ʡAdvanced Care Dental Office åץǥʡnaomi

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

եòŤΤ«Ⱦڡ
ǶݥХǎ
ǥ쥤ʻʰ

˴줿Ƕݥƥ

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



͡ФϡnaomiǤ

ơХϲʤؤƤᤤΤ3᤮褦ȤƤޤ56Ͼݿγ°졢辮ٶ򤷤Ƥޤ ϥڥˡδ¿Ĵ٤ΤˤäѤäѤǤ

椫顢åȾɸפˤĤƽ񤤤ƤߤȻפޤ

åȾɸϡ˽ȯɤڶĥ㲼ķθ塢˻ͤ礤Ԥʤɤξ㳲ȯãڡ٤Ū㳲иȯã㳲Ǥ

ĻˤϡŪäαưǽξüӡ͡ǹʤ롢Ҽ˻äƤ¾μǶáͭʼξƱưиޤ

¾ƬȯڤȸŷŪʾƬɡζڶĥжʡȥ˥ꡢƵ̵ۡƵθƵ۰۾롢䤿­ʤɤμΧФΰ۾٤⤯ʤޤ

ƾɾǯ¸˽иΤμħǤ

ͭΨ1ͤν0.9͡XͥҡXĹӤXq28

åȾɸ

A ŵŪŵŪåȾɸο׷
A-1 ԤΥԥɤ뤳ȡʤθ塢¸ߤ
A-2 ٤Ƥμ׿ǴȤ٤ƤνǴ

B ŵåȾɸο׷
B-1 ԤΥԥɤ뤳ȡʤθ塢¸ߤ
B-2 4Ĥμ׿ǴΤ2İʾ
B-3 11λٻŪǴΤ5İʾ

׿Ǵ 

1.ŪŪʼεǽӼ:̣ΤαưǽˡεǽʬŪ뤤ϴӼ뤳
2.쥳ߥ˥Ӽ:cˡεǽʬŪ뤤ϴӼ뤳
3.԰۾:Ծ㳲Լ
4.ξƱư:ͤ롦ʤ롢áĤ餹롢äꤳäꤹ褦ʼưư

ŵŪåȾɸǤΤ 

1.餫ʸΤǾ㳲
ʼŷǾ㳲ռٴɤʤɤˤǾ»
2.6ޤǤ˽иưȯã餫ʰ۾

ŵåȾɸǤΤٻŪǴ 

1.ûθƵ۰۾
2.ûλ
3.̲ꥺ㳲
4.ڶĥ۾
5.ɱưȿͰ۾
6.¦׿׿
7.Ĺ㳲
8.䤿­
9.ŬڤʾФ
10.˳Фؤȿ
11.ܤˤ륳ߥ˥󡢤äȸĤ뤷

...ȤʽŪ˽񤯤ȻפΤϡøʸϤǽ񤯤ȡ̵ŪʪüŪɽƤ褦ʵƤޤɡºݤˤϴԤ󡢤ĤޤȤοʹ֤ʤʡȻפΤǤ

ͤ󣱿ͤä...줬λˤʤȡñʤʤơ䡢²ˤʤ櫓...
äŪǡǤɽ̵ªƤϤʤʤȻפΤǤդαƤˤϷ̤äʹ֤λѤ롣줬ŤǤ

åȾɸˤĤƤäȾܤΤꤿϡåȾɸťɥ֥åפ򤴻Ȳ
䤬ؤФĺƤϲʤ¼ʸɮƤޤ

retto

ơȣǤ­ʤ뤱ɡͿ줿֤ͭյˡ
̿˳ؤӤȻפޤ
    Υȥ꡼ϤƤʥ֥åޡɲ mixiå

naomi֥γ͡ФѸʱnaomiǤ 



ʰդλΥ꡼˥ڤӰ̤λΥ꡼˥󥰤ΤߤΤդ򾵤äƤޤܤϤǤ䤤碌˾αΤϤäˤƤλݤ⤪

ʿǯĴˤܤˤǤμΨ20Ǥ¤θ򤷤ƤϤ鷺14.4Ǥ屡ǡʥᥤƥʥ󥹡ˤǤڤ¤ΥåɬܤǤ



屡˿üλCTCBCTˤƳޤw(*o*)w

CBCT

1972ǯåѤComputed TomographyCTˤȯˤƿΤڤ褦ˤʤꡢθ͡ʲɤˤ껰ŪʲǤǽȤʤޤ

ʤǤϥǥ󥿥ѥΥ޻Ƥˤ󼡸ŪʲǤ˹ԤƤޤץȤܴɤʤɤΥˡιٲȼŪʲǵѤͤˤʤޤޤǤϰѤΥåCTMRIƬܴɤʤɤοǤ˱ѤƤޤ̡١֤礭ѤǻѥåCTγȯ˾ޤƤޤ

CTΤˤCone Beam CTʥӡCTȸƤӤޤ

CTFan BeamʥեӡCTˤǤեȤΤȤ̣ǡå«˾ȼͤޤ

fan beam

Ф CTϥӡǤȤΤϱ߿Ȥ̣ǡå«߿˾ȼͤޤ

cone beam

եӡϴܣλƤǣβƤǤޤ󤬡ӡϣλƤ ɴβƤǤޤӡ Τǡû٤饤ǽȤʤޤ CTظϺ0.5mm屡Ƴ줿CBCTΥ饤0.125mm
ޤܥ륵0.1250.1250.125mmʹ֤λФǧǤ³β٤ɵᤷޤϰϤFOV:field of view)40H40mm˾Ǥޤ

饤ܥ륵ȤϤ̪ʾ٤ΤǤȤǤ˻ϰϤǤϰϤⶹȤǤͤΥåȤ¤˹ͤͤΤCTǤ

CBCTνиˤܴϤܹ京ɡ졢Ⱦƶ䲼ܴɤȤδطʤɤߥ򻰼ŪİǤ褦ˤʤޤ

ãοŤǻ¤νŤȤƻڤӱﲼλФνԤޤǽŪʥϻκǤʤκ񤷤

λʽ֤Ǥϻ򳫤ȿΥ᡼礭ȿɬפȿޤƻٻ뤿λ礭冷ˤʤޤ

Ѹϻ̤γвҤꡢץ顼ȥ뤬񤷤ʤȯ¿

ѸѤƻ򳫤ʤݥå̤ݥåȾ夫ƻﲼФνȿĤ̵ΤȿΥ᡼Ǿ¤˻ߤ뤿Ǥ

ޤǻ򹯤ǤڵǤξ֤ϥǥ󥿥XǤʿ̡󼡸ˤǤʤŪʿǤϤǤƤŪǤԲǽǤCBCTƳˤλŪʿǺǽȤʤꡢޤѸλβκΩŪ˳ǧǤ褦ˤʤޤ

CBCTƳˤΤʿǤǤ褦ˤʤꡢƼŷ̤Τİ褦ˤʤޤ

㿯ʽ֤ǤѸȺüǿCBCTƳˤꡢͤ˺ǹεѤ󶡤Ǥ褦ˤʤޤ

ơüδﵡ餱ʤ褦Ӥᤫʤĥޤ礦


ޥϥ˥ȤΥ֥
ʻʱKimΥ֥
ʥYUΥ֥
ʻʱnaomiٶ֥



ޥ׸ʰDr.IritaniΥ֥
ʥsachiΥ֥ 
ʥAkiΥ֥
    Υȥ꡼ϤƤʥ֥åޡɲ mixiå

naomi֥γ͡ФѸʱnaomiǤ

ǶᡢʱΤζ̳ˤĤƹͤƤޤ

ܤǤˡΧǻʱΤοǤϤƤϤʤȤˤʤäƤޤ

Ǥ͡褯ͤпǤΤʤ֤ʤơŤȤƤʤǤ硩

Ǥ⡣ˡΧǤޤäƤΤʤ顢ʤΤ顢֤ФΤ

ä¼ŤΥץ
ǺǢŷײ袪Ţɾʽ֡ʰʲά

ǺǤʰդơŤʱΡ
äƤɤʤΤ衩

Ǥ⡢¤ʤ
ǺǤʰդơнʱΤäƤ

äɡФ԰٤ïǤǤޤиѤС
Ǥ⤵ɸ֤ǤäơФ뤳ȤʤǤ硩
֤οǺǤǤƤʤΤˡ֤äơǤ櫓ʤʤ

͡ܤαΤäơ

Ǥޤ뤱ɡˡΧǿǤϤǤʤ櫓顢м결Ǥ顢ܤαΤȸ䤬äƤȤ

ǺǢŷײ袪Ţɾ

䤬פˡޤǤΥץǤäƤ褦Ȼפä顢Τμ̤פޤ

㤨ФФȸäƤ⡢ȼǤϤλм꤬̿ˤʤ뤳Ȥ⤢ޤڤ˻мȤǤʤȻפΤϻ

ʤ̷⤬ޤ

褯Τ󤬡νǤϽޤäƤƤ̤ˤ餵ƤפäƤޤɡˡΧʱΤϿǺǤϤǤʤŷײޤἣŤμƳϻʰդäƤ櫓ǡˤ餻Ƥ館ʤȸΤΤǤϡ

ˡ⤷ʱΤƳ򰮤ΤǤǤʬˤäƤи礷ʤФʤʤγи礬ǤΤƤμѤäƤΤ

䤬פˡʱΤˤǽϤϤʤǰɡã⤽פäƤȻפޤ

ãꡢ̤ˤ٤餻ƥ륯뤵뵤褯狼ޤ
ݤǤޤΤ͡ºݡ

ǽŪǤϻʰդˤäƤ櫓Ǥ

ܤλʱΤϹͤǤ͡
ʰդʸФääƤʤǡ ʬܤߤääǤ

᤮ƤޤϤդǼȤޡ

Ϥ٤ߤǤեå夷ʤ
    Υȥ꡼ϤƤʥ֥åޡɲ mixiå

naomi֥γ͡ФѸʱnaomiǤ

ϡ֤ǤױΤˤĤƹͤƤߤȻפޤ

񤭤ޤʱƱΤǽ֤򸫹äƤȡߤ˼ʬƱ֤򤷤Ƥ褦˸ޤ㤨пͤ٥ƥν֤򸫤ȥ٥ƥν֤ʬƱ˸Τǡ

ڤä̤ˤȤʤʤ

ȻפΤǤ

Ϥɤפޤ

餯ͱΤ

֤̤

٥ƥ

ֿͤȻν֤Ʊ櫓ʤǤ

ȸޤ

ͤθ̤

äPCܤäƤ٥ƥΤ¿Ǥ礦
ǤǰʤƱǤ٥ƥγ
ǯȤäƤ뤫äƲκʤͤꤤȻפΤְ㤤Ǥ
פΤϤ狼ޤ

㤢ڤΰ̣ʤáȻפ⤷ޤ󤬡ʻϤޤ

ʱΤˤȤäưڤʥäƲȻפޤ

ϡֿϡפǤ

ˡΧʱΤϿǤϤǤޤ
ǤȤƤɤϤ狼ʤɡŤǤ¿ʱΡ͡ʸʿǺˤ󤫤鼣ŷײΩƤޤ

ΤμŷײϻʰդΩƤޤʱΤŤԤΤǤлϽŤˤײʻϤʱΤΥץȸƤӤޤˤΩƤɬפȻפäƤޤ

̾ʰդԤŤμϰʲǤ

Ǻ

ŷײ

ɾʥᥤƥʥ󥹡

ɾʥᥤƥʥ󥹡
ǽ֡
ᥤƥʥ

ǤϻʱΤΩƤ륱ץȤϡ

ޤŪǽŪʥɤꤹ뤫

ɤӼŪȤ롢ݥåͤθŪȤ롢ٶݿθŪȤ롢ͤθŪȤʤɡ¾ˤ͡ˤޤʴǤƤϤޤ⤤ޤƤϤޤ⤤ޤ

ˤκǽŪʥ롢ɸ˸ƻܽƤͤޤ

꡼˥󥰤βѤʪʾѤ뤫ʤʤɡˡܽѴ֤˹Ԥ١άʸΥ١Υ٥İȡܽѴˤɤΤ餤ޤǥ١夲뤫夲뤫ιͻˡTBIޤ᤿򹯶Τξ󶡡ʸμ٥İȻܽѴ٤Ȥ뤳ȡޤĹϤä󶡤ơˤʤɤͤƥץΩƤޤ

ΥϽŤޤǤûɸȡθʽ֤ɬפȤʤˤϡޤ᤿塢ƥᥤƥʥ󥹤ͤǯñ̤ĹΤΤȤʬޤ

뤬ǤʤС̤Τ˽ФʤˤäƷ̤㤤ޤ

DZФȤ㤢äʪǤϤޤ󤷡λܽѤΥ뤬ݥåȤθǤϤʤɤӼǤ⤢ޤ

¤Υ뤷ƤʤʰŽԤڥꥪϺȻϸƤǤޤʾС
ڥꥪϺϤä1mmΥݥåȤθǰͫޤ

ԤοˤƤ1mmθϲ̣Τ
̣ϤޤޤɡԤˤȤäựΤͤ򴶤ΤȤǤ

1mmޤз줬ʤʤޤơ褫äǤ͡ȤǾΤϼޤ礦

ˤȻפϡԤ󤬼餹Ȼפޤ衣ϺٶݿѲäꡢͤθäꡢʬδФäꡣ줬ԤưȤǤưдԤϾưޤͤϴưΤǤƿ鴶դޤ

鴶դʤᥤƥʥ󥹤̤äƲޤ

¤μŤˤȤäưڤʪϲǤ礦

ᥤƥʥ󥹤ǤѸᥤƥʥ󥹤̤äƤʤʤ顢Ѥ̣Ϥʤ̵̤ǿμŤǽäƤޤޤ1mmѲڤʤΤǤϤʤ1mmѲȤθΥᥤƥʥ󥹤åȤڤʤΤǤ

ǺǤ򤷡ץΩƤܽѤɸꤷ̤ФΤ٥ƥǤ
ޤͤκ鲿ͤˤᤴƤ٥ƥǤϿϤ⿷ͤƱ٥Ȼפޤ

ΥץΩƤ뤿οϤäΤ񤷤

դΤä񤷤٤naomiοŤդnaomiʹʤȻλʤ

ФȤȤȤˤǤȤʱΤޤʤδѤʿͤäïäƤǤޤ

ץλʱΤȤƼǤˤƿǤ衢ץΩƤǤܽѤǤ̤Ф롣줬٥ƥǤ

飱ν֤ƤƤ⿷ͤƱ˸ΤǤ
֤ϡнϤ褦ʪʤ꤬Ǥ

ƤͤäƤǤ

Ϥͤʤä顣ѱꤷޤѶϫޤ

ΥåդϷäޤƤȻפޤnaomiƶ
Ϥդְ㤤ʤȤϤդ褦˰ƤޤͤդƤФ 

˻

轵ΤȥȤζ餷ʤ鴵ͤͽMAX

 ĥޤ
    Υȥ꡼ϤƤʥ֥åޡɲ mixiå

naomi֥γ͡ФϡʱnaomiǤ

ϱĹ˻äΤᡢ屡ϵٿǤǤ

ȴǤΤĤδ֡ϳزΥ饤ɺ˿ϥߥʡ˻äƤޤ

дΰˤο
λˤߡܤˤߤ

Ǥֻաʸгʳض

дˤȤ

дˤȤϡ񼣤ʻˡˡTMDƬˤȤäˤ񤹤ˤߤǤɤɵᤷ̡Ω줿ʤˤ룱Ĥʬ

 Ǻʻ

ΤäƤµǤǤʤǤˤ

ñʬ
 

ΤʤµʤΤǿǤǤʤ

۽
a.Ϣˡʸ̵Ȥˤߡˤϲʤ

 a. ڡ
b.о㳲
c.

  Non Odontogenic Toothache

ӻȿʳθˤˤ

ڡʶڡˡȥꥬݥȤˤˡ
о㳲ʳо㳲Ӿ׿ˤʤɤˤˡ
ƶɡʵƶˤˡ
зƬƬˡȯƬˤˤˡ
¡ʿڹɡɤˤˡ
ʿɽ㳲

¾ȯ

ˤʬȿǼ

˹¤

в



³

ŪѲ
Ͷȯҡ

ȼɾϢɾ
˻ư

ڡ

꤬ʤȻƬˤʤ
ڡ¨ƬڤTrirrer pointˤˡʴϢˤΥᥫ˥

ڡˤħ
ưλ³

ꡢƬˤȤʤȤ
ڳư𡢤ߤˤˤäˤ
ڤβۡޥåˤäƻˤ

ȥꥬݥȤȤ

ȥꥬݥȤȤľ1-2mmǡκŷtaut bandˤ˴
ȥꥬݥȤϼȯˤ
ȲҤȿݤĤLocal twitch
Activeʾ֤ǥԥ󥰥ȸƤФƨȿۤɤαԤˤߤɽ

˴ϢˤTrigger Point

ڡλˤμ

ˡʶڤ٤ηڸ˹ưǧιưˡ
ФεդߡܿưƳ
ȿ¦ؼŸʪζػ
̲㳲βʿ̲ˤΤФ
оˡʤФäڤؤμš
ۥåȥѥåĶ
سȥåá
ȥꥬݥ
ˤμšķϹǤ

ȯᥫ˥ˤˤߤʬ

Ectopic Discharge۽ȯ

üοƴʳ̤ɷ㤵쾡˳ưṲ̋
˦˵ζʳ
æ
ü˽褿ץ饦

ˡ˥塼ѥʿа

СФβҲ

Ǵĥإ˥ˤ¹

˥塼ѥˤο

ϻǴγа۾̵ͭ
Allodyniaܻɷİ䴶Сˢ˥塼ѥ

о㳲ˤμ

Ťˡο

Ūɽˤˤɤ١ü뤫

̤ޤˤ֥å
Neurosensory Stent
ɽѡܵޡܥץ

ʪˡķϹ

ˤ֡

˸Τʤˤ
ˤߤ򴶤硢λ˸ȹͤΤQŪǤäɬ⤽ǤϤʤȤȽäƤ

ˤؤн衡ޤȤ

ˤϻǵȤϸ¤ʤ

ȿʳȿ֤͡ˤˤ롣

ȿʳΰ۽ˤȤƤλ
ȯ˴̤ۤʤ
ڡˡϢ
۽ȯСʿƴʳ̤dzưṲ̋

ˤǰƬ˻˿



ǽ񤭤ʤ⤦ʻ֤

ߤޤ󡣡³

ʱΤȤƻѸŸ˾ˤĤƤäĺФȻפäƤޤΤǤ̣볧ϤҤäޤ زʤƤ⻲òǽǤ
 



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