Bulletin of Tokyo Dental College

Rather than focusing solely on cost-effectiveness and accessibility, it is also important to assess the quality of treatments available under Japan's Public Health Insurance System (PHIS). The purpose of this retrospective study was to assess the survival rate of metal crowns used to replace first molars in a clinical setting. Only metal crowns made of 12% gold-silver-palladium alloy placed on first molars and available under the PHIS were included. The endpoint was removal/separation of a crown or extraction of the tooth. A total of 603 crowns fitted at 20 dental offices were investigated. During the observation period, 133 of these crowns showed failure. The crown survival rate was 92.5% at 5 years, 80.8% at 10 years, 70.5% at 15 years, and 54.0% at 20 years as estimated using the Kaplan-Meier method. The estimated mean survival period was 20.6 years. The analysis revealed 3 risk factors: male (hazard ratio [HR]: 1.51), low gonial angle (HR: 1.74), and deep pockets around the abutment teeth (HR: 1.53). The main reasons for crown failure were extraction of an abutment tooth (22.6%), separation from an abutment tooth (21.8%), root fracture (18.8%), and caries (15.8%). The results showed that metal crowns available under the PHIS at dental offices have a long survival period, and that plaque control and measures to prevent separation from the abutment teeth are important for their longterm survival.

Koichi Yoshino

Koji Ito

Masahiko Kuroda

Naoki Sugihara

Hideshi Sekine

The Bulletin of Tokyo Dental College

Survival Rate of Metal Crowns Covered by Public Health Insurance System in Japan: A Quality-of-Care Perspective

日本公共健康保险体系下金属冠的存活率：从护理质量角度分析

Sialolithiasis is a common disease of the salivary glands. This report describes a rare case of a submandibular gland sialolithiasis that grew over an extended period. The patient was a 72-year-old woman who presented with a mass in the right submandibular gland that had remained untreated for approximately 34 years. She had noticed the mass from the beginning, but had ignored it as it had caused no pain. She was eventually referred to our hospital, however, because panoramic X-ray images taken at another facility showed that it had grown over the previous 10 years. Extraoral findings at our clinic revealed a hen egg-sized, elastic, hard mass in the right submandibular region, strongly suggesting intraglandular sialolithiasis of the right submandibular gland. Extraction of the right submandibular gland was performed under general anesthesia. The size of the sialolith inside the submandibular gland was 42×22×15 mm, with a visually rough and yellowish-white surface. Histopathological findings showed a lamellar structure with basophilically stained bacteria in the hard material at the core, a finding typical of sialoliths. Therefore, the diagnosis was intraglandular sialolithiasis of the right submandibular gland. This report describes a case of a rare giant sialolith located within the right submandibular gland.

Masae Yamamoto

Masashi Iwamoto

Akira Katakura

Giant Sialolithiasis in Submandibular Gland Growing over Extended Period: A Case Report

颌下腺巨大涎石症长期生长：一例报告

A 38-year-old woman with a history of systemic lupus erythematosus presented at our university hospital with fever, fatigue, and oral pain and was urgently admitted based on a diagnosis of septic shock. Initially, dental infection was suspected based on the symptoms and clinical presentation of purpura accompanied by severe tenderness along the marginal gingiva in the maxilla and mandible. However, subsequent investigations, including an oral examination, radiographic studies, and blood cultures, ruled out dental infection as the cause of the septic shock. The patient received antibiotic therapy and was discharged on Day 16 after admission, with no definitive source of the infection yet being identified. The gingiva around where the purpura was observed on Day 1 gradually necrosed and detached, leading to ulcer formation by Day 8 and gingival recession by Day 15. Gingival necrosis was attributed to septic shock-induced neutropenia and circulatory disturbances, indicating the severity of the systemic conditions. Follow-up after discharge revealed no recurrence. This case underscores the importance of recognising oral symptoms as potential precursors to severe systemic conditions such as septic shock. Timely intervention and interdisciplinary collaboration are essential in effectively managing such cases. Further research is warranted to elucidate the relationship between oral health and systemic diseases to enable clinicians to provide optimal patient care.

Risako Mikami

Tetsuya Saito

Ruriko Mizuno

Yuji Kabasawa

Koichiro Matsuo

Gingival Necrosis Associated with Septic Shock of Unknown Origin in Patient with Systemic Lupus Erythematosus: A Case Report

系统性红斑狼疮患者不明来源脓毒性休克相关牙龈坏死：一例报告

A condylar head fracture in the mandible is often misdiagnosed as a contusion of the temporomandibular joint (TMJ). Moreover, they are often overlooked by general practitioners as the fragments are small, making them difficult to identify. This report describes 2 cases of old mandibular condylar head fractures: one involving an 84-year-old woman referred to our dental office with suspected medication-related osteonecrosis of the jaw; and another involving a 23-year-old man who visited with the chief complaint of slight pain in the left TMJ. An old condylar head fracture with dislocation or displacement was coincidentally found on panoramic radiographs obtained during dental treatment in both cases. No disturbances in mouth opening or masticatory forces were observed in either case. Analysis of injury status and imaging with X-rays and computed tomography revealed that the relationship between the dislocated/displaced condylar head and the mandibular fossa changed as the bone structure and muscle positions stabilized.

Shiro Kubo

Healing Process of Old Mandibular Condylar Head Fractures: A Report of Two Cases

老年下颌髁突头骨折愈合过程：两例报告

Noriyuki Seta

Role of Circulating Monocytes and Periodontopathic Bacteria in Pathophysiology of Rheumatoid Arthritis

循环单核细胞和牙周致病菌在类风湿性关节炎病理生理学中的作用

Abbreviation	Bull. Tokyo Dent. Coll.
Journal Impact	0.67
Quartiles(Global)	DENTISTRY, ORAL SURGERY & MEDICINE(Q4)

ISSN	0040-8891
h-index	26

Publication Information	Publisher: Tokyo Dental College Society，Publishing cycle: ，Journal Type: journal，Open Access Journals: No
Basic data	Year of publication: 1965，Proportion of original research papers: 100.00%，Self Citation Rate:0.00%， Gold OA Rate: 100.00%

Bulletin of Tokyo Dental College

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Survival Rate of Metal Crowns Covered by Public Health Insurance System in Japan: A Quality-of-Care Perspective

Giant Sialolithiasis in Submandibular Gland Growing over Extended Period: A Case Report

Gingival Necrosis Associated with Septic Shock of Unknown Origin in Patient with Systemic Lupus Erythematosus: A Case Report

Healing Process of Old Mandibular Condylar Head Fractures: A Report of Two Cases

Role of Circulating Monocytes and Periodontopathic Bacteria in Pathophysiology of Rheumatoid Arthritis

Survival Rate of Metal Crowns Covered by Public Health Insurance System in Japan: A Quality-of-Care Perspective

Giant Sialolithiasis in Submandibular Gland Growing over Extended Period: A Case Report

Gingival Necrosis Associated with Septic Shock of Unknown Origin in Patient with Systemic Lupus Erythematosus: A Case Report

Healing Process of Old Mandibular Condylar Head Fractures: A Report of Two Cases

Role of Circulating Monocytes and Periodontopathic Bacteria in Pathophysiology of Rheumatoid Arthritis