著者

中村広一

雑誌

ザ クインテッセンス

巻号頁・発行日

vol.11, pp.159-165, 1992

被引用文献数

1

著者

中村 広一

出版者

一般社団法人 日本有病者歯科医療学会

雑誌

有病者歯科医療 (ISSN:09188150)

巻号頁・発行日

vol.4, no.1, pp.1-6, 1995-08-31 (Released:2011-08-11)

参考文献数

4

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本論文においては, 61例の精神疾患と神経疾患患者からなる患者群, および17例の健常者からなる健常群という二つの群を対象として, 上下床義歯の装着所要時間の計測という方法で義歯の取扱い能力を評価した。患者群では脳血管障害1例を除く全例が調査時点ですでに床義歯の装用経験者であった。各群はさらに2つの群に下位分類された: 1群は上下に全部床義歯を装用中のもの, 2群は部分床義歯と部分床ないし全部床義歯を装用中のもの(表1)。患者群の疾患には, 精神分裂病(21例), パーキンソン病(9例), 脳血管障害(8例), アルコール依存症(7例), 気分障害(7例)およびその他が含まれた(表2)。結果は以下のごとくであった(図1)。1. 健常群の対象は3秒から11秒の間に義歯の装着を行い, その所要時間の平均は6.9±2.0秒であった。これに対して患者群の対象は, 3秒から356秒を超えるまでの広い範囲の散らばりを呈した。2.疾患が義歯取扱い能力に及ぼす影響を評価する目的で, 1, 2群の各々について装着所要時間を健常群と患者群との問で比較した。1群においては,患者群の平均所要時間は16.7±15.6秒と, 健常群の平均7.0±1.0秒に対して長かった。その差は有意(P<0.05)ではなかった。2群においては, 患者群の平均は, 23.7±17.9秒と健常群の6.9±2.4秒に対して有意(P<0.05)に長かった。3. 床義歯の形態が所要時間に及ぼす影響を明らかにするために, 健常群と患者群の各々について装着所要時間を1, 2群間で比較した。健常群においては, 両群間に差がなかった。患者群においては, 2群の平均所要時間が23.7±17.9秒と1群の16.7±15.6秒よりも長かったが, その差は有意(P<0.05)ではなかった。4. 義歯の装着所要時間が60秒を超えた5例の疾患には, パーキンソン病, 脳血管障害, 筋ジストロフィー, アルコール依存症, および精神分裂病の各1例が含まれた。これらの症例は義歯装着という行為を成し遂げるに必須のさまざまな要因を示唆した。

著者

中村 広一

出版者

Japanese Society of Psychosomatic Dentistry

雑誌

日本歯科心身医学会雑誌 (ISSN:09136681)

巻号頁・発行日

vol.15, no.2, pp.185-189, 2000-12-25 (Released:2011-09-20)

参考文献数

12

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A 26-year-old female patient with schizophrenia was referred to us by her psychiatrist, complaining of the breakage of half of her bridge in the 5+5 region. Denture treatment was suitable for this case, in view of the long span of missing tooth in the 3+3 region, the condition of the abutment tooth, her mental problem and financial standing. She persisted, however, in demanding the bridge and never accepted denture treatment. All efforts to make her understand the suitability of the treatment proved useless due to the failure of mutual understanding. Her demands for the prosthesis were often unreasonable and bizarre.The author gave her time to change her mind while performing other tooth treatment. Three years and 7 months after her first visit, her partial denture was completed. At first, she was not able to accept it because of her youth and for aesthetic reasons. Often, she revealed unreasonable and delusional reactions to her denture. However, she came to accept it a little more day by day and now wears it normally, although it remains unclear whether she is fully reconciled to its use in her heart.The greater part of the difficulty in managing this patient was due to the lack of mutual undertanding and her bizarre thoughts and behavior caused by her schizophrenia. On the basis of this case, it is suggested that dentists treating such schizophrenic patients should try to 1) recognize the patients' mental pathology but not become involved in that, 2) understand the patient's desire for a certain treatment but reject it firmly if it is unreasonable, 3) sustain the dentist-patient relationship with patience, 4) wait for improvement in the patient's delusions and behavior regarding dental treatment, and 5) bring the treatment to the appropriate goal by these means.

著者

中村 広一

出版者

Japanese Society of Psychosomatic Dentistry

雑誌

日本歯科心身医学会雑誌 (ISSN:09136681)

巻号頁・発行日

vol.3, no.1, pp.32-36, 1988-12-25 (Released:2011-09-20)

参考文献数

29

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Danger of overlooking organic diseases and difficulty of a dentist's situation in treatment under a diagnosis of masked depression are discussed in this article. We propose the utility of introducing the concept of psychogenic overlay into the diagnosis and treatment of dental patients suspected to be depressive.

著者

中村 広一

出版者

Japanese Society of Psychosomatic Dentistry

雑誌

日本歯科心身医学会雑誌 (ISSN:09136681)

巻号頁・発行日

vol.12, no.2, pp.119-122, 1997-12-25 (Released:2011-09-20)

参考文献数

5

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The management of two cases of schizophrenic patients with delusions is reported in this article. The first case was a 45-year-old man who was refered to our office by a psychiatrist. He had a cosmetic disturbance due to the dropping off and fracturing of the resin-faced cast crowns of the upper central incisors. During treatment, he suffered from a sensation of tightness on the tooth. He asserted that the sensation was caused by the temporary crowns, which he thought were too wide and long. The shapes of the crowns were, in fact, appropriate and the contact pressures between them and the adjacent tooth were loose. His sensation was therefore unfounded and seemed to be abnormal. His interpretation that the agony was caused by the crowns was judged to be a delusion. He demanded lighter and looser crowns. His claim, fouunded on this false belief, placed us in a dilemma. The author waited for such a time as when he would become mentally stable. During this wait, only reversible dental treatment, newly adjustments to the surface of the temporary crowns or trial sets of wax patterns, was repeated. In due course, with the progress of psychiatric treatment, he became calm and accepted his final prosthetic crowns.The second case was a 45-year-old male schizophrenic patient who attributed his toothache to the machinations of an acquaiatance. The pain was due to pulpitis of a right upper first premolar. It was clear that his belief was unfounded, and it was therefore judged to be a delusion. The author listened carefully to his assertion but did not give it special importance. The treatment of his teeth was completed without trouble by ordinary procedures with his consent.The evaluation of these two cases suggests that the dental treatment of delusional patients becomes more difficult when the delusion involves elements of dental practice itself and the patient demands inappropriate dental treatment because of the delusion.

著者

中村 広一

出版者

Japanese Society of Psychosomatic Dentistry

雑誌

日本歯科心身医学会雑誌 (ISSN:09136681)

巻号頁・発行日

vol.19, no.1-2, pp.23-26, 2004-12-25 (Released:2011-09-20)

参考文献数

8

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The case of a 61-year old male schizophrenic patient who complained of occlusal disturbance after upper denture repair by the author is reported. The author found no problem with the denture and considered the blaming of occlusal disturbance on the denture repair unreasonable and misguided. The subjective symptoms were treated as qualia rather than delusions. A good relationship was established by listening to the complaint. Medical interviews and explanations by the author, in his role as dentist, were repeated for three years and the patient was finally convinced of the truth.

著者

尾口 仁志 中村 広一 石川 圭子 瀬戸 皖一

出版者

Japanese Society of Psychosomatic Dentistry

雑誌

日本歯科心身医学会雑誌 (ISSN:09136681)

巻号頁・発行日

vol.3, no.1, pp.20-25, 1988-12-25 (Released:2011-09-20)

参考文献数

16

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The patient, a 22 years old man, came to us hoping to receive dental treatment under general anesthesia on account of his extreme dental treatment phobia.The symptoms had been manifest since primary school. On the first medical examination day, the patient found it impossible to sit in a dental chair.We diagnosed a severe dental treatment phobia from his symptoms. As a result of six hours of interviews, at the rate of two hours a day, we recognized the possibility to cure the patient of his symptoms.Although a long period would be required, we decided to proceed with systematic desensitization.In systematic desensitization, we utilize autogenic training for reciprocal inhibitation. In the early stage, we used desensitization by image, then in-vivo desensitization.At the same time, we combined assertive response and modeling therapy.As a consequence, we were able to successfully alleviate the dental treatment phobia itself, although a total treatment period of 11 months was required.

著者

中村 広一

雑誌

日本歯科心身医学会雑誌 = Japanese journal of psychosomatic dentistry (ISSN:09136681)

巻号頁・発行日

vol.17, no.2, pp.109-112, 2002-12-25

被引用文献数

2 7