowing adjustment of luminosity may be useful. The cement used in this study can be easily matched to the color tone by a simple system of selecting from three colors with different luminosity.
The following three cases were carefully observed after rest treatment for damaged vital pulp. (1) 24-year course of pulp conservation therapy for chronic pulpitis (12-year-old boy at the time of initial examination); (2) Rest treatment for pain during mastication (33-year-old woman at the time of initial examination); and (3) Pulp conservation therapy for a mandibular molar suspected of chronic pulpitis due to deep caries (23-year-old man at the time of initial examination). The standard treatment for early pulpitis is preservation of the living pulp, but the diagnosis of pulp is not a matter of black-and-white. This is because the pulp tissue is a recoverable tissue with vigorous vitality. Therefore, rest treatment and careful follow-up are the initial treatment of damaged pulp, which should determine whether it can be saved or not. Although much attention has been paid to precise and efficient root canal treatment, I would like to remind that the basis of endodontic treatment is pulp preservation, and rest treatment is the rites of passage in the course of proper endodontic treatment.
This report is to present a case of periodontal orthodontic treatment in which a comprehensive approach was taken involving periodontal, orthodontic, and occlusal intervensions while assessing masticatory function in a patient with generalized severe chronic periodontitis. In this case, the interdental separation of 2 1 and the protrusion of 1 were apparent due to extensive severe periodontitis and clenching, and 2 2 were squeezing the maxillary gingiva. There was moderate to severe alveolar bone resorption throughout the maxilla and mandible, and the dentition was inclined proximally, with gingival swelling, bleeding and tooth mobility. The findings of masticatory movement showed a very slow masticatory cycle of about 1 second, TMJ noise, and TMD symptoms such as inability to open the mouth straight. In addition, various complaints such as headache, hearing loss, and stiff shoulders were also observed. In this complicated case, we reconstructed the malpositioned dentition and occlusion by periodontal orthodontic treatment, provided functional mastication, and reconstructed the occlusion with a crown bridge. 14 years had passed since the initial examination, and the regeneration of periodontal tissue was confirmed, and the occlusion, function, and aesthetics were restored in harmony with the temporomandibular joint.
A 56 years old woman visited our clinic with a chief complaint of pain in the upper right premolar area. Longitudinal root fractures were observed in the maxillary right second premolar and second molar, which were later extracted. The patient had a two-rooted third molar on the right side of the mandible. By analysis with cone beam CT, when the root of the third molar was divided and then transplanted, it was found that the root shape coincided with the extraction socket of the second premolar and second molar. The root of the third molar was divided and tooth transplantation was performed at two sites simultaneously. More than 4 years has passed since the operation. We report the details of periodontal tissue recovery, and that the transplanted teeth are also clinically functional.
In this case (68 years old, female, at the time of initial examination), an implant overdenture was used for bilateral molar defects to restore oral dysfunction due to masticatory disorders caused by ill-fitting dentures. In an oral cavity with multiple missing teeth, it is necessary to provide an appropriate mandibular position and to construct an occlusal position to maintain it. In some cases, orthodontic treatment is necessary to correct the malpositioning of the remaining teeth, and an implant prosthesis is the first choice to provide solid occlusal support for the missing teeth. However, considering the patient's wishes and financial background, the ideal treatment is rarely attained. In particular, prosthodontic treatment for partially edentulous dentition with existing implant prostheses is difficult due to the selection of prostheses and prosthetic design. In the present study, a mandibular dentition with bilateral molar defects was treated with an implant-assisted removable partial denture (IARPD) using an existing implant to restore oral function, which in effect led to desirable results.