ʡAdvanced Care Dental Office åץǥʡnaomi

ϤޤơAdvenced Care dentai Office ޥ׸ʡʱnaomiȸǤˤΡֻŻפǤɤֻŻפ򤹤뤿˻ʱƻޤä顣ʡ

ե餵ȰòŤΤ«Ⱦ

ˤѸʱnaomiǤ 


 
ޤ1֤Ϥޤޤ
1֤äȤ֤ơ®Ƥޤ

ơäܶȤ˥󥸥󤬤ä䡣
ǯХϤ䴶ʬؤޤܶȤȻ䤬פäƤ롢ѸѤʱζ̳αĹǤޤ

ˤϡޥϥ˥Ȥޤ

䤬ʱγع´Ȥ20ǯˤ ʱΤȤϡʤƥѥեåȤäۤɡޤޤʱΤȤȤФǧ٤㤯ԤδǸؤ󡩤ʤƸƤޤ

ʱΤˤ͡ʶ̳ΤǤϻʼͽɤᥤˤŻƤޤ

ʻʰ屡οŤػҡˣʱѤ˻Ȥ碌ĺơФν˻Ϥޤ¤νŤ䡢ˤĤƤΥ쥯㡼бλƳƳ¾򹯤ˤޤĤ󶡡ԥ󥻥󥰤̤ޤ

ĹԤ15ǯ餤ҸĺƤޤ

դ礤Ǥ롢ΤΥѡȥʡǤޥϥ󥹥Ȥ򳧤ϤǤ礦

ѸȤϤơ⤦10ǯۤɷФޤѸȤȡ˽Ť٤ʤ˾夬ޤƤζȳǸƤ롢Ū˸Ƥ¤μˡΤɤäȵ˻פäƤޤ

ŤɸŪʿʤϡưˡ ܻ³زλؿˤˤСʲοޤΤ褦ˡܡ¸¿ǡŷײΩơܼšɾʼšɾŢᥤƥʥ󥹡⤷ϡɾ¾ꢪݡƥ֥ڥꥪɥ󥿥륻ԡν˿ʤޤ

Ťλؿ2015 

Ťή2015

䤿ʱΤϡ ܼŤΰץ顼ȥ䥹󥰡ʻнˤ롼ȥץ졼˥󥰤ʤɤôޤ

ν֤٤ˤäơʽ֤˰ܹԤ뤫ɤޤޤ

ʽ֤ȿˡڽˡȿˡѤ 4 ʬवޤ

ɤλʼѤԤΤϹ»֡б֡ݥ ȿץӥ󥰻νз졢å긫ʤɤŪȽǤޤ ʼѤϡŪ˺ɾλݥåȿ 4 mm ʾ塢ץӥ νз(+)ŬȤʤޤ

γʽƤˤ褯˴ޤޤƤΤݥåɤα(ݥåȾ顢ȿ)ȤĤǤ

ٶݤˤäƱ줿ݥå̤ਤʴñ˸ڤ롢ڽˡ

äȻƬǤϡäưʤǽȤɤʤΤ
륰롢륰䤤äƤΤǤ

籱θ¦ῴλݥåȤΤưǤ
̤֤ܤΤ褦ʡƺ˼Τ褦ĤߡޤǤ礦

°˸äƤλǤ礦
ݥåȤ̤ਤäƤ֤Ĥߤ冷ȤäƻǤ礦

¿ʬ

ʤɤΤǤϤʤȻפΤǤ

ĤߤỊ̇Ȥ

ηиä򤷤ޤΥ֥ĥ֥ġФ˼ơФ̤ˤʤȡݥå̤⼫ʿóˤʤꡢ줳Τ褦˵ȿѲΤǤ

֤ΤĤǤΤϡФ̤ʪǤʺٶݤDZ줿̤äꡢβ˶Ūʱ̤äꡣǤ¿ʬٶݤˤäƱ줿ʤΤȻפޤ˱ɤäƤʤΤǤ

ɤϺٶݤٶݤǡʪʤɤΤȿơäĤ褦ȡȱֺ˦ɥɥդ˾äƱФƤ롣Ĥޤդޤ뢪롢֤롢äȤɷǽз줹롣

ηդνޤäĤߤʿʪǺ襤ɤΤŪˤݷ줬ꡢ롣⤽⤽ˤϺٶݤ㤦㤤ƼƤΤˡΤΥХꥢǤ冷äɤΤ֤󡢥ǤХǤ

ưŪ˻¤¾夤褦˸ΤϡȿڽȤˤȿ뤫ǤβˤΤǡʤпǯФƤиޤĤޤޤɤ롣

Ĥޤꡣʱ˳μ¤˺̤λФˡͤפȻϹͤƤޤ

ѸϤǤȤˤޤ

ѸȤʱΤˤϡäĺǤ
ܵǺ̤ˤ̿򤫤줬򰷤ʱΤλ̿

⤦ȤϤ10ǯФޤ
ۤȤɤδԤϻФʤʤäơä褦ʾ⤫ʤ긺ޤ

ơ⤬Ф뤾

ҳ󡢥ޥϥ󥹥Ȥ򸫤ĤƤ͡
    Υȥ꡼ϤƤʥ֥åޡɲ mixiå

ե餵ȰòŤΤ«Ⱦ

ˤѸʱnaomiǤ 


 
ޤ1֤Ϥޤޤ

ǶϻʤδˤĤƤλФ񤤤Ƥޤ¤ϻܶȡ

ܶȤȸȤǤʱΤ顢ϰλŻܶȤʤΤǤɡǶϡnaomiϴؤǤȸƤޤۤɡʵǶݡǤޤ᤿Υ᡼ʤäƤͤǤ

䤤䡢ϤޤԷǶݴĺǤơȤۤɤǤϡ

ʱζ̳Dz礫ȤˤʤϻѸǻФνᥤƥʥ󥹤ԤǤȤǤ礦͡

屡ǤƤμŤѸȤäƹԤʤäƤޤ

ʱΤԤФν䡢ƥʥ󥹤ν֤ѸȤäƤޤ

Ѹν֤Ѥ񤷤䤿ϻʰդȰäơλ򸫤ɤȤΤǤϤʤäȾʡäȶμλݥåȤȤ鷺mm٤ʤƤϤʤޤƤ夷Ƥ褽0.ߥ꤫ߥ礭Ƥ3mm٤Ǥ礦ˤλФʤФʤʤ⡢̤»ʤ

»ȿʤΤǡз줷Ƥޤ֤ޤޤ񤷤ʤޤޤ̡ʲˤ⤢ޤ̤»нѸγвҤƻߤ⤢ޤβǽ㤯ʤޤΤФȤ֤Ǥ

褯ʱΤγ󤬡ѸϷȤ ԤΥ١UPΤΥġȤä㤤ޤ󡢤ä¦̤⤢ޤɴ٤ι⤤֤Ǥ ѸκΥååȤǤ

Υ꡼˥ȤλмȤä㤤ޤȤΥåդϤϻפäƤޤ󡣤ϤääƳʼѤƱǤޤѤۤɤζĥϤޤ󤬡⤷Ƕĥä顢֤Ǥޤɤ

ʤ֤ϰϤǤΤȤǤϤȾüޤ

ξϲܱ쾮ζῴǤ
쾮
ʤߤˡCTϤ
IMG_2316
ơϤʤưդǤɤ

ݥåȥǥץ3mm 
֥꡼ǥ󥰥ץӥ󥰡ʡܡ
ǽϥݥå˸ФФɤ狼餺ȼΥ⤷ϻޤΤ褦ˤ⸫ơĶȤǺäƤ褤¤ޤФŤƻФȼ̤ĤʤäȤΤ⤢ޤ

äȤˡ׾δڤˤʤޤ

󴶷㤹ΤΤ餷ǤϥݥåȤ˺ٶݤʤɸ浡ôäƤޤäޤäƤưʪʤ

Ф夷ƤƤ⤽εǽ˰㤤Ϥޤ󡢤ष˴ĥäưʪ򤤤ʤȰյߤ򴶤̤⤢ޤФν򤷤ƤȡФ¦̤ޤäƤΤ򴶤ޤ

♡Τ

ξޤˡݥåȤκ̤Υ줿Ф˶ޤƤʤʤǤƤʤ
ɽ̤Ȼ̤ʪŪȹ礷Ƥ롣ɽ̤̱˻̾餬ηѤ߹褦ˡդ褦ʤ֤äƤΤǤ̤ˤӺٷɤ

ݥåȤʤФʤۤɡФν񤷤ʤȤΤϳ¸ΤλȤȻפޤʤ顢ݥåȤǤäƤ⡢ˤǤФμ¤˸ĤƽΤ˺Ǥ

ʻΩĤΤѸǤꡢȿ˥᡼Ϳˡμ¤˻ФǤΤΥåȤǤ

ʤʵѤפޤ

СɻС

ξʻФˤȤʤꡢٶݤβȤʤꡢɤȱֱȱֱ˴Ϣ͡ʪФ͡¡˱ƶ롣ƻ˲졢Ӽ롣

ʤˤβѤѸ򰷤ʱΤȡϹͤƤޤ

ޡϴʤꤽǤǯ˸ơǯ᤯򤷤Ƥޤ礦
 
    Υȥ꡼ϤƤʥ֥åޡɲ mixiå

ѸʱnaomiǤ 
ƥ֥ˤۤϤʼͽɤνʥ֥Ϥ(ߢώ)ǤHPϿܤǤ(Վ)



ФϡnaomiǤܤ˥֥񤯤ΤϤʤפ֤ʵޤ
ʤǶᡢ֤ФĤΤ᤹...ǯǯؤ˹ԤäƤ⤢äơ屡λŻڤꤤʻޤ

褯褯ͤСؤ˹Ԥ⡢οܤˤʤäƤΤǤ ;͵ä顢ؤ˹ԤäΤˡؤ鵢äƤΤʤ֤˥֥åʰ屡 ϢԤҸƤơ¾˻Ż򤹤֤ʤ̳ίޤǤ Ť˻

P80905392

ǤŤ˻ȤϴԤΤˤΩäƤ櫓 ơ轵麣ˤƤϡﲼнΥѥ졼ɡʤʤ֥񤯻֤ϤʤɡοŤϤʴǤ

ᥤƥʥ󥹤δͤǤ󥯥꡼˥󥰤碌ơҸĺƤΤǤϺΣ֤˻ﲼФǧޤ Ĥޤϡ䤬ĤƤФǤ ʤ顢ͤˤҤͤΤǤФäƴ˽ǤΤǤ礦

NOʸǤƤޤ

Waerhaug J:Healing of the dento-epithelial junction following subgingival plaque control. . As observed on extracted teeth. J Periodontol,49:119,1978.ˤ

The chances of removing all of the subgingival plaque from all four surfaces are fairly good if the pocket depth is less than 3mm. If the pocket depth ranges from 3 to 5mm the chances of failure are greater than the chances of success, and if the pocket depth surpasses 5mm, the chances of failure dominate.

󤵤ĺޤ
ݥåȤο3mmʲfairly good
goodǤvery goodȤɽǤʤޤޤɤȤ̣̩ˤϽƤʤ
3mm-5mmthe chances of failure are greater than the chances of success
פˤʤȤȡ
5mmʾthe chances of failure dominate
餫˼ºݤϻнǤƤʤȤȡ


Stambaugh RV, Dragoo M, Smith DM, Carasali L.The limits of subgingival scaling. Int J Periodontics Restorative Dent. 1981;1(5):30-41.ˤ

ݥåȤοʿ3.73mmʾˤʤȼĤ¿ʤ 

3.73mmʲǤϳμ¤˼ȤϸäƤ餺3.73mmʲǤʤ줿ʸϤǤǤФϴ˽Τ񤷤Τ⤷ޤ

ϡ¤ΥǡǤ顢ȤǤϤʤʤɤСΨ㤯ʤ櫓Ǥ

ϻŪ˸ѤƤʤŪȤΥǡȻפޤ顢쳵ӤǤʤ¦̤⤢ޤ  ǤѤäΤǤƤ䲤ƴ줿ɡȤäơн򡢻ʱΤԤʤäƤ䤬ΤܤʤΤǤ

001

¸ΤǤϤ줬ɤȥäĤޤꡢ줬ƱɤȤ뤯ʤΤǤ 䤬Ҹͤ⡢̤ޤǥäȤޤäǤ
󤤤餷ˡϤ⤦Ǥʤɡ줿ȤääƤΤǤ 

Ϥ
20170606-1

ϥݥåȥƤݥåȤץˤʤäƤޤ
ˤϻﲼФޤޤĶȤǽƹԤޤ礦
 
201706006-2 

äƤǤ͡顼褬ФäƤΤ⡼Τ褦˸ΤǤ椷Ƥȡ⤹ɡʹ֤ܤҤҤȴޤ

20170606-3

ѥѥ̡ߤäƤ 

20170606-3


Ū˻ﲼФϡľŪ˱狼麬˸äƹԤޤޤǤμ̿Ϸ빽夫鸫Ƥ󥰥롣 

20170606-5
 
ϤۤξǤ٤ĤΡֺǽ˻Фǧ˶ᤤ󥰥Ǥ͡
Ф˸ΤϡФΤꤿ顣ФɤäƹԤȼ˸٤ѤäƹԤޤ

20170606-6

ƥݥåȥƤ֤ȤȤ˾ˤꤷޤǤ⡢ձڤʤ¤ꡢޤäȤޤäƤޤ ơϤǻФ줿Ȼפޤ...ʤơҤͤԡ꿼ʤʤΤ...

20170606-7

 ݥåȤ˥ޥߥ顼ơ¦̤ľܸޤȡäǤľŪˤϽǤ褦˸Ƥ⡢ľ뤹ȤޤޤĤƤΤǤ ξϡФ⤢ޤФǤϤޤ󡣤줬ޤԻ׵ĤʤǤɡȼźṳ́Ωä褦ˤʤäƤޤ

ơɤޤǽɤΤ

狼ʤ׾ŪʴФǸСꤹ㤤ʤɡ˥ץ졼˥󥰤ʤФʤȻפΤǤʤȡԤä꤯äĤʤĤޤݥåȥ㡼Ǥʤ

20170606-8

顢ʴ˻ž夲Ƹޤ졢ñ˸ޤɡȤäƤΤǤ
象줿ĹΤΤ礤ˡ֥꥿˥եϥɤ͡פäƸޤ

Ͼ˥ڤˤƤޤ

ϸμŤϻ1ͤǤϤǤʤǤλФνǽˤΤϡǤϤʤȤAkiǤ ֡ˤϡܤιäơǴ줬ܤƤΤǡǴޤʤ顢ޥߥ顼ݥåΤԲǽǤ

顢ɤƤ뤫ȤȡȤߥ顼Ǵʤ顢ˤ᤭䤬ޥߥ顼ǻӤʤĶȥ顼Ǻ̤ˤȤ餯ï⤭äȤä̵ȤäƤޤ ơʵǽˤʤΤϡɤ줷ޤĤⴶաǤ

20170606-9

ơ⤦پ夫顣ǽ˥åȤ򻣤ä󥰥Ǥǡݥåޤdzǧȿ֤ޤǤäǧޤ֥ҥ 轵ϤʤФääʡȸäƤ⡢䤬ĤƤФ̵... Фˤϼɤޤ

ϴԤˤ⤤Ĥ⤪äǤϰ򤷤Ƥʤ1mm­餺λФ᤯äƽĤƤޤǼɬפ̵ȻפäƤޤФĤФĤɬݥåȤˤ롣 λɤǤ

Ǥ⤽ϡĤ򿮤ƥᥤƥʥ󥹤̤äƤ봵ͤˤ⤿餵ʡǤ ԤǴ...ĥꤹƸȤʤäɡǤΤɤäǤޤɤ櫓ˤϤʤޤ󤱤ɡ̵ʤΤ̵ʻȻפƱˡʬε̤Ϥ礤ȿʤ櫓Ǥ ơ

֥񤤤Ƥʤɡʽ֤򤷤Ƥޤ

;̤ǤեǤ˻ʱΤΥȤ򤷤Ƥ롢ʱΤγХȤ罸Ƥޤʳ˸¤ޤ åȤȤƤϡʱΤμºݤν֤򸫤ٶǤ...ȤФʱΤζԤʹȤ ̣ϥեޤǸϢ


ǤϤޤĥޤ礦
    Υȥ꡼ϤƤʥ֥åޡɲ mixiå

եòŤΤ«Ⱦڡ
ǶݥХǎ
ǥ쥤ʻʰ

˴줿Ƕݥƥ

ʪŪ󥸥
Ū󥸥 / CI Bowie & Dick test Helix test
ʪŪ󥸥  / BI 
ѸʱnaomiǤ ƥ֥ˤۤϤʼͽɤνʥ֥Ϥ(ߢώ)ǤHPϿܤǤ(Վ)



ФϡʱnaomiǤ

GW ⳫƤŻ˥⡼ɥޤʤФȻפäƤǤ

λʱΣˡ䤿Υꥹ޻ʱīֻʤ˾ޤʤä´ԤؤSRPפȤý񤤤Ƥޤ

09
57
13
ФʪڤʪƤޤݥåȤƤ¤ȤФʤ⤤ä㤤ޤФޤ󤫤ʽ֤ϴ˾ޤ󡣲ˤ餫饢ץȤƤ⡢ǽŪ˳ʽ֤뤫ɤϴͤȽǤޤ

ϻʤȿФ櫓ǤϤޤ󤬡ʱ3ǯܤ5ǯֻʤѶŪ˹ԤäƤΤȤ˶̳δͤ5ǯôĺޤСڤʤΤϣγʽ֤ǤϤʤ⿽夲ޤθΥᥤƥʥ󥹤ʤΤǤ

ᥤƥʥ󥹤ʤƻʤϤޤ󡣤Ǥ...򸫤Ƥߤ餿Ǥ礦ʤԤä屡ǰᥤƥʥ󥹤³Ƥ봵ԤϤäˤޤ

ʤԤäǤʤ¾ˤϹѲƤ櫓Ǥ顢Ȥ⤫ᥤƥʥ󥹤פǤ

ʱΤγϼʬΥᥤƥʥΨ¸ΤǤ礦δǤϤʤƿͲƤǤ礦ᥤƥʥ󥹤ʬϡʬҤϡɤ׻ΡᥤƥʥΨη׻äƷޤ꤬ʤĤޤ¾ͤӤǤʤ

ƤĤ⿽夲ޤ¯˸ܤΥᥤƥʥΨ2%20%
ᥤƥʥ󥹤̤äƤΤ϶˾ɤǤ

äᤷޤФʪʪϿݥåȤ˸¤äΤǤϤޤ󡣥ݥåȤ3mmǤФʪʪϤޤ

ܤˤϻФʪʪν򿿷˹ͤꡢᥤƥʥ󥹤λ򿿷˹ͤƸ椷ƤʱΤ󤬤󤤤ޤޤǤ⤽Ƥ줫⡣

ȿͤǤʾ弫ʬοȤοˤĤˡΧޤƤȹͤڤȻפޤ
줬ץǤʰդˤĤޤǤ⤪֤äǤϻʱΤβͤʤƤޤ󡣻ʱΤϻʰդȤϰ㤦ȤǤ

ǸդãƱ褦˰դȿ褬֤ޤʬãλŻ˥ץ饤ɤʬãǻŻͤ˹ԤΤǤʱΤϡʰդθʤǤ

ͽŪSRPïôΤ
ڤϤߤȯܤλʱΤοͤƤãѼǤʤäʱΤλŻݷƳͽŪнãäƤΤ...

ǴĥäƤ餤ĤⵤˤƤ... ǰ
Ǥ⤢̣Ǵ˶ڤ꤬ĤƤդä줿˳ؤڤ֤ȻפäƤ뤱ɡǤ⤦äƤޤäĤĤޤǤ饻μѤʤ(T ^ T)ܿͤΤǤϤʤȻפɡĻǰʡ

ʱΤλŻ˸ؤȥץ饤ɤ

ϻƻԤޤ‼︎

λʱΤýѶ̣ΤǤͤˤȻפޤ
    Υȥ꡼ϤƤʥ֥åޡɲ mixiå

եòŤΤ«Ⱦڡ
ǶݥХǎ
ǥ쥤ʻʰ

˴줿Ƕݥƥ

ʪŪ󥸥
Ū󥸥 / CI Bowie & Dick test Helix test
ʪŪ󥸥  / BI 
ѸʱnaomiǤ ƥ֥ˤۤϤʼͽɤνʥ֥Ϥ(ߢώ)ǤHPϿܤǤ(Վ)



⴨Ǥ͡ϣǯĤƤãȥ֥åեθϤDz򸫤ƻޤ
2015-01-18-17-18-02

ͤϥХˤ
줬äƾФʤܼ򥺥ХäȤĤϿοиˤʤDz衣Ǥ

ơDz򸫤ʤ顢Żʹ֤naomiϻפ櫓Ǥ
ïιŰŪ˹ͤ뤳ȤǼʬ˭ˤʤ...ʱΤäŨʿȤʤäơ
ͤΤˤΩƤ롣ͤ˭ˤǤ롣

naomiκǶΤθϿϡϻ̤ޤǤβˤĤ֤ϻ̤ޤǤλפкꡣפơʹ֤¤Ǥʪǡϵ¸ߤʪͣռǤʪʤΤȤߥåȤޤäƤ롢ߥåȤռǤ롣ɤĤ̤Τʤ顢ͤΤˤΩĤפäƤ䡣

ʤʤʹ֤δ郎Τǡפ̤ˤϤʤʤΤɡξnaomiΥåȡϡܤοͤ򹬤ˤǤ¿οͤ򹬤ˤʤ󤫤Ǥʤ׻䤬ôΤⲿΤ뤫狼ʤԤȤνв񤤤ϰȻפäܤˤ봵ԤϤ򤫤롣

κ

ͤοȤо줵ĺʱΤȤȤϤȤƤ餷ȤȻפǤⴵͤοо줵ĺʾ塢ŨоʪǤ

ǯʾᥤƥʥ󥹤̤Ƥ봵͡ĤޤꤳΣǯ֡naomiϤδͤˣ˰о줹ʤΤǤ롣

ǯФäƤ⡢εѤʤΤǼĤƤФ롣Ǥ⡢Ťʷ⡣ŤʲƤ롣

BlogPaint


֤α󿴡ʡʡﲼС
SRP1

礭...ͤδΣ1mm䤬ǯּĤƤФǤ
Ǥ...ĤƤȸäơӼƤ櫓Ǥ⡢ɾФƤ櫓Ǥ⤢ޤ󡣴ͤˤȤäƤϲⴶƤʤߥλС

ͤΤΩʵΤäƤΤ餺ä̤äƲ봵͡ĹʡƣǯвᤷѸƳơѸȤ褦˥ȥ졼˥󥰤ƺλФ櫓ǤǤ

ͤˤϤĤ⿽夲ޤФϤ줬ɤȻޤäƸʤޤǤФ夬ФĤɤƸޤޤä̵곫ƻФ뤳ȤǽǤ礦Ǥ⡢򹯤ޤä̵곫ƽĤƤޤäƤϡθɤɤΤǤ礦

ʹ֤Τ̵̤ϤʤݥåȤޤäưʪʤ褦ˤƤ롣Ѱդ˽ĤФθäƤޤͤϻФ뤿ƤΤǤϤޤɤ뤿˥ᥤƥʥ󥹤̤äĺΤǤΤĤƤޤǼФνʤ̣ޤ

SRP2

δͤϽǤλ찵⤯naomiޤ档֤˼ơ찵Ǥ뤫;פ˼ơ֥֥衣äȿнз줹뤷...٤λ¡㤤ɤ뤳ȤǤΤμʤΤȸС԰¤Ǥ뤷ʤäƻ䤬ôʤΡƨ뤳ȤϤǤʤ

ꤷƣǯ̤äƲäƤΤΡ⤽Τ˱ʤС

ơޤ飱֤Ϥޤޤ

ϳ鴵ͤǥᥤƥʥ󥹤象ޤ

⥬Фä 
    Υȥ꡼ϤƤʥ֥åޡɲ mixiå

եòŤΤ«Ⱦڡ
ǶݥХǎ
ǥ쥤ʻʰ

˴줿Ƕݥƥ

ʪŪ󥸥
Ū󥸥 / CI Bowie & Dick test Helix test
ʪŪ󥸥  / BI 
ѸʱnaomiǤ ƥ֥ˤۤϤʼͽɤνʥ֥Ϥ(ߢώ)ǤHPϿܤǤ(Վ)



ǯ⿷ǯ餿ΤͽĺƤޤơδͤᥤƥʥ󥹤Ȥ餤ԤƤޤѿޤ

ϻФνԤޤʪθԤޤ󡢤屡ǤμŤǤϤʤ¾ΰ屡ͤǼŤ줿ΤǤŤɬפϤʤɡͽɤδ餹ɬȤΤǤ 

20150107_102614564750


̤˥ݥåȥ쥸Ŷǧ롣

ʻʰդ򺨤ᤷפִ֤Ǥ롣

20150107_102617400920

ʤ...줬ޤ᤹ˤʾȷʤǻ䤬褩ȤΤܲǤʤ顢ߡʪǤʤ¤Ǥʤ̾Ĥʤ櫓顢ïΤĤ褦ʤ⡢´ȤƤᥤƥʥ󥹤äʤʱΤʪθ⤷Ȥʤ

㤫ꤷ͡ʰ屡ǷиѤμȵѤ20ǯäƤΤϺǽ餫ͽɻʤˤϤʤäΤǤ...

Ŷ⤷ʪλŬ⤷ϷäɡǤ⺣ȤʤäƤϤɤäȤ̥饤ʺ

ʪΤǡμ줬񤷤̤ʤ櫓Ǥ...

20150107_104305475684

ʪᤷݥå쵤롣̤ˤӤä夷С

20150107_104811281497

ä򤷤ѸСФФäΤΡ

20150107_104812115664

ϰϤ򹭤ƻФνԤäƤ

20150107_104920317201

ۤΤäȤݥåȥ쥸ΤϤߤϡʰŽԤˤȤäƤϤۤ礭Ϥʤʤ⤷ʤ

Ϥ߽ФƤʡʡȤǤ⤽ϴԤˤȤäƤϻμ̿򺸱礭Ȥʤ롣㤢Υȥ֥νȯϡܤ˸ʤٶݤƤ롣ܤ˸벿ŪƤ롣

ơϤäǯǽνǤ

Ϥ٤ߤɡǤˤȤäƤϻŻƱ餤˻ǤäǤΤϣ餤ʤǯޤԻ˻ΤǤ

ơ⥬Фä

 
    Υȥ꡼ϤƤʥ֥åޡɲ mixiå

եòŤΤ«Ⱦڡ
ǶݥХǎ
ǥ쥤ʻʰ

˴줿Ƕݥƥ

ʪŪ󥸥
Ū󥸥 / CI Bowie & Dick test Helix test
ʪŪ󥸥  / BI 
ѸʱnaomiǤ ƥ֥ˤۤϤʼͽɤνʥ֥Ϥ(ߢώ)ǤHPϿܤǤ(Վ)



ǯ⤢3572015ǯ⤹Ǥ8вᤷޤ

ʤͤˡֻѸȤäƻʱΤᥤƥʥ󥹤ƤޤפHP˽񤫤ƤΤˡʱΤξʲưˤHP֥ǸϤۤȤɤޤ

äưϱĤʤ

ǯ⿷ǯ᡹ѸȤäФνԤäƤޤϡѸʱΤѤϡ¼Ťˤ礭ѤΤȻפäƤꡢŪˤȻפäƤޤ

ޤǤʸǤϥݥåȤ4mmʾξˤϡڥꥹȤФνԤäƤĤȤ뤫Ǥʱζ̳ˤѸγ

ǰʤ餽礭ʰ̣ܤλʱμȤ򤷤Ƥʤˡ˾夫ˤǤ⤢ޤ


ǰᤤԾǤΤï˿򤷤ơ⤽οͤǽΤ褦˼򴬤夲Ƥ...ܤλʱΤ˱Фܤαμ餬捥ǤޤäѸϷʤ

ݥå6mm6ֱ󿴡̵첼

SRP1

Ķȥ顼ˤƽߤ롣
 
SRP2

ФʤäˤϤä礭ʻФݥå⤫饴ꡣ

SRP3

Ի׵ĤʻˡФ礭Ƥ⡢ճȺޤǤ˻Фν򤷤ʤˤϡϼ夤ݥȼ礬¿ޤǤ˲٤Фν򤷤ƤꡢʰդʱΤˤäƻФɽ̤٤ʿˤƤˤϹŤƽǤʤ

ĤޤФνϰȯܤפǡθ٤դʤ褦˥ᥤƥʥ󥹤 

SRP4

ݥåȤĤޤäƤƤ⡢ˤϤ礭ʻФ夷Ƥ⤢롣

SRP5
 

ʤ礭

ʰդ줷ƥݥåȤ򳫤Ǥ롣ܤǤϻʱΤϤǤʤݥå6mmǤ⡢̵ǥݥåλФľܸʤǤ롣줬Ѹ

SRP6

нλ塢ݥåǧǤ롣

Ȥä򤹤ȡѸСФνǤȳ㤤롣ѸϤȯΤϡФƤФݥåˤɤ뤫ޤɤä夷Ƥ뤫ϡ϶Ƥʤ

ǤϤɤäƻФΤΤΤϻʱΤĤޤʱΤοǤ롣롣ȥCTǡǤʤɤŪȽ롣ϤʤлФ򸫤ĤϤǤʤĤޤѸΤ졣

ΤɤǤƤ롣Ф夷ƤƤ⡢ݥåȤĤޤä˺ٶݤʤ褦˵夹뤷ФäƤǤ⡢ФˤԤäȤäĤƻФιԤˤࡣʤ顢ΤȤƤ夷Ƥ롣ʹ֤ΤϤ


ʤ顢ɤʤ˻ФνǤ褦ȡ夷ʤ褦˥١夲뤳ȤɤʤڤʤȤ

ơⴵͤιΤˡФä
    Υȥ꡼ϤƤʥ֥åޡɲ mixiå

եòŤΤ«Ⱦڡ
ǶݥХǎ
ǥ쥤ʻʰ

˴줿Ƕݥƥ

ʪŪ󥸥
Ū󥸥 / CI Bowie & Dick test Helix test
ʪŪ󥸥  / BI 
ѸʱnaomiǤ ƥ֥ˤۤϤʼͽɤνʥ֥Ϥ(ߢώ)ǤHPϿܤǤ(Վ)



ƺǯοŤ⺣Ϥޤޤǯĥڤäƻޤ礦

ƻɸϻǡ

Ǥ⤳ʳȤäǤʳ񤷤ǤʤʤǤ礦͡ˤ狼ޤ

ǤƱ褦˥ᥤƥʥ󥹤ƤƤ⡢Ʊ褦˻᤭Ƥ褦ˤߤƤ⡢з줹ͤɬ롣ᥤƥʥ󥹤ФɬפȻϻפΤɡ

Ǥ⡢ᥤƥʥ󥹤ɬפȻפɡǤ⡢Ԥ˥ᥤƥʥ󥹡Ĥޤµͽɤ̤ΤϤäʥ󥻥󥹤ǡµͽɤȻפ©Ĥޤ...

ϥᥤƥʥ󥹤Ȥդ⤢ޤ깥ʤΥ꡼˥󥰤ȤդϹʤΥƤȤ

ɤԥȤʤ͡

ʤ󤫻ΤݽäƤȡФȤߤʤΤΥ꡼˥󥰤ϻмꤸʤԤǾ뤫顢᡼ޤʤʤȳͤˤǤʤ⤷ʤɡ

ϴͤλž夲ǡФȤꤿ櫓Ǥ⡢plaque櫓ǤʤˤơΤįơ

֤äˤʤäפäƴӤ

ϤǤ

ơäæɡˤΤɡ̲ȤƻФν⤢롣

ͤϻδԤˤƤϤ᤺餷γ

subvgingival2

֤ޤ˨ Ǥͤʤ˱ﲼ
¤ϣ夫ϤޤͤµäƻפäƤ뤫⤷ʤɡ¤ϣ夫ϤޤäƤ롣ǻԤˤˣˤʤäƤ...

ФˤʤޤǤȣǯǯޤޤ֤롣

ͤȶ

ϤȤƤ¿ʻǡ褬äꡢäꡢͷ֤Τ˻äꡣλʤƤäȹͤƤʤλͤʤ繥λͤ

Ǥ...ʣǤǦӴ¤­

¤ϥȥǥȸäơۤµɾФˤϡϤƻɤ롢äƤߤ롢᤯Ӥ˽з줹...

 ϤƤޤäϻǰʤʤϤʤڡ

ʤΤˡʤΤˡʤΤˡɤʱΤ˽вˤǤ˹Ϥ㤦ʤ 

񡣻ʱΤȤνв񤤤ڡ

ɤʱΤȽв񤨤С١夲Ƥ館ƼιưѥѲ롣ϰΤκ⻺ǤⲼʻʱΤȽв񤨤С١夲ɤ١򲼤ƻԷˤʤʰ屡󤶤롣ϰ»

ʱΤ֤٤

ǶޤإӡʴͤƤޤ꤬äơä㡼Ȥȿ̡긺äƤʤꤷɤȤΤ⤢롣

subgingival

Ǥ⤵äƱﲼȸäƤݥå1mmʤΤ㤤ͤλȿ餫Ĥ䤹...ݥå1mmλФưƤߤ褦鸫äƤäƤ͡Ϥ٤ưʤ

äȽ줷Ǥ⡢ϼ㤤顢Ϥ˴Ԥƻнͥ褹櫓Ǥ

㤨Сƥ֥å󥰤Ƥäƻαɤޤ褷Ф餺˥֥å󥰤Ƥ餦褷άˡ͡ϻʱΤά̤ˤ롣Ϥڡ

ƺ⥬Фäǯ⤢ȣˤʤޤ

 
    Υȥ꡼ϤƤʥ֥åޡɲ mixiå


եòŤΤ«Ⱦڡ
ǶݥХǎ
ǥ쥤ʻʰ

˴줿Ƕݥƥ

ʪŪ󥸥
Ū󥸥 / CI Bowie & Dick test Helix test
ʪŪ󥸥  / BI 
ѸʱnaomiǤ ƥ֥ˤۤϤʼͽɤνʥ֥Ϥ(ߢώ)ǤHPϿܤǤ(Վ)



ʱΤϻФνǤФΤ

ϸä򤷤ƤߤȻפ

ϻʱΤˡΧŪ˿ǤϤǤʤɡǤοǤɬפȸäʱΤϤλ᤭ǤϤʤˤΥƥǤʤ󥰡ʻФνˤϤäȤŹ԰٤Ǥ롣

ȤŽ֤ʤƥᥤƥʥ󥹤ʤƤʤԤȤϴäԡĤޤʰ屡ˬۤȤɤοͤϤʤ餫λʼä象롣

ŤνλʼͽɤΥȤǤ뤬ǰʤ¤ϤĤǤȯ롢ޤȯɤǽΤǤ롣Ĥޤ꼣ŤͽɤΥ饤ưפˤä꤭ꤹðŪʼǤ롣

֤򤭤Ȥǥᥤƥʥ󥹤˰ܹԤʤа̣ʤ

ĤޤʱΤϻ֤ȤǤʤФʤʤʻʰդľܤλؼδǤ줿ʤФä

ä֤򤭤Ȥ뤿ˤϡ֤οǤפǤ롣ǤмŤ롣ƿǤ뤿ˤϲǤ򤹤ΤθȤƤפǡ餳Τ˸򤹤Τɤθ򤹤Τθ̣Τ򤭤򤷤ƤʤФʤʤ

ƻã֤򤹤ˤꡢŪʸ֥ץӥ󥰡פȸƤФ븡

48

ʱΤ繥ʥץӥ󥰡⤽ץӥ󥰤äƲǤ礦
ä񤤤ɳμ¤˽֤Ԥˤϳμ¤ʿǤɬפǡǤΤˤϳμ¤ʸɬפץӥ󥰤ϤθΣġ

ץӥ󥰤ǺǤפʤΤϥݥåȤο¬Ƚз졣åȥ٥¬⤢뤱ɡϤƤȤ

ץ֤ǥݥåȤ¬...

ɤ򡩥ݥåȤäƤɤDz˶μɬפȤʤ

ȿäơ

졢ȼ

ޤ褯˺㤦

ǤϡݥåȤäƤɤ

ݥåȤ¬ȴñ˸ץ֤ɤޤΤ

21

Ǥοޤפ⤫٤롣ʪŪ¡Biological widthȻΰ֤ͼ

륫mm1mmȿ1mmǡCEJϤɤʤΡǡȤ줾εΥϤɤʤäƤΡ

ץ֤äƤɤޤΡޤΡ

ʬϥץ֤ΡƤΡȤɤʤΡ

Ƕϥڥꥪ繥ʻʱΡʥڥꥪϺȻϸƤǤˤΤǡץӥ󥰤򤹤ʱΤޤ

Ǥ͡Ԥ˻¤θ򤷤ޤݥåȤο¬ޤͤȸȡ֥ץӥ󥰤Ǥ͡ˤǤ...פȤä㤤ޤץӥ󥰤Ȥ̾¸ΤǶϤä㤤ޤ

ơʤˤΤǤ礦

Ͽޤ̤夷Ƥ뤫Ǥ򤷤ƹԤäƤޤ͡ɤޤǥץ֤뤫ƽ֤Ƥޤ͡ɤޤǥץ֤äƤ뤫ʤԤäƤޤ͡

ƻޤäƤƴˤ⤢...ɤäˤ⤢...͡ʾޤƤ򤷤ƹԤäƤޤץӥ󥰡

֥ץӥ󥰤ˤΤʤΤǤƲפȡԤˤ򲡤դƤޤ󤫡⤷ϡʱΤ󼫿Ȥ֥ץӥ󥰤ˤΡפˤͳ狼餺˹ԤäƤޤ󤫡줬ޤ󡣼줬Τˤϡֻ䤬ץӥ󥰤ˤǤפǤ硩

µŤȤʾ֤ΤʤФʤʤ¸ΤǤ
1ʳġƧߤʤ֤Ԥʤз̤ĤƤʤ

ʱΤԤïäƤƱäƻפäƤ뤫⤷ʤɡ㤦ԤϻʱΤζʱΤμ굻ʹԤθФˤȿǤ롣

󥰤äƱǤ礦󥰤ä򤷤Τˡé夯ޤǤ˲ä򤷤ʤȤʤ 

ȤäǶϤ뵡ޤ...

ޤǯʤǤ礦ʤ⤦ϷûΤǡ㤤Τã˰ѤǤʤȤʤΤȻפκǤ

ͤޤǤˤYu

⥬Хå

 

    Υȥ꡼ϤƤʥ֥åޡɲ mixiå

ڻʱθѸļ 
ޥץۥ磻ȥ˥󥰥

ͽļ
ǹCarzeiss OPMI pico with MORA interface
ʱǤ
ǡĶǹⵡޥCTϥ졼X-ray 
PCȣΥ˥ 
ޥȥեRCR

naomi֥γ͡ˤѸʱnaomiǤ ƥ֥ˤۤϤʼͽɤνʥ֥Ϥ(ߢώ)ǤHPϿܤǤ(Վ)



ʰդλΥ꡼˥ڤӰ̤꡼˥󥰤ΤߤοǻϤޤܤ䤤碌



ʾ򤳤ʤƤޤ

51


ǥ꡼˥󥰽δ͡ˣ¾ǥᥤƥʥ󥹤ƤȤλ
 
ʤϻμŤǤꡢʱȤμǤϡñոη̤ʹĺᡣη򹯤ˤϤʤμΤͻҡ

ǤˣټʤǤƤ櫓ǤʱΤζ̤ᤤƤ櫓Ǥ顣

ʤ顢οǤ...ʼºݤˤϻʱΤϿǤǤޤ¾ŬʸդĤʤΤǤǤϿǤɽĺޤ 

ˤϥȥ˻Ф褦˸롣ֱ󿴡ֶ󿴡ֶῴ...ľ...ӥʥ

ϸ߻ʰդȰ˶ٶ򤵤ĺƤޤä㤤ޤ
ϿǤڡǤǤФȤϿǤ̤˿ʤ

ʱΤλŻƱʤȤĤ⤷ߤ߻פΤǤФΤФïǤǤޤǤǤ뤫ɤήˤʤ뤫ɤθ

ˣˣ٥꡼˥󥰤ʱΤθбƳƤäơϥӥӥǤ⡢줬ôʱΤܻؤȤʤСϴְ㤤Ȼϻפޤ

μ¤˻Фν򤷤ʤǡ᤭ƳƻФĤȤƳĹǸХޥʥܤˤʤʰդ˫뤫⤷ޤ󡣤Ǥ⡢ȥ򸫤ܤСΥˤ꤬ȽǤǤ롣

ݥå1.5mmФäꤷޤäǶήԤǸʤСݥåȥǥ㡼Ǥ
Ĺʤޤϼ̿ǡ̿ƤʪäƤǤ礦

SRP

 ݥå1.5mm

SRP
 
̡¦¦ˤۤɤ˻Ф롣Ķȥ顼ۤɤˤݥåȤϳʤ

SRP

츫ǤΤ褦˻פ줬

SRP

٤ѤȤ̤ꡣζƬ٤򼫺ߤ뤫ʱΤε̡

SRP

ٽ˥ȥ饤

SRP

ޤޤ˸Фס

SRP

Ķȥ顼üʤΥݥåȤκ̤ɤäƥץ졼˥󥰤뤫...
¦ƬնˤޤФ롣

SRP

ե˥å塣̤˥Ĥ뤬1mmδüʤݥåȤǡ̤ץ졼˥󥰤ΤϺǤ롣̵򤹤С̤ɬפں路ͤʤ

̤ˤ롣кڤ뤫ΤȤƤ롣ʾν֤ϥС󥹥ĥȤȻȽǤ롣

狼ˤʤƬ夷Ƥꡢ夬ˤǤΤ֤Ǥ롣о̡ݥåȤ˻ФĤˤʤä

ϻФʱΤդĤϤʤ

ФϽǤȻפäƤ뤬ϴʻФνϤǤʤȹͤƤ뤫顣⤳ʹľλлĤäǤ롣

̤ϤɤǤ졢ĤˤȿǤƹԤä줬Ǥ롣ȥ򸫤ƹľ˻Ф򤭤İĤʤ褦˿Ť˽֤򤷤ʤΤǤ롣

Υ꡼˥󥰤ȸäïôƤƱȻפäƤ롣
ºݤˤôʱΤε̤ˤäƸ̤礭Ѥ롣

 λФ夷ޤޣǯФˤäƼ꤬ưʤʤꡢȼˤȱϤ㲼СɬǿϤ

ߤǤ̤ͽۤ롣ʱΤͽɤȤϤΤ֤Ҥá
    Υȥ꡼ϤƤʥ֥åޡɲ mixiå

ΥڡΥȥåץ