Background/purpose In Japan, medical and dental care is provided by the universal health insurance system. The Ministry of Health, Labour, and Welfare (MHLW) in Japan sets the rules for health care services provided by health insurance. The MHLW issued a notice in 2020 permitting telemedicine and dental telemedicine for the first visit and for follow-up visits to prevent the spread of COVID-19 infection. We conducted this study to clarify the status of dental telemedicine during 2020. Materials and methods We used data from lists obtained on the MHLW website in the analysis. We investigated the number of dental institutions conducing dental telemedicine for the first visit and for follow-up visits by prefecture. Results In each prefecture, fewer dental institutions conducted telemedicine for the first visit than for follow-up visits. Regions with large metropolitan areas had higher numbers of dental institutions conducting dental telemedicine for the first visit and follow-up visits. Private dental clinics provided the largest proportion of dental telemedicine for the first visit, and general hospitals provided the largest proportion for follow-up visits. Conclusion Our study findings indicated that many dental institutions in Japan made efforts to provide dental services via dental telemedicine using the telephone or online with video to help prevent the spread of COVID-19 infection. Dental telemedicine can help patients to access dental services and dental care, thereby expanding the potential of dental telemedicine in Japan.
Soluble tumor necrosis factor receptors 1 and 2 (sTNF-R1 and sTNF-R2) are reported to protect against excessive TNF-α, a primary mediator of systemic responses to infection. This study aimed to investigate the levels of TNF-α, sTNF-R1, and sTNF-R2 in saliva and to verify whether their dynamics are associated with periodontal health. The study population comprised 28 adult patients. Probing pocket depth, clinical attachment level, and bleeding on probing were assessed, and periodontal inflamed surface area (PISA) was calculated. Stimulated saliva was collected before the oral examinations. The levels of TNF-α, sTNF-R1, sTNF-R2, and total protein (TP) in saliva samples were determined. There were significant positive correlations between TNF-α, sTNF-R1, and sTNF-R2 to TP (/TP) in stimulated saliva. Moreover, there were significant positive correlations between PISA and sTNF-R2/TP. Stepwise multiple regression analysis revealed that PISA was significantly associated with sTNF-R2/TP in saliva; however, TNF-α/TP was not significantly associated with PISA. In conclusion, this study demonstrates that significant relationships exist between the salivary levels of TNF-α and sTNF-R1, and that salivary sTNF-R2 is associated with the expansion of inflamed periodontal tissue.
Objective. In this study, we have introduced a case in which the effective blood oxygenation level-dependent signal on functional magnetic resonance imaging (fMRI) was altered by the improvement of periodontal tissue and occlusal function in a patient with periodontitis Stage II Grade B. Material and Methods. A 61-year-old female patient requiring periodontal treatment was diagnosed as having periodontitis Stage II Grade B via clinical and radiographic examinations. Her past medical history included type 2 diabetes, hypertension, and hyperlipidemia. Following the patient’s informed written consent, the periodontal initial treatment provided to the patient included tooth brushing instruction and scaling and root planing; however, occlusal adjustment was not performed at this stage. Occlusal force and fMRI results were also evaluated at the initial and reevaluation examinations. Results. After the periodontal initial treatment had been performed, it was noted that the patient’s periodontal tissue and occlusal force had improved. It was also evident from fMRI that cerebral blood flow had been activated in the insula, primary motor cortex, and premotor cortex. Conclusion. This result suggested that the periodontal ligament had recovered and the periodontal ligament neuron had been further subjected to clenching in the insula so that the muscle spindle sensation impacted the motor cortex.
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