アブストラクト(48巻1号:神奈川歯学)

神奈川歯学

Japanese

Title : シェーグレン症候群を伴う慢性歯周炎患者の歯周治療にエナメルマトリックスデリバティブを応用した一症例
Subtitle : 症例
Authors : 宮島恒一, 根本賢治, 田胡和浩, 辻上弘, 出口眞二
Authors(kana) :
Organization : 神奈川歯科大学口腔治療学講座歯周病学分野
Journal : 神奈川歯学
Volume : 48
Number : 1
Page : 31-37
Year/Month : 2013 / 6
Article : 報告
Publisher : 神奈川歯科大学学会
Abstract : 「緒言」歯周治療の最終目標は, 歯周病により破壊された歯周組織の再生である. 歯周組織の再生とは, セメント質や, 歯根膜, ならびに歯槽骨が新生し, 本来の構造と機能が復元されることである. 現在, 歯周組織再生誘導法(guided tissue regeneration:GTR), エナメルマトリックスデリバティブ(enamel matrix derivative:EMD), 骨移植の3つの方法が歯周組織再生療法として広く応用されている. GTR法は, 骨欠損部へ遮断膜を設置することで上皮の侵入を排除し, 細胞や組織の再増殖の調整, スペースメイキング, 血餅の保持を行う1). EMDは, エナメルマトリックスタンパク質がセメント質形成をコントロールする重要な役割を持つことが明らかになり2), エナメルマトリックスタンパク質を根面に塗布して歯周組織再生を図る方法である3,4). エナメルマトリックスタンパク質の構造はほぼアメロゲニンで構成されており2), EMDGAIN(R)-gel (straumann, Switzerland)は, ブタの歯胚から抽出したアメロゲニン誘導体である.
Practice : 歯科学
Keywords : 歯周治療, エナメルマトリックスデリバティブ, シェーグレン症候群

English

Title : A case of periodontal therapy using enamel matrix derivative (EMD) for chronic periodontitis with Sjogren's syndrome
Subtitle :
Authors : Koichi MIYAJIMA, Kenji NEMOTO, Kazuhiro TAGO, Hiroshi TSUJIGAMI, Shinji DEGUCHI
Authors(kana) :
Organization : Department of Oral medicine, Division of Periodontology, Kanagawa Dental College
Journal : Kanagawa Shigaku
Volume : 48
Number : 1
Page : 31-37
Year/Month : 2013 / 6
Article : Report
Publisher : Kanagawa Odontological Society
Abstract : The ultimate goal of periodontal therapy is the regeneration of periodontal tissue destroyed by periodontal disease. Periodontal tissue regeneration is characterized by de novo formation of cementum, a functionally oriented periodontal ligament, alveolar bone, and the gingiva. At present, guided tissue regeneration, use of enamel matrix derivative (EMD), and osseous grafting are the techniques with the most histologic documentation on periodontal regeneration. Sjogren's syndrome is an autoimmune disease that causes functional decline and chronic inflammation of exocrine activity mainly in the lacrimal and salivary glands. The hallmarks of Sjogren's syndrome are oral symptoms such as dry mouth and tongue inflammation. Therefore, visits to the dentist are often reported as the first step by the patient. Impaired secretion of the salivary glands can cause a dry mouth, resulting in increased progression of caries and periodontitis, as well as oral candidacies and halitosis. Dental procedures that identify these oral symptoms will be important for improving the quality of life for patients with Sjogren's syndrome. Here we report a comprehensive periodontal treatment approach that includes regenerative surgery using EMD for patient with Sjogren's syndrome. As an initial preparation, we performed oral hygiene instruction, scaling, caries treatment, and root canal treatment. After re-evaluation, we performed periodontal tissue regeneration therapy that applied EMD for residual intrabony defects. At re-evaluation 6 months after surgery, no inflammation was observed in the gingiva, the periodontal pocket was within 3 mm, and the addition of bone was confirmed on X-ray. The recurrence of caries and periodontal disease can be considered due to the dry mouth of Sjogren's syndrome. Therefore, it is important to maintain oral hygiene. We currently perform maintenance once every three months, which appears to be sufficient for effective periodontal tissue maintenance.
Practice : Dentistry
Keywords :