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1 J Health Care Dent. 2004; 6: Printed in Japan. All rights reserved * Reconsideration of Diagnosis, Treatment and Maintenance of Periodontal Disease Periodontitis is different from other infectious diseases, because it is an inflammatory disease with a unique feature of periodontopathic bacteria colonizing in the exterior portion of the soft tissues in many cases. The local host resistance and reaction to the bacteria triggers the expression of the disease. We evaluated mrna levels of the cytokines, and our study indicates that with the increase in the severity of clinical findings the levels of the cytokines (IL-1 IL-6, and TNF ), potent stimulator of bone resorption, maintain high in the local sites. In order to understand periodontitis, we need to have a better understanding of commonly called Constitution as well as bacteria. The interindividual difference of 1 codogenic (1 base) (more than 1% frequency of the population) is called as polymorphism, and this codogenic difference prescribes the constitution. Kornman et al demonstrated in their study that there is a correlation between IL-1 genotype and severity of periodontitis. About 30 % of the Caucasians and about 7-10% of the Japanese are IL-1 genotype positive group. Thus, there are controllable risk factors of periodontitis, such as plaque accumulation, and uncontrollable risk factors. We think that it will become more important to offer a patient a preventive program of periodontitis by objectively evaluating his/her risk factors. The purpose of this review is to describe the significance of the classification of periodontitis developed by AAP and a workflow of diagnosis and treatment of periodontitis within its scope, subject to the understanding of periodontitis. J Health Care Dent. 2004; 6: Shinya MURAKAMI, DDS, PhD 1-8 Professor, Department of Periodontology, Osaka University, Graduate School of Dentistry 1-8, Yamadaoka, Suita, Osaka, , Japan periodontal diseases diagnosis periodontal treatment maintenance polymorphism IL-1 gerotype positive classification common disease 21 1 *
2 MURAKAMI
3 IL-1 interleukin-1
4 MURAKAMI 5 needle punch biopsy mrna gingival index IL-1 IL-6 TNF
5 SNP single nucleotide polymorphism IL SNP IL-1 SNP IL IL-1 IL IL Kornman IL-1 IL-1 IL-1 IL AAP
6 MURAKAMI I II. III. A B A B 1 IV A B V. A NUG B NUP VI. A B C VII. A - VIII. A / B C D
7 3 Chronic Periodotitis A. 30 B. 30 HIV attachment loss
8 MURAKAMI 4 Agressive Periodotitis A. attachment loss 2 B. 3 famillial aggregation A.a. P.g familial aggregation Actinobacillus actino-
9 5 Periodontitis as a Manifestation of Systemic Diseases A B Papillon-Lefèvre 5 Chédiak-Higashi Cohen 10 Ehiers-Danlos IV VIII C. mycetemcomitance A.a. P.g. A.a. Porphyromonas gingivalis P.g
10 MURAKAMI SPT supportive periodon-tal therapy definitive curettage GI 6 6 2mm 5 8 GI1 2 P.g. 2-3 AAP
11 6 IDDM Type1 Diabetes Mellitus 30 NIDDM Type HIV HIV AIDS T HIV HIV HIV Neison et al.,
12 MURAKAMI
13 13 X TNF 8 TNF TNF 15 H D IL-1 TNF
14 MURAKAMI IL-1 TNF BMI BMI TNF 7 A 16
15 Ca 2 A
16 MURAKAMI 17-1 Axelsson P & Lindhe J: J Clin Periodontol, 8(4): , attachment level
17 Supportive Periodontal Therapy SPT 3-3 SPT definitive curettage SPTsupportive periodontal therapy supportive periodontal treatment 1 SPT SPT recolonization)
18 MURAKAMI definitive curettage SPT SPT definitive curettage Schluger caries activity caries 3 definitive curettage 3 SPT 100 SPT definitive curettage SPT definitive curettage definitive curettage definitive curettage M2 M3 definitive curettage definitive curettage
19 Axelsson P & Lindhe J: The significance of maintenance care in the treatment of periodontal disease. J Clin Periodontol, 8(4): , Emrich LJ, Shlossman M, Genco RJ: Periodontal disease in noninsulin-dependent diabetes mellitus. J Periodontol, 62(2): , Kornman KS, Crane A, Wang HY et al.: The interleukin-1 genotype as a severity factor in adult periodontal disease. J Clin Periodontol, Jan; 24(1): 72-77, Schluger S, Yuodelis R, Page R et al.: Periodontal Diseases. Lea & Febiger, Philadelphia, AAP
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A comparison of abdominal versus vaginal hysterectomy for leiomyoma and adenomyosis Kenji ARAHORI, Hisasi KATAYAMA, Suminori NIOKA Department of Obstetrics and Gnecology, National Maizuru Hospital,Kyoto,
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ABSTRACT The "After War Phenomena" of the Japanese Literature after the War: Has It Really Come to an End? When we consider past theses concerning criticism and arguments about the theme of "Japanese Literature
Title 生活年令による学級の等質化に関する研究 (1) - 生活年令と学業成績について - Author(s) 与那嶺, 松助 ; 東江, 康治 Citation 研究集録 (5): 33-47 Issue Date 1961-12 URL http://hdl.handle.net/20.500.12000/ Rights 46 STUDIES ON HOMOGENEOUS
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Title 発達障害と睡眠困難 に関する研究の動向と課題 ( fulltext ) Author(s) 柴田, 真緒 ; 髙橋, 智 Citation 東京学芸大学紀要. 総合教育科学系, 69(2): 107-121 Issue Date 2018-02-28 URL http://hdl.handle.net/2309/148914 Publisher 東京学芸大学学術情報委員会 Rights
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