先端医療シリーズ 歯科医学2 歯周病 新しい治療を求めて

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これまでの歯科学にBreakthroughをもたらす可能性があるのが歯周病学なのである。歯周病学は歯学の研究の先端を走っているといっても過言ではない。(序文より）

目次

  • 表紙
  • カラーグラビア
  • 著者一覧
  • 序文
  • 目次
  • 第1章 歯周組織の再構築による治療
  • 1. 骨形成と骨再生
  • 1.1 はじめに
  • 1.2 骨形成の基本
  • 1.3 骨折の治癒過程
  • 1.4 間葉系幹細胞
  • 1.4.1 間葉系幹細胞とは?
  • 1.4.2 間葉系幹細胞の骨再生への応用の可能性
  • 1.5 骨芽細胞の分化の調節
  • 1.5.1 骨芽細胞の分化と骨形成に必須の転写因子Cbfal
  • 1.5.2 骨芽細胞の分化を調節する局在因子
  • 1.5.2.1 骨芽細胞の分化とBMPs
  • 1.5.2.2 Hedgehogと骨格形成
  • 1.6 骨形成と骨再生の共通性
  • 1.7 新しい骨再生療法をめざして
  • 2. 骨再生と歯周病治療
  • 2.1 はじめに
  • 2.2 コラーゲンと非コラーゲン性タンパク質
  • 2.3 石灰化組織に特異的なタンパク質
  • 2.4 骨形成タンパク質による骨誘導
  • 2.5 ホルモンと成長因子
  • 2.6 細胞培養系(骨芽細胞様細胞)を用いた石灰化および骨再生の研究
  • 2.7 オステオカルシンとBSPの転写調節機構
  • 2.8 臨床応用への可能性
  • 2.9 骨再生と歯周病治療
  • 3. 歯周組織の再生
  • 3.1 はじめに
  • 3.2 再生の評価法
  • 3.2.1 歯周ポケット深さの測定
  • 3.2.2 臨床的アタッチメントレベルの測定
  • 3.2.3 レントゲン写真による分析
  • 3.2.4 リエントリー手術(再手術)
  • 3.2.5 組織学的評価方法
  • 3.3 歯周組織の創傷治癒
  • 3.3.1 骨由来細胞の新付着形成能について
  • 3.3.2 歯肉結合組織由来細胞の新付着形成能について
  • 3.3.3 歯根膜由来細胞の新付着形成能について
  • 3.4 創傷の安定性
  • 3.5 再生治療
  • 4. 骨吸収の抑制による歯周病治療―ビスフォスフォネートの応用―
  • 4.1 はじめに
  • 4.2 ビスフォスフォネートの化学構造
  • 4.3 ビスフォスフォネートの薬理作用
  • 4.3.1 骨吸収抑制作用
  • 4.3.2 異所性骨化・石灰化の抑制
  • 4.4 ビスフォスフォネートの骨吸収抑制機序
  • 4.4.1 プロトン放出の抑制と、破骨細胞下の骨吸収面へのプロトン蓄積の抑制
  • 4.4.2 フォスファターゼ活性の抑制
  • 4.4.3 メバロン酸経路の抑制とアポトーシスの誘導
  • 4.4.4 ATP類似化合物の形成
  • 4.4.5 他の細胞を介した機序
  • 4.5 実験的歯周炎による歯槽骨吸収のビスフォスフォネートによる抑制
  • 4.6 ビスフォスフォネートの歯周病治療への応用の可能性
  • 5. 歯周組織の再生医学
  • 5.1 はじめに
  • 5.2 再生医学のための生体材料
  • 5.2.1 生体材料の分類
  • 5.2.2 生体材料の再生医学における役割
  • 5.3 DDSとは
  • 5.4 DDS徐放化技術を用いた再生医学
  • 5.5 生体吸収性ゼラチンハイドロゲルを用いた細胞増殖因子の徐放化
  • 5.5.1 血管新生とその再生医学への応用
  • 5.5.2 骨組織の再生
  • 5.6 おわりに
  • 第2章 歯周組織の誘導再生療法
  • 1. 組織誘導再生法(GTR)
  • 1.1 はじめに
  • 1.2 適応症
  • 1.2.1 患者側の要因
  • 1.2.2 骨欠損および歯の要因
  • 1.3 術式のポイント
  • 1.4 メンブレンの種類・選択
  • 1.4.1 非吸収性メンブレン
  • 1.4.2 吸収性メンブレン
  • 1.5 併用療法
  • 1.6 長期経過評価
  • 1.7 おわりに
  • 2. 線維芽細胞増殖因子(FGF)による歯周組織再生療法
  • 2.1 はじめに
  • 2.2 FGFとは?
  • 2.3 歯周組織における内因性bFGFの発現
  • 2.4 bFGFを用いた歯周組織再生の試み
  • 2.5 bFGFによる歯周組織再生のメカニズム
  • 2.6 再生医学(Regenerative medicine)の展望
  • 3. 歯槽骨補填材による誘導再生療法
  • 3.1 誘導再生療法
  • 3.2 骨補填材の種類
  • 3.3 歯周支持組織の誘導再生
  • 3.4 骨組織の誘導再生
  • 3.5 今後の展望
  • 4. 骨形成蛋白(BMP)による誘導再生療法
  • 4.1 はじめに
  • 4.2 BMPとBMP研究の特徴
  • 4.3 牛骨から部分精製したBMPによる歯周組織再生の研究
  • 4.4 リコンビナントヒトBMPを用いた歯周組織再生の研究
  • 4.5 BMPの臨床応用への課題と研究
  • 4.6 まとめと今後の展望
  • 5. 骨誘導再生法(GBR)
  • 5.1 はじめに
  • 5.2 GBR開始前の一般的注意事項
  • 5.2.1 最適応症
  • 5.2.2 患者選択
  • 5.2.3 術前処置
  • 5.3 GBRの分類とクリニカルガイドライン
  • 5.3.1 段階法(staged procedure)
  • 5.3.2 同時法(simultaneous procedure)
  • 5.3.3 抜歯即時インプラントに伴うGBR
  • 5.4 おわりに
  • 6. エナメル基質(エムドゲイン)による誘導再生療法
  • 6.1 はじめに
  • 6.2 歯根セメント質
  • 6.3 エナメル基質タンパクの基礎科学
  • 6.3.1 エナメル基質タンパクと歯根セメント質の発生
  • 6.4 エムドゲイン(R)とは
  • 6.4.1 エムドゲイン(R)の効果
  • 6.4.2 エムドゲイン(R)療法での適応症
  • 6.5 臨床術式
  • 6.6 臨床応用:症例
  • 6.7 GTR法との比較
  • 6.8 歯周組織再生療法の考慮点
  • 6.9 まとめ
  • 第3章 外科およびレーザー治療
  • 1. 歯周ポケットの除去
  • 1.1 はじめに
  • 1.2 歯肉切除術
  • 1.3 ポケット掻爬術
  • 1.4 新付着術
  • 1.5 フラップ手術
  • 1.5.1 歯肉弁根尖側移動術
  • 1.5.2 歯間部歯槽骨露出術
  • 1.5.3 ポケット除去の長期的な効果に関する研究
  • 2. 歯肉歯槽粘膜組織の形成
  • 2.1 はじめに
  • 2.2 歯肉歯槽粘膜形成術
  • 2.3 遊離歯肉移植術
  • 2.4 結合組織移植術
  • 2.5 露出歯根被覆術
  • 2.6 歯槽堤増大術
  • 2.7 まとめ
  • 3.歯槽骨の整形と切除
  • 3.1 はじめに
  • 3.2 定義
  • 3.2.1 骨整形 Osteoplasty
  • 3.2.2 骨切除 Osteotomy
  • 3.3 適応と禁忌
  • 3.4 利点と欠点
  • 3.5 骨欠損と骨の除去部位
  • 3.6 手術手技
  • 3.6.1 骨整形
  • 3.6.2 骨切除
  • 3.7 手術後の創傷治癒
  • 4. 骨移植
  • 4.1 はじめに
  • 4.2 適応症
  • 4.3 骨移植材
  • 4.3.1 自家骨移植
  • 4.3.2 同種他家骨移植
  • 4.3.2.1 非脱灰凍結乾燥他家骨
  • 4.3.2.2 脱灰凍結乾燥他家骨
  • 4.3.3 異種他家骨移植
  • 4.3.4 人工骨移植
  • 4.4 手術手技
  • 5. レーザーによる歯周治療の進歩
  • 5.1 はじめに
  • 5.2 生体組織における光の特性
  • 5.3 歯科におけるハードレーザー
  • 5.3.1 Nd:YAGレーザー
  • 5.3.2 CO2レーザー
  • 5.3.3 半導体レーザー
  • 5.3.4 エルビウムヤグレーザー
  • 5.4 う蝕の治療への応用
  • 5.5 レーザーによる軟組織処理
  • 5.6 レーザーによる歯石除去
  • 5.7 レーザーによる骨外科への応用
  • 5.8 まとめ
  • 6. エルビウムヤグ(Er:YAG)レーザーによる治療
  • 6.1 はじめに
  • 6.2 Er:YAGレーザー
  • 6.2.1 Er:YAGレーザーとは
  • 6.2.2 Er:YAGレーザーの特徴と作用メカニズム
  • 6.2.3 装置の種類と仕様
  • 6.3 研究の経過と臨床応用
  • 6.3.1 軟組織処置
  • 6.3.2 殺菌効果
  • 6.3.3 歯周病罹患根面への応用
  • 6.3.4 歯周ポケットへの応用
  • 6.3.5 歯周外科治療への応用
  • 6.4 おわりに
  • 7. 半導体レーザーによる治療
  • 7.1 はじめに
  • 7.2 歯周外科手術への応用
  • 7.3 臨床例
  • 7.4 使用のポイント
  • 7.5 まとめ
  • 8. 炭酸ガスレーザーによる治療
  • 8.1 はじめに
  • 8.2 炭酸ガスレーザー照射による歯肉色素沈着除去方法
  • 8.2.1 臨床効果による色彩学的検索
  • 8.2.1.1 研究方法
  • 8.2.1.2 結果
  • 8.2.2 ビーグル犬を用いた組織学的検索
  • 8.2.2.1 研究方法
  • 8.2.2.2 結果
  • 8.2.3 考察
  • 8.2.4 臨床応用
  • 8.3 炭酸ガスレーザー照射が歯周病罹患歯根表面に与える影響
  • 8.3.1 炭酸ガスレーザー照射後の象牙質表面の変化
  • 8.3.1.1 研究方法
  • 8.3.1.2 結果
  • 8.3.1.3 考察
  • 8.4 実験的歯周炎に対する炭酸ガスレーザー照射が与える影響
  • 8.4.1 イヌを用いた実験的歯周炎に対する歯周外科処置後の炭酸ガスレーザー照射の歯周組織再生の効果
  • 8.4.1.1 研究方法
  • 8.4.1.2 結果
  • 8.4.1.3 考察
  • 8.4.1.4 臨床応用
  • 8.5 炭酸ガスレーザー照射の急性症状に対する歯周治療への応用
  • 8.5.1 歯周急性症状に対する炭酸ガスレーザー照射後の効果
  • 8.5.1.1 研究方法
  • 8.5.1.2 結果
  • 8.5.1.3 考察
  • 8.5.1.4 臨床応用
  • 8.6 まとめ
  • 9. ネオジウムヤグ(Nd:YAG)レーザーの歯周治療への応用
  • 9.1 はじめに
  • 9.2 Nd:YAGレーザーの特徴
  • 9.3 歯肉縁下歯石の除去
  • 9.4 Nd:YAGレーザーのポケット内照射
  • 9.4.1 ポケット内照射で臨床的効果がある理由
  • 9.4.1.1 レーザー照射の歯周ポケット内細菌に対する効果
  • 9.4.1.2 レーザー照射の露出根面内エンドトキシンに対する効果
  • 9.5 歯肉のメラニン沈着に対する処置
  • 9.6 象牙質知覚過敏症に対する処置
  • 9.7 Nd:YAGレーザーを使う上での諸注意
  • 9.7.1 レーザー照射に伴う熱について
  • 9.7.2 照射方法について
  • 9.8 まとめ
  • 10. 低出力レーザーの生物学的効果の機序
  • 10.1 緒言
  • 10.2 歯周組織細胞の役割と実験モデル
  • 10.2.1 歯肉線維芽細胞
  • 10.2.2 歯根膜線維芽細胞
  • 10.2.3 骨芽細胞
  • 10.3 レーザー照射による歯周治療効果のメカニズム
  • 10.3.1 低出力レーザーの機種と照射法
  • 10.3.2 歯肉炎、歯周炎の消炎作用
  • 10.3.3 骨形成能の促進
  • 10.4 骨芽細胞へのレーザー照射で発現変化する遺伝子の探索
  • 10.4.1 サブトラクション遺伝子クローニング
  • 10.4.2 細胞周期のライセンス遺伝子
  • 10.4.3 ATP合成酵素F0F-ATPase
  • 10.5 将来の展望
  • 第4章 薬物療法
  • 1. 抗菌剤
  • 1.1 はじめに
  • 1.2 歯周疾患に使用される防腐・消毒薬
  • 1.2.1 酸化剤
  • 1.2.2 ハロゲン類
  • 1.2.3 フェノール類
  • 1.2.4 揮発油類
  • 1.2.5 界面活性剤
  • 1.2.6 有機色素類
  • 1.2.7 アルカロイド:サンギナリン(sanginaline)
  • 1.3 腐食作用と抗菌作用
  • 1.3.1 乳酸
  • 1.3.2 硫酸亜鉛、塩化亜鉛、酸化亜鉛
  • 1.4 歯肉縁上のプラークのコントロールが可能と考えられる薬物
  • 1.5 局所消毒薬
  • 1.6 歯肉マッサージ剤
  • 2. 抗生物質
  • 2.1 はじめに
  • 2.2 抗生物質の性質等
  • 2.2.1 作用機序
  • 2.2.2 耐性発現機序
  • 2.2.3 副作用
  • 2.2.4 薬物相互作用
  • 2.3 抗生物質の全身投与による歯周治療
  • 2.4 局所投与
  • 2.5 まとめ
  • 3. 抗炎症薬
  • 3.1 はじめに
  • 3.2 炎症の経過
  • 3.3 炎症のケミカルメディエーター
  • 3.4 抗炎症薬
  • 3.4.1 ステロイド系抗炎症薬
  • 3.4.2 非ステロイド系抗炎症薬
  • 3.4.2.1 酸性非ステロイド系抗炎症薬
  • 3.4.2.2 塩基性非ステロイド系抗炎症薬
  • 3.4.2.3 消炎酵素薬
  • 3.4.2.4 抗プラスミン薬
  • 3.4.3 口腔内歯周疾患で用いられる抗炎症薬
  • 4. 鎮痛薬
  • 4.1 はじめに
  • 4.2 痛みの発生機構と抑制機構
  • 4.2.1 末梢における痛みの受容
  • 4.2.2 発痛物質
  • 4.2.3 痛覚伝導路
  • 4.2.4 痛覚の内因性抑制機構
  • 4.2.5 鎮痛薬
  • 4.2.6 解熱性鎮痛薬
  • 4.3 おわりに
  • 5. 止血薬
  • 5.1 はじめに
  • 5.2 血液凝固機序
  • 5.3 止血薬の分類
  • 5.3.1 血液蛋白を凝固するもの
  • 5.3.2 血液凝固機序を促進するもの
  • 5.3.3 毛細血管強化薬
  • 5.3.4 末梢血管を収縮させる薬物
  • 5.4 おわりに
  • 第5章 免疫療法
  • 1. 歯周病の受動免疫療法
  • 1.1 緒言
  • 1.2 受動免疫研究の歴史
  • 1.3 安全性の高い抗体の開発
  • 1.3.1 遺伝子組み換えScFv抗体
  • 1.3.2 ヒト型抗体
  • 1.4 歯周病の受動免疫用抗体の開発
  • 1.4.1 P.gingivalisの共凝集因子
  • 1.4.2 P.gingivalisの赤血球凝集因子
  • 1.5 将来の展望
  • 2. 歯周病ワクチン
  • 2.1 はじめに
  • 2.2 ワクチン開発の背景
  • 2.3 粘膜免疫機構
  • 2.4 歯周病ワクチン開発の現状
  • 2.4.1 対象菌の選定
  • 2.4.2 抗原の性状
  • 2.4.3 感作方法
  • 2.5 おわりに
  • 3. DNAワクチン
  • 3.1 はじめに
  • 3.2 DNAワクチンの作用機序
  • 3.3 DNAワクチンの投与経路
  • 3.4 DNAワクチンの免疫調節因子
  • 3.5 DNAワクチンの応用
  • 3.6 おわりに
  • 第6章 歯周病の病因
  • 1. 病因の直接因子と増悪因子
  • 1.1 概説
  • 1.2 歯周病の病因論の変遷
  • 1.3 歯周病細菌
  • 1.4 歯周病病因因子
  • 1.5 バイオフィルムとしてのデンタルプラーク
  • 1.6 歯周病病因因子の伝播
  • 1.7 歯周病増悪因子
  • 1.8 歯周病病因と増悪因子の相互関係
  • 1.9 歯周病病因因子の抑制
  • 2. 歯周病原細菌の表層構造と機能
  • 2.1 はじめに
  • 2.2 P.gingivatis線毛の構造
  • 2.3 P.gingivalis線毛の免疫生物学的作用
  • 2.4 P.gingivalisリピドAの構造
  • 2.5 P.gingivatisリピドAの免疫生物学的作用
  • 2.6 おわりに
  • 3. 歯肉炎下プラークという生態系
  • 3.1 はじめに
  • 3.2 歯肉炎下プラークの細菌叢と環境
  • 3.3 歯周病関連細菌の代謝活性と歯周病原性
  • 3.3.1 歯肉縁下プラークあるいは歯周ポケット内に生息する細菌の代謝的特徴
  • 3.3.2 P.gingivalisとP.intermediaの代謝システム
  • 3.3.3 代謝活性と歯周病原性
  • 3.4 歯周病関連細菌の病原性と生息環境の相互関係
  • 3.4.1 生息環境pHと歯周病関連細菌の増殖能
  • 3.4.2 栄養環境と歯周病関連細菌の病原性
  • 3.4.3 細菌によるプラーク環境のコントロール
  • 3.5 歯肉縁下あるいは歯周ポケット内生態系の理解に基づいたプラークコントロールへ
  • 4. 歯周病原因菌のPorphymonas gingivalisの蛋白質分解酵素シンジパインの構造と病原作用
  • 4.1 はじめに
  • 4.2 シンジパインの構造
  • 4.2.1 シンジパイン
  • 4.2.2 シンジパインRの構造
  • 4.2.3 シンジパインKの構造
  • 4.2.4 他のシステインプロテアーゼとの関係
  • 4.3 シンジバリス菌の生存と感染におけるシンジパインの役割
  • 4.3.1 栄養源である蛋白質の分解
  • 4.3.2 赤血球凝集、接着、ヘモグロビン結合作用
  • 4.3.3 線毛を介した接着への関与
  • 4.3.4 菌蛋白質のプロセシング
  • 4.4 シンジパインの間質結合織破壊作用
  • 4.5 宿主防御機構からの回避におけるシンジパインの役割
  • 4.5.1 補体機能不全化
  • 4.5.2 好中球機能抑制
  • 4.5.3 血液凝固系活性化と線溶亢進
  • 4.5.4 カリクレイン/キニン系の活性化
  • 4.5.5 サイトカインネットワークの破壊
  • 4.6 シンジパインをターゲットにした歯周病治療法開発
  • 4.7 おわりに
  • 5. 歯周病原細菌の熱ショック蛋白質
  • 5.1 はじめに
  • 5.2 熱ショック蛋白質の特徴
  • 5.2.1 種類と分子相同性
  • 5.2.2 熱ショック蛋白質の微細構造と局在性
  • 5.3 熱ショック蛋白質の宿主細胞に対する影響
  • 5.3.1 歯根膜上皮細胞の増殖促進と細胞毒性作用
  • 5.3.2 骨吸収促進能
  • 5.3.3 炎症性サイトカイン誘導能
  • 5.4 歯周病患者の熱ショック蛋白質に対する免疫応答
  • 5.4.1 熱ショック蛋白質の抗原性状
  • 5.4.2 歯周病の病態と熱ショック蛋白質に対する免疫応答の2つの考え方
  • 5.5 まとめ
  • 6. 歯周病原細菌によるアポトーシスの誘導
  • 6.1 はじめに
  • 6.2 アポトーシスとは
  • 6.3 歯周病細菌が産成する毒素により誘導されるアポトーシス
  • 6.3.1 歯周病細菌由来の組織障害因子
  • 6.3.2 アポトーシスを誘導する毒素
  • 6.4 歯周病細菌が感染した細胞にみられるアポトーシス
  • 6.4.1 感染防御を担うマクロファージ
  • 6.4.2 アポトーシス誘導のメカニズム
  • 6.4.3 肺胞マクロファージのアポトーシス
  • 7. 歯周病細菌口臭
  • 7.1 はじめに
  • 7.2 口臭症の分類と原因
  • 7.3 口腔内における口臭原因物質の発生源
  • 7.3.1 舌苔
  • 7.3.2 歯肉縁下プラーク
  • 7.4 歯周病と口臭
  • 7.5 口臭の検査
  • 7.5.1 官能試験
  • 7.5.2 ポータブルサルファイドモニター
  • 7.5.3 ガスクロマトグラフィー
  • 7.6 予防と治療
  • 7.6.1 口腔清掃
  • 7.6.2 歯科疾患の治療
  • 7.6.3 飲食物
  • 7.6.4 全身疾患
  • 7.6.5 仮性口臭症、口臭恐怖症の患者へのアプローチ
  • 7.7 おわりに
  • 8. 歯周病の遺伝的素因
  • 8.1 歯周病病因への遺伝子的因子と環境因子の関わり
  • 8.2 歯周病の遺伝的因子の解析の問題点
  • 8.3 歯周病の遺伝的因子の解析の今後の方向
  • 8.4 生体側で遺伝子に規定される歯周病感受性の因子
  • 8.4.1 歯肉溝周囲の口腔細菌の増加を助長するもの
  • 8.4.2 歯周組織の構造維持に関わるもの
  • 8.4.3 免疫と炎症を主体とする生体防御反応
  • 8.5 歯周病の遺伝子レベルでの診査
  • 8.5.1 全身的変化を伴うもの
  • 8.5.2 歯周病に特徴的なもの
  • 8.6 歯周病の遺伝子診断の方法
  • 8.6.1 染色体DNAを得るための被検体とその保存
  • 8.6.2 特異遺伝子の増幅
  • 8.6.3 増幅した遺伝子からの変異の検出
  • 8.6.3.1 制限断片長多型(RFLP)法
  • 8.6.3.2 アリル特異的オリゴヌクレオチド(ASO)法
  • 8.6.3.3 DNAアレイ法
  • 8.6.3.4 DNA一本鎖構造多型(SSCP)法
  • 8.6.3.5 DNA塩基配列決定法
  • 8.6.4 遺伝子変異のhomoまたはhetero型の判定
  • 8.7 歯周病の遺伝子診断に関わる社会的問題点
  • 8.8 歯周病の遺伝子診断の将来
  • 第7章 宿主細胞による歯周病病因因子に対する応答
  • 1. 宿主細胞による歯周病原細菌の認識機構-歯周組織のCD14/TLR系
  • 1.1 菌体表層には免疫生物学的に活性な成分が局在している
  • 1.2 CD14/TLR系とinnate immunity機構
  • 1.3 歯周組織のCD14/TLR系と菌体成分応答
  • 1.3.1 歯周病原細菌の菌体表層成分の免疫生物活性
  • 1.3.2 歯周組織構成細胞のCD14/TLR系
  • 1.3.3 LTAのLPSアンタゴニスト作用
  • 1.3.4 口腔細菌ならびに好中球由来酵素によるCD14分解
  • 1.4 おわりに-innate immunityに基づく過敏症と歯周病
  • 2. 体液中の細菌認識分子
  • 2.1 はじめに
  • 2.2 可溶型CD14とは
  • 2.2.1 sCD14の役割
  • 2.2.2 sCD14と歯周病原性細菌のLPS
  • 2.2.3 歯周炎患者におけるsCD14の濃度
  • 2.2.4 sCD14の産生機序
  • 2.2.5 sCD14の上昇が歯周炎患者に及ぼす影響
  • 2.3 LPS結合蛋白
  • 2.4 BPI
  • 2.4.1 疾患におけるBPIの濃度
  • 2.4.2 治療薬としてのBPI
  • 2.5 高密度リボ蛋白質
  • 2.5.1 治療薬としてのHDL
  • 2.6 LPSをめぐる細菌認識分子の相互作用
  • 2.7 補体とは
  • 2.7.1 補体による細菌防御機能
  • 2.7.2 細菌による補体の活性化機序
  • 2.7.3 歯周病における補体の研究
  • 2.8 マンナン総合レクチンとは
  • 2.8.1 補体活性化の第三の経路・レクチン経路
  • 2.8.2 MBLと疾患
  • 2.9 最後に
  • 3. 歯周病における線維芽細胞の表現型の変化-アルカリホスファターゼの発現-
  • 3.1 はじめに
  • 3.2 アルカリホスファターゼ(ALP)について
  • 3.3 歯周炎に罹患した歯肉に存在する線維芽細胞のALP発現について
  • 3.4 線維芽細胞の適応現象説VSクローン選択説
  • 3.5 歯肉線維芽細胞のALP発現の誘導に影響を及ぼす因子について
  • 3.5.1 増殖因子
  • 3.5.2 細胞外マトリクス
  • 3.6 歯周炎罹患部の歯肉線維芽細胞におけるALP発現の誘導
  • 3.7 歯肉線維芽細胞によるALP発現の機能的意義について
  • 4. 好中球とマクロファージの動態
  • 4.1 はじめに
  • 4.2 好中球とマクロファージの遊走の機序
  • 4.2.1 Rollingに関与する接着分子
  • 4.2.2 活性化-強固な付着、Activation-Firm Adherenceに関与する接着分子
  • 4.2.3 Transmigration subendothelial migrationに関与する接着分子
  • 4.3 炎症局所への白血球動員における選択性について
  • 4.4 Chemokine
  • 4.5 炎症局所に到達した好中球、マクロファージの機能的特性
  • 4.5.1 好中球機能のpriming
  • 4.5.2 マクロファージの逆遊走
  • 4.6 Leukocyte adhesion deficiences(LAD)syndromes
  • 4.7 好中球とマクロファージの殺菌の機序
  • 4.8 白血球が関与する蛋白質分解
  • 4.8.1 白血球の持つ蛋白分解酵素
  • 4.8.1.1 好中球の持つ蛋白分解酵素
  • 4.8.1.2 単球とマクロファージの持つ蛋白分解酵素
  • 4.8.2 白血球の持つ蛋白分解酵素の活性発現調節機構
  • 4.8.2.1 蛋白分解酵素阻害物質
  • 4.8.2.2 MMPの活性発現
  • 4.9 歯周炎における好中球、マクロファージの動態
  • 4.9.1 歯周炎の発症、転帰の概要
  • 4.9.2 上皮細胞の細菌に対する応答に誘導された白血球の動態
  • 4.9.3 歯肉の炎症開始期の白血球の動態
  • 4.9.4 免疫担当細胞の応答による破壊的環境の形成
  • 4.10 歯周炎患者の好中球の機能
  • 5. T細胞の歯周病原性細菌の認識機構の動態
  • 5.1 はじめに
  • 5.2 T細胞
  • 5.2.1 αβ型T細胞
  • 5.2.2 γδ型T細胞
  • 5.3 T細胞の抗原認識
  • 5.3.1 MHC分子の多型性
  • 5.3.2 HLA分子による抗原提示
  • 5.3.3 γδ型T細胞およびNKT細胞の抗原認識
  • 5.3.4 スーパー抗原によるT細胞
  • 5.4 T細胞のクローン増殖
  • 5.5 歯周病患者由来T細胞の抗原認識
  • 5.6 T細胞応答性の人為的調整
  • 5.6.1 TCRアンタゴニスト
  • 5.6.2 部分的なアゴニスト
  • 5.6.3 臨床応用へのアプローチ
  • 5.7 今後の展望
  • 6. 歯周炎における感染症と自己免疫応答の接点
  • 6.1 はじめに
  • 6.2 Heat shock protein(熱ショックタンパク:hsp)とは
  • 6.3 自己免疫疾患とhsp60
  • 6.4 歯周炎とhsp60
  • 6.5 hsp60に対する体液性応答
  • 6.6 歯周炎組織におけるhsp60反応性T細胞
  • 6.7 分子相同性に基づく自己反応性T細胞の歯周炎における役割
  • 6.8 まとめ
  • 7. 血液凝固因子
  • 7.1 生体防御反応における血液凝固因子の役割
  • 7.2 血液凝固因子とP.gingvalisの奇妙な関係
  • 7.3 Factor Xaの炎症惹起作用
  • 7.4 プロテアーゼカスケード制御を基盤とした新規歯周病治療法の展望
  • 第8章 骨組織の病態
  • 1. 骨代謝異常
  • 1.1 はじめに
  • 1.2 カルシウム供給源としての骨組織
  • 1.3 骨代謝異常を診断する生化学的指標
  • 1.4 骨代謝異常と歯槽骨代謝
  • 1.5 おわりに
  • 2. サイトカインと骨吸収
  • 2.1 はじめに
  • 2.2 破骨細胞の分化と機能を調節する骨芽細胞の役割
  • 2.3 骨芽細胞が産生するサイトカイン
  • 2.3.1 M-CSF
  • 2.3.2 RANKL
  • 2.4 炎症性サイトカインによる骨吸収調節
  • 2.4.1 IL-6とIL-11
  • 2.4.2 IL-1
  • 2.4.3 TNFα
  • 2.4.4 IL-17
  • 2.5 破骨細胞の分化と機能を調節するシグナル系
  • 2.5.1 RANKLの発現調節
  • 2.5.2 RANKL/TNFα/IL-1受容体のシグナル系
  • 2.6 おわりに
  • 3. 歯周病原性細菌と骨吸収
  • 3.1 はじめに
  • 3.2 P.gingivalis菌体成分と炎症性サイトカイン発現
  • 3.2.1 リポ多糖
  • 3.2.2 線毛
  • 3.2.3 その他の因子
  • 3.3 歯周組織における炎症性サイトカインの発現
  • 3.3.1 IL-1ならびにTNF-αの発現
  • 3.3.2 ケモカインの発現
  • 3.3.3 T細胞由来のサイトカインの発現
  • 3.4 広域抗生物質による炎症性サイトカイン発現の抑制作用
  • 3.5 おわりに
  • 4. セメント質由来細胞の細胞因子の動態
  • 4.1 はじめに
  • 4.2 歯周病に罹患したセメント質の病態
  • 4.2.1 歯周病に罹患した根面
  • 4.2.2 内毒素はどの程度罹患セメント質基質中に入り込んでいるのか
  • 4.3 実際のスケーリング、ルートプレーニングはどこまでするべきなのか?
  • 4.4 セメント質新生のメカニズム解明のためのアプローチとその困難性
  • 4.5 セメント質基質中の細胞増殖因子および細胞接着因子
  • 4.5.1 セメント質からの生物学的活性因子の抽出
  • 4.5.2 セメント質基質中の細胞増殖因子
  • 4.5.3 セメント質由来増殖因子の分子性状
  • 4.5.4 セメント質基質中の細胞接着因子
  • 4.5.5 セメント質由来接着蛋白質の分子性状
  • 4.6 セメント質基質中の細胞増殖因子、細胞接着因子研究の今後の展望
  • 4.7 おわりに
  • 第9章 歯周病の診断
  • 1. 歯周病原性細菌の遺伝子型による歯周病の診断
  • 1.1 プラーク細菌叢の検索
  • 1.1.1 はじめに
  • 1.1.2 歯周病原性細菌の検出法
  • 1.1.2.1 従来の検査法
  • 1.1.2.2 細菌遺伝子を用いた検出法
  • 1.2 歯周病に関与するプラーク細菌叢
  • 1.3 Porphyromonas gingvalis
  • 1.3.1 P.gingvalisの線毛
  • 1.3.2 P.gingvalis線毛の構造遺伝子の多様性
  • 1.3.3 P.gingvalis線毛の発現調節の変化
  • 1.4 P.gingvalis線毛タイプと歯周病
  • 1.4.1 線毛タイプ特異的なPCRプライマー
  • 1.4.2 歯周病患者のP.gingvalis線毛タイプの分布
  • 1.5 P.gingvalisのISRによる分類
  • 1.6 最後に
  • 2. DNAによる歯周病原細菌の検出
  • 2.1 はじめに
  • 2.2 DNAとセントラルドグマ
  • 2.3 歯周病原細胞検出のターゲットとしての"DNA"
  • 2.4 DNAプローブ法
  • 2.5 PCR検出法
  • 2.6 おわりに
  • 3. 白血球由来蛋白カルプロテクチンによる歯周病の診断
  • 3.1 はじめに
  • 3.2 白血球由来蛋白カルプロテクチン
  • 3.3 歯周組織とカルプロテクチン
  • 3.4 カルプロテクチンの歯周疾患診断指標としての有用性
  • 3.5 歯周疾患におけるカルプロテクチンの機能
  • 3.6 おわりに
  • 4. 歯肉溝滲出液ホスホリパーゼA2による疾病活動度の診断
  • 4.1 はじめに
  • 4.2 疾病活動度を反映する歯肉溝滲出液検査の必要性
  • 4.3 歯肉溝滲出液中のホスホリパーゼA2活性
  • 4.4 歯周病におけるPLA2の役割
  • 4.5 おわりに
  • 5. Fcγレセプター遺伝子型による歯周炎感受性診断
  • 5.1 はじめに
  • 5.2 Fcγレセプターの構造と機能
  • 5.2.1 概要
  • 5.2.2 リガンド結合
  • 5.2.3 シグナル伝達
  • 5.3 Fcγレセプターの遺伝子多型
  • 5.4 Fcγレセプター遺伝子多型と歯周炎感受性
  • 5.4.1 Fcγレセプター遺伝子多型が関連する疾患
  • 5.4.2 Fcγレセプター遺伝子型による歯周炎感受性診断
  • 5.4.2.1 はじめに
  • 5.4.2.2 歯周炎再発の診断
  • 5.4.2.3 早期発症型歯周炎の診断
  • 5.4.2.4 歯周炎抵抗性の診断
  • 5.4.2.5 FcγRIIIb遺伝子型と好中球機能
  • 5.5 結語
  • 第10章 全身性疾患と歯周病
  • 1. 全身性疾患と歯周病(概説)
  • 1.1 はじめに
  • 1.2 歯周病原菌による細菌性心内膜炎
  • 1.3 プラーク細菌の循環障害・心疾患への関与
  • 1.4 発熱の原因となる内毒素
  • 1.5 歯周病と病巣感染
  • 1.6 妊娠トラブルを起こす歯肉炎
  • 1.7 おわりに
  • 2. 糖尿病と歯周病
  • 2.1 はじめに
  • 2.2 糖尿病患者における歯周炎の疫学
  • 2.2.1 糖尿病と歯周炎の相関
  • 2.2.2 1型糖尿病の歯周炎リスク因子
  • 2.2.3 2型糖尿病の歯周炎リスク因子
  • 2.3 糖尿病が歯周炎に及ぼす影響
  • 2.3.1 好中球機能不全
  • 2.3.2 歯根膜線維芽細胞の機能異常
  • 2.3.3 AGEの炎症性組織破壊への関与
  • 2.3.4 アデイポサイトカインの炎症への関与
  • 2.4 歯周炎が糖尿病に及ぼす影響
  • 2.4.1 歯周炎とバイオフィルム
  • 2.4.2 歯周治療とインスリン抵抗性
  • 2.4.3 歯周炎と抗GAD抗体
  • 3. 喫煙と歯周病
  • 3.1 はじめに
  • 3.2 歯周組織への影響
  • 3.2.1 疫学研究
  • 3.2.2 喫煙者の歯周破壊の特徴
  • 3.2.3 若年者への影響
  • 3.3 歯周治療への影響
  • 3.3.1 喫煙者の歯周組織診査
  • 3.3.2 歯周治療の効果
  • 3.3.3 サポーティブケアへの影響
  • 3.4 歯周破壊のメカニズム
  • 3.4.1 歯周破壊の経路
  • 3.4.2 微生物
  • 3.4.3 宿主応答
  • 3.4.4 微少循環
  • 3.5 歯周病患者への禁煙指導
  • 3.5.1 禁煙の効果
  • 3.5.2 禁煙の過程
  • 3.5.3 歯周病患者の禁煙指導
  • 3.6 まとめ
  • 4. 肥満と歯周病
  • 4.1 はじめに
  • 4.2 肥満の指標
  • 4.3 増加する肥満と虚血性心疾患
  • 4.4 歯周炎と肥満との関連性
  • 4.5 肥満が歯周炎を引き起こすメカニズム
  • 4.6 肝、脂質代謝、インスリンと抵抗性の関連
  • 4.7 おわりに
  • 5. 歯周病と骨粗鬆症の関係
  • 5.1 はじめに
  • 5.2 骨粗鬆症
  • 5.2.1 骨粗鬆症とは
  • 5.2.2 骨粗鬆症の診断
  • 5.3 歯周病と骨粗鬆症の関係をめぐって
  • 5.3.1 調査対象と評価方法
  • 5.3.1.1 骨粗鬆症患者
  • 5.3.1.2 閉経後女性歯周病患者
  • 5.3.1.3 歯科検診受診者
  • 5.3.1.4 卵巣摘出者
  • 5.3.2 調査結果
  • 5.3.2.1 骨粗鬆症患者の歯周病所見
  • 5.3.2.2 閉経後女性歯周病患者の骨粗鬆症所見
  • 5.3.2.3 歯科検診受診者の骨粗鬆症所見と歯周病所見
  • 5.3.2.4 卵巣摘出者の骨粗鬆症所見と歯周病所見
  • 5.4 考察
  • 5.5 われわれの調査結果のまとめ
  • 5.6 今後の方向性について
  • 6. 社会的・心理的ストレス刺激と歯周病
  • 6.1 歯周病と心理神経免疫学
  • 6.2 ストレス
  • 6.2.1 ストレス反応の調節因子
  • 6.2.2 ホルモン・神経調節因子
  • 6.2.3 ストレス反応と免疫反応
  • 6.2.4 ストレス刺激に対する危弱性と感情障害
  • 6.2.5 ストレス刺激と疾患
  • 6.3 社会・心理学的な要因と歯周病
  • 6.3.1 感情・情動に関連する行動変化
  • 6.3.2 自律神経を介した反応による影響
  • 6.3.3 内分泌の変化による影響
  • 6.4 心理神経免疫学と歯周病
  • 6.4.1 社会的・心理的ストレス刺激が疾患感受性に及ぼす影響
  • 6.4.2 日常生活におけるストレス刺激
  • 6.4.3 ストレス刺激としての感染症
  • 6.4.4 心理神経免疫学から捉えた歯周病
  • 7. 腎疾患と歯周病
  • 7.1 はじめに
  • 7.2 腎機能障害がもたらすカルシウム代謝異常
  • 7.3 人工透析患者にみられた歯周病の一例
  • 7.4 人工透析患者の歯周病罹患度
  • 7.5 糖尿病性腎症と歯周病
  • 7.6 尿路結石と歯石
  • 7.7 おわりに
  • 8. 薬物誘発性歯肉増殖症
  • 8.1 はじめに
  • 8.2 歯肉増殖症の病態と治療
  • 8.3 歯肉増殖症と炎症の関わり
  • 8.4 歯肉増殖症発症機構の解明
  • 8.5 おわりに
  • 9. HIV感染症/AIDSと歯周疾患
  • 9.1 HIV感染症/AIDSとは
  • 9.1.1 概念・定義
  • 9.1.2 分類
  • 9.1.3 構造・病因
  • 9.1.4 感染経路・疫学
  • 9.1.5 臨床経過
  • 9.1.6 治療と予後
  • 9.2 HIV感染症/AIDSに見られる口腔内病変
  • 9.2.1 線状歯肉紅斑
  • 9.2.1.1 有病率
  • 9.2.1.2 臨床症状
  • 9.2.1.3 病因
  • 9.2.1.4 治療
  • 9.2.2 壊死性(潰瘍性)歯肉炎・歯周炎
  • 9.2.2.1 有病率
  • 9.2.2.2 臨床症状
  • 9.2.2.3 病因
  • 9.2.2.4 治療
  • 9.2.3 成人性歯周炎
  • 9.2.3.1 有病率
  • 9.2.3.2 病因
  • 9.2.3.3 治療
  • 第11章 歯周病の予防と治療の現状と将来展望
  • 1. 歯周病の予防の現状と将来展望
  • 1.1 はじめに
  • 1.2 プロフェッショナルケアの推進の必要性
  • 1.3 若年時からの口腔管理の必要性
  • 1.4 病因論に基づいた新しい歯周病予防法の開発の必要性
  • 1.5 歯周病のリスク評価法の開発の必要性
  • 1.6 おわりに
  • 2. 歯周病の予防と治療の現状と将来展望
  • 2.1 はじめに
  • 2.2 歯周病の診断の現状と将来展望
  • 2.2.1 歯肉縁下プラークに対する検査の現状と将来展望
  • 2.2.2 歯周病の病態診断の現状と将来展望
  • 2.3 歯周治療の将来展望
  • 2.3.1 歯周病に対する化学療法
  • 2.3.2 歯周組織再生療法の現状と将来展望
  • 2.4 全身の保健に寄与する歯周治療
  • 2.5 おわりに
  • 技術資料編
  • PMTC:Professional Mechanical Tooth Cleaning
  • 1 プロフェッショナルツースケア:PTCの背景
  • 2 PMTCとは
  • 半導体レーザ手術装置 オサダライトサージ3000
  • 1 はじめに
  • 2 商品構成
  • 3 仕様
  • 4 レーザーの作用と使用上の注意点
  • 5 効能・効果
  • 6 適用症例
  • 7 今後の課題
  • 歯科における顕微鏡治療について
  • 1 はじめに
  • 2 顕微鏡治療のメリット
  • 3 顕微鏡選定にあたっての検討項目
  • 3.1 光学性能
  • 3.2 倍率
  • 3.3 操作性
  • 3.4 アクセサリーの豊富さ
  • 手術顕微鏡を用いた歯周外科(Periodontal Microsurgery)-Carl zeiss.OPM1 111を用いて-
  • 歯周病における高周波治療
  • 1 はじめに
  • 2 高周波の原理
  • 3 高周波の効果
  • 4 実験1
  • 4.1 材料・機器
  • 4.2 実験(内部温度の測定)
  • 4.3 結果
  • 4.4 実験(高周波通電点からの距離による温度差:表面温度)
  • 4.5 結果
  • 5 実験2
  • 5.1 材料及び方法
  • 5.2 実験
  • 5.3 症例・急性化膿性歯周炎
  • 5.4 結果
  • 6 考察
  • 7 まとめ
  • ボトルタイプの超音波スケーラー・ピエゾンマスター400とペリオプロラインシステム
  • 1 はじめに
  • 2 ピエゾンマスター400の特長
  • 2.1 ボトルタイプで持ち運び自由自在
  • 2.2 耐食性のあるハンドピース
  • 2.3 イリゲーション(洗浄)システム
  • 2.4 歯質を傷つけない
  • 2.5 少ないパワーロス
  • 2.6 安定したスケーリング
  • 2.7 滅菌消毒が可能
  • 3 ペリオプロラインの特長
  • 3.1 チップの種類・形状と適用部位
  • 3.2 使用上のポイント
  • スプラソンP/MAXを用いたURMペリオドンティックスの効果的なPMTC
  • 1 はじめに
  • 2 URMとP/MAX
  • 3 PMTC(PTC)とPSC(PMSC)について
  • 4 臨床におけるPSCの重要性と安全な処置の難しさ
  • 5 PSCと安全性
  • 歯科用エルビウムヤグレーザー装置 デントライト
  • 1 はじめに
  • 2 デントライトの特徴
  • 3 Er:YAGレーザーの臨床応用
  • 歯周炎治療薬 ペリオクリン歯科用軟膏
  • 1 はじめに
  • 2 ペリオクリンの開発
  • 3 ペリオクリンの特徴
  • 4 ペリオクリンの投与方法
  • 5 臨床成績
  • 6 今後の展開
  • 歯科医師のニーズにこたえる「ヒノポロン」の開発-特に「ヒノポロンキット」について-
  • 1 はじめに
  • 2 ヒノポロンの臨床的評価
  • 3 ヒノポロンキットの開発
  • 4 ヒノポロンキットの有用性
  • 5 まとめ
  • クラリスロマイシン
  • 1 はじめに
  • 2 抗菌カ
  • 3 組織移行性
  • 4 Biofilm
  • 5 おわりに
  • 歯周病原菌検査薬 ペリオチェック
  • 1 はじめに
  • 2 ペリオチェックの特徴
  • 3 測定原理
  • 4 測定方法
  • 5 臨床評価
  • 6 歯周病治療における臨床診断上の使用時期とその意義
  • ペリオテストのインプラント治療への導入
  • 1 はじめに
  • 2 ペリオテストの概要
  • 3 ペリオテストの測定原理
  • 4 ペリオテストの測定法
  • 4.1 前準備と校正
  • 4.2 測定時の注意点
  • 4.3 測定に影響を与える因子
  • 4.3.1 垂直的な槌打部位の違いによる影響
  • 4.3.2 水平的な槌打部位の違いによる影響
  • 4.4 ペリオテストの再現性について
  • 5 ペリオテストのインプラント治療への応用
  • 5.1 ペリオテスト値測定に使用したインプラントおよび対象患者
  • 5.2 ペリオテスト値の経時的変化
  • 5.3 二次手術時のペリオテスト値
  • 5.4 ペリオテスト値に影響を与える因子
  • 5.5 インプラント失敗症例に学ぶ
  • 6 まとめ
  • 歯科用口内法X線フィルム
  • 1 はじめに
  • 2 歯科用口内法X線フィルムの特徴
  • 3 ISO感度による分類
  • 4 サイズによる分類
  • 5 現像法による分類
  • 5.1 普通現像用フイルム
  • 5.2 インスタント現像用フィルム
  • 6 弊社のインスタント現像システム
  • 6.1 開発史
  • 6.2 1液式の現像法の特徴
  • 6.3 インスタントフィルムとプッシャー
  • 7 結び
  • 企業一覧(技術資料編)
  • 和文索引
  • 欧文索引
  • 奥付

この書籍の参考文献

参考文献のリンクは、リンク先の都合等により正しく表示されない場合がありますので、あらかじめご了承下さい。

本参考文献は電子書籍掲載内容を元にしております。

第1章 歯周組織の再構築による治療

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第2章 歯周組織の誘導再生療法

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第3章 外科およびレーザー治療

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第4章 薬物療法

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第5章 免疫療法

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第6章 歯周病の病因

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第7章 宿主細胞による歯周病病因因子に対する応答

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第8章 骨組織の病態

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第9章 歯周病の診断

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第10章 全身性疾患と歯周病

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第11章 歯周病の予防と治療の現状と将来展望

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技術資料編

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