著者

須田 英明

出版者

一般社団法人 日本歯内療法学会

雑誌

日本歯内療法学会雑誌 (ISSN:13478672)

巻号頁・発行日

vol.32, no.1, pp.1-10, 2011 (Released:2017-10-31)

参考文献数

31

著者

前田 宗宏 五十嵐 勝

出版者

一般社団法人 日本歯内療法学会

雑誌

日本歯内療法学会雑誌 (ISSN:13478672)

巻号頁・発行日

vol.42, no.2, pp.83-90, 2021 (Released:2021-06-15)

参考文献数

71

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抄 録 : 垂直性歯根破折 (Vertical Root Fracture : VRF) が長期間放置されると, 当該歯根の破折線に沿って歯周組織の広範な破壊が進行する. このため, 単根歯であれば抜歯, 大臼歯ではルートアンプテーションやヘミセクションなどの対応が普遍的にとられてきた. 1980年代以降では, 4-META/MMA-TBBレジンをはじめとする接着修復材料の開発が進むとともに, 破折歯根や支持歯槽骨の状態により, 破折歯根を口腔内で接着する方法, 破折歯根の口腔外接着再植法といったVRFの保存的治療法が試みられ, さまざまな知見が得られてきた. 歯周組織の炎症が拡大する前であれば保存的治療法の予後も良好となることが報告されている. 加えて, 近年普及が著しいCBCT, 歯科用マイクロスコープ, 超音波振動装置などを応用することで, 新たな展開も期待されている.  歯内療法医としてはVRF治療の現状を踏まえ, 可能な限り歯の延命を図ることが重要と考える. 本稿ではVRFの今日的な保存的治療についてまとめてみた.

著者

田宮 資己 山田 雅司 番場 桃子 井瀬 智之 佐古 亮 古澤 成博

出版者

一般社団法人 日本歯内療法学会

雑誌

日本歯内療法学会雑誌 (ISSN:13478672)

巻号頁・発行日

vol.43, no.1, pp.37-40, 2022 (Released:2022-02-15)

参考文献数

9

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Abstract : There are different classifications of external root resorption. As Heithersay GS reported, treatment for invasive cervical resorption becomes difficult once the resorption reaches the apical portion. In the present case report, root resorption that continued from the root area of the lower right canine into the root canal was observed by CBCT. It was diagnosed as invasive resorption accompanying periodontitis. Regular root canal treatment, with rubber-dam and sufficient irrigation followed by obturation, was performed. After root canal obturation, a flap was opened under a microscope, followed by curettage of the granulation tissue of the resorption area from the periodontal ligament side. Then, MTA was used to seal the resorption area. At one-year follow-up, there was no tenderness, pus from periodontal pockets or any other symptoms. It is considered that the removal of granulation tissue and separation of the root canal from the periodontal pocket with MTA filling is effective for the treatment of invasive resorption.

著者

山田 志津香 吉村 篤利

出版者

一般社団法人 日本歯内療法学会

雑誌

日本歯内療法学会雑誌 (ISSN:13478672)

巻号頁・発行日

vol.40, no.3, pp.157-166, 2019 (Released:2019-10-15)

参考文献数

83

著者

吉岡 隆知 猪原 光

出版者

一般社団法人 日本歯内療法学会

雑誌

日本歯内療法学会雑誌 (ISSN:13478672)

巻号頁・発行日

vol.38, no.3, pp.165-170, 2017 (Released:2017-10-06)

参考文献数

27

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Abstract : The purpose of this study was to investigate the root canal morphology of extracted second mandibular molars determined as single root. Sixty-nine single rooted mandibular second molars were used. Gutta-percha point was inserted into the root canal after root canal preparation by a standardized method. Transparent specimens were made from the test teeth and the root canal morphology was evaluated on images taken with a digital microscope. A C-shaped canal was found in 28.9%. When the root canal was prepared in accordance with the root canal orifice observed in the pulp chamber floor, a missed canal was found in 42% of the teeth. Missed canals could not be discovered due to branching inside the root.

著者

福西 一浩 石川 亮

出版者

一般社団法人 日本歯内療法学会

雑誌

日本歯内療法学会雑誌 (ISSN:13478672)

巻号頁・発行日

vol.40, no.1, pp.31-36, 2019 (Released:2019-02-15)

参考文献数

8

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Abstract : In 1972, Simon et al. classified endo-perio lesions into five patterns based on etiology. However, just the concept was presented, without details directly leading to treatment strategies. Here, we report the case of a 36-year-old male with furcation lesion. Although the lesion was preoperatively diagnosed to have been caused by periodontal disease, it was considered that endodontic lesions were intricately involved based on the treatment process and results. The involved tooth was a double-rooted tooth. The electric pulp test result was positive, but the tooth had both vital and non-vital root canals which made diagnosis difficult before surgery. Additionally, the spread of periodontal lesions to the lateral branches of non-vital root canals complicated the situation. This case highlights that endo-perio lesions cannot always be accurately diagnosed before surgery, but reviewing the treatment results and continual evaluation of the etiology would help improve the success rate of treatment.

著者

和達 礼子

出版者

一般社団法人 日本歯内療法学会

雑誌

日本歯内療法学会雑誌 (ISSN:13478672)

巻号頁・発行日

vol.37, no.3, pp.144-149, 2016 (Released:2017-09-30)

参考文献数

21

著者

吉岡 隆知 猪原 光

出版者

一般社団法人 日本歯内療法学会

雑誌

日本歯内療法学会雑誌 (ISSN:13478672)

巻号頁・発行日

vol.39, no.1, pp.9-11, 2018 (Released:2018-02-15)

参考文献数

11

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Abstract : The purpose of this study was to investigate the root canal morphology of extracted two-rooted second mandibular molars. Seventy-seven two-rooted mandibular second molars were used. Gutta-percha point was inserted into the root canal after root canal preparation by a standardized method. Transparent specimens were made from the test teeth and the root canal morphology was evaluated on images taken with a digital microscope. As for the mesial root, 70.1% were two-root canals, whereas for the distal root 88.3% were single-root canals. Although two-rooted mandibular second molars have a simple root canal configuration, in some cases the root canal system is complex, so careful root canal detection is necessary.

著者

田口 正博

出版者

一般社団法人 日本歯内療法学会

雑誌

日本歯内療法学会雑誌 (ISSN:13478672)

巻号頁・発行日

vol.34, no.3, pp.135-139, 2013 (Released:2017-10-31)

参考文献数

14

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Abstract : In daily dental practice, hand hygiene is performed before putting on gloves to carry out medical treatment. However, if the glove is in contact with an unsanitized area and when there is not sufficient time to change the gloves, an alternative disinfection procedure involving antiseptic hand rub (AHR) or washing under running water while wearing the gloves may be unavoidable. This study examined the risks of this disinfection procedure, to check whether or not the gloves might be perforated. Three types of gloves were used in the tests : two latex gloves (powdered and unpowdered) and unpowdered nitrile gloves. As a hand disinfectant, an ethanol-based formulation containing 0.2% benzalkonium chloride was used. The procedure employed for the three different types of gloves was : 1) to conduct AHR or 1-minute hand washing under running water after wearing gloves, and 2) to repeat a “rock-scissors-paper” movement five times as a medical simulation. The gloves were then examined for perforations using the water-proof test according to Japanese Industrial Standards (JIS), by repeating the procedure once, then five times, and finally ten times. As a result, there were no significant differences among the three types of gloves in the occurrence of perforation by the hand hygiene methods described above, or by the number of times that hand hygiene was conducted (Fisher’s exact test : p>0.05). The potential occurrence of perforations of gloves is low even when washing the hands with water or AHR while wearing the gloves.

著者

河野 雅臣 福田 治久 藤久保 美紀 佐伯 康弘 菅原 えりさ 木村 哲

出版者

一般社団法人 日本歯内療法学会

雑誌

日本歯内療法学会雑誌 (ISSN:13478672)

巻号頁・発行日

vol.41, no.2, pp.91-102, 2020 (Released:2020-06-15)

参考文献数

71

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Abstract : Background : Aseptic root-canal treatment (aRCT), in which a bacteria-free protocol is used, results in a high success rate of approximately 90%. However, most Japanese patients do not receive aRCT due to unsuitable procedures that put emphasis on saving cost. Purpose : The aim of this study was to estimate the cost-effectiveness of aRCT in Japan with a cost-utility analysis (CUA). Methods : We used CUA to estimate the cost-effectiveness of aRCT against septic RCT (sRCT) which is thought to be commonly performed in Japan, and evaluated CUA using the incremental cost-effectiveness ratio (ICER). The ICERs were compared with criteria. The expected costs of aRCT were estimated using the fees of Medicaid in the United States and the scheduled fees of the Swedish medical insurance system. The expected cost of sRCT and endodontic surgery (ES) were estimated using the fees of the Japanese reimbursement system. The utility of RCT and ES were quantified with quality-adjusted life years (QALY) calculated by the QOL value of one tooth loss, the rate of RCT failure, and the life expectancy of the median age of the Japanese population. Results : In Japan, the ICERs of aRCT compared with sRCT were lower than the smallest criterion, 5,000,000 yen. Conclusion : The results of this study revealed that aRCT may be a cost-effective procedure in Japan.

著者

石井 信之 浜田 信城 渡辺 清子

出版者

一般社団法人 日本歯内療法学会

雑誌

日本歯内療法学会雑誌 (ISSN:13478672)

巻号頁・発行日

vol.29, no.1, pp.26-29, 2008 (Released:2017-12-30)

参考文献数

10

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Abstract : Hypochlorous acid is a weak acid with the chemical formula HClO. It forms when chlorine dissolves in water. HClO is an acid involving a polyatomic ion. HClO is used as a bleach, oxidizer, deodorant, and disinfectant. CampherTM contains 80% HClO and is used as a food disinfectant, deodorant, air cleaner, and in instrument and package cleaner systems. The purpose of this study was to examine the efficacy of CampherTM as a root canal irrigant in endodontics. Both pH 6.5 and pH 7.0 CampherTM were examined for bactericidal effect and cytotoxicity. Obligative anaerobic bacteria were completely inhibited by applying CampherTM for 1 minute, and facultative bacteria was inhibited 10−2~10−3 by CampherTM for 1 minute in bactericidal effect. The growth of oral epithelial cells was not affected by CampherTM for 48 hours. Both bactericidal effect and cytotoxicity did not vary with the different pH of CampherTM. These results suggested that CampherTM has a bactericidal effect and no cytotoxicity, and could be useful as a root canal irrigant.

著者

中村 裕子 杉山 僚 小此木 雄 関根 慧 牛込 瑛子 高橋 慶壮 小谷 依子 中村 幸生

出版者

一般社団法人 日本歯内療法学会

雑誌

日本歯内療法学会雑誌 (ISSN:13478672)

巻号頁・発行日

vol.31, no.1, pp.29-35, 2010 (Released:2017-11-30)

参考文献数

35

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Abstract : The aim of this study was to investigate the antimicrobial effects of electrolyzed neutral water (Perfect Perio®) (PPW) on Enterococcus faecalis formed biofilm. This PPW contained hypochlorous acid concentrations at 600-700 ppm in pH 7.5. The effects of PPW were compared with those of NaClO and sterilized water (DW). Biofilms of E. faecalis were induced on tissue-culture plates. An overnight culture of E. faecalis grown in brain-heart-infusion broth was seeded (initial concentration of 107-8 cells/mL) with trypticase soy broth (with 0.25% glucose), which was incubated under aerobic conditions for 48h to allow biofilm formation. After incubation, the biofilms were irrigated with PBS and treated as irrigants. The remaining biofilms were stained with crystal violet to gratify the amounts of biofilm, which were determined using a microplate reader. Morphological changes of E. faecalis biofilm by NaClO, PPW or DW were investigated by SEM. NaClO can disaggregate and remove biofilm at all times, and treatment with PPW can cause a high degree of biofilm disaggregation. SEM analysis showed that 5% NaClO eliminated the bacteria completely, PPW was capable of disrupting and removing the biofilm, but not eliminating the bacteria. According to the results, PPW showed the highest eliminatory effect on the E. faecalis-derived biofilm.

著者

橋爪 英城 北原 信也

出版者

一般社団法人 日本歯内療法学会

雑誌

日本歯内療法学会雑誌 (ISSN:13478672)

巻号頁・発行日

vol.35, no.3, pp.133-137, 2014 (Released:2017-09-30)

参考文献数

16

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Abstract : Invasive cervical resorption (ICR) is a type of external inflammatory root resorption. A 30-year-old patient showed, on intraoral radiograph and cone beam computed tomography, ICR of the upper-right central incisor caused by walking bleach. The tooth had a fistula, and showed draining not only from the fistula but also into a root canal. After root canal re-treatment and obturation, the ICR lesion in the pulp chamber was curetted with Nd:YAG laser, then mineral trioxide aggregate was used to fill the resorptive defect. Subsequently, the pulp chamber was restored with composite resin. Radiographs at 2, 4 and 6 months showed the suppression of resorption and endodontic success. Clinically, the tooth was asymptomatic, and no periodontal pocket was found at each point.

著者

反町 香子 北島 佳代子 川崎 孝一

出版者

一般社団法人 日本歯内療法学会

雑誌

日本歯内療法学会雑誌 (ISSN:13478672)

巻号頁・発行日

vol.26, no.2, pp.119-123, 2005 (Released:2018-02-28)

参考文献数

22

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Abstract : There are three roots : the mesiobuccal, the distobuccal, and the palatal (lingual) in the maxillary first and second molars. However, these teeth seldom show malformation of crown or roots. Dental radiographs may reveal variations with two separate palatal roots, each of which has its own canal. The practitioner should be aware of variations in the root canal system. This paper reports the case of a 47-year old man in whom a second maxillary molar with two palatal roots was found. A radiograph of the tooth showed a large radiolucency extending to the apex related to severe periodontal disease. The extracted tooth was evaluated macroscopically, radiographically and by using micro-CT. The tooth had two widely divergent palatal roots that were long. The buccal separate roots were shorter and were parallel. A well-defined enamel projection extended into the furcation proper of the two separate palatal roots on the lingual side of the tooth. A large accessory Carabelli cusp was located on the mesiopalatine cusp of the tooth. The cusp had its own root with pulp canal which lay mesial to the palatal root. The Carabelli cusp and splitting of palatal root were unilateral in the maxillary left second molar.

著者

河野 哲 木方 一貴 吉田 隆一

出版者

一般社団法人 日本歯内療法学会

雑誌

日本歯内療法学会雑誌 (ISSN:13478672)

巻号頁・発行日

vol.43, no.2, pp.76-81, 2022 (Released:2022-06-15)

参考文献数

30

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抄 録:Infection Controlの主幹が根管拡大形成である一方,根管の形態は非常に複雑であり,根管拡大形成のみでは根管内のInfection Controlを十分に達成することができない.根管洗浄はこの機械的清掃の限界を補うため,物理的な洗浄作用のみならず,薬剤の化学的作用を応用した重要な操作である. 本総説では根管洗浄の歴史や意義とともに,2003年および2018年に実施した日本に29校ある歯科大学・歯学部が実際の臨床で行われている根管洗浄に関するアンケート調査の比較により,根管洗浄の実態について論説する.

著者

淺井 知宏 三橋 晃 林 誠 坂東 信 古澤 成博 前田 英史

出版者

一般社団法人 日本歯内療法学会

雑誌

日本歯内療法学会雑誌 (ISSN:13478672)

巻号頁・発行日

vol.42, no.3, pp.166-173, 2021 (Released:2021-10-15)

参考文献数

25

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Abstract : Purpose : In 2003, a study was conducted in Japan on the use of a rubber dam during endodontic treatment. As a result, 25.4% of the Japan Endodontic Association (JEA) member group and 5.4% of the general dentists group (JEA non-member group) answered that they routinely use it. On the other hand, with the increasing interest in preserving teeth among Japanese people in recent years, interest in endodontic treatment has increased too, and the equipment and materials used have also made great progress. Therefore, we hypothesized that the frequency of use of a rubber dam might have changed, and examined it in this study. Materials and Methods : The study period was from October 2019 to November 2020, and questionnaires were conducted through workshops and seminars, etc. held by the JEA, and the Internet. The recovery rate of questionnaires was 97.5%, and responses were received from a total of 986, including 463 in the JEA member group, 100 in the endodontist/dental clinical instructor group of the Japan Endodontic Association (JEA endodontist group), and 523 in the JEA non-member group. Results and Discussion : As a result of the questionnaire, 51.5% of the JEA member group, 60.0% of the JEA endodontist group, and 14.1% of the JEA non-member group answered that they would routinely use a rubber dam. The percentages who use it on a daily basis were : 74.0%, 81.1%, and 28.6%, respectively. In addition, 65.3%, 61.1%, and 34.8% of these three groups answered that they would perform pre-endodontic build-up when necessary for root canal treatment. The JEA member group and the JEA endodontist group were aware of the necessity of the rubber dam isolation technique and pre-endodontic build-up, but the JEA non-member group seemed to have a low usage rate due to complexity and economic reasons. Conclusion : Compared to the 2003 study, it was revealed that the frequency of rubber dam use had increased significantly in both the JEA member group including the JEA endodontist group, and the non-JEA member group. In addition, more than half of the JEA member group and JEA endodontist group routinely perform pre-endodontic build-up, and one third in the non-JEA member group also perform it, suggesting increasing awareness of the importance of using a rubber dam in endodontic treatment.

著者

中澤 弘貴 馬場 俊晃 辻本 恭久

出版者

一般社団法人 日本歯内療法学会

雑誌

日本歯内療法学会雑誌 (ISSN:13478672)

巻号頁・発行日

vol.38, no.1, pp.31-35, 2017 (Released:2017-06-30)

参考文献数

28

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Abstract : This study aimed to identify the root and root canal morphology of maxillary first (P1) and second (P2) premolars in Japanese patients using computed tomography (CT). The subjects were 200 Japanese individuals (100 males, 100 females) who had undergone CT for investigation of oral pathologies in the Department of Radiology at our hospital. For all subjects, one root was present in about 80% of P1 and >90% of P2. Using Turner's classification, one root and one apex were observed in about 50% of P1 and >90% of P2 in both sexes. P2 never showed a complex root in females, but two complex roots were observed in males. P1 predominantly (about 83%) showed two root canals, however, P2 predominantly (about 70%) showed one root canal. In addition, two root canals were more frequent in P1 than in P2 in both sexes (p<0.01). Using Vertucci's classification of the anatomy of one root in P1 and P2, two root canals in P1 were mostly Type Ⅳ (two root canals did not join in the morphology of two root canals and two apical foramina) or Type Ⅱ (two root canals joined in the morphology of one root canal and one apical foramen).

著者

湯本 浩通 平尾 功治 富永 敏彦 松尾 敬志

出版者

一般社団法人 日本歯内療法学会

雑誌

日本歯内療法学会雑誌 (ISSN:13478672)

巻号頁・発行日

vol.41, no.2, pp.82-90, 2020 (Released:2020-06-15)

参考文献数

51

著者

興地 隆史 芳澤 享子

出版者

一般社団法人 日本歯内療法学会

雑誌

日本歯内療法学会雑誌 (ISSN:13478672)

巻号頁・発行日

vol.26, no.3, pp.175-183, 2005 (Released:2018-02-28)

参考文献数

83

著者

澤田 則宏 的場 一成

出版者

一般社団法人 日本歯内療法学会

雑誌

日本歯内療法学会雑誌 (ISSN:13478672)

巻号頁・発行日

vol.38, no.2, pp.107-113, 2017 (Released:2017-06-20)

参考文献数

6

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Abstract : Nickel-titanium files can be used to prepare curved canals, but cannot penetrate the original canals if a previous dentist modified the root canal morphology. Negotiation, patency, and glide path before nickel-titanium instrumentation are important for success. This case report introduces a novel technique for negotiating root canals. Negotiation was performed by the novel technique using clockwise and counter-clockwise motion of the engine in three cases. This technique was effective in cases of a ledge in retreatment, a canal not easy to access, and challenging anatomy.