Depar t ment of Dent i s t r y
Masashi Sugisaki,Professor Akihiro Ikai,Associate Professor Kazuo Ioroi,Associate Professor Shigeru Suzuki,Assistant Professor Katsuhiko Hayashi,Assistant Professor
Gener al Summar y
Cl i ni c al s t udi e s o f t e mp o r o mandi b ul ar di s o r de r s
We ha v e c ont i nue d our s t udi e s of s c r e e ni ng que s t i onna i r e s a nd t he e v a l ua t i on of qua l i t y of l i f e f or pa t i e nt s wi t h t e mpor oma ndi bul a r di s or de r s( TMDs ) . We s t udi e d c l i ni c a l que s t i ons f or dr a f t i ng g ui de l i ne s f or TMDs .
Mo r p ho l o g i c al and hi s t o l o g i c al s t udi e s o f t he t e mp o r o mandi b ul ar j o i nt
We c ont i nue t o s t udy a na t omi c a l a nd hi s t ol og i c a l e x a mi na t i on of t e mpor oma ndi bul a r j oi nt a nd a r t i c ul a r di s k i n Ma mma l i a .
Bas i c s t udi e s o f o r al muc o s al ke r at i no c y t e s
We e x a mi ne d t he e x pr e s s i on a nd f unc t i on of t r e f oi l f a c t or 3 i n nor ma l or a l muc os a l ke r a t i noc y t e s i n v i t r o . I n- s i t u i mmunohi s t ol og i c a l e x pr e s s i on of ne r v e g r owt h f a c t or a nd i t s r e c e pt or s Tr kA a nd p7 5 NTR i n ke r a t i noc y t e s f r om nor ma l or a l muc os a a nd or a l l i c he n pl a nus wa s a l s o s t udi e d.
Res ear ch Act i v i t i es Cl i ni c al s t udi e s o f TMDs
1 . Epi de mi ol og i c a l s t udy of TMDs i n wor ki ng pe r s ons i n Toky o
We ha v e de v e l ope d a 4 - i t e m que s t i onna i r e f or t he s c r e e ni ng of pa t i e nt s f or TMDs , whi c h s howe d a s e ns i t i v i t y of 0 . 7 4 6 a nd a s pe c i f i c i t y of 0 . 8 1 1 .
Pur pos e :Us i ng t hi s 4 - i t e m que s t i onna i r e ,we s c r e e ne d pe r s ons wor ki ng i n t he Toky o me t r opol i t a n a r e a f or TMDs i n 2 0 0 5 a nd 2 0 0 6 , t o de t e r mi ne t he pr e v a l e nc e of TMDs a nd c ont r i but i ng f a c t or s .
Me t hods :We us e d t he s e c onda r y da t a of t he Toky o De nt a l As s oc i a t i on f or bot h 2 0 0 6 ( 4 1 2 pe opl e ,3 9 6 e f f e c t i v e a na l y s i s s ubj e c t ［9 6 . 1 % ］ )a nd 2 0 0 7( 7 9 5 pe opl e ,6 7 9 e f f e c t i v e a na l y s i s s ubj e c t s ［8 5 . 4 % ］ ) .
Re s ul t s :The pr e v a l e nc e of TMDs i n me n wa s 1 9 . 5 %f or t hos e i n t he i r 2 0 ʼ s ,3 5 . 1 %f or t hos e i n t he i r 3 0 ʼ s ,2 7 . 3 %f or t hos e i n t he i r 4 0 ʼ s ,1 4 . 3 %f or t hos e i n t he i r 5 0 ʼ s ,a nd 3 . 9 % f or t hos e i n t he i r 6 0 ʼ s . The pr e v a l e nc e a mong wome n wa s 3 2 . 2 %f or pa t i e nt s i n t he i r 2 0 ʼ s ,3 8 . 3 %f or t hos e i n t he i r 3 0 ʼ s ,2 3 . 5 %f or t hos e i n t he i r 4 0 ʼ s ,a nd 6 . 1 %f or t hos e i n t he i r 5 0 ʼ s . Mul t i v a r i a t e l og i s t i c r e g r e s s i on a na l y s i s r e v e a l e d t ha t s i g ni f i c a nt f a c t or s a mong pe r s ons wi t h TMDs we r e f a t i g ue( odds r a t i o ＝ 1 . 5 5 )i n me n a nd de pr e s s i on( odds r a t i o ＝ 1 . 3 7 )a nd f a t i g ue( odds r a t i o ＝1 . 3 0 )i n wome n.
Conc l us i ons :The s e r e s ul t s we r e de v e l ope d f r om s e c onda r y da t a ;t he r e f or e ,whi l e di r e c t r e l a t i ons c a nnot be c onf i r me d, t he ne e d t o i nv e s t i g a t e wor k- t i me s l e e p a nd i t s a s s oc i a t i on
wi t h t he ons e t of TMD wa s r e v e a l e d.
2 . Compa r i s on of e pi de mi ol og i c s t udi e s of TMDs us i ng t he s a me s c r e e ni ng que s t i on Some e pi de mi ol og i c a l s ur v e y s of TMDs ha v e us e d di f f e r e nt que s t i onna i r e s whos e v a l i di t y ha s r a r e l y be e n r e v i e we d;t he r e f or e ,c ompa r a t i v e s t udy i s di f f i c ul t .
Pur pos e :To s t udy e pi de mi ol og i c a l s ur v e y s of TMDs whi c h ha v e us e d t he TMD s c r e e ni ng que s t i onna i r e t ha t wa s a c qui r e d by v a l i di t y e x a mi na t i on.
Me t hods :Subj e c t s we r e a s ke d t he f ol l owi ng que s t i on:“ Do y ou ha v e j a w pa i n whe n y ou wi de l y ope n a nd c l os e y our mout h? ”
Re s ul t s :A 2 0 0 5 s ur v e y of de nt a l di s e a s e s by t he Mi ni s t r y of He a l t h, La bour a nd We l f a r e s howe d t ha t t he pe r c e nt a g e s of pe r s ons r e pl y i ng“ y e s ”we r e 3 . 5 %( 1 3 9 of 3 , 9 6 9 )a mong pe r s ons a g e d 1 5 t o 8 5 y e a r s ;2 0 . 0 %( 1 3 0 of 6 4 9 )a mong pe r s ons a g e d 1 8 t o 7 0 y e a r s who we r e e mpl oy e d i n Toky o;5 . 8 %( 2 9 of 5 0 1 )a mong pe r s ons a g e d 4 0 t o 5 5 y e a r s l i v i ng i n Yokot e - s hi ,Aki t a ;a nd 2 0 . 5 %( 2 5 8 of 1 , 2 6 1 )a mong pe r s ons a g e d 1 2 t o 9 3 y e a r s who we r e pa t i e nt s of g e ne r a l c l i ni c s i n ur ba n a nd s ubur ba n a r e a s of Toky o.
Conc l us i ons :Thi s s t udy r e v e a l e d l oc a l di f f e r e nc e s a nd s ubj e c t di f f e r e nc e s i n e pi de mi ol og i c a l s ur v e y f i ndi ng s of di s e a s e wi t h t he s a me que s t i onna i r e . The pr e v a l e nc e of TMDs wa s pa r t i c ul a r l y hi g h a mong pe r s ons wor ki ng i n Toky o. The r e f or e ,t he s e r e s ul t s i ndi c a t e t he ne e d t o i nv e s t i g a t e wor ki ng c ondi t i ons .
3 . Que s t i onna i r e a na l y s i s of“ c l i ni c a l que s t i ons ”f or t r e a t i ng TMDs c ol l e c t e d f r om de nt a l c a r e pr ov i de r s :A pr e l i mi na r y i nv e s t i g a t i on of pa r t i c i pa nt s i n t he 2 0 a nnua l me e t i ng of t he J a pa ne s e Soc i e t y f or t he Te mpor oma ndi bul a r J oi nt
The c ommi t t e e dr a f t i ng g ui de l i ne s f or t he pr i ma r y c a r e of TMDs of t he J a pa ne s e Soc i e t y f or t he Te mpor oma ndi bul a r J oi nt pe r f or me d a que s t i onna i r e s ur v e y of pa r t i c i pa nt s of t he 2 0 t h a nnua l me e t i ng he l d on J ul y 1 4 a nd 1 5 ,2 0 0 7 . The pur pos e of t he s ur v e y wa s t o c ons i de r s t r a t e g i e s f or c ol l e c t i ng c l i ni c a l que s t i ons f r om he a l t h c a r e pr ov i de r s . The que s t i onna i r e i nc l ude d t he pos i t i on i n t he s oc i e t y a nd s oc i a l s t a g e ,t he l e ng t h of t i me t r e a t i ng TMDs ,t he f or ma t f or c l i ni c a l que s t i ons ,a nd opi ni ons r e g a r di ng g ui de l i ne s . Ef f or t s t o publ i c i z e t he ne x t i nv e s t i g a t i on we r e c ons i de r e d ne c e s s a r y be c a us e we we r e a bl e t o c ol l e c t c ompl e t e d s ur v e y s f r om onl y 6 1 r e s ponde nt s . Of t he s e r e s ponde nt s ,5 4 ( 8 9 %)we r e s oc i e t y me mbe r s a nd 2 4( 3 9 %)we r e a ut hor i z e d s pe c i a l i s t s . The r e we r e 3 1 de nt i s t s( 5 1 %)who ha d t r e a t e d TMDs f or mor e t ha n 1 1 y e a r s . Of t he s y mpt oms de s c r i be d i n t he c l i ni c a l que s t i on f or ma t ,pa i n wa s t he mos t f r e que nt a nd wa s f ol l owe d by j oi nt noi s e a nd l i mi t e d mout h ope ni ng . Spl i nt t he r a py wa s t he mos t c ommon t r e a t me nt a nd wa s f ol l owe d by mout h- ope ni ng e x e r c i s e s a nd a pha r ma c ot he r a py . For s e v e r a l a ns we r s t he r e s ponde r s s e e me d una bl e t o r e c og ni z e t he f or ma t s t y l e f or c l i ni c a l que s t i ons . The s e f i ndi ng s s ug g e s t t ha t mor e - de t a i l e d me t hods s houl d be c ons i de r e d f or c ol l e c t i ng c l i ni c a l que s t i ons .
4 . Que s t i onna i r e a na l y s i s of g e ne r a l pr a c t i c e de nt i s t r y f or t he s y s t e ma t i c unde r s t a ndi ng of c l i ni c a l que s t i ons f or c l i ni c a l g ui de l i ne s f or TMDs
Whe n dr a f t i ng c l i ni c a l g ui de l i ne s ,we s houl d a dopt t he a c r ony m “ PI CO” :pa t i e nt( or di s e a s e ) ,i nt e r v e nt i on( a dr ug or t e s t ) ,c ompa r i s on( a not he r dr ug ,pl a c e bo or t e s t ) ,a nd out c ome of c l i ni c a l que s t i ons .
Pur pos e :We pe r f or me d a que s t i onna i r e s ur v e y of de nt i s t s i n g e ne r a l pr a c t i c e t o c ol l a t e
c l i ni c a l que s t i ons f or t he t r e a t me nt of TMDs .
Subj e c t s a nd Me t hods :The J a pa n De nt a l As s oc i a t i on( J DA)c ol l e c t e d que s t i onna i r e s , a nd we a na l y z e d t he s e c onda r y da t a ,whi c h e l i mi na t e d pe r s ona l i nf or ma t i on. Al l s ubj e c t s we r e g e ne r a l me mbe r s of t he J DA or we r e me mbe r s or nonme mbe r s of t he J DA wor ki ng i n pa r t i c i pa t i ng c l i ni c s . I n pr i nc i pl e ,1 0 % of t he g e ne r a l me mbe r s we r e e x t r a c t e d f r om e v e r y a g e g r oup. To uni f y t e r ms ,one a ut hor c ompi l e d a l i s t of s i mi l a r t e r ms us i ng t he t e x t - mi ni ng me t hod.
Re s ul t s :We s e nt que s t i onna i r e s t o 5 , 9 9 9 de nt i s t s a nd r e c e i v e d r e s pons e s f r om 1 , 4 1 2 ( r e s pons e r a t e ,2 3 . 8 %) . I na de qua t e a nd i nc ompl e t e c l i ni c a l que s t i ons( 3 5 3 )we r e e x c l ud- e d f r om t he t ot a l a na l y s i s s e t of 4 , 4 2 3 ,l e a v i ng a n e f f e c t i v e a na l y s i s s e t of 4 , 0 7 0 . The ma i n t he r a pi e s( mor e t ha n 5 %)c hos e n f or ma i n s y mpt oms( mor e t ha n 3 %)we r e 3 2 ki nds of c l i ni c a l que s t i ons .
Conc l us i on:The s e da t a a nd / or c ombi na t i on s houl d be c ons i de r e d whe n dr a f t i ng c l i ni c a l g ui de l i ne s f or TMD.
Mo r p ho l o g i c al and hi s t o l o g i c al s t udi e s o f t he t e mp o r o mandi b ul ar j o i nt
1 . Abs e nc e of a n a r t i c ul a r di s k i n t he Ta s ma ni a n de v i l t e mpor oma ndi bul a r j oi nt Ba c kg r ound:The a r t i c ul a r di s k of t he t e mpor oma ndi bul a r j oi nt i s a c ons t a nt s t r uc t ur e i n t he Ma mma l i a . Ac c or di ng t o Pa r s onʼ s r e por t i n 1 9 0 0 ,howe v e r ,t he a r t i c ul a r di s k i s a bs e nt i n 4 ma mma l s :t he a r ma di l l o,2 ki nds of monot r e me( t he e c hi dna a nd t he pl a t y pus ) ,a nd t he Ta s ma ni a n de v i l . Si nc e 1 9 0 0 ,howe v e r ,no r e s e a r c h ha s be e n done t o c onf i r m t hi s obs e r v a t i on. The a i m of t hi s s t udy wa s t o de t e r mi ne by me a ns of a na t omi c a l a nd hi s t ol og i c a l e x a mi na t i on whe t he r t he Ta s ma ni a n de v i l ha s a n a r t i c ul a r di s k i n i t s t e mpor oma ndi bul a r j oi nt .
Me t hods :Fr e s h c or ps e s of 8 Ta s ma ni a n de v i l s we r e obt a i ne d f r om t he Sc hool of Zool og y , Uni v e r s i t y of Ta s ma ni a . The y we r e di s s e c t e d, a nd t he s t r uc t ur e of t he t e mpor - oma ndi bul a r j oi nt wa s c a r e f ul l y obs e r v e d a na t omi c a l l y . The n, t he t e mpor oma ndi bul a r j oi nt wa s r e mov e d,i mme r s e d i n 1 0 %buf f e r e d f or ma l de hy de s ol ut i on,de c a l c i f i e d i n 1 0 % e t hy l e ne di a mi ne t e t r a a c e t i c a c i d s ol ut i on,a nd e mbe dde d i n pa r a f f i n. Se r i a l s a g i t t a l s e c t i ons we r e c ut a nd s t a i ne d wi t h he ma t ox y l i n a nd e os i n f or hi s t ol og i c a l e x a mi na t i on.
Re s ul t s :I n a l l c a s e s , g r os s obs e r v a t i on a nd di s s e c t i on r e v e a l e d t he a bs e nc e of a n a r t i c ul a r di s k. Hi s t ol og i c a l e x a mi na t i on s howe d t ha t t he s ur f a c e l a y e r s of bot h t he c ondy l e a nd t he g l e noi d f os s a c ons i s t e d of f i br ous t i s s ue t hi c ke r t ha n t ha t i n ot he r ma mma l s . A s y nov i a l me mbr a ne - l i ke s t r uc t ur e wa s obs e r v e d i n t he a nt e r i or a nd pos t e r i or pa r t s of t he f i br ous s t r uc t ur e of t he c ondy l e .
Conc l us i on:We c onf i r me d t he a bs e nc e of a n a r t i c ul a r di s k i n t he Ta s ma ni a n de v i l ʼ s t e mpor oma ndi bul a r j oi nt . Fur t he r mor e , t hi c k f i br ous l a y e r s on t he s ur f a c e s of bot h t he c ondy l e a nd t he g l e noi d f os s a mi g ht pl a y a r ol e a s a buf f e r a g a i ns t ha r d j a w mov e me nt i ns t e a d of a r t i c ul a r di s k.
2 . Obs e r v a t i on of t he c ondy l e us i ng mi c r o- c omput e d t omog r a phy i n t he Ta s ma ni a n de v i l t e mpor oma ndi bul a r j oi nt
Pur pos e :The a i m of t hi s s t udy wa s t o e x a mi ne t he s t r uc t ur e s of c a nc e l l ous a nd c or t i c a l bone of t he Ta s ma ni a n de v i l ʼ s c ondy l e .
Me t hods :Fr e s h c a r c a s s e s of 6 Ta s ma ni a n de v i l s( 5 ma l e a nd 1 f e ma l e ;body we i g ht :4 . 3 t o 1 0 . 4 kg )we r e obt a i ne d f r om t he Sc hool of Zool og y ,Uni v e r s i t y of Ta s ma ni a . One
of t he s e dr y s kul l s wa s obt a i ne d a nd us e d f or mi c r o- c omput e d t omog r a phy( CT) e x a mi na t i on. The c ondy l e on t he l e f t s i de of t he dr y s kul l wa s e x a mi ne d wi t h mi c r o- CT( HMX- 2 2 5 Ac t i s 4 ,Te s c o,Toky o,J a pa n) . I ma g i ng wa s pe r f or me d wi t h a t ube v ol t a g e of 1 4 0 kV,a t ube c ur r e nt of 1 2 0 μ A,a ma g ni f i c a t i on of 6 . 0 ,a nd a s l i c e wi dt h of 5 0 μ m. Thr e e - di me ns i ona l i ma g e s we r e c r e a t e d wi t h t he v ol ume - r e nde r i ng me t hod us i ng Vg s t udi o( Ni hon Vi s ua l Sc i e nc e I nc . ,Toky o J a pa n) . The f i ndi ng s we r e c ompa r e d wi t h t hos e of a be a g l e .
Re s ul t s a nd Conc l us i on:Sa g i t t a l a nd c or ona l mi c r o- CT s c a ns r e v e a l e d de ns e a nd f i ne c a nc e l l ous bone a nd t hi nne r c ov e r i ng c or t i c a l bone i n t he c ondy l e of t he Ta s ma ni a n de v i l a s c ompa r e d wi t h t hos e of t he be a g l e . The s e f i ndi ng s mi g ht be due t o r a pi d t ur nov e r / r e ne wa l of bone a s a r e s ul t of powe r f ul ma s t i c a t i on a nd he a v y l oa di ng on t he c ondy l e .
Bas i c s t udi e s o f o r al muc o s al ke r at i no c y t e s
1 . Sa l i v a r y t r e f oi l f a c t or 3 e nha nc e s mi g r a t i on of or a l ke r a t i noc y t e s
Pur pos e :Tr e f oi l f a c t or( TFF)3 i s a me mbe r of t he ma mma l i a n TFF f a mi l y . TFFs a r e s e c r e t e d ont o muc os a l s ur f a c e s of t he e nt i r e body a nd e x e r t di f f e r e nt e f f e c t s a c c or di ng t o t he t i s s ue l oc a t i on. TFFs ma y e nha nc e muc os a l he a l i ng by modul a t i ng mot og e ni c a c t i v i t y ,i nhi bi t i ng a popt os i s ,a nd pr omot i ng a ng i og e ne s i s . TFF3 i s s e c r e t e d f r om t he s ubma ndi bul a r g l a nd a nd i s pr e s e nt i n whol e s a l i v a . The a i m of t hi s s t udy wa s t o a s s e s s t he mi g r a t or y a nd pr ol i f e r a t i v e e f f e c t s of TFF3 on pr i ma r y or a l huma n ke r a t i noc y t e s a nd or a l c a nc e r c e l l l i ne s .
Re s ul t s :The a ddi t i on of TFF3 i nc r e a s e d t he mi g r a t i on of bot h nor ma l or a l ke r - a t i noc y t e s a nd t he c a nc e r c e l l l i ne D1 2 ,a s e v a l ua t e d wi t h a 2 - di me ns i ona l s c r a t c h a s s a y . I n c ont r a s t ,no i nc r e a s e i n pr ol i f e r a t i on or e ne r g y me t a bol i s m wa s obs e r v e d a f t e r s t i mul a t i on wi t h TFF3 . The TFF3 - e nha nc e d mi g r a t i on wa s f ound t o be dr i v e n pa r t l y by t he e x t r a c e l l ul a r s i g na l ―r e l a t e d ki na s e pa t hwa y ,a s s hown by a ddi t i on of t he mi t og e n- a c t i v a t e d pr ot e i n ki na s e i nhi bi t or PD 9 8 0 5 9 . Conc l us i on:Al l pr e v i ous f unc - t i ona l s t udi e s of t r e f oi l pe pt i de s ha v e be e n ba s e d on c e l l s f r om monol a y e r e d e pi t he l i um, s uc h a s t he i nt e s t i na l muc os a ;t hi s i s t he f i r s t r e por t t o s how t ha t nor ma l a nd c a nc e r ous ke r a t i noc y t e s f r om s t r a t i f i e d e pi t he l i um r e s pond t o TFF s t i mul i . The s e f i ndi ng s s ug g e s t t ha t s a l i v a r y TFF3 c ont r i but e s t o or a l wound he a l i ng .
2 . Ne r v e g r owt h f a c t or a nd i t s r e c e pt or s Tr kA a nd p7 5 NTR i n t he e pi t he l i um of or a l l i c he n
Ba c kg r ound:Ne r v e g r owt h f a c t or( NGF)c a n, t hr oug h i t s r e c e pt or s Tr kA a nd p7 5 NTR, c onv e y s i g na l s f or c e l l s ur v i v a l ,di f f e r e nt i a t i on,a nd de a t h. The a i m of t hi s s t udy wa s t o e x a mi ne whe t he r NGF pl a y s a r ol e i n t he pa t hol og y of or a l l i c he n.
Me t hods :Se c t i ons of bi ops i e s f r om pa t i e nt s wi t h e r y t he ma t ous or a l l i c he n a nd f r om v ol unt e e r s wi t h nor ma l or a l muc os a we r e i mmunos t a i ne d wi t h a nt i bodi e s a g a i ns t NGF, pr oNGF,Tr kA,phos phor y l a t e d Tr k,p7 5 NTR,a nd phos phor y l a t e d Akt ,a nd t he e x pr e s s i on of RNA c odi ng f or pr oNGF / NGF wa s i nv e s t i g a t e d wi t h i n s i t u hy br i di z a - t i on.
Re s ul t s :Bot h i n e r y t he ma t ous or a l l i c he n a nd nor ma l or a l muc os a , c y t opl a s mi c s t a i ni ng f or NGF wa s s e e n i n g r a nul a r a nd uppe r s pi nous c e l l l a y e r s of t he e pi t he l i um,whe r e a s
pr oNGF s t a i ni ng wa s s e e n i n a l l e pi t he l i a l c e l l l a y e r s . I n s i t u hy br i di z a t i on s howe d t ha t t he pr oNGF pr ot e i n wa s pr oduc e d i n t he s a me c e l l l a y e r s . I n or a l l i c he n,s t r ong c y t opl a s mi c s t a i ni ng f or Tr kA a nd phos phor y l a t e d Tr k wa s obs e r v e d i n a l l e pi t he l i a l c e l l l a y e r s ,but s t a i ni ng wa s we a k i n nor ma l or a l muc os a . Ba s a l ke r a t i noc y t e s i n or a l l i c he n s howe d no or onl y we a k c y t opl a s mi c s t a i ni ng f or p7 5 NTR,but i n nor ma l or a l muc os a t he r e wa s c l e a r c e l l - me mbr a ne s t a i ni ng . I n or a l l i c he n,s t r ong c y t opl a s mi c a nd i nt e r mi t t e nt nuc l e a r s t a i ni ng f or phos phor y l a t e d Akt wa s obs e r v e d i n s pi nous ,g r a nul a r , a nd s upe r f i c i a l l a y e r s ,whe r e a s ba s a l a nd pa r a ba s a l ke r a t i noc y t e s s howe d no s t a i ni ng . Thi s s t a i ni ng wa s we a k or a bs e nt i n t he e nt i r e e pi t he l i um of nor ma l or a l muc os a . Conc l us i on:Tr kA upr e g ul a t i on a nd a c t i v a t i on i n or a l l i c he n i s a pa t hwa y t ha t c a n a c t i v a t e phos phor y l a t e d Akt a nd t he r e by r e s c ue e pi t he l i a l c e l l s f r om unt i me l y c e l l de a t h.
Publications
Storesund T,Hayashi K,Kolltveit KM ,Bryne M , Schenck K (Univ Oslo).Salivary Trefoil Factor 3 enhances migration of oral keratinocytes.Eur J Oral Sci 2008;116:135‑40.
Hayashi K,Karatsaidis A,Schreurs O,Bjornland T,Sugisaki M,Schenck K (Univ Oslo).NGF and its receptors TrkA and p75NTR in the epith- elium of oral lichen.J Oral Pathol 2008;37:
241‑8.
Sugisaki M,Tanaka N,Kino K,Hayashi K,Saito T,Nishiyama A,Suzuki S(Tokyo Dental Assoc,
Tokyo Med Dental Uni v).Prevalence of temporomandibular disorders among working population of Tokyo.J Jpn Soc TMJ 2008;20:
127‑33.
Sigisaki M,Kakudo K,Kino K,Yuasa H,Erigu- chi A,Hirata S (Osaka Dental Univ, Tokyo
Med Dental Univ,Tokai Municipal Hosp,Tokyo Dent Coll).Questionnaire analysis of general practice dentists for systematic understanding of
“Clinical Questions” for clinical guideline for temporomandibular disorders.J Jpn Soc TMJ 2008;20:157‑65.
Fukumoto Y,Suzuki Y,Shigematsu S,Yoshida N,Kuruma E,Yakushiji T (Tokyo Metrop Fuchu Hosp,Tokyo Dent Coll).Factors that influence the period required for the restoration of anticoagulant effect after tooth extraction in patients receiving oral warfarin therapy.Jpn J Oral Maxillofac Surg 2008;54:517‑21. Saito T,Sato T,Usui H,Hirashita K,Asada K, Ishibashi K (Tsurumi Uni v).A case of squamous cell carcinoma arising from brachial cleft cyst.Oral Sci Int 2008;5:135‑40.
