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Various techniques have been applied to the fabrication of duplicate dentures. In this new method, after scanning the cameo and intaglio surfaces of the complete denture using an intraoral scanner, the two images were superimposed on the interocclusal image. The linear gap between cameo and intaglio surfaces was filled using free downloadable CAD software. The superimposed image was subsequently used as data for fabricating the duplicate complete denture with a 3D printer. Using the intraoral scanner, duplication of complete dentures could be performed without needing any complicated processes, laboratory scanners, or advanced CAD software.

Purpose To investigate the difference in improvement of oral health-related quality of life (OHR-QoL) depending on the oral and denture conditions of a complete denture wearer when using a cream or powder type denture adhesive in a 10-center parallel randomized clinical trial.Methods Two hundred edentulous subjects who wore complete dentures were allocated to each of the three groups according to denture adhesive type: cream, powder, and control (saline solution). The materials were applied to the mucosal surface of the dentures for 4 days, and baseline data and data after the intervention were collected. OHR-QoL was assessed using the Japanese version of the modified Oral Health Impact Profile for Edentulous Patients (OHIP-EDENT-J) scale for outcome. Multivariate analysis was used to investigate improvements in OHR-QoL according to participant characteristics among complete denture wearers using these materials.Results OHIP-EDENT-J scores were significantly decreased in all groups after the intervention (p < 0.05); however, there were no statistically significant differences among the groups. Multiple logistic regression analysis revealed a significant association between the vertical height of the maxillary and mandibular alveolar ridge and OHIP-EDENT-J scores in the cream-type denture adhesive group. In contrast, there were no significant association between participant characteristics and OHIP-EDENT-J scores in the powder-type adhesive and control groups.Conclusions The use of denture adhesives could improve OHR-QoL for complete denture wearers. The cream-type denture adhesives may be expected to improve OHR-QoL in patients with poor residual ridge conditions compared with patients with good residual ridge conditions.

The purpose of this study was to investigate the effect of denture adhesives on oral moisture in a 10-center parallel randomized clinical trial.Two hundred edentulous subjects wearing complete dentures were allocated into three groups: cream-type adhesive, powder-type adhesive and control groups. The adhesives (and saline solution in the control group) were applied to the mucosal surface of the dentures for 4 days, and baseline data and data after the intervention for eight meals over 4 days were obtained. For the main outcome, oral moisture was measured with a moisture checking device. Secondary outcomes were denture satisfaction, masticatory performance, denture retention, and occlusal force. In addition to between-group and within-group comparisons of oral moisture, investigations for secondary outcomes were undertaken in subgroups classified according to the degree of oral moisture at baseline (normal subgroup and dry mouth subgroup). Intention-to-treat analysis was also performed.Between-group and within-group comparisons of oral moisture showed no significant differences. The cream-type and powder-type denture adhesives were significantly effective in the dry mouth group for denture satisfaction ratings of ability to masticate, stability, retention, and comfort of mandibular dentures (p0.05). The masticatory performance and retentive force of the dry mouth denture adhesive using groups were significantly improved after intervention (p0.05).The oral moisture of complete denture wearers was not influenced by the use of denture adhesives. Our findings showed that denture adhesives improved subjective denture satisfaction, masticatory performance, and retention for complete denture patients with oral dryness.

When the sinus is enlarged, it may be necessary to elevate the floor of the maxillary sinus using the crestal or lateral approach. This report presents a case where sinus floor elevation was performed using tricalcium phosphate (TCP) plates supported by implant bodies, and only the blood clot was present around the implant bodies. Cone-beam computed tomography images, taken one year after the lateral approach, revealed the presence of a TCP-like radio-opacity, which almost disappeared after two years. About seven years after the surgery, the patient's superstructure and occlusion were stable. Furthermore, the grafted TCP was completely absorbed, and the implant body appeared to be in good condition, with no signs of bone resorption around the implant.

Purpose To reveal effects of improvement of masseter muscle activity on brain function in elderly people wearing complete dentures.Methods Subjects were 14 edentulous patients with a chief complaint of the inconvenience of their complete dentures. The surface electromyographic (EMG) activity of the masseter muscles was measured. Brain activities were analyzed with functional magnetic resonance imaging (fMRI), employing chewing gum as the task program. Cognitive functions were evaluated with Trail Making Test Part A (TMT-A), Rey Auditory Verbal Learning Test (RAVLT) and Rey-Osterrieth Complex Figure Test (R-OCFT). Those evaluations were performed in which subjects wore their old dentures (OD) or newly fabricated dentures (ND).Results We compared ND condition with OD condition. The masseter muscle activity significantly increased in ND condition (p0.05, Wilcoxon signed rank test). The brain activity increased significantly in the superior frontal gyrus, precentral gyrus, putamen, inferior parietal lobule, cerebellum, inferior frontal lobe, and middle frontal gyrus under the ND condition than under the OD condition (p0.01, uncorrected, cluster size10 voxels). Results of TMT-A, RAVLT, and R-OCFT were also significantly improved (p0.05, Wilcoxon signed rank test).Conclusions In the edentulous elderly, the brain activity was increased following the improvement of the masseter muscle activity. Consequently, it is possible that the improvement of the masseter muscle activity might influence on the attention, verbal skills, and visual memory.

PURPOSE The purpose of this study was to examine morphological changes in the superstructure of implants in relation to the degree of attrition of the implant superstructure and its antagonists. METHODS Thirty-three patients participated. The implant superstructures of the first molar and its antagonists were scanned with an intraoral scanner every 3 months. The amount of attrition was calculated in relation to the various materials used for the superstructure, and differences were analyzed statistically (P < 0.05). RESULTS Attrition of the implant superstructure was 110 ± 30 µm for monolithic zirconia and 105 ± 27 µm for resin-veneered metal after 12 months. No statistically significant difference was found between the two groups. In contrast, attrition of the antagonists was 75 ± 25 µm for zirconia and 105 ± 20 µm for resin-veneered metal after 12 months. A statistically significant difference in the attrition levels between the two groups was observed after 9 and 12 months. CONCLUSION During the 12-month observation period, there was no difference in superstructure attrition between zirconia and resin-veneered metal. Attrition of the antagonists was higher for hybrid composite resin-veneered metal than for zirconia, suggesting that surface roughness affected the degree of attrition.

Adequate oral status and functional assessments are important for dysphagia rehabilitation in acute care inpatient settings, especially to establish individualised oral intake. However, the association between food intake levels and oral function has not been elucidated in acute care inpatients. This cross-sectional study clarified the association between oral intake levels and the oral status/function of patients with dysphagia admitted to acute care settings. Admitted patients aged ≥40 years (n = 459; men: 288; mean age: 70.8 ± 12.0) examined at the Department of Dysphagia Rehabilitation at the Iwate Medical University Hospital from April 2007 to March 2014 were included. The oral health status was evaluated by the tongue coating, oral dryness severity, plaque control, posterior occlusal support and a repetitive saliva swallowing test (RSST). Dysphagia severity was determined from the Dysphagia Severity Scale. Oral intake levels were evaluated using the Functional Oral Intake Scale (FOIS) at the time of the initial dental examination (FOIS-I), and they were re-evaluated after the revision of levels according to the participants' general condition and oral health status (FOIS-R). Divergence between FOIS-I and FOIS-R was noted in >40% patients. Multiple regression analysis showed significant associations between FOIS-R and consciousness level, activities of daily living, tongue coating, RSST and posterior occlusal support. Patients with dysphagia in acute care settings require detailed assessments of their oral status and function, including swallowing, to determine the most suitable feeding methods and dental interventions to improve oral intake levels.

Purpose One of the most prominent issues in a super-aging society is the rapid increase in dementia patients. Cross-sectional studies in dentistry have indicated that patients with dementia have worse oral health compared to healthy people. The purpose of this study was to clarify the influence of tooth loss on brain structure by comparing the volumes of gray matter (GM) and white matter (WM) between edentulous and dentulous subjects. Methods Subjects were recruited from the Denture Clinic at Iwate Medical University Hospital Dental Center. Experiments were performed on edentulous (5 males, 8 females, 81.8±1.24years) and dentulous subjects (4 males, 7 females, 77.1±4.25years). Patients with dementia were excluded from this study. Brain volumes of GM and WM in edentulous and dentulous subjects were compared using intracranial volume, age, gender and history of hypertension as covariates. Analyzed brain areas were identified by transforming the Montreal Neurological Institute coordinate into the anatomical coordinate in edentulous subjects. Results The analysis of WM structural images found no morphological differences between dentulous and edentulous subjects. However, significant atrophy of GM was observed in the hippocampus, caudate nucleus and temporal pole of the right hemisphere in edentulous subjects. Conclusions The results of this study suggest that tooth loss was a causal factor for volume reduction in brain areas related to memory, learning and cognition.

Purpose To determine the appropriate attachment and design of a denture base for mandibular implant overdenture (IOD), the oral mucosa pressure caused by mandibular implant overdentures was measured using edentulous jaw models with various attachments. Methods An experimental edentulous mandibular model with a 1.5-mm thick artificial oral mucosa was used. Two implants were placed at the area equivalent to the bilateral canines of an experimental jaw model. Locator attachments (LA), ball attachments (BA), magnetic attachments (MA), and round-bar attachments (R-BA) were fabricated. Six miniature pressure sensors were placed at the bilateral buccal premolar regions, bilateral buccal shelves, and bilateral lingual molar regions. A precision universal testing machine was used to apply dynamic repetitive loads of 50 N. The load points were the center of the model, which should represent bilateral mastication on both sides (bilateral load), and were equivalent to the left first molar, which should represent unilateral mastication (unilateral load). Statistical analysis was performed using one-way analysis of variance. Multiple comparisons were then performed using the Bonferroni post hoc test. P Results Under the bilateral load condition, the lower oral mucosa pressure value with BA was measured, compared to other attachments at all measurement sites. Under the unilateral load condition, the oral mucosa pressure value of BA was smaller than the other attachments at the measurement site on the loading side. Conclusions BA has exerted the greatest effects on support and bracing, suggesting that, BA is suitable for reducing oral mucosa pressure during mastication.

Objective To investigate the effects of wearing complete dentures on pharyngeal shape for swallowing in edentulous older people. Background In the absence of complete dentures, edentulous older people often lose the occlusal support necessary to position the mandible, which leads to an anterosuperior shift of the mandible during swallowing. This may result in pharyngeal shape changes effecting swallowing function in older people. However, the details of this phenomenon are currently unclear. Materials and methods Participants were 17 older edentulous volunteers. Cone-beam computed tomography imaging was performed with the participant in the seated position and wearing (i) both maxillary and mandibular dentures, (ii) maxillary dentures only and (iii) no dentures. During imaging, participants were instructed to keep their mouth closed to the mandibular position determined in advance during swallowing for each denture-wearing condition. The volume, height and average cross-sectional area of the velopharynx and oropharynx were measured, and the positions of the epiglottis and mandible were recorded. Results While the vertical height of the oral cavity and pharynx significantly decreased, the volume and average cross-sectional area of the oropharynx significantly increased when dentures were not worn (p

The key objective of mastication is to form a food bolus suitable for smooth swallowing. However, chewing is usually performed without a conscious effort. Poor bolus formation can cause pharyngeal residue and suffocation in elderly individuals with reduced swallowing function. Therefore, chewing with a conscious effort may help the bolus to more easily pass the pharynx. This study aimed to clarify the impact of mastication with a conscious effort on the feeding sequence. Subjects included 25 dentulous volunteers who were informed and provided written consent. Lateral videofluoroscopy was performed during the feeding of solid agar jelly under two conditions: chewing naturally in their usual manner (without volition) and chewing with a conscious effort (with volition). Temporal evaluation was performed for mastication, stage II transport (STII), swallow onset and oropharyngeal transit time. Moreover, bolus volume at swallow onset and subjective evaluation of swallowing easiness were measured. Volitional chewing with a conscious effort lengthened the duration of the chewing sequence before and after STII and delayed the swallow onset despite the fact that the bolus volume in the vallecula and hypopharynx (HYP) had significantly increased. Furthermore, with volition, the bolus transit time from swallow onset in the oral cavity, upper oropharynx and HYP was reduced, and subjective evaluation of swallowing easiness demonstrated significant improvement. These results suggest that volitional chewing with a conscious effort can alter bolus transport and swallowing, resulting in easier swallowing.

This position paper proposes a definition and naming standard for removable partial dentures (RPDs) using thermoplastic resin, and presents a guideline for clinical application. A panel of 14 experts having broad experience with clinical application of RPDs using thermoplastic resin was selected from members of the Japan Prosthodontic Society. At a meeting of the panel, “non-metal clasp denture” was referred as the generic name of RPDs with retentive elements (resin clasps) made of thermoplastic resin. The panel classified non-metal clasp dentures into two types: one with a flexible structure that lacks a metal framework and the other having a rigid structure that includes a metal framework. According to current prosthetic principles, flexible non-metal clasp dentures are not recommended as definitive dentures, except for limited cases such as patients with a metal allergy. Rigid non-metal clasp dentures are recommended in cases where patients will not accept metal clasps for esthetic reasons. Non-metal clasp dentures should follow the same design principles as conventional RPDs using metal clasps.

Palatal coverage is often required for elderly edentulous patients with complete dentures. The purpose of this study was to clarify impacts of palatal coverage on bolus formation and subsequent adaptive changes. Subjects were 18 healthy young dentulous adults who wore 1·5-mm-thick palatal plates. Subjects were asked to feed 12 g of bicoloured rice as usual, and the bolus formation by mastication and swallowing in the pharynx was observed using a nasal videoendoscopy. The bolus formation index (BFI), number of mastication strokes until swallowing, visual analogue scale about swallowing easiness and masticatory performance using colour-changeable gum were measured under three conditions: before placement of the palatal plate (day 0), immediately after placement (day 1) and after 7 days of wearing the plate (day 7). BFI and visual analogue scale on day 1 were significantly lower than those on day 0, but those on day 7 significantly recovered to the level of day 0. The number of mastication strokes did not change from day 0 to day 1, however, that on day 7 was significantly higher. Masticatory performance on days 1 and 7 was significantly lower than that on day 0. Although palatal coverage inhibits bolus formation during feeding, subjects increased the number of mastication strokes until swallowing threshold as they adapted to palatal coverage over time. This adaptive change was due to compensate for the lowered masticatory performance to achieve bolus formation for comfortable swallowing.

Wearing dentures and dysphagia are common in older individuals; however, it is still unknown how dentures affect oral and pharyngeal swallowing. The purpose of this study was to reveal the effects of wearing and removing dentures on oropharyngeal movements during pharyngeal swallowing in the feeding sequence of solid food. Participants were 25 edentulous volunteers (nine men, 16 women; mean age 76·2 years) who wore complete dentures. The test food was minced agar jelly containing barium sulphate. Subjects were instructed to feed and swallow the test food with or without dentures during observation using videofluorography. We quantitatively evaluated the range, distance and duration of oropharyngeal movements during pharyngeal swallowing. When dentures were absent, the range of mandible and hyoid movements were significantly expanded in the anterosuperior direction, and the range of laryngeal movement was significantly expanded in the anterior direction. Additionally, the posterior pharyngeal wall contraction and upper oesophageal sphincter opening significantly increased. In addition, the distances of the mandible, hyoid and laryngeal movements and the mandibular duration were significantly extended when dentures were absent. No significant differences were observed in the duration of movements of other organs between wearing and removing dentures. The hyoid bone, larynx, posterior pharyngeal wall and upper oesophageal sphincter do not change their duration of movements when dentures were removed but, rather, expand their range of movement. This might be a spatial change of oropharyngeal movement to avoid temporal changes in pharyngeal swallowing when dentures were absent in edentulous older individuals.

Background It is important to visualize the phenomenon which occurs in actual clinical cases to decide the timing of implant placement subsequently after sinus graft. Although several clinical cases of bone augmentation using xenograft have been evaluated, the number of those reports which have described bone remodeling by alloplasty are not sufficient. Findings In the present report, to investigate bone remodeling histologically after maxillary sinus augmentation with porous hydroxyapatite alloplast, bone cores from the sinus floor of three female nonsmoking patients (aged 64–73 years) were collected 6 months after sinus lift surgery, embedded in methyl methacrylate resin, and prepared by conventional methods. Bone architecture and graft residues were evaluated by micro-computed tomography of the same specimens. Hematoxylin–eosin and Villanueva–Goldner staining revealed mature osteoblasts and multinucleated osteoclasts on the grafted sinus floor and surface of residual hydroxyapatite particles. The particulate interspace was partially filled with osteoid and calcified tissue and showed active vascularization. Conclusion The results suggested that bone regeneration and angiogenesis within and between porous hydroxyapatite particles were sufficiently found after 6 month histologically in the grafted sinus floor. Electronic supplementary material The online version of this article (doi:10.1186/s40064-016-1885-2) contains supplementary material, which is available to authorized users.

Purpose We examined safety issues related to the presence of various metallic dental materials in magnetic resonance (MR) imaging at 7 tesla. Methods A 7T MR imaging scanner was used to examine 18 kinds of materials, including 8 metals used in dental restorations, 6 osseointegrated dental implants, 2 abutments for dental implants, and 2 magnetic attachment keepers. We assessed translational attraction forces between the static magnetic field and materials via deflection angles read on a tailor-made instrument and compared with those at 3T. Heating effects from radiofrequency during image acquisitions using 6 different sequences were examined by measuring associated temperature changes in agarose-gel phantoms with a fiber-optic thermometer. Results Deflection angles of the metallic dental materials were significantly larger at 7T than 3T. Among full metal crowns (FMCs), deflection angles were 18.0° for cobalt-chromium (Co-Cr) alloys, 13.5° for nickel-chromium (Ni-Cr) alloys, and 0° for other materials. Deflection angles of the dental implants and abutments were minimal, ranging from 5.0 to 6.5°, whereas the magnetic attachment keepers were strongly attracted to the field, having deflection angles of 90° or more. Increases in temperature of the FMCs were significant but less than 1°C in every sequence. The dental implant of 50-mm length showed significant but mild temperature increases (up to 1.5°C) when compared with other dental implants and abutments, particularly on sequences with high specific absorption rate values. Conclusion Although most metallic dental materials showed no apparent translational attraction or heating at 7T, substantial attraction forces on the magnetic attachment keepers suggested potential risks to patients and research participants undergoing MR imaging examinations.

Reduction of loading force to bone induces osteopenia. Although the tail suspension model is the frequently used osteopenia model, this model burdens the animals with nonphysiologic blood distribution and systemic stress. We developed a new simple animal model for osteopenia under reduced loading. Both hind legs of male ICR mice (8 weeks old) in the experimental group were inserted into plastic tubes, which then were connected with wires of three sizes. This apparatus completely immobilized both femurs while allowing the tibias to move. Animals were pair-fed and sacrificed on Days 3, 7, 10, and 14 after immobilization. Bone mineral density measurement with dual energy xray absorptiometry revealed bone loss in the immobilized femurs. Histomorphometric analysis showed increased bone resorption and decreased bone formation, which started from Day 7 and continued until Day 14, resulting in structural disorders in the cancellous bone. Osteoclast population increase before osteoblast population decrease revealed that osteoclasts initially affect the process of this type of osteopenia. Our immobilization model is simple, easy to use, well-tolerated by the animal, and has potential for evaluating the therapeutic effects of drugs to treat osteopenia caused by reduced loading.

INTRODUCTION: Although previous studies have shown that maxillary molar extraction in ovariectomized (OVX) animals causes mandibular loss of bone, it is still questionable as to whether estrogen deficiency affects mandibles with functional occlusion. MATERIALS and METHODS: To answer this question, 13-week-old female Sprague‐Dawley rats were bilaterally OVX or sham-operated. After 109 days, the bone mineral density (BMD) of the femurs and mandibles was measured using dual-energy X-ray absorptiometry (DEXA) and peripheral quantitative computed tomography (pQCT). RESULTS: In DEXA analysis, although the BMD of the total mandible of the OVX rats was similar to that of the sham-operated rats, the BMD of the condylar region in the OVX rats had decreased by 12.5%. In pQCT analysis, decrease in trabecular BMD of the mandibular bone was detectable but low in the molar region (maximal 13%), whereas no difference was seen in cortical BMD. In the femurs, the trabecular bone prominently decreased in OVX rats (30% decrease in pQCT analysis) as previously reported. CONCLUSION: This study revealed regional differences in the mandibular bone decrease in OVX rats. Although the mechanism of low susceptibility of the mandible to estrogen-deficient conditions remains unknown, it is likely that mechanical stress derived from functional occlusion is preventing bone loss in this pathological condition. Furthermore, this study demonstrated the advantage of pQCT in analyzing rat mandibular bone. Oral Diseases (2003) 9, 24–28

Summary Prosthetic treatment with dentures is often required for the elderly who have reduced swallowing function. Therefore, it is important to understand the relationship between denture-wearing and feeding function from the perspective of swallowing. To clarify changes in bolus transport during feeding in elderly edentulous patients with or without complete dentures. Subjects were 15 elderly edentulous volunteers who were treated with maxillary and mandibular complete dentures. The test food was 10 g of minced agar jelly containing barium sulphate with a particle diameter of 4·0–5·6 mm. Lateral videofluoroscopy was performed to assess the position of the leading edge of the bolus, the bolus volume in each area at swallow onset, bolus transit time and the mandibular position during pharyngeal swallowing. There were significant changes between the bolus transport with and without dentures. Without dentures, the leading edge of the bolus at swallow onset fell from the valleculae area to the hypopharynx, and the bolus volume in the hypopharynx increased. Bolus transit time increased in the oral cavity, valleculae and hypopharynx. The mandibular position shifted anterosuperior direction. The results arose owing to anatomical changes in the oral and pharyngeal structure and the following functional changes: poor food manipulation, poor bolus formation and delayed swallowing reflex. Removing dentures in elderly edentulous individuals influences bolus transport during feeding, resulting in the exacerbation of the reduced swallowing reserve capacity that accompanies ageing, and may increase the risk of dysphagia.

Denture adhesives, characterized as medical products in 1935 by the American Dental Association, have been considered useful adjuncts for improving denture retention and stability. However, many dentists in Japan are hesitant to acknowledge denture adhesives in daily practice because of the stereotype that dentures should be inherently stable, without the aid of adhesives. The aim of this study is to verify the efficacy of denture adhesives to establish guidelines for Japanese users. The null hypothesis is that the application of denture adhesives, including the cream and powder types, or a control (isotonic sodium chloride solution) would not produce different outcomes nor would they differentially improve the set outcomes between baseline and day 4 post-application. This ten-center, randomized controlled trial with parallel groups is ongoing. Three hundred edentulous patients with complete dentures will be allocated to three groups (cream-type adhesive, powder-type adhesive, and control groups). The participants will wear their dentures with the denture adhesive for 4 days, including during eight meals (three breakfasts, two lunches, and three dinners). The baseline measurements and final measurements for the denture adhesives will be performed on the first day and after breakfast on the fourth day. The primary outcome is a general satisfaction rating for the denture. The secondary outcomes are denture satisfaction ratings for various denture functions, occlusal bite force, resistance to dislodgement, masticatory performance, perceived chewing ability, and oral health-related quality of life. Between-subjects comparisons among the three groups and within-subjects comparisons of the pre- and post-intervention measurements will be performed. Furthermore, a multiple regression analysis will be performed. The main analyses will be based on the intention-to-treat principle. A sample size of 100 subjects per group, including an assumed dropout rate of 10 %, will be required to achieve 80 % power with a 5 % alpha level. This randomized clinical trial will provide information about denture adhesives to complete denture wearers, prosthodontic educators, and dentists in Japan. We believe this new evidence on denture adhesive use from Japan will aid dentists in their daily practice even in other countries. ClinicalTrials.gov NCT01712802 . Registered on 17 October 2012.

Background: Resonance frequency analysis (RFA) is applied to evaluate implant stability, and the clinical relevance of this application is accepted. However, a discrepancy between resonance frequency (RF) and other parameters of implant stability such as implant insertion torque and bone mineral density at the insertion site has been reported. In addition, the relation between RF and histological implant–bone contact has not been well documented. Purpose: To explain this discrepancy and to clarify the relation between RF and histological implant–bone contact, we conducted the present study. Materials and methods: A hydroxyapatite-coated implant, 4 mm diameter and 10 mm length, was used. We placed the implant in a small plastic box vertically and fixed the implant in the box with small screws at different height positions. An ‘Osstell’ transducer was mounted on the implant and RF was measured with or without loosening the screws. Twenty-four implants were placed in the tibiae of four mini-pigs. The animals were sacrificed 1, 2 and 4 weeks after the placement, and the RF of each implant was measured. Ground sections were prepared and implant–bone contact was histomophometrically measured. Results: Loosening the screw at the neck region of the implant remarkably decreased RF compared with the screws of the other regions. Correlation between RF and implant–bone contact, which was measured all around the implant, was not significant (r=0.221, P=0.299). However, the correlation coefficient increased to ‘0.361’ when implant–bone contact was measured at the neck of the implant (P=0.0835), although these two parameters were not statistically correlated. Conclusions: Although RF did not correlate with histological implant–bone contact, the present results demonstrated that a connection between the implant and bone at the neck region of the implant affects RF the most effectively, further suggesting the superiority of RFA in the process of implant treatment and the follow-up. The present results could explain the discrepancy between RFA and other parameters of implant stability.

Purpose Dentists may encounter patients who present with a sense of a malocclusion but in whom no objective findings can be detected. For the patient who insists that there is occlusal discomfort, in the absence of evidence some dentists elect to perform an occlusal adjustment that not only fails to alleviate symptoms, and may, in fact, exacerbate the discomfort. The patient–dentist relationship is then likely compromised because of a lack of trust. Study selection In 2011, the Clinical Practice Guidelines Committee of the Japan Prosthodontic Society formulated guidelines for the management of occlusal discomfort. When formulating clinical practice guidelines, the committee bases their recommendations on information derived from scientific evidence. For "occlusal dysesthesia," however, there are an insufficient number of high-quality papers related to the subject. Therefore, a consensus meeting was convened by the Japan Prosthodontic Society to examine evidence in the Japanese- and English-language literature and generate a multi-center survey to create an appropriate appellation for this condition. Results As a result of the consensus meeting and survey findings, this condition may be justifiably termed "occlusal discomfort syndrome." Conclusions The Japan Prosthodontics Society believes that identification of an umbrella term for occlusal discomfort might serve as a useful guide to formulating clinical practice guidelines in the future. This position paper represents summary findings in the literature combined with the results of a multicenter survey focused on dental occlusal treatment and the condition of patients who present with occlusal discomfort syndrome.

Purpose: The Japan Prosthodontic Society (JPS) has proposed a new diagnostic nomenclature system (DNS), based on pathogenesis and etiology, to facilitate and improve prosthodontic treatment. This systemspecifies patient disability and the causative factor (i.e. ‘‘B (disability) caused by A (causative factor)’’). The purpose of this study was to examine the reliability and validity of this DNS. Study selection: The JPS Clinical Guideline Committee assessed mock patient charts and formulated disease names using the new DNS. Fifty validators, comprising prosthodontic specialists and dental residents, made diagnoses using the same patient charts. Reliability was evaluated as the consistency of the disease names among the validators, and validity was evaluated using the concordance rate of the disease names with the reference disease names. Results: Krippendorff’s α was 0.378 among all validators, 0.370 among prosthodontic specialists, and 0.401 among dental hospital residents. Krippendorff’s α for 10 validators (3 specialists and 7 residents) with higher concordance rates was 0.524. Two validators (1 specialist and 1 resident) with the highest concordance rates had a Krippendorff’s α of 0.648. Common disease names had higher concordance rates, while uncommon disease names showed lower concordance rates. These rates did not show correlation with clinical experience of the validator or time taken to devise the disease name. Conclusions: High reliability was not found among all validators; however, validators with higher concordance rates showed better reliability. Furthermore, common disease names had higher concordance rates. These findings indicate that the new DNS for prosthodontic dentistry exhibits clinically acceptable reliability and validity.