第6回

日本総合歯科学会
総会・学術大会−総合歯科学が包括すべき学術体系とコンピテンシーを考える−

プログラム・抄録集
会期：平成25年11月16日（土）・17日（日）会

場：昭和大学旗の台キャンパス

主催：昭和大学歯学部・歯科保存学講座・総合診療歯科学部門

大会長：長谷川篤司➨㻢ᅇ᪥ᮏ⥲ྜṑ⛉Ꮫ఍⥲఍䞉Ꮫ⾡኱఍㻌኱఍㛗ᣵᣜ㻌
኱఍㛗㻌 㛗㇂ᕝ㻌 ⠜ྖ㻌䠄᫛࿴኱ᏛṑᏛ㒊䞉ṑ⛉ಖᏑᏛㅮᗙ䞉⥲ྜデ⒪ṑ⛉Ꮫ㒊㛛䠅㻌㻌㻌 ➨㻢ᅇ᪥ᮏ⥲ྜṑ⛉Ꮫ఍⥲఍䞉Ꮫ⾡኱఍䜢㛤ദ䛩䜛䛻ᙜ䛯䜚䚸䛤ᣵᣜ䜢⏦䛧ୖ䛢䜎䛩䚹㻌 ᫖ᖺᮎ䛻㛤ദ䛥䜜䛯➨㻡ᅇ᪥ᮏ⥲ྜṑ⛉༠㆟఍⥲఍䠄୺ᖿ䠖኱㜰ṑ⛉኱Ꮫ㻌 ᑠฟ㻌 Ṋ኱఍㛗䠅䛻䛚䛔䛶䚸ᮏᖺᗘᏛ⾡኱఍఍ᮇ୰䛻Ꮫ఍タ❧⥲఍䜢㛤ദ䛧䚸༠㆟఍䛛䜙Ꮫ఍䜈䛾⛣⾜䛩䜛䛣䛸䛜஢ᢎ䛥䜜䜎䛧䛯䚹䛣䛾グᛕ䛩䜉䛝Ꮫ⾡኱఍䜢ᮏᖺ㻝㻝᭶㻝㻢᪥䚸㻝㻣᪥䛻᫛࿴኱Ꮫ䛷ᢸᙜ䛥䛫䛶䛔䛯䛰䛟䛣䛸䛻䛺䜚䜎䛧䛯䚹㻌 䝯䜲䞁䝔䞊䝬䛸䛧䛶䛂⥲ྜṑ⛉Ꮫ䛜ໟᣓ䛩䜉䛝Ꮫ⾡య⣔䛸䝁䞁䝢䝔䞁䝅䞊䜢⪃䛘䜛䛃䜢ᥖ䛢䚸᪥ᮏ⥲ྜṑ⛉Ꮫ఍䛜┠ᣦ䛧䛶䛔䛟άື䜢ල⌧໬䛩䜛䛯䜑䛾┠ᶆ䠄䝁䞁䝢䝔䞁䝅䞊䠅䚸᪉␎䚸ホ౯䜢䛒䜙䛯䜑䛶⪃䛘䜛ᶵ఍䛻䛺䜜䜀䛸⪃䛘䛶䛚䜚䜎䛩䚹㻌㻌 ኱఍ึ᪥䛻䛿䚸≉ูㅮ₇䊠䛸䛧䛶䚸᪥ᮏ䝥䝷䜲䝬䝸䞉䜿䜰㐃ྜᏛ఍䞉๓⌮஦㛗䞉๓ἑᨻḟඛ⏕䜢䛚ᣍ䛝䛧䛶䛂་⒪䛻䛚䛡䜛䇿⥲ྜ䇿䛾ព⩏䛸ㄢ㢟䛃䛸㢟䛧䛶ㅮ₇䛧䛶䛔䛯䛰䛝䚸་⛉䛾䝥䝷䜲䝬䝸䞉䜿䜰䠄⥲ྜデ⒪䠅་䛻ồ䜑䜙䜜䛶䛔䜛䝁䞁䝢䝔䞁䝅䞊䛺䛹䜢ゎㄝ䛔䛯䛰䛝䛺䛜䜙䚸ṑ⛉⥲ྜデ⒪䜈䛾䜰䝗䝞䜲䝇䜢䛚㢪䛔䛧䛶䛔䜎䛩䚹⥆䛟䝅䞁䝫䝆䜴䝮䛷䛿䛂⥲ྜṑ⛉་䛻ồ䜑䜙䜜䜛䝁䞁䝢䝔䞁䝇䛸ホ౯䛾ල⌧໬䛻䛴䛔䛶䛃䛸㢟䛧䚸Ꮫ⾡᳨ウጤဨ఍ጤဨ㛗䛷䛒䜛ᵽཱྀ຾つඛ⏕䠄஑ᕞ኱Ꮫ䠅䛻ᗙ㛗䛸ᇶㄪㅮ₇䜢䛚㢪䛔䛧䛶䛚䜚䚸ḟ䛔䛷䚸䝅䞁䝫䝆䝇䝖䛸䛧䛶Ꮫ⾡᳨ウጤဨ఍⥲఍ṑ⛉ᢏ⾡䝥䝻䝆䜵䜽䝖་⒪⾜ື䝏䞊䝮䝸䞊䝎䞊䛾ᮌᑿဴᮁඛ⏕䠄஑ᕞṑ⛉኱Ꮫ䠅䚸୍⯡ṑ⛉デ⒪䠄ಖᏑ⣔䠅䝏䞊䝮䝸䞊䝎䞊䛾బ⸨཭๎ඛ⏕䠄᪥ᮏṑ⛉኱Ꮫ᪂₲䠅䚸୍⯡ṑ⛉デ⒪䠄⿵⥛⣔䠅䝏䞊䝮䝸䞊䝎䞊䛾ụ⏣࿴ὒඛ⏕䠄໭ᾏ㐨་⒪኱Ꮫ䠅䚸㐃ᦠデ⒪䞉඲㌟⟶⌮䝏䞊䝮䝸䞊䝎䞊䛾㉏⏣㈏ඛ⏕䠄஑ᕞ኱Ꮫ䠅䛾䠐ඛ⏕䛻ྛ䝏䞊䝮䛷᳨ウ䛥䜜䛯⥲ྜṑ⛉་䛻ồ䜑䜙䜜䜛䝁䞁䝢䝔䞁䝅䞊䛻䛴䛔䛶䛤ㅮ₇䜢䛚㢪䛔䛧䚸༠㆟఍䛸䛧䛶䛾䝁䞁䝢䝔䞁䝅䞊❧᱌䛾᪉ྥᛶ䜢඲య䛷ウㄽ䛧䛶䛔䛯䛰䛝䛯䛔䛸⪃䛘䛶䛚䜚䜎䛩䚹䝷䞁䝏䝵䞁䝉䝭䝘䞊䛿ᩘᰯ䛾ඛ⏕䛻䛤༠ຊ㡬䛔䛶
㛤Ⓨ䛧䛯ᩍ⫱㈨※䜢᫛࿴኱Ꮫụ⏣ள⣖Ꮚඛ⏕䛜䛂ṑ⛉⥲ྜデ⒪⬟ຊ䜢Ꮫ⩦䛷䛝䜛ᩍ⫱㈨※䛾㛤Ⓨ䛃䛸䛔䛖䝔䞊䝬䛷⤂௓䛧䛶㡬䛝䜎䛩䚹㻌㻌 䜎䛯䚸୍⯡ㅮ₇䚸䝫䝇䝍䞊Ⓨ⾲䜒㛤ദ䛧䜎䛩䚹䝫䝇䝍䞊Ⓨ⾲䛷䛿䚸౛ᖺ㏻䜚ඃ⚽Ⓨ⾲⪅䜢⾲ᙲ䛩䜛ணᐃ䛷䛩䛾䛷Ꮫ⏕䚸◊ಟ་䚸ⱝᡭ䛾ඛ⏕᪉䜒ዧ䛳䛶䛤Ⓨ⾲䜢䛚㢪䛔䛔䛯䛧䜎䛩䚹㻌㻌 ึ᪥⤊஢ᚋ䚸Ꮫ఍タ❧⚃㈡఍䜢ணᐃ䚸‽ഛ䛧䛶䛔䜎䛩䚹᫝㠀䚸ከ䛟䛾ඛ⏕᪉䛻ᮏ༠఍䛜Ꮫ఍䛻㣕㌍䛩䜛▐㛫䛻❧䛱఍䛳䛶䛔䛯䛰䛝䛯䛔䛸㢪䛳䛶䛚䜚䜎䛩䚹㻌㻌 ๓ᅇ䠄኱㜰ṑ⛉኱Ꮫᑠฟᩍᤵ䠅䚸๓䚻ᅇ䠄᪥ᮏṑ⛉኱Ꮫ᪂₲Ᏹ㔝ᩍᤵ䠅䛸䛔䛪䜜䜒኱䛝䛺⥲ྜṑ⛉Ꮫ⤌⧊䛾୺ᖿ䛷䛧䛯䛜䚸᫛࿴኱Ꮫ⥲ྜデ⒪ṑ⛉Ꮫ䛿䠄ຓᩍ௨ୖ㻠ྡ䠅ᑠ䛥䛺⤌⧊䛷䛩䚹㻌ᮏᏛ⾡኱఍䜢㛤ദ䛩䜛䛻㝿䛧䚸ከ䛟䛾㛵㐃௻ᴗ䛚䜘䜃㛵ಀྛ఩䛛䜙ከ኱䛺䜛䛤ᨭ᥼䞉䛤༠ຊ䜢㡬䛝䜎䛧䛯䚹䛣䛣䛻ཌ䛟ᚚ♩⏦䛧ୖ䛢䜎䛩䚹㻌㻌 ᭱ᚋ䛻䚸Ꮫ⾡኱఍䛻䛤ཧຍ䛥䜜䜎䛧䛯ඛ⏕᪉䛻䛸䛳䛶᭷ព⩏䛷䛒䜛䛣䛸䜢♳ᛕ䛧䚸Ꮫ఍䛸䛧䛶┈䚻Ⓨᒎ䛩䜛䛣䛸䜢㢪䛔䚸䛤ᣵᣜ䛸䛥䛫䛶㡬䛝䜎䛩䚹㻌ᖹᡂ㻞㻡ᖺ㻝㻝᭶ྜྷ᪥㻌➨䠒ᅇ᪥ᮏ⥲ྜṑ⛉Ꮫ఍⥲఍䞉Ꮫ⾡኱఍㻌䇷⥲ྜṑ⛉䛜ໟᣓ䛩䜉䛝Ꮫ⾡య⣔䛸䝁䞁䝢䝔䞁䝅䞊䜢⪃䛘䜛䇷㻌㻌 ᴫ㻌 㻌 㻌 㻌 㻌 せ㻌 㻌㻌᪥㻌 㻌 ⛬㻌䠖㻞㻜㻝㻟ᖺ㻝㻝᭶㻝㻡᪥䠄㔠䠅䚸㻝㻢᪥䠄ᅵ䠅䚸㻝㻣᪥䠄᪥䠅㻌୺㻌 㻌 ദ㻌䠖᫛࿴኱ᏛṑᏛ㒊䞉ṑ⛉ಖᏑᏛㅮᗙ䞉⥲ྜデ⒪ṑ⛉Ꮫ㒊㛛㻌఍㻌 㻌 ሙ㻌䠖᫛࿴኱Ꮫ᪝䛾ྎ䜻䝱䞁䝟䝇㻌኱㻌 ఍㻌 㛗㻌䠖㛗㇂ᕝ⠜ྖ㻌‽ഛጤဨ㛗㻌
䠖ఀబὠඞᙪ㻌㻌㻌 ᪥㻌 㻌 㻌 㻌 ⛬㻌 㻌㻌ᖹᡂ㻞㻡ᖺ㻝㻝᭶㻝㻡᪥䠄㔠䠅㻌㻝㻞䠖㻜㻜㻌 䡚㻌ྛ✀ጤဨ఍㻌
㻝㻟䠖㻜㻜㻌 䡚㻌ᖖ௵⌮஦఍㻌
㻝㻡䠖㻜㻜㻌 䡚㻌⌮஦఍㻌㻝㻢䠖㻟㻜㻌 䡚㻌
ホ㆟ጤဨ఍䞉⥲఍㻌㻌ᖹᡂ㻞㻡ᖺ㻝㻝᭶㻝㻢᪥䠄ᅵ䠅㻌㻌 㻤䠖㻟㻜㻌 䡚㻌ཷ௜㛤ጞ㻌㻌 㻥䠖㻜㻜㻌 䡚㻌㛤఍ᘧ䚸ཱྀ₇Ⓨ⾲䚸⥲఍䚸≉ูㅮ₇䚸䝅䞁䝫䝆䜴䝮䚸䝫䝇䝍䞊Ⓨ⾲㻌㻌㻝㻤䠖㻟㻜㻌 䡚㻌Ꮫ఍タ❧⚃㈡఍㻌㻌ᖹᡂ㻞㻡ᖺ㻝㻝᭶㻝㻢᪥䠄ᅵ䠅㻌㻌 㻤䠖㻟㻜㻌 䡚㻌ཷ௜㛤ጞ㻌㻌 㻥㻦㻜㻜㻌 䡚㻌
ཱྀ₇Ⓨ⾲䚸⥲఍䚸㛢఍ᘧ䠄㻝㻞䠖㻜㻜㡭⤊஢ணᐃ䠅㻌㻌㻌 Ꮫ⾡኱఍䛻ཧຍ䛥䜜䜛ⓙᵝ䜈㻌 㻌㻌䠄䠍䠅Ⓩ㘓㻌
⥲ྜཷ௜䜢㻝㻢ྕ㤋䠍㝵䛻タ⨨䛧䜎䛩䚹㻌䠍䚸䠎᪥䛸䜒䛻༗๓䠔᫬䠏䠌ศ䜘䜚⾜䛔䜎䛩䚹㻌㻌
஦๓Ⓩ㘓䛚῭䜏䛾᪉䛿䚸ཧຍド䜢䛚ཷ䛡ྲྀ䜚䛟䛰䛥䛔䚹㻌㻌
ᙜ᪥Ⓩ㘓䛥䜜䜛᪉䛿⥲ྜཷ௜䛻䛶⏦䛧㎸䜏䜢䛚ཷ䛡䛧䜎䛩䚹Ⓩ㘓⏝⣬䛻䛤グධᚋ䚸㻌㻌⥲ྜཷ௜䛻⏝⣬䜢䛚ᣢ䛱ୗ䛥䛔䚹㻌䠄䠎䠅ཧຍド䠄䝛䞊䝮䜹䞊䝗䠅㻌㻌఍ሙෆ䛷䛿ཧຍド䜢㌟䛻䛴䛡䛶ୗ䛥䛔䚹㻌㻌
―1―䠄䠏䠅䝥䝻䜾䝷䝮䞉ᢒ㘓㞟㻌㻌䝥䝻䜾䝷䝮䚸ᢒ㘓㞟䛿ᙜ᪥ཷ௜䛷䛚Ώ䛧䛧䜎䛩䚹㻌㻌

ཧຍ㈝㻌
㻌 ṑ⛉་ᖌ఍ဨ㻌㻌㻌 㻣㻘㻜㻜㻜෇㻌㻌 ṑ⛉⾨⏕ኈ఍ဨ㻌㻌 㻣㻘㻜㻜㻜෇㻌㻌 䛭䛾௚఍ဨ㻌 㻌㻌 㻣㻘㻜㻜㻜෇㻌㻌 ୍⯡㻌 㻌㻌㻝㻜㻘㻜㻜㻜෇㻌㻌 ⮫ᗋ◊ಟ་㻌 㻌㻌 㻝㻘㻜㻜㻜෇㻌㻌 ኱Ꮫ㝔⏕㻌㻌㻌 㻝㻘㻜㻜㻜෇㻌㻌 Ꮫ㻌 㻌 ⏕㻌㻌㻌 㻝㻘㻜㻜㻜෇㻌䈜⮫ᗋ◊ಟ་䚸኱Ꮫ㝔⏕䚸Ꮫ⏕䛿㌟ศド䛾䛤ᥦ♧䜢䛚㢪䛔䛔䛯䛧䜎䛩䚹㻌㻌 ణ䛧䚸኱Ꮫ༢఩䛷஦๓Ⓩ㘓㡬䛔䛯ሙྜ䛻䛿୙せ䛷䛩䚹㻌㻌Ꮫ఍タ❧⚃㈡఍఍㈝㻌
㻌 ཧຍ㈝㻌㻌㻌 㻌 㻡㻘㻜㻜㻜෇㻌ධ㝔Ჷ䠍䠓㝵䝍䝽䞊䝺䝇䝖䝷䞁᫛࿴䛻䛶Ꮫ఍タ❧⚃㈡఍䜢⾜䛔䜎䛩䚹㻌஦๓⏦䛧㎸䜏䛜䛚῭䜏䛷䛺䛔᪉䛿䚸⚃㈡఍఍ሙཷ௜䛻䛶䛚⏦㎸䜏䛟䛰䛥䛔䚹㻌ణ䛧䚸ேᩘ䛻䜘䛳䛶䛿䛚᩿䜚䛩䜛ሙྜ䛜䛒䜛䛛䛸ᛮ䛔䜎䛩䛜䚸䛭䛾㝿䛿䛤ᐜ㉧䛟䛰䛥䛔䚹㻌㻌䜽䝻䞊䜽㻌䠍䠒ྕ㤋䠏㝵䛻タ⨨䛔䛯䛧䜎䛩䚹ణ䛧㈗㔜ရ䚸䝟䝋䝁䞁➼䛿䛤⮬㌟䛷䛚ᣢ䛱䛟䛰䛥䛔䚹㻌䜽䝻䞊䜽䛾ཷ௜᫬㛫㻌ᖹᡂ㻞㻡ᖺ㻝㻝᭶㻝㻢᪥䠄ᅵ䠅㻌㻌 㻤䠖㻟㻜㻌 䡚㻌 䝫䝇䝍䞊Ⓨ⾲⤊஢᫬㻌ᖹᡂ㻞㻡ᖺ㻝㻝᭶㻝㻢᪥䠄ᅵ䠅㻌㻌 㻤䠖㻟㻜㻌 䡚㻌 㛢఍ᘧ⤊஢᫬㻌㻌㻌
ཱྀ₇Ⓨ⾲䚸⥲఍䚸㛢఍ᘧ䠄㻝㻞䠖㻜㻜㡭⤊஢ணᐃ䠅㻌㻌㻌㻌 Ⓨ㻌 㻌 ⾲㻌 㻌 ᙧ㻌 㻌 ᘧ㻌 㻌
ཱྀ࠙₇Ⓨ⾲ࠚ
ཱྀ₇఍ሙࡣࠊ㸯㸴ྕ㤋㸰㝵࣓࢖ࣥ఍ሙ࡜࡞ࡾࡲࡍࠋ
Ⓨ⾲㸵ศࠊウㄽ㸱ศࢆணᐃࡋ࡚࠾ࡾࡲࡍࠋ㐍⾜࡟ᨭ㞀ࡢ࡞࠸ࡼ࠺᫬㛫ཝᏲ࡛࠾㢪࠸⮴ࡋࡲࡍࠋ኱఍୺ദ⪅ഃ࡛⏝ពࡍࡿࢥࣥࣆ࣮ࣗࢱ࣮ࡣࠊ26ࡣ:LQGRZVࠊࣉࣞࢮࣥࢸ࣮ࢩࣙࣥࢯࣇࢺࡣ
3RZHU3RLQW࡜ࡉࡏ࡚㡬ࡁࡲࡍࠋࡇࡢ⎔ቃ࡛3RZHU3RLQWཎ✏ࡀṇࡋࡃ⾲♧ࡉࢀࡿ࠿࡝࠺
࠿஦๓࡟ᚚ☜ㄆୗࡉ࠸ࠋ
―2―ࣉࣞࢮࣥࢸ࣮ࢩࣙࣥ࡟౑⏝ࡍࡿᶵჾࡣ3&ࣉࣟࢪ࢙ࢡࢱ࣮㸯ᇶࡢࡳ࡜ࡉࡏ࡚࠸ࡓࡔࡁࡲࡍࠋ
㸦ࢫࣛ࢖ࢻ2+3➼ࡣ౑⏝࡛ࡁࡲࡏࢇࠋ㸧ᙜ᪥౑⏝ࡍࡿ3&ࡣ୺ദ⪅ഃࡀ⏝ព⮴ࡋࡲࡍࠋ
ཱྀ₇Ⓨ⾲ࡍࡿ3RZHU3RLQWཎ✏ࡣ࢘࢕ࣝࢫࢳ࢙ࢵࢡࡢࡓࡵ᭶᪥㎾࡟ῧ௜᭩㢮࡜ࡋ࡚࣓࣮
࡛ࣝ࠾㏦ࡾࡃࡔࡉ࠸ࠋࡑࡢ⚍ࡢ࣓࣮ࣝ௳ྡࡣཱྀࠗ₇㈨ᩱ 㸦➹㢌⪅Ặྡ㸧࠘࡜ࡋ࡚ୗࡉ࠸ࠋ
ᙜ᪥ࡣணഛࡢⅭ3RZHU3RLQWཎ✏ࢆᚲࡎ࠾ᣢࡕࡃࡔࡉ࠸ࠋ㸦&'ࡲࡓࡣ86% ࣏࠙ࢫࢱ࣮Ⓨ⾲ࠚ࣏ࢫࢱ࣮఍ሙࡣࠊ㸯㸴ྕ㤋㸱㝵࣏ࢫࢱ࣮࣭௻ᴗᒎ♧఍ሙ࡜࡞ࡾࡲࡍࠋ  ࡇࢀࡲ࡛ࡢ኱఍ྠᵝࠊⓎ⾲ウㄽᙧᘧࢆணᐃࡋ࡚࠸ࡲࡍࠋ
Ⓨ⾲᫬㛫ࡣ㸱ศࠊウㄽ᫬㛫ࡣ㸰ศࢆணᐃࡋ࡚࠸ࡲࡍࠋ
࣏ࢫࢱ࣮ࣃࢿࣝࡣᶓFP×⦪FPࢆ‽ഛࡋࡲࡍࠋࣃࢿࣝୗ㒊࡟ࣃࢿࣝ↓ࡋࡢ✵㛫ࡀ࠶ࡾࡲࡍ
ࡢ࡛ࠊྛ⮬᭷ຠ࡟ࡈ౑⏝ࡃࡔࡉ࠸ࠋ㸦ୗᅗཧ↷㸧࣏ࢫࢱ࣮ࡢୖ㒊FPࢆ₇㢟⏝ࢫ࣮࣌ࢫ࡜ࡋࠊᕥഃFPࢆ₇㢟␒ྕ⏝ࢫ࣮࣌ࢫ࡜ࡋ࡚⠊ᅖෆ࡛࣏ࢫࢱ࣮ࢆసᡂࡋ࡚ࡃࡔࡉ࠸ࠋ





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―3―

኱㻌 ఍㻌 ఍㻌 ሙ㻌㻌Ꮫ఍఍ሙ䜈䛾䜰䜽䝉䝇㻌㻌㻌䖃䛤᮶ሙ䛥䜜䜛ඛ⏕䜈㻌㻌 ⑓㝔䛻㥔㌴䝇䝨䞊䝇䛜䛤䛦䛔䜎䛩䛜䚸኱఍ึ᪥䛾㻝㻝᭶㻝㻢᪥䠄ᅵ᭙䠅༗๓୰䛿䚸㏻ᖖ
䛹䛚䜚デ⒪䛜⾜䜟䜜䛶䛔䜎䛩䚹䛺䜛䜉䛟බඹ஺㏻ᶵ㛵䜢䛤฼⏝䛟䛰䛥䛔䚹㻌
㻌
㻌
㻌
㻌
㻌
㻌
㻌
㻌
㻌
㻌

―4―

㻌

᪝䛾ྎ䛛䜙㻝㻢ྕ㤋䜎䛷䛾䜰䜽䝉䝇㻌኱஭⏫⥺䠄኱஭⏫᪉㠃⾜䝩䞊䝮䜘䜚ᮾཱྀ䠍ᨵᮐ䜢ฟ䜛䚹㻌ᕥ䛻⾜䛟䛸᪝䛾ྎၟᗑ⾤䛸䛺䜚䜎䛩䚹㻌ṇ㠃䛻᫛࿴኱Ꮫ㻝㻣㝵ධ㝔Ჷ䛜ぢ䛘䜎䛩䚹㻌ၟᗑ⾤䜢┤㐍䊻୰ཎ⾤㐨䛻ฟ䜎䛩䚹㻌ᶓ᩿Ṍ㐨䜢Ώ䜚୕஭ఫ཭㖟⾜䛾ṇ㠃䛻❧䛱䜎䛩䚹㻌୕஭ఫ཭㖟⾜䛾ᕥᡭ䛾ഃ㐨ᕥᢡ䚸㻌㻠㻜㻜㼙┤㐍䊻᫛࿴኱Ꮫ᪝䛾ྎ䜻䝱䞁䝟䝇䛻ฟ䜎䛩䚹㻌᪝䛾ྎ䜻䝱䞁䝟䝇䜢ྑᡭ䛻㻝㻜㻜㼙┤㐍㻌䊻་Ꮫᇽ᭩ᗑ䜢㐣䛞᭱ึ䛾ゅ䜢ᕥᢡ䚹㻌༊❧➨஧ᘏᒣᑠᏛᰯ䜢ྑᡭ䛻ぢ䛺䛜䜙㻠㻜㻜㼙┤㐍㻌䊻✺䛝ᙜ䜚䜢ᕥᢡ䛩䜛䛸ྑᡭ䛻㻝㻢ྕ㤋䛻฿╔㻌 㻌㻌㻌㻌ධ㝔Ჷ㻌 㻌㻌㻌㻌㻝ྕ㤋㻌 㻌㻌―5―㻌㻌 㻌 㻌 㻝㻢ྕ㤋㻌➨䠒ᅇ᪥ᮏ⥲ྜṑ⛉Ꮫ఍⥲఍䞉Ꮫ⾡኱఍䚷䝇䜿䝆䝳䞊䝹᫬㛫㻝㻡᪥䠄㔠䠅
๓᪥㻝䠒᪥䠄ᅵ䠅
➨䠍᪥
㻝㻢ྕ㤋
ᆅୗ㝵
䠍㝵

᫬㛫

᫬㛫

㻤㻦㻟㻜

ධ㝔Ჷ
䠏㝵
䠍䠓㝵
䝫䝇䝍䞊 䝍䝽䞊
䝯䜲䞁఍ሙ 䝃䝤఍ሙ ௻ᴗᒎ♧
఍ሙ
䝺䝇䝖䝷䞁
ཷ௜㛤ጞ
㻤㻦㻟㻜

㻥㻦㻜㻜

㻥㻦㻜㻜

㻥㻦㻟㻜

㻥㻦㻟㻜

㻝㻜㻦㻜㻜

㻝㻜㻦㻜㻜

㻝㻜㻦㻜㻜

㻝㻜㻦㻟㻜

㻝㻜㻦㻟㻜

䠎㝵

㻝㻜㻦㻟㻜

௻ᴗᒎ♧ 䝫䝇䝍䞊ᒎ♧
ཱྀ₇Ⓨ⾲㻝䠓᪥䠄᪥䠅
➨䠎᪥
䠍䠒ྕ㤋
ධ㝔Ჷ
䠎㝵
䠍㝵
䠍䠓㝵

㻤㻦㻟㻜

䝯䜲䞁఍ሙ ௻ᴗᒎ♧ 㻯఍㆟ᐊ
ཷ௜㛤ጞ

㻥㻦㻜㻜

ཱྀ₇Ⓨ⾲ ௻ᴗᒎ♧

㻥㻦㻟㻜

ཷ௜
㻝㻝㻦㻜㻜
㻝㻝㻦㻟㻜
㻝㻞㻦㻜㻜
㻝㻞㻦㻟㻜

䝅䞁䝫䝆䝇䝖
ᡴྜ䛫䠄㻝ྕ㤋㻡㝵
㻼㻮㻸ᐊ䠅

㻝㻝㻦㻜㻜

㻝㻝㻦㻜㻜

⥲఍

⥲఍
㻝㻝㻦㻟㻜

㻝㻝㻦㻟㻜

㻝㻡㻦㻜㻜䜎䛷ᘏ㛗ྍ
ྛ✀ጤဨ఍
㻝㻞㻦㻜㻜
䠄㻝ྕ㤋㻡㝵
㻼㻮㻸ᐊ䠅
㻝㻞㻦㻟㻜

㛢఍ᘧ
㻝㻞㻦㻜㻜
䝷䞁䝏䝵䞁
䝉䝭䝘䞊
㻝㻞㻦㻟㻜

ᖖ௵
⌮஦఍

㻝㻟㻦㻜㻜

䠄ධ㝔Ჷ
䠍䠓㝵
䠟఍㆟ᐊ䠅

㻝㻡㻦㻜㻜䜎䛷ᘏ㛗ྍ
㻝㻟㻦㻜㻜

㻝㻟㻦㻜㻜
≉ูㅮ₇

㻝㻟㻦㻟㻜

ᖖ௵⌮஦఍
䠄ධ㝔Ჷ㻝㻣㝵
㻯఍㆟ᐊ䠅

㻝㻠㻦㻜㻜

㻝㻟㻦㻟㻜

㻝㻟㻦㻟㻜

㻝㻠㻦㻜㻜

㻝㻠㻦㻜㻜
䝅䞁䝫䝆䜴䝮

㻝㻠㻦㻟㻜
㻝㻡㻦㻜㻜
㻝㻡㻦㻟㻜

⌮஦఍
䠄㻝ྕ㤋㻡㝵
఍㆟ᐊ䠅

㻝㻢㻦㻜㻜

㻝㻠㻦㻟㻜

㻝㻠㻦㻟㻜

㻝㻡㻦㻜㻜

㻝㻡㻦㻜㻜

㻝㻡㻦㻟㻜

㻝㻡㻦㻟㻜
䝫䝇䝍䞊
Ⓨ⾲
ウㄽ

㻝㻢㻦㻜㻜

㻝㻢㻦㻜㻜

㻝㻢㻦㻟㻜

㻝㻢㻦㻟㻜
ホ㆟ጤဨ఍䞉⥲఍䠄㻝㻢ྕ㤋ᆅୗ
㻝㻣㻦㻜㻜
䝃䝤఍ሙ䠅
㻝㻣㻦㻜㻜
㻝㻣㻦㻟㻜
㻝㻤㻦㻜㻜
㻝㻤㻦㻟㻜

⌮஦᠓ぶ఍

㻝㻢㻦㻟㻜
㻝㻣㻦㻜㻜

㻝㻣㻦㻟㻜

ཷ௜㛤ጞ 㻝㻣㻦㻟㻜

㻝㻤㻦㻜㻜

㻝㻤㻦㻜㻜

㻝㻤㻦㻟㻜

Ꮫ఍タ❧

㻝㻤㻦㻟㻜

⚃㈡఍
㻝㻥㻦㻜㻜

㻝㻥㻦㻜㻜

㻝㻥㻦㻜㻜

㻝㻥㻦㻟㻜

㻝㻥㻦㻟㻜

㻝㻥㻦㻟㻜

㻞㻜㻦㻜㻜

㻞㻜㻦㻜㻜

㻞㻜㻦㻜㻜

㻞㻜㻦㻟㻜

㻞㻜㻦㻟㻜

㻞㻜㻦㻟㻜
―6―

➨㻢ᅇ᪥ᮏ⥲ྜṑ⛉Ꮫ఍⥲఍䞉Ꮫ⾡኱఍䝥䝻䜾䝷䝮㻌㻌➨㻝᪥┠㻌 㻝㻝᭶㻝㻢᪥䠄ᅵ㻕㻌
㻌

㻌

㻌

㻌

㻥㻦㻜㻜䡚㻥㻦㻞㻜㻌 㛤఍ᘧ㻌 㻌

㻌

㻌

㻌

㻌

㻌

㻝㻢ྕ㤋㻞䠢⮫ᗋㅮᇽ㻌

㻌
㻌

㻌
㻌
㛤఍䛾㎡㻌

㻌

㻌

㻌

㻌

㻌

㻌

㻌

➨㻢ᅇ᪥ᮏ⥲ྜṑ⛉Ꮫ఍⥲఍䞉Ꮫ⾡኱఍㻌

㻌

㻌

㻌

㻌

㻌

㻌
㻌

⌮஦㛗ᣵᣜ㻌
㻌
㻌

㻌
㻌

㻌
㻌

᪥ᮏ⥲ྜṑ⛉Ꮫ఍㻌㻌㻌㻌⌮஦㛗㻌 ᑠᕝ㻌 ဴḟ㻌㻌㻌㻥㻦㻞㻜䡚㻝㻜㻦㻝㻜㻌㻌㻌
ཱྀ₇Ⓨ⾲㻌㻌

㻌
㻌

㻌
㻌

㻌
㻌

㻌
㻌
㻝㻢ྕ㤋㻞䠢⮫ᗋㅮᇽ㻌

㻌

㻌

㻌

㻌

㻌

㻌

㻌

㻌

㻌

㻌

㻌

䝉䝑䝅䝵䞁㻝䠄㻥㻦㻞㻜㻌 䡚㻌 㻥㻦㻡㻜㻕㻌 㻌
㻌
㻌
㻌
㻌

㻌

㻌

㻌

኱఍㛗㻌 㛗㇂ᕝ㻌 ⠜ྖ㻌㻌㻌ᗙ㛗㻌 ᑠᕝ㻌 ဴḟ䠄ᗈᓥ኱Ꮫ㻕㻌䠫䇲㻝㻌 㻜㻥㻞㻜㻌㻌㻌䕿㟷ᮌఙ୍㑻㻝㻘㻞㻕䠈Ლᮏ┿⃈㻝㻕䠈ᒸᮏᗣ⿱㻝㻘㻞㻕䠈ෆ⏣㈗அ㻝㻘㻞㻕䠈㐲⸨ᘯᗣ㻝㻘㻞㻕䠈㻌㻌኱ἑ⪷Ꮚ㻝㻘㻞㻕䠈ከ⏣඘⿱㻝㻘㻞㻕䠈ఀ⸨Ꮥカ㻝㻘㻞㻕㻌㻌㻌ึデ་⒪㠃᥋䛻䛚䛡䜛⌧⑓Ṕグ㍕䛸㻾㻵㻭㻿䛻䜘䜛㛵ಀゎᯒ䛾ヨ䜏㻌 㻌
㻌

㻌

㻌

㻌

㻌

㻌

㻌

㻝㻕

㻌

㻌

᪥ᮏ኱ᏛᯇᡞṑᏛ㒊ṑ⛉⥲ྜデ⒪Ꮫㅮᗙ 㻘㻌㻌㻌᪥ᮏ኱ᏛᯇᡞṑᏛ㒊ཱྀ⭍⛉Ꮫ◊✲ᡤ㻞㻕㻌㻌㻌䠫䇲㻞㻌 㻜㻥㻟㻜㻌㻌㻌య⣔໬䛥䜜䛯㻱㼢㼕㼐㼑㼚㼏㼑㻙㻮㼍㼟㼑㼐㻌㻰㼑㼚㼠㼕㼟㼠㼞㼥䞉⮫ᗋ␿Ꮫᩍ⫱䛾ヨ䜏㻌䕿ゅ⯓┤ᶞ 䠈ⰼ㇂ᬛဢ 䠈၈ᮌ⣧୍ 䠈⚟Ἠ㝯႐ 㻘ᮌᑿဴᮁ 䠈すཎ㐩ḟ 㻌㻌㻌㻌஑ᕞṑ⛉኱Ꮫ໭஑ᕞᆅ༊኱Ꮫ㐃ᦠᩍ⫱◊✲䝉䞁䝍䞊㻝㻕䠈㻌㻌㻌஑ᕞṑ⛉኱ᏛṑᏛ㒊ṑᏛ⛉⥲ྜᩍ⫱Ꮫศ㔝♫఍ṑ⛉Ꮫ◊✲ᐊ㻞㻕䠈㻌㻌㻌஑ᕞṑ⛉኱ᏛṑᏛ㒊ṑᏛ⛉⥲ྜデ⒪Ꮫศ㔝㻟㻕䠈㻌㻌㻌஑ᕞṑ⛉኱ᏛṑᏛ㒊ṑᏛ⛉ឤᰁศᏊ⏕≀Ꮫศ㔝㻠㻕㻌 㻌

㻌

㻌

㻌

㻝㻕

㻝㻕

㻝㻕

㻝㻘㻞㻕

㻟㻕

㻌
㻠㻕

㻌

䠫䇲㻟㻌 㻜㻥㻠㻜㻌 㻌㻌㻌䕿ⓑ஭㻌 ⫕㻝㻘㻞䠅㻘ሷὠ⠊Ꮚ㻝㻕㻘Ṋ⏣ᏹ᫂㻝㻕㻘኱ሯᜨ⌮㻝㻕㻘᱓ᒣ㤶⧊㻝㻕㻘㕥ᮌᗣྖ㻝㻕㻘㻌㻌㻌Ἑ㔝㝯ᖾ㻝㻕㻘ᑠ᮶⏣⨾㤶㻝㻕㻘ኴ⏣ளᕼ㻝㻕㻘ྜྷ⏣ⓏᚿᏊ㻞䠅㻘㫽஭ᗣᘯ㻝㻕㻌㻌㻌ᒸᒣ኱Ꮫ⑓㝔㻌 ⥲ྜṑ⛉㻝㻕㻘㻌㻌㻌ᒸᒣ኱Ꮫ㻌 ་⒪ᩍ⫱⤫ྜ㛤Ⓨ䝉䞁䝍䞊㻔ṑᏛᩍ⫱㒊㛛㻕㻞㻕㻌㻌ᒸᒣ኱Ꮫ⑓㝔䛻䛚䛡䜛◊ಟṑ⛉་䛻ᑐ䛩䜛་⒪Ᏻ඲ᩍ⫱䛾ྲྀ䜚⤌䜏㻌㻌䝉䝑䝅䝵䞁㻞䠄㻥㻦㻡㻜㻌 䡚㻌 㻝㻜㻦㻞㻜㻕㻌 㻌

㻌

㻌

㻌

㻌

㻌

㻌

㻌

㻌

ᗙ㛗㻌 ఀ⸨㻌 Ꮥカ䠄᪥ᮏ኱ᏛᯇᡞṑᏛ㒊㻕㻌䠫䇲㻠㻌 㻜㻥㻡㻜㻌㻌㻌⮫ᗋ◊ಟṑ⛉་䛾ᐇែㄪᰝ䠄➨㻞ሗ㻕㻌 㻌䕿ᮧୖᖾ⏕㻘㻌 ᕝ⏣ᮁྐ㻘㻌 ᒸ⏣඾ஂ㻘㻌 ⏣୰ᗉ஧㻘㻌 ୰㔝᠇୍㻘㻌 㧗Ὀᾈ㻘㻌 ୸ᒣ๛ኸ㻘㻌 㻌㻌㻌஧䝜ᐑⰋᩥ㻘㻌 ⛅⏣⣪ୡᏊ㻘㻌 ೺▼㞝㻘㻌 ୰Ụၨ᫛㻘㻌 ኱஭ඃ୍㻘㻌 㛵㻌 ຬဢ㻘㻌 ๓ᕝ䜎䜖䛝㻘㻌 㻌㻌㻌㧗ᯇ⣪⪨Ꮚ㻘㻌 ⏣ᮧ㟹Ꮚ㻘㻌 ᪂ᒃᬛᜨ㻘㻌 ⏫㔝Ᏺ㻘㻌 ∦ᒣ┤㻌 㻌

㻌

㻌

㻌

㻌

᫂ᾏ኱ᏛṑᏛ㒊㻌 ⑓ែデ᩿἞⒪Ꮫㅮᗙ㻌 ⥲ྜཱྀ⭍デ᩿Ꮫศ㔝㻌 㻌

㻌

―7―

㻌

㻌

㻌

㻌

㻌

㻌

䠫䇲㻡㻌 㻝㻜㻜㻜㻌㻌㻌ᯇᮏṑ⛉኱Ꮫ⑓㝔⥲ྜデ⒪ᐊ䛻䛚䛡䜛⮫ᗋ◊ಟᣦᑟ䛾ヨ䜏㻌
䕿㡢⍆῟୍

㻌

㻌

ᯇᮏṑ⛉኱Ꮫ⑓㝔⥲ྜデ⒪ᐊ㻝㻕㻘㻌 ᯇᮏṑ⛉኱Ꮫ኱Ꮫ㝔೺ᗣቑ㐍ཱྀ⭍⛉Ꮫㅮᗙ㻞㻕㻘㻌 㻌㻌㻌ᯇᮏṑ⛉኱Ꮫ⑓㝔◊ಟ⟶⌮ጤဨ఍㻟㻕㻌

㻌

㻌

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㻝㻘㻞㻘㻟㻕

㻞㻕㻝㻕㻝㻘㻞㻘㻟㻕㻘㻌 ఀ⬟ಇஅ 㻘㻌 Ᏻᮾಙ⾜ 㻘㻌 ⸨஭೺⏨

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㻘㻌 㯮ᒾ᫛ᘯ 㻘㻌 ᒣᮏ᫛ኵ㻟㻕㻌㻌㻌䠫䇲㻢㻌 㻝㻜㻝㻜㻌㻌㻌㻌㻌䕿ᑠฟ㻌 Ṋ 䠈ᯇᮏᑦஅ 䠈ᒸᓮᐃྖ 䠈⏣୰ᫀ༤ 䠈ᯘ㻌 ᏹ⾜ 䠈᳃⏣❶௓ 䠈㻌㻌ぬ㐨೺἞㻣㻕㻌

㻌኱㜰ṑ⛉኱Ꮫ㝃ᒓ⑓㝔」ྜᆺ⮫ᗋ◊ಟ䝥䝻䜾䝷䝮䛷ᐇ᪋䛧䛯㻌䝩䞊䝮䝹䞊䝮䛾ព⩏㻌 㻌 㻌䠉ၥ㢟஦౛䛾ㄪᰝ䠉㻌
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኱㜰ṑ⛉኱Ꮫ㝃ᒓ⑓㝔⥲ྜデ⒪䞉デ᩿⛉ 㻌 䠈኱㜰ṑ⛉኱Ꮫṑ⛉▹ṇᏛㅮᗙ㻞㻕䠈㻌㻌㻌኱㜰ṑ⛉኱ᏛḞᦆṑิ⿵⥛ညྜᏛㅮᗙ㻟㻕㻌 䠈኱㜰ṑ⛉኱Ꮫ᭷ṑ⿵⥛ညྜᏛㅮᗙ㻠㻕䠈㻌㻌㻌኱㜰ṑ⛉኱Ꮫཱྀ⭍἞⒪Ꮫㅮᗙ㻡㻕䠈኱㜰ṑ⛉኱Ꮫཱྀ⭍እ⛉Ꮫ➨୍ㅮᗙ㻢㻕䠈㻌㻌㻌኱㜰ṑ⛉኱Ꮫཱྀ⭍እ⛉Ꮫ➨஧ㅮᗙ㻣㻕㻌㻌㻌㻝㻜䠖㻞㻜䡚㻝㻜䠖㻟㻜㻌 ఇ᠁㻌㻌㻌㻝㻜㻦㻟㻜䡚㻝㻝㻦㻡㻜㻌Ꮫ఍タ❧⥲఍㻌

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㻝㻢ྕ㤋㻞䠢⮫ᗋㅮᇽ㻌䝷䞁䝏䝵䞁䝉䝭䝘䞊㻌㻌㻌㻌㻌 㻌 㻌 㻝㻢ྕ㤋ᆅୗ㻝㝵⮫ᗋㅮᇽ㻌㻌㻌㻝㻞㻦㻜㻜䡚㻝㻞㻦㻡㻜㻌㻌㻌䛂ṑ⛉⥲ྜデ⒪⬟ຊ䜢Ꮫ⩦䛷䛝䜛ᩍ⫱㈨※䛾㛤Ⓨ䛃㻌㻌ụ⏣㻌 ள⣖Ꮚ㻌 ඛ⏕䠄᫛࿴኱ᏛṑᏛ㒊㻌 ṑ⛉ಖᏑᏛㅮᗙ㻌 ⥲ྜデ⒪ṑ⛉Ꮫ㒊㛛㻕㻌㻌㻝㻞䠖㻡㻜䡚㻝㻟䠖㻜㻜㻌 ఇ᠁㻌㻌㻌㻌㻝㻟㻦㻜㻜䡚㻝㻟㻦㻡㻜㻌≉ูㅮ₇㻌㻌㻌㻌㻌㻝㻢ྕ㤋㻞䠢⮫ᗋㅮᇽ㻌ᗙ㛗㻌 㛗㇂ᕝ㻌 ⠜ྖ䠄᫛࿴኱Ꮫ㻕㻌㻌㻌䛂་⒪䛻䛚䛡䜛䇾⥲ྜ䇿䛾ព⩏䛸ㄢ㢟䛃㻌㻌㻌㻌 ๓ἑ㻌 ᨻḟ㻌 ඛ⏕㻌 䠄᪥ᮏ䝥䝷䜲䝬䝸䞊䜿䜰㐃ྜᏛ఍ྡ㄃⌮஦㛗㻕㻌㻝㻟䠖㻡㻜䡚㻝㻠䠖㻜㻜㻌 ఇ᠁㻌

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㻝㻠㻦㻜㻜䡚㻝㻡㻦㻟㻜㻌䝅䞁䝫䝆䜴䝮㻌

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㻝㻢ྕ㤋㻞䠢⮫ᗋㅮᇽ㻌ᗙ㛗㻌 ᵽཱྀ㻌 ຾つ䠄஑ᕞ኱Ꮫ㻕㻌䛂⥲ྜṑ⛉་䛻ồ䜑䜙䜜䜛䝁䞁䝢䝔䞁䝇䛸ホ౯䛾ල⌧໬䛻䛴䛔䛶䛃㻌㻝䠊㻝㻠㻦㻜㻜䡚㻝㻠㻦㻝㻞㻌 ᇶㄪㅮ₇㻌䛂⥲ྜṑ⛉་䛻ồ䜑䜙䜜䜛⬟ຊ䜢⪃䛘䜛䛃㻌㻌ᵽཱྀ㻌 ຾つ㻌 ඛ⏕㻌 䠄஑ᕞ኱Ꮫ⑓㝔㻌 ཱྀ⭍⥲ྜデ⒪⛉㻌 ᩍᤵ㻕㻌 㻌㻌㻌㻌㻞䠊㻝㻠㻦㻝㻞䡚㻝㻠㻦㻞㻥㻌 ་⒪⾜ື䛻䛴䛔䛶㻌䛂⥲ྜṑ⛉་䛻ồ䜑䜙䜜䜛་⒪⾜ື䛾䝁䞁䝢䝔䞁䝇䛃㻌㻌ᮌᑿ㻌 ဴᮁ㻌 ඛ⏕㻌 䠄஑ᕞṑ⛉኱Ꮫ㻌 ཱྀ⭍ᶵ⬟Ꮫㅮᗙ㻌 ⥲ྜデ⒪Ꮫศ㔝㻌 ⑓㝔ᩍᤵ㻕㻌㻌㻌㻌㻟䠊㻝㻠㻦㻞㻥䡚㻝㻠㻦㻠㻢㻌 ୍⯡ṑ⛉デ⒪䠄⿵⥛⣔㻕䛻䛴䛔䛶㻌䛂⥲ྜṑ⛉་䛻䛚䛡䜛ṑ⛉⿵⥛Ꮫ䛾䝁䞁䝢䝔䞁䝇䜢⪃䛘䜛䛃㻌㻌ụ⏣㻌 ࿴༤㻌 ඛ⏕㻌 䠄໭ᾏ㐨་⒪኱ᏛṑᏛ㒊㻌 㧗㱋⪅䞉᭷⑓⪅ṑ⛉Ꮫศ㔝㻌 ෸ᩍᤵ㻕㻌㻌㻌㻌㻠䠊㻝㻠㻦㻠㻢䡚㻝㻡㻦㻜㻟㻌 ୍⯡ṑ⛉デ⒪䠄ಖᏑ⣔㻕䛻䛴䛔䛶㻌䛂⥲ྜṑ⛉་䛻ồ䜑䜙䜜䜛䝁䞁䝢䝔䞁䝇䛸ホ౯䛾ලయ໬䛻䛴䛔䛶㻌䠉୍⯡ṑ⛉デ⒪䠄ಖᏑ⣔㻕䛻䛴䛔䛶䠉䛃㻌㻌బ⸨㻌 ཭๎㻌 ඛ⏕㻌 䠄᪥ᮏṑ⛉኱Ꮫ᪂₲⑓㝔㻌 ⥲ྜデ⒪⛉㻌 ෸ᩍᤵ㻕㻌㻌㻌㻌㻡䠊㻝㻡㻦㻜㻟䡚㻝㻡㻦㻞㻜㻌 ་⒪㐃ᦠ䛻䛴䛔䛶㻌䛂ᆅᇦ་⒪䛻䛚䛡䜛⥲ྜṑ⛉་䛾❧䛱఩⨨䜢⪃䛘䜛䛃㻌㻌ᑉ⏣㻌 ㈏㻌 ඛ⏕㻌 䠄஑ᕞ኱Ꮫ⑓㝔㻌 ཱྀ⭍⥲ྜデ⒪⛉㻌 ෸ᩍᤵ㻕㻌㻌㻌㻌㻢䠊㻝㻡㻦㻞㻜䡚㻝㻡㻦㻟㻜㻌 䝣䝻䜰䛸䛾ウㄽ㻌㻌㻝㻡䠖㻟㻜䡚㻝㻡䠖㻠㻜㻌 ఇ᠁㻌㻌㻌㻝㻡㻦㻠㻜䡚㻝㻣㻦㻜㻡㻌䝫䝇䝍䞊Ⓨ⾲㻌

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㻝㻢ྕ㤋㻟䠢⮫ᗋㅮᇽ㻌㻌ᗙ㛗㻌 Ọᯇ㻌 ᾈ䠄஑ᕞṑ⛉኱Ꮫ㻕㻌㻌䝫䝇䝍䞊䝉䝑䝅䝵䞁㻝㻌

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㻼䇲㻝㻌 㻝㻡㻠㻜㻌㻌 㻌㻌᪥ᮏṑ⛉኱Ꮫ᪂₲⑓㝔䛻䛚䛡䜛ゼၥṑ⛉デ⒪ᐇ⩦䛾䜹䝸䜻䝳䝷䝮㻌䕿㭯㇂㻌 ⥤Ꮚ㻝㻘㻞㻘㻟㻕䠈ྜྷᒸ㻌 ⿱㞝㻝㻘㻞㻕䠈ᖹ㻌 ㈼ஂ㻝㻘㻞㻕䠈ୖ⏣㻌 ₶㻝㻘㻠㻕䠈㧗ᶫ㻌 㟹அ㻝㻘㻟㻕䠈㻌㻌 㻌㻌ⓑ㔝㻌 ⨾࿴㻝㻘㻞㻕䠈ᚋ⸨㻌 ᇶ㄃㻝㻘㻞㻕䠈ᑠᯘ㻌 ⱥ୕㑻㻝㻘㻠㻕䠈ᾏ⪁ཎ㻌 㝯㻞㻕䠈⸨஭㻌 ୍⥔㻟㻕䠈㻌㻌 㻌㻌㯮ᕝ㻌 ⿱⮧㻝㻕㻌㻞㻕䠈ᒣཱྀ㻌 ᫭㻠㻕䠈㛵ᮏ㻌 ᜏኵ㻡㻕䠈୰ཎ㻌 Ἠ㻢㻕㻌㻌㻌᪥ᮏṑ⛉኱Ꮫ᪂₲⑓㝔㻌 ᅾᏯṑ⛉ デ䜿䜰䝏䞊䝮㻝㻕䠈㻌㻌㻌᪥ᮏṑ⛉኱Ꮫ᪂₲⑓㝔㻌 ⥲ྜデ⒪⛉㻞㻕䠈㻌㻌㻌᪥ᮏṑ⛉኱Ꮫ᪂₲⑓㝔㻌 ṑ⛉㯞㓉䞉඲㌟⟶⌮⛉㻟㻕䠈㻌㻌㻌᪥ᮏṑ⛉኱Ꮫ᪂₲⑓㝔㻌 ཱྀ⭍እ⛉㻠㻕䠈㻌㻌㻌᪥ᮏṑ⛉኱Ꮫ᪂₲⏕࿨ṑᏛ㒊㻌 ᑠඣṑ⛉Ꮫㅮᗙ㻡㻕䠈᪥ᮏṑ⛉኱Ꮫ㻢㻕㻌㻌

―9―㻼㻙㻞㻌 㻝㻡㻠㻡㻌㻌㻌䕿ẚ␃㛫ᬒᏊ㻝㻘㻞㻕㻘኱ᮌ⤮⨾㻞㻕㻘ᑠୖᑦஓ㻞㻕㻘㡢⍆῟୍㻝㻘㻞㻕㻘⸨஭೺⏨㻞㻕㻌㻌ᯇᮏṑ⛉኱Ꮫ⑓㝔⥲ྜデ⒪⛉㻝㻕㻘ᯇᮏṑ⛉኱Ꮫ⑓㝔⥲ྜデ⒪ᐊ㻞㻕㻌㻌ᯇᮏṑ⛉኱Ꮫ⑓㝔༢⊂ᆺ⮫ᗋ◊ಟ䛾༙ᖺ⤒㐣ሗ࿌㻌㻌㻼㻙㻟㻌 㻝㻡㻡㻜㻌㻌 㻌㻌ᘧ᰿ᓥ䛻䛚䛡䜛ṑ⛉་ᖌ⮫ᗋ◊ಟ䛾⤒㦂㻌䕿┾⏣㻌 ῟ኴ㑻㻝㻕䠈ఀ⸨㻌 ᑑ඾㻝㻕䠈ᕝᮏ㻌 ㄹ㻞㻕䠈ᮧᒣ㻌 Ⰻ௓㻞㻕䠈㰺⸨㻌 㑥Ꮚ㻟㻕䠈㻌㻌 㻌㻌㛵㻌 ၨ௓㻟㻕䠈➉ෆ㻌 ⩏┿㻟㻕䠈ྂᆅ㻌 ⨾ె㻟㻕㻘㻌 ⣬ᮏ㻌 ⠜㻟㻕㻌 㻌㻌 㻌㻌᪥ᮏ኱ᏛṑᏛ㒊௜ᒓṑ⛉⑓㝔⥲ྜデ⒪⛉㻝㻕㻌 䠈㻌㻌 㻌㻌᪥ᮏ኱ᏛṑᏛ㒊ಖᏑᏛᩍᐊṑ⛉ಖᏑᏛ➨㻝ㅮᗙ㻞㻕䠈㻌㻌 㻌㻌᪥ᮏ኱ᏛṑᏛ㒊㝃ᒓṑ⛉⑓㝔⣔༞┤ᚋ◊ಟศ㔝㻟㻕㻌㻌㻼㻙㻠㻌 㻝㻡㻡㻡㻌㻌 㻌㻌᪥ᮏṑ⛉኱Ꮫ᪂₲⑓㝔◊ಟṑ⛉་䛾ಖ೺ᡤ◊ಟ䛻䛴䛔䛶㻌䕿⠛ཎ㝯௓㻝㻕䠈኱➉⏤ెᏊ㻝㻕䠈Ṋ஭㻌 ᚭ㻝㻕䠈ෆ἟ⱱᶞ㻝㻕䠈⸨ᒣ཭⣖㻞㻕䠈୰ᮧಇ⨾㻝㻕䠈㻌㻌 㻌㻌బ⸨཭๎㻝㻕䠈Ᏹ㔝Ύ༤㻝㻕㻌㻌㻌᪥ᮏṑ⛉኱Ꮫ᪂₲⑓㝔⥲ྜデ⒪⛉㻝㻕䠈᪂₲ᕷಖ೺ᡤ೺ᗣቑ㐍ㄢ㻞㻕㻌㻌㻼㻙㻡㻌 㻝㻢㻜㻜㻌㻌㻌◊ಟṑ⛉་䛸ᣦᑟṑ⛉་䛾⌮᝿䛸䛩䜛◊ಟ་ീ䛾┦㐪㻌䕿୰ᓥ⣖୍㑻㻝㻕㻘ྂᕝ࿘ᖹ㻝㻕㻘໭ᮧඃዉ㻝㻕㻘㤿ΏᫍⰋ㻝㻕㻘Ἑ㔝༤ྐ㻝㻕㻘㻌㻌㻌ᒾୗὒ୍ᮁ㻞㻕㻘⏣ཱྀ๎ᏹ㻝㻘㻞㻕㻌㻌㻌㮵ඣᓥ኱Ꮫ་Ꮫ㒊䞉ṑᏛ㒊㝃ᒓ⑓㝔㻌 ṑ⛉⥲ྜデ⒪㒊㻝㻕㻌㻌㻌㮵ඣᓥ኱Ꮫ኱Ꮫ㝔་ṑᏛ⥲ྜ◊✲⛉㻌 ṑ⛉་Ꮫᩍ⫱ᐇ㊶Ꮫศ㔝㻞㻕㻌㻌㻼㻙㻢㻌 㻝㻢㻜㻡㻌᫛࿴኱Ꮫṑ⛉⑓㝔⥲ྜデ⒪ṑ⛉䛻䛚䛡䜛䝕䞊䝍䛾ά⏝㻌㻌㻌䠉◊ಟṑ⛉་䛾⑕౛ሗ࿌䛛䜙䠉㻌㻌㻌㻌䕿㫽ᒃ㻌 㯞⳯㻘຾㒊㻌 ┤ே㻘㛗㇂ᕝ㻌 ⠜ྖ㻌㻌᫛࿴኱ᏛṑᏛ㒊㻌 ṑ⛉ಖᏑᏛㅮᗙ㻌 ⥲ྜデ⒪ṑ⛉Ꮫ㒊㛛㻌㻌䝫䝇䝍䞊䝉䝑䝅䝵䞁㻞㻌
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ᗙ㛗㻌 ㎮ᕭ㻌 ᾈ㝯䠄኱㜰ṑ⛉኱Ꮫ㻕㻌㻼㻙㻣㻌 㻝㻢㻝㻜㻌㻌㻌㮵ඣᓥ኱ᏛᏛ⏕ṑ⛉᳨デ䛻䛚䛡䜛Ꮫ⏕ᑐ㇟䜰䞁䜿䞊䝖⤖ᯝ㻌䕿ᯇᮏ♸Ꮚ㻝㻕䠈ྜྷ⏣♩Ꮚ㻝㻕䠈ㄶゼ⣲Ꮚ㻝㻕䠈ᚿ㔝ஂ⨾Ꮚ㻝㻕䠈Ἑ㔝༤ྐ㻝㻕䠈ᒾୗὒ୍ᮁ㻞㻕䠈㻌㻌㻌⏣ཱྀ๎ᏹ㻝㻘㻞㻕㻌㻌㻌㮵ඣᓥ኱Ꮫ་Ꮫ㒊䞉ṑᏛ㒊㝃ᒓ⑓㝔㻌 ṑ⛉⥲ྜデ⒪㒊㻝㻕䠈㻌㻌㻌㮵ඣᓥ኱Ꮫ኱Ꮫ㝔་ṑᏛ⥲ྜ◊✲⛉㻌 ṑ⛉་Ꮫᩍ⫱ᐇ㊶Ꮫศ㔝㻞㻕㻌㻌㻼㻙㻤㻌 㻝㻢㻝㻡㻌㻌㻌᪥ᮏṑ⛉኱Ꮫ㝃ᒓ⑓㝔⥲ྜデ⒪⛉䛾⌧ᅾ㻌䖣ⲡ㛫༤ᩥ㻝㻕䠈ᶓ⃝㻌 ⱱ㻝㻕䠈▼⏣㕲ග㻝㻕䠈▼஭㝯㈨㻝㻕䠈ᑠᕝᬛஂ㻝㻕䠈኱⃝㖟Ꮚ㻝㻕䠈㻌㻌㻌௰㇂㻌 ᐶ㻝㻕䠈ᒸ⏣ᬛ㞝㻝㻕䠈୕௦෤ᙪ㻝㻕䠈⩚ᮧ㻌 ❶㻞㻕㻌㻌㻌᪥ᮏṑ⛉኱Ꮫ㝃ᒓ⑓㝔㻝㻕䠈᪥ᮏṑ⛉኱Ꮫ⏕࿨ṑᏛ㒊㻞㻕㻌

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㻼㻙㻥㻌 㻝㻢㻞㻜㻌㐺ษ䛺䜲䞁䝣䜷䞊䝮䝗䝁䞁䝉䞁䝖䛻䜘䛳䛶䝰䝏䝧䞊䝅䝵䞁䛜ྥୖ䛧䛯ᝈ⪅䛾⤒㦂㻌㻌㻌䕿ᅧศ༤Ꮚ㻝㻕㻘㻌 ዠᮧᬸ᪦㻞㻕㻘୰ᓥ㈗Ꮚ㻞㻕㻘▼ᓮ⿱Ꮚ㻞㻕㻘ఀ⸨ᬕỤ㻞㻕㻘⸨஭つᏕ㻞㻕㻌㻌㻌᪂₲኱Ꮫ་ṑᏛ⥲ྜ⑓㝔㻌 ◊ಟṑ⛉་㻝㻕㻘㻌 㻌㻌㻌᪂₲኱Ꮫ་ṑᏛ⥲ྜ⑓㝔ṑ⛉⥲ྜデ⒪㒊㻞㻕㻌㻌㻼㻙㻝㻜㻌 㻝㻢㻞㻡㻌
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㻼㻙㻝㻝㻌 㻝㻢㻟㻜㻌㻌 㻌㻌デ᩿䛻ⱞ៖䛧䛯⯉⭘⒆䛾㻝౛㻌䕿㭯㇂㻌 ࿴᫂㻌㻘㻌㻌䠈౫⏣㻌 ⱥಇ㻌㻌䠈ᒸᮏ㻌 ♸㻌㻌䠈஧ᐑ㻌 ୍ᬛ㻌㻌䠈Ṋ⏣㻌 ᖾᙪ㻌㻌䠈Ᏹ㔝㻌 Ύ༤㻌㻌㻌᪂₲┴❧୰ኸ⑓㝔ṑ⛉ཱྀ⭍እ⛉㻌㻌䠈᪥ᮏṑ⛉኱Ꮫ᪂₲⑓㝔㻌 ⥲ྜデ⒪⛉㻌㻌㻌ୖ၁䛻⏕䛨䛯ᑠၚᾮ⭢ၚ▼⑕䛾୍౛㻌䕿㛵㞝௓㻞㻕㻘ᑠ⏣ษṇ⥘㻞㻕㻘ᑠෆ䛥䛟䜙㻞㻕㻘ᐑஂಖ䛒䜔Ꮚ㻝㻕㻘ᯇ஭ᗉᖹ㻝㻕㻘Ἀளభ⨾㻝㻕㻘㻌㻌㻌㻌ྜྷ⏣♸Ꮚ㻝㻕㻘ᑠᯘⱸ฼ዉ㻝㻕㻘㟷ᒣ៞ኴ㻝㻕㻘㏆⸨ᆂ♸㻝㻕㻘Ọᑿᗣ㻝㻕㻘䝬䜲䝲䞊䝇୕ᜨ㻝㻕㻘㻌㻌 㻌㻌㛗㇂ᕝ⠜ྖ㻞㻕㻘୸ᒸ㟹ྐ㻝㻕㻌㻌㻌᫛࿴኱ᏛṑᏛ㒊䝇䝨䝅䝱䝹䝙䞊䝈ཱྀ⭍་Ꮫㅮᗙᆅᇦ㐃ᦠṑ⛉Ꮫ㒊㛛㻝㻕䠈㻌㻌㻌᫛࿴኱ᏛṑᏛ㒊ṑ⛉ಖᏑᏛㅮᗙ⥲ྜデ⒪ṑ⛉Ꮫ㒊㛛㻞㻕㻘㻌㻌㻼㻙㻝㻞㻌 㻝㻢㻟㻡㻌ṑ⫗⦕ୗ㱘⼃䜢᭷䛩䜛ᑠ⮻ṑ䛻ᑐ䛧䛶▹ṇⓗ᣿ฟฎ⨨䜢㻌㻌㻌⾜䛳䛯୍⑕౛㻌㻌㻌㻌䚽⚟஭⿱Ꮚ㻝㻕㻘㻌 ෠ᕝ࿴ဢ㻞㻕㻘㻌 ᵽཱྀ຾つ㻞㻕㻌㻌஑ᕞ኱Ꮫ⑓㝔㻌 ⮫ᗋ◊ಟ䝉䞁䝍䞊㻝㻕䠈஑ᕞ኱Ꮫ⑓㝔㻌 ཱྀ⭍⥲ྜデ⒪⛉㻞㻕㻌㻌䝫䝇䝍䞊䝉䝑䝅䝵䞁㻟㻌
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ᗙ㛗㻌 ⓑ஭㻌 ⫕䠄ᒸᒣ኱Ꮫ㻕㻌㻼㻙㻝㻟㻌 㻝㻢㻠㻜㻌㻌㻌ከᩘṑḞᦆ⑕౛䛻䛚䛡䜛⩏ṑ䛾Ᏻᐃ䛸ṧᏑṑ䛾ືᦂ䛻㛵䛩䜛⪃ᐹ㻌䚽ஂಖΎ㤶㻝㻕㻘㻌 ⸨஭つᏕ㻞㻕㻘㻌 ୰ᓥ㈗Ꮚ㻞㻕㻘㻌 ▼ᓮ⿱Ꮚ㻞㻕㻌㻘㻌 ఀ⸨ᬕỤ㻞㻕㻘㻌 ዠᮧᬸ᪦㻞㻕㻌 㻌㻌㻌᪂₲኱Ꮫ་ṑᏛ⥲ྜ⑓㝔㻌 ◊ಟṑ⛉་㻝㻕㻘㻌 㻌㻌㻌᪂₲኱Ꮫ་ṑᏛ⥲ྜ⑓㝔ṑ⛉⥲ྜデ⒪㒊㻞㻕㻌㻌㻼㻙㻝㻠㻌 㻝㻢㻠㻡㻌䝏䞊䝮་⒪䛻䜘䜚἞⒪䜢⾜䛳䛯䝡䝇䝣䜷䝇䝣䜷䝛䞊䝖〇๣㛵㐃㻌

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㢡㦵ቯṚ䛾㻝౛㻌䕿⬟ໃ䛺䛴䜏㻞㻕㻘㎷㻌 ῄᜨ㻞㻕㻘Ṋ⸨⏤᲍㻞㻕㻘ᯇ஭ᗉᖹ㻝㻕㻘ᐑஂಖ䛒䜔Ꮚ㻝㻕㻘୕Ꮿ⌮Ꮚ㻝㻕㻘㻌㻌㻌Ἀளభ⨾㻝㻕㻘ᑠᯘⱸ฼ዉ㻝㻕㻘ྜྷ⏣♸Ꮚ㻝㻕㻘㟷ᒣ៞ኴ㻝㻕㻘㏆⸨ᆂ♸㻝㻕㻘Ọᑿᗣ㻝㻕㻘㻌㻌㻌䝬䜲䝲䞊䝇୕ᜨ㻝㻕㻘㛗㇂ᕝ⠜ྖ㻞㻕㻘୸ᒸ㟹ྐ㻝㻕㻌 㻌㻌㻌᫛࿴኱ᏛṑᏛ㒊䝇䝨䝅䝱䝹䝙䞊䝈ཱྀ⭍་Ꮫㅮᗙᆅᇦ㐃ᦠṑ⛉Ꮫ㒊㛛㻝㻕㻌㻌㻌᫛࿴኱ᏛṑᏛ㒊ṑ⛉ಖᏑᏛㅮᗙ⥲ྜデ⒪ṑ⛉Ꮫ㒊㛛㻞㻕㻌㻌㻼㻙㻝㻡㻌 㻝㻢㻡㻜㻌㖋ṑ䛸䛧䛶୙฼䛺ṧᏑṑ䜢ಖᏑ䛧䛯⩏ṑ〇స㻌䕿బ⸨ᆂ♸䠍㻕㻘୰ᓥ㈗Ꮚ䠎㻕㻘▼ᓮ⿱Ꮚ䠎㻕㻘ఀ⸨ᬕỤ䠎㻕㻘ዠᮧᬸ᪦䠎㻕㻘⸨஭つᏕ䠎㻕㻌㻌㻌᪂₲኱Ꮫ་ṑᏛ⥲ྜ⑓㝔㻌 ◊ಟṑ⛉་㻝㻕㻘㻌 㻌㻌㻌᪂₲኱Ꮫ་ṑᏛ⥲ྜ⑓㝔ṑ⛉⥲ྜデ⒪㒊㻞㻕㻌

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―11―

㻼㻙㻝㻢㻌 㻝㻢㻡㻡㻌㻌㻌⥲ྜṑ⛉デ⒪⛉䛻䛚䛡䜛⣽⬊デ䛾ᐇ㊶㻌䕿℩㔝㻌 ᜨ⾰㻝㻘㻞㻕㻘኱㔝㻌 ⣧㻞㻕㻘ᒣ⏣㻌 ࿴ᙪ㻝㻕㻘㇂ཱྀ㻌 ዉኸ㻝㻕㻘ᘅ⸨㻌 ༟㞝㻝㻕㻌㻌㻌⚟ᒸṑ⛉኱Ꮫ⥲ྜṑ⛉Ꮫㅮᗙ⥲ྜṑ⛉Ꮫศ㔝㻝㻕㻘㻌㻌㻌⏕యᵓ㐀Ꮫㅮᗙ⑓ែᵓ㐀Ꮫศ㔝㻞㻕㻌㻌㻼㻙㻝㻣㻌 㻝㻣㻜㻜㻌㻌㻌㻌㻌἞⒪䛻༠ຊⓗ䛷䛺䛔㧗㱋ᝈ⪅䛻ᑐ䛧䛶䝁䝭䝳䝙䜿䞊䝅䝵䞁䜢ᕤኵ䛧㻌ညྜ෌ᵓᡂ䜢క䛖⿵⥛ⓗྲྀ䜚⤌䜏㻌䕿ྜྷ✚㻌 ⮫ኴ㑻㻘຾㒊㻌 ┤ே㻘㛗㇂ᕝ㻌 ⠜ྖ㻌㻌᫛࿴኱ᏛṑᏛ㒊㻌 ṑ⛉ಖᏑᏛㅮᗙ㻌 ⥲ྜデ⒪ṑ⛉Ꮫ㒊㛛㻌㻌㻌䝫䝇䝍䞊䝉䝑䝅䝵䞁㻠㻌
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ཱྀ⭍୙ᐃឋッᝈ⪅䛻ᑐ䛩䜛ṑ⛉ⓗᑐᛂ㻌㻼㻙㻝㻤㻌 㻝㻡㻠㻜㻌
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ᗙ㛗㻌 㛵㻌 ၨ௓䠄᪥ᮏ኱Ꮫ㻕㻌㻌䕿ᒾぢỤ฼⳹㻘㎮ᕭᾈ㝯㻘ᑠฟ㻌 Ṋ㻘ᯇᮏ᫭୍㻘⡿㇂⿱அ㻘㎷㻌 ୍㉳Ꮚ㻘⡿⏣㻌 ㆤ㻘㻌㻌኱す᫂㞝㻘ᵽཱྀᜤᏊ㻘୰஭ᬛຍ㻘⛳⏣ල⨾㻌㻌኱㜰ṑ⛉኱Ꮫ㻌 ⥲ྜデ⒪䞉デ᩿⛉㻌㻌㻼㻙㻝㻥㻌 㻝㻡㻠㻡㻌
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ṑิ୙ṇ䜢క䛖୰➼ᗘṑ࿘⅖䜢᭷䛩䜛ᝈ⪅䛻ᑐ䛩䜛ᡓ␎ⓗᢤṑ䛸㻌⿵⥛἞⒪䛻䜘䜛ྲྀ䜚⤌䜏㻌䕿ὸぢ㻌 ᣅဢ㻘຾㒊㻌 ┤ே㻘㛗㇂ᕝ㻌 ⠜ྖ㻌㻌᫛࿴኱ᏛṑᏛ㒊㻌 ṑ⛉ಖᏑᏛㅮᗙ㻌 ⥲ྜデ⒪ṑ⛉Ꮫ㒊㛛㻌㻌㻼㻙㻞㻜㻌 㻝㻡㻡㻜㻌㻌㻌⩏ṑ⿦╔䛷䛾㢦ㇺᨵၿ䛻䜘䜛ᝈ⪅䛾㻽㻻㻸䛾ྥୖ㻌䕿ኴ⏣ளᕼ㻝㻘㻞㻕㻘᱓ᒣ㤶⧊㻞䠅㻘㕥ᮌᗣྖ㻞䠅㻘Ἑ㔝㝯ᖾ㻞䠅㻘ⓑ஭㻌 ⫕㻞䠅㻘㫽஭ᗣᘯ㻞䠅㻌㻌ᒸᒣ኱Ꮫ⑓㝔䝺䝆䝕䞁䝖㻝㻕㻘ᒸᒣ኱Ꮫ⥲ྜṑ⛉㻞㻕㻌㻌㻌㻼㻙㻞㻝㻌 㻝㻡㻡㻡㻌㻌㻌㻌㐣ປ䜢క䛖៏ᛶṑ࿘⑓ᝈ⪅䛻ᑐ䛧䛶ໟᣓⓗ䛻䜰䝥䝻䞊䝏䛧䛯㻝౛㻌䕿ྜྷ┤㻌 ኱భ㻘㻌 ఀబὠ㻌 ඞᙪ㻘㻌 㛗㇂ᕝ㻌 ⠜ྖ㻌㻌᫛࿴኱ᏛṑᏛ㒊㻌 ṑ⛉ಖᏑᏛㅮᗙ㻌 ⥲ྜデ⒪ṑ⛉Ꮫ㒊㛛㻌㻌㻼㻙㻞㻞㻌 㻝㻢㻜㻜㻌䝷䜲䝣䜲䝧䞁䝖䜢ᶵ䛻䜰䝗䝠䜰䝷䞁䝇䜢ྥୖ䛥䛫䛶ṑ࿘἞⒪䜢㻌㻌㻌⾜䛳䛶䛔䜛⑕౛㻌㻌㻌㻌䚽ᘅ℩຾ಇ㻌㻌䠈෠ᕝ࿴ဢ㻌㻌䠈ὠ⏣⦆Ꮚ㻌㻌䠈ᵽཱྀ຾つ㻌㻌㻌㻌஑ᕞ኱Ꮫ⑓㝔㻌 ⮫ᗋᩍ⫱䝉䞁䝍䞊㻌㻌䠈஑ᕞ኱Ꮫ⑓㝔㻌 ཱྀ⭍⥲ྜデ⒪⛉㻌㻌㻌㻌㻼㻙㻞㻟㻌 㻝㻢㻜㻡㻌἞⒪䛾㑅ᢥ⫥䛾⮬ᕫỴᐃ䛻⣡ᚓฟ᮶䛺䛛䛳䛯ᝈ⪅䛻ᑐ䛧䛶㻌

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䝘䝷䝔䜱䝤䜢⪃៖䛧䛯᥼ຓ䜢ヨ䜏䛯⑕౛㻌䕿ᯈᐙᮁ㻘㻌 ⏣୰᐀㻘㻌 ᮌᑿဴᮁ㻌㻌㻌஑ᕞṑ⛉኱Ꮫ㻌 ⥲ྜデ⒪Ꮫศ㔝㻌㻌䝫䝇䝍䞊䝉䝑䝅䝵䞁㻡㻌
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ᗙ㛗㻌 ከ⏣㻌 ඘⿱䠄᪥ᮏ኱Ꮫᯇᡞ㻕㻌㻼㻙㻞㻠㻌 㻝㻢㻝㻜㻌㻌㻌἞⒪⏝⩏ṑ䜢⏝䛔䛶㢡఩䛾ಟṇ䜢ヨ䜏䛯୍⑕౛㻌䕿Ḉ஭▱ᕫ㻝㻕㻘▼ᓮ⿱Ꮚ㻞㻕㻘୰ᓥ㈗Ꮚ㻞㻕㻘ఀ⸨ᬕỤ㻞㻕㻘ዠᮧᬸ᪦㻞㻕㻘⸨஭つᏕ㻞㻕㻌㻌㻌᪂₲኱Ꮫ་ṑᏛ⥲ྜ⑓㝔㻌 ◊ಟṑ⛉་㻝㻕㻘㻌 㻌㻌㻌᪂₲኱Ꮫ་ṑᏛ⥲ྜ⑓㝔ṑ⛉⥲ྜデ⒪㒊㻞㻕㻌㻌㻼㻙㻞㻡㻌 㻝㻢㻝㻡㻌㔜ᗘᗈỗᆺ៏ᛶṑ࿘⅖ᝈ⪅䛾ṑ࿘἞⒪䛻⣽⳦᳨ᰝ䜢⏝䛔䛯୍⑕౛㻌㻌 㻌㻌䕿℩㔝ᩥ㻝㻕㻘㻌 ᒣ⏣࿴ᙪ㻞㻕㻘㻌 ℩㔝ᜨ⾰㻞㻕㻚㻌 ㇂ཱྀዉኸ㻞㻕㻘㻌 ఀἼᖾస㻞㻕㻘㻌 ᱝᑿ㝧௓㻞㻕㻘㻌㻌 㻌㻌⡿⏣㞞⿱㻟㻕㻘ᘅ⸨༟㞝㻞㻕㻌 㻌㻌㻌⚟ᒸ་⒪▷ᮇ኱Ꮫᑓᨷ⛉䠍䠅㻌 ⚟ᒸṑ⛉኱Ꮫ⥲ྜṑ⛉Ꮫㅮᗙ⥲ྜṑ⛉Ꮫศ㔝㻞㻕㻌 㻌㻌㻌⚟ᒸṑ⛉኱Ꮫཱྀ⭍་⒪䝉䞁䝍䞊䠏䠅㻌㻌㻼㻙㻞㻢㻌 㻝㻢㻞㻜㻌㻌㻌㻼㻻㻿䜢ᇶ┙䛸䛧䛯ᗈỗᆺ㔜ᗘṑ࿘⅖䛾デ᩿䛸἞⒪ィ⏬㻌䚽ྂᕷ㻌 㝯㻝㻌㻕㻘㛵㻌 ၨ௓㻞㻌㻕䠈㰻⸨㑥Ꮚ㻞㻕䠈➉ෆ⩏┿㻞㻕䠈ྂᆅ⨾ె㻞㻕䠈⣬ᮏ㻌 ⠜㻞㻕㻌㻌㻌᪥ᮏ኱ᏛṑᏛ㒊௜ᒓṑ⛉⑓㝔⥲ྜデ⒪⛉㻝㻌㻕䠈㻌 㻌㻌㻌᪥ᮏ኱ᏛṑᏛ㒊㝃ᒓṑ⛉⑓㝔⣔༞┤ᚋ◊ಟศ㔝㻞㻌㻕㻌㻌㻼㻙㻞㻣㻌 㻝㻢㻞㻡㻌㻌㻌㻌ညྜ㧗⤒䛾ቑຍ䛻క䛖ညྜᨭᣢ䛸䜰䞁䝔䝸䜰䝹䜺䜲䝎䞁䝇䛾෌ᵓᡂ䜢㻌㻌㻌ᅗ䛳䛯㻝⑕౛㻌䕿ᐅ㔝ᗙ㻌 ⧊ᜨ㻘ụ⏣㻌 ள⣖Ꮚ㻘㛗㇂ᕝ㻌 ⠜ྖ㻌㻌᫛࿴኱ᏛṑᏛ㒊㻌 ṑ⛉ಖᏑᏛㅮᗙ㻌 ⥲ྜデ⒪ṑ⛉Ꮫ㒊㛛㻌㻌㻼㻙㻞㻤㻌 㻝㻢㻟㻜㻌㻌㻌䕿⚟⏣ె⧊㻝㻕䠈ᡞᮌ㻌 ᪂㻝㻕䠈⸨ཎ㻌 ༓ᬗ㻝㻕䠈ྂᆅ⨾ె㻞㻕䠈➉ෆ⩏┿㻞㻕䠈㰻⸨㑥Ꮚ㻞㻕䠈㻌㻌㻌㛵㻌 ၨ௓㻞㻕䠈⣬ᮏ㻌 ⠜㻞㻕㻌㻌㻌᪥ᮏ኱ᏛṑᏛ㒊௜ᒓṑ⛉⑓㝔㻝㻕䠈㻌㻌㻌᪥ᮏ኱ᏛṑᏛ㒊㝃ᒓṑ⛉⑓㝔⣔༞┤ᚋ◊ಟศ㔝㻞㻕㻌ᨭྎ⠏㐀䛛䜙䜽䝷䜴䞁⿦╔䜎䛷䛾඲䛶䛾⮫ᗋ䛚䜘䜃ᢏᕤ᧯స㻌㻌䝫䝇䝍䞊䝉䝑䝅䝵䞁㻢㻌

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ᗙ㛗㻌 ゅ⏣㻌 ᫭䠄⚄ዉᕝṑ⛉኱Ꮫ㻕㻌㻼㻙㻞㻥㻌 㻝㻢㻟㻡㻌㻌㻌㻌㻌ᝈ⪅୰ᚰ䛾་⒪䜢ᐇ㊶䛩䜛Ⅽ䛻ᝈ⪅䛾ゎ㔘䝰䝕䝹䜢ᘬ䛝䛰䛩䛣䛸䜢┠ⓗ㻌䛸䛧䛯䝒䞊䝹䜢౑⏝䛧䛯⑕౛㻌䕿ᒣᙧ㻌 ࿴ᘯ㻝㻕㻘ὸぢ㻌 ᣅဢ㻝㻕㻘⚄㈡㻌 ⫕Ꮚ㻞㻕㻘᱓㏕㻌 ⩧Ꮚ㻞㻕㻘຾㒊┤ே㻝㻕㻘㻌㻌㻌㛗㇂ᕝ㻌 ⠜ྖ㻝㻕㻌㻌㻌᫛࿴኱ᏛṑᏛ㒊㻌 ṑ⛉ಖᏑᏛㅮᗙ㻌 ⥲ྜデ⒪ṑ⛉Ꮫ㒊㛛㻝㻕㻌 㻌㻌㻌᫛࿴኱ᏛṑᏛ㒊㻌 Ꮫ⏕㻞㻕㻌㻌㻼㻙㻟㻜㻌 㻝㻢㻠㻜㻌㻌㻌᫛࿴኱Ꮫṑ⛉⑓㝔⥲ྜデ⒪ṑ⛉䛻䛚䛡䜛⮫ᗋᐇ⩦㻌䠉୰➼ᗘṑ࿘⅖ᝈ⪅䛻ᑐ䛩䜛඲ேⓗ䛺䝸䝇䜽ホ౯䛻䜘䜛⥲ྜデ⒪ィ⏬❧᱌䠉㻌㻌㻌䕿⃝㇂㻌 ♸኱㻝㻕㻘㰻⸨㻌 ၏㻝㻕㻘ᒣᙧ㻌 ࿴ᘯ㻞㻕㻘຾㒊㻌 ┤ே㻞㻕㻘㛗㇂ᕝ㻌 ⠜ྖ㻞㻕㻌㻌㻌᫛࿴኱ᏛṑᏛ㒊㻌 Ꮫ⏕㻝㻕㻌 㻌㻌㻌᫛࿴኱ᏛṑᏛ㒊㻌 ṑ⛉ಖᏑᏛㅮᗙ㻌 ⥲ྜデ⒪ṑ⛉Ꮫ㒊㛛㻞㻕㻌

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㻼㻙㻟㻝㻌 㻝㻢㻠㻡㻌 㻌㻌་⒪㠃᥋䛻䛚䛔䛶ᛴᛶᬛṑ࿘ᅖ⅖䛸デ᩿䛩䜛䛯䜑䛻᭷ຠ䛺ゝㄒ᝟ሗ䛻䛴䛔䛶㻌䕿ఀ⸨Ꮥဢ㻝㻕䠈㨣ሯ༓⤮㻞㻕䠈㫽㉺㙾௦㻝㻕䠈⏕⏣᭷ᶞᏊ㻝㻕䠈Ọᯇᾈ㻞㻕䠈ᮌᑿဴᮁ㻞㻕㻌㻌㻌஑ᕞṑ⛉኱Ꮫ㻌 ṑᏛ㒊㻌 ṑᏛ⛉㻌 㻡ᖺ⏕㻝㻕㻘㻌㻌㻌஑ᕞṑ⛉኱Ꮫ㻌 ⥲ྜデ᩿Ꮫศ㔝㻞㻕㻌㻌㻼㻙㻟㻞㻌 㻝㻢㻡㻜㻌㻌㻌㻌㻌᫛࿴኱Ꮫṑ⛉⑓㝔⥲ྜデ⒪ṑ⛉䛻䛚䛡䜛⮫ᗋᐇ⩦㻌䠉䜶䝡䝕䞁䝇䛻ᇶ䛵䛟἞⒪ィ⏬❧᱌䠉㻌䕿㨣୸⨾⳯Ꮚ㻝㻕㻘➟ཎ⏤㤶㻝㻕㻘ྜྷ✚⮫ኴ㑻㻞㻕㻘຾㒊㻌 ┤ே㻞㻕㻘㛗㇂ᕝ㻌 ⠜ྖ㻞㻕㻌㻌㻌᫛࿴኱ᏛṑᏛ㒊㻌 Ꮫ⏕㻝㻕㻌 㻌㻌㻌᫛࿴኱ᏛṑᏛ㒊㻌 ṑ⛉ಖᏑᏛㅮᗙ㻌 ⥲ྜデ⒪ṑ⛉Ꮫ㒊㛛㻞㻕㻌㻌㻼㻙㻟㻟㻌 㻝㻢㻡㻡㻌㻌㻌㻌㻌་⒪㠃᥋䛻䛚䛡䜛㠀ゝㄒ䝁䝭䝳䝙䜿䞊䝅䝵䞁䛾ᙺ๭㻌䠉䛂䛖䛺䛪䛝䛃䛸䛂㛫䛃䛻䛴䛔䛶䠉㻌䕿㫽㉺㙾௦㻝㻕䠈⏕⏣᭷ᶞᏊ㻝㻕䠈㨣ሯ༓⤮㻞㻕䠈ఀ⸨Ꮥဢ㻝㻕䠈Ọᯇᾈ㻞㻕䠈ᮌᑿဴᮁ㻞㻕㻌㻌஑ᕞṑ⛉኱Ꮫ㻌 ṑᏛ㒊㻌 ṑᏛ⛉㻌 㻡ᖺ⏕㻝㻕㻘஑ᕞṑ⛉኱Ꮫ㻌 ⥲ྜデ᩿Ꮫศ㔝㻞㻕㻌㻌㻝㻣㻦㻟㻜䡚㻌 㻌Ꮫ఍タ❧⚃㈡఍㻌 ཷ௜㛤ጞ㻌 㻌㻌㻝㻤㻦㻟㻜䡚㻞㻜㻦㻟㻜㻌Ꮫ఍タ❧⚃㈡఍㻌 㻌㻌ධ㝔Ჷ㻝㻣䠢䝍䝽䞊䝺䝇䝖䝷䞁᫛࿴㻌㻌㻌㻌➨㻞᪥┠㻌 㻝㻝᭶㻝㻣᪥䠄᪥㻕㻌㻌㻤㻦㻟㻜䡚㻌 㻌㻌ཷ௜㛤ጞ㻌㻥㻦㻜㻜䡚㻝㻝㻦㻝㻜㻌

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㻌㻌䝉䝑䝅䝵䞁䠏䠄㻥㻦㻜㻜㻌 䡚㻌 㻥㻦㻠㻜㻕㻌 㻌
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㻻㻙㻣㻌 㻜㻥㻜㻜㻌
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㻝㻢ྕ㤋㻞䠢⮫ᗋㅮᇽ㻌㻌ᗙ㛗㻌 ⣬ᮏ㻌 ⠜䠄᪥ᮏ኱Ꮫ㻕㻌Ᏻ඲䛺䜶䞁䝗䛾୕ゅ㝖ཤ⏝䝗䝸䝹䛾㛤Ⓨ䛸౑⏝ୖ䛾ᕤኵ㻌䕿ᑠཎ㻌 ຾㻝㻘㻞㻕䠈኱ᯘὈ஧㻝㻕䠈す㻌 ⿱⨾㻝㻕䠈⏣୰Ⰻ἞㻝㻕䠈᪥㔝Ꮥ᐀㻞㻕䠈ᑠᕝဴḟ㻝㻕㻌ᗈᓥ኱Ꮫ⑓㝔㻌 ཱྀ⭍⥲ྜデ⒪⛉㻝㻕䠈ᗈᓥ኱Ꮫ⑓㝔㻌 ṑ⛉デ⒪ᡤ㻞㻕㻌㻌㻻㻙㻤㻌 㻜㻥㻝㻜㻌㻌 㻌㻌኱㜰ṑ⛉኱Ꮫ⮫ᗋ◊ಟᩍ⫱⛉䛻䛚䛡䜛ṑ⛉⏝䝁䞊䞁䝡䞊䝮㻯㼀䛾฼⏝≧ἣ㻌䕿⳥ụඃᏊ㻝㻕䠈୰ᓥ᭷ెᏊ㻞㻕䠈ᅄ஭㈨㝯㻞㻕䠈໭㔝ᛅ๎㻝㻕䠈኱஭἞ṇ㻝㻕䠈ᑠᕝᩥஓ㻝㻕䠈㻌㻌㻌㻌⤃஭ᣑ㝯㻝㻕䠈ΎỈ㇂බᡂ㻞㻕䠈๓⏣↷ኴ㻝㻕㻌㻌㻌኱㜰ṑ⛉኱Ꮫ㻌 ⮫ᗋ◊ಟᩍ⫱⛉㻝㻕䠈኱㜰ṑ⛉኱Ꮫ㻌 ṑ⛉ᨺᑕ⥺Ꮫㅮᗙ㻞㻕㻌㻌㻻㻙㻥㻌 㻜㻥㻞㻜㻌㻌 㻌㻌ṑෆ἞⒪䛻䛚䛡䜛ṑ⛉⏝䝁䞊䞁䝡䞊䝮㻯㼀䛾฼⏝㻌䕿୰ᓥ᭷ెᏊ㻞㻕䠈⳥ụඃᏊ㻝㻕䠈ᅄ஭㈨㝯㻞㻕䠈໭㔝ᛅ๎㻝㻕䠈኱஭἞ṇ㻝㻕䠈㻌㻌 㻌㻌ᑠᕝᩥஓ㻝㻕䠈⤃஭ᣑ㝯㻝㻕䠈ΎỈ㇂බᡂ㻞㻕䠈๓⏣↷ኴ㻝㻕㻌㻌㻌኱㜰ṑ⛉኱Ꮫ㻌 ⮫ᗋ◊ಟᩍ⫱⛉㻝㻕䠈኱㜰ṑ⛉኱Ꮫ㻌 ṑ⛉ᨺᑕ⥺Ꮫㅮᗙ㻞㻕㻌

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㻻㻙㻝㻜㻌 㻜㻥㻟㻜㻌㻌 㻌㻌ႍᜥᝈ⪅䛾ṑ⛉デ⒪䛻䛚䛡䜛ὀពⅬ㻌㻌 㻌㻌⏣ᓥ䛛䛚䜚㻝㻕㻘῝℩ಟ୍㻝㻕㻘㻌 ⯪ὠኴ୍㑻㻝㻕㻘᪥㧗ீᙪ㻝㻕㻘ᒣཱྀ༤ᗣ㻝㻕㻘ᒣᮏⱥ㞝㻝㻕㻘ᒣᮏ⏤⨾Ꮚ㻟㻕㻘㻌㻌 㻌㻌Ꮚᓥ₶㻝㻕㻘ᑠᯘ㤾㻟㻕㻌㻌㻌㭯ぢ኱ᏛṑᏛ㒊⥲ྜṑ⛉㻞㻌㻝㻕㻌 㭯ぢ኱ᏛṑᏛ㒊ෆ⛉Ꮫㅮᗙ㻞㻕㻌㻌㻌㭯ぢ኱ᏛṑᏛ㒊ཱྀ⭍㢡㢦㠃ᨺᑕ⥺䞉⏬ീデ᩿Ꮫㅮᗙ㻟㻕㻌䚽ᮡᮏዉኸ㻝㻕㻘୹⃝ᙬ㻝㻕㻘၈ᮌᡂᏊ㻝㻕㻘Ỉὠ⨾㭯㻝㻕㻘୰ᮧோ⨾㻝㻕㻘㐲⏣ளᏘᏊ㻝㻕㻘㕥ᮌ෪Ἃ㻝㻕㻘㻌㻌㻥䠖㻠㻜䡚㻥䠖㻡㻜㻌 ఇ᠁㻌㻌䝉䝑䝅䝵䞁䠐䠄㻥㻦㻡㻜㻌 䡚㻌 㻝㻜㻦㻟㻜㻕㻌 㻌
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ᗙ㛗㻌 㡢⍆㻌 ῟୍䠄ᯇᮏṑ⛉኱Ꮫ㻕㻌㻻㻙㻝㻝㻌 㻜㻥㻡㻜㻌᪂䛧䛔᪉ᘧ䜢⏝䛔䛯㠀᥋ゐᘧ㻟ḟඖᙧ≧ィ ᶵ䛾㛤Ⓨ㻌㻌㻌䕿኱ᕝᩄỌ㻝㻕䠈Ᏻ㝙㻌 ᫴㻝㻕䠈ᒸ㻌 ㅬḟ㻝㻕䠈㔝ཱྀ┤ே㻞㻕䠈ᮧୖឡ⏤㻝㻕䠈Ἑ㔝ᩥ᫛㻞㻕㻌㻌㻌ᚨᓥ኱Ꮫ⑓㝔⥲ྜṑ⛉デ⒪㒊㻝㻕䠈㻌㻌㻌ᚨᓥ኱Ꮫ኱Ꮫ㝔䝦䝹䝇䝞䜲䜸䝃䜲䜶䞁䝇◊✲㒊⥲ྜデ⒪ṑ⛉Ꮫศ㔝㻞㻕㻌㻌㻌㻻㻙㻝㻞㻌 㻌 㻝㻜㻜㻜㻌㻌㻌ṑ࿘἞⒪䛻㛵㐃䛩䜛䝫䞊䝖䝣䜷䝸䜸䛛䜙ぢ䛯◊ಟṑ⛉་䛾᣺䜚㏉䜚䛻䛴䛔䛶㻌䕿Ἑ㔝㝯ᖾ㻝䠅䠈᱓ᒣ㤶⧊㻝䠅䠈኱ሯᜨ⌮㻝䠅䠈ሷὠ⠊Ꮚ㻝䠅䠈Ṋ⏣ᏹ᫂㻝䠅䠈ኴ⏣ளᕼ㻝䠅䠈㻌㻌㻌ᑠ᮶⏣⨾㤶㻝䠅䠈㕥ᮌᗣྖ㻝䠅䠈ⓑ஭㻌 ⫕㻝䠅䠈ྜྷ⏣ⓏᚿᏊ㻞䠅䠈㫽஭ᗣᘯ㻝䠅㻌㻌㻌ᒸᒣ኱Ꮫ⑓㝔㻌 ⥲ྜṑ⛉㻝䠅㻌㻌㻌ᒸᒣ኱Ꮫ㻌 ་⒪ᩍ⫱⤫ྜ㛤Ⓨ䝉䞁䝍䞊㻔ṑᏛᩍ⫱㒊㛛㻕㻞䠅㻌㻌㻻㻙㻝㻟㻌 㻌 㻝㻜㻝㻜㻌㻌 㻌㻌㻿㼠㼞㼑㼜㼠㼛㼏㼛㼏㼏㼡㼟㻌㼙㼡㼠㼍㼚㼟㻌 䛾⑓ཎᛶ䛻䛚䛡䜛㼟㼏㼞㻭㑇ఏᏊ䛾ᙺ๭㻌㻌 㻌㻌⠛ཎ㻌 ༓ᑜ㻝㻕䠈Ṋᕝ㻌 ᜨ⨾㻡㻕䠈୕Ꮿ㻌 ὒ୍㑻㻠㻕䠈ᯇᑿ㻌 ᩗᚿ㻟㻕䠈Ἑ㔝㻌 ᩥ᫛㻝㻕㻌㻌㻌ᚨᓥ኱Ꮫ኱Ꮫ㝔䝦䝹䝇䝞䜲䜸䝃䜲䜶䞁䝇◊✲㒊⥲ྜデ⒪ṑ⛉Ꮫศ㔝㻝㻕㻌㻌㻌ᚨᓥ኱Ꮫ኱Ꮫ㝔䝦䝹䝇䝞䜲䜸䝃䜲䜶䞁䝇◊✲㒊ཱྀ⭍ಖ೺Ꮫ⛉ཱྀ⭍ಖ೺ᨭ᥼Ꮫㅮᗙ㻞㻕㻌㻌㻌ᚨᓥ኱Ꮫ኱Ꮫ㝔䝦䝹䝇䝞䜲䜸䝃䜲䜶䞁䝇◊✲㒊ṑ⛉ಖᏑᏛศ㔝㻟㻕㻌㻌㻌ᚨᓥ኱Ꮫ኱Ꮫ㝔䝦䝹䝇䝞䜲䜸䝃䜲䜶䞁䝇◊✲㒊ཱྀ⭍ឤᰁ⑕Ꮫศ㔝㻠㻕㻌㻌㻌ᚨᓥ኱Ꮫ኱Ꮫ㝔䝦䝹䝇䝞䜲䜸䝃䜲䜶䞁䝇◊✲㒊⏕యᮦᩱᕤᏛศ㔝㻡㻕㻌䕿ᮌᮧ㻌 ᬛᏊ㻝㻕䠈ᑿᓮ㻌 ࿴⨾㻞㻕䠈‫‮‬ᮏ㻌 ᾈ㏻㻟㻕䠈ᮧୖ㻌 ᆂྐ㻠㻕䠈Ⳣཎ㻌 ༓ᜨᏊ㻝㻕䠈㻌㻌㻻㻙㻝㻠㻌 㻌 㻝㻜㻞㻜㻌㻌㻌ேᕤ⾑⟶⨨᥮䞉ேᕤ㛵⠇ᝈ⪅䛾ṑ⛉デ⒪㻌
䚽ᑠ㔝ி㻘▼ሯᛅᘯ㻘Ᏻಸᗣ἞㻘஭⃝ᆂモ㻘▼ᕝ๛ᝆ㻘⊦Ꮚᬛ༤㻘➟㛫㝯ே㻘㻌㻌㻌ᒸᮏளᕼᏊ㻘㻌 㻌 㔠Ꮚዉኸ㻘బ㈏༓ኟ㻘㔛ᮧᬛ❶㻘⋢ཱྀ㐍୍㻘ᒣᮏⱥ㞝㻘ᒣཱྀ༤ᗣ㻘㻌㻌㻌Ꮚᓥ₶㻝㻕㻘ᒣᮏ⏤⨾Ꮚ㻞㻕㻘ᑠᯘ㤾㻞㻕㻌㻌㻌㭯ぢ኱ᏛṑᏛ㒊⥲ྜṑ⛉㻞㻌㻝㻕㻌 㭯ぢ኱ᏛṑᏛ㒊ෆ⛉Ꮫㅮᗙ㻞㻕㻌㻌㻌㭯ぢ኱ᏛṑᏛ㒊ཱྀ⭍㢡㢦㠃ᨺᑕ⥺䞉⏬ീデ᩿Ꮫㅮᗙ㻌㻌㻝㻜䠖㻟㻜䡚㻝㻜䠖㻠㻜㻌 ఇ᠁㻌―15―䝉䝑䝅䝵䞁䠑䠄㻝㻜㻦㻠㻜㻌 䡚㻌 㻝㻝㻦㻝㻜㻕㻌㻌
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ᗙ㛗㻌 㫽஭㻌 ᗣᘯ䠄ᒸᒣ኱Ꮫ㻕㻌㻻㻙㻝㻡㻌 㻌 㻝㻜㻠㻜㻌䝠䝜䜻䝏䜸䞊䝹㓄ྜ䝆䜵䝹䜢⏝䛔䛯ཱྀ⭍䜿䜰䛾ཱྀ⮯ᨵၿຠᯝ㻌㻌 㻌㻌䕿ఀἼᖾస㻝㻕㻘㻌 㕥ᮌዉኸ㻝㻕㻘㻌 ⡿⏣㞞⿱㻞㻕㻘㻌 ᒣ⏣࿴ᙪ㻝㻕㻘㻌 ᒾඖ▱அ㻝㻕㻘㻌 ᱝᑿ㝧௓㻝㻕㻘㻌 㻌
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⸨ᮏᬡỤ㻝㻕㻘㻌 ℩㔝ᜨ⾰㻝㻕㻘㻌 ᫓ྡ୍ே㻝㻕㻘㻌 Ᏻ㻌 ᛅ኱㻝㻕㻘㻌 ධỤ୹ెᏊ㻝㻕㻘㻌 すཎဴୡ㻝㻕㻘㻌 㻌௰すᏹ௓㻝㻕㻘㻌 ᘅ⸨༟㞝㻝㻕㻌⚟ᒸṑ⛉኱Ꮫ㻌 ⥲ྜṑ⛉Ꮫㅮᗙ㻌 ⥲ྜṑ⛉Ꮫศ㔝㻝㻕㻘㻌⚟ᒸṑ⛉኱Ꮫ㻌 ཱྀ⭍་⒪䝉䞁䝍䞊㻞㻕㻌

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㻻㻙㻝㻢㻌 㻌 㻝㻜㻡㻜㻌㻌㻌ᆅᇦ་⒪䛻䛚䛡䜛⥲ྜṑ⛉デ⒪䛾ᯝ䛯䛩ᙺ๭䛸䛭䛾ሗ࿌㻌䕿ụ⏣ဴ㻝㻘㻞㻕䠈㛗㇂ᕝ⠜ྖ㻝㻕䠈ఀబὠඞᙪ㻝㻕䠈ụ⏣᪼㻞㻕䠈ụ⏣䜎䜚䛣㻞㻕㻌㻌㻌᫛࿴኱Ꮫṑ⛉ಖᏑᏛㅮᗙ⥲ྜデ⒪ṑ⛉㒊㛛㻝㻕䠈㻌㻌㻌་⒪ἲே♫ᅋ㻌 ụ⏣ṑ⛉䜽䝸䝙䝑䜽㻞㻕㻌㻌㻻㻙㻝㻣㻌 㻌 㻝㻝㻜㻜㻌⮫ᗋᐇ⩦䞉⮫ᗋ◊ಟ㐃ᦠ䝻䜾䝤䝑䜽䛾㟁Ꮚ໬㻌 㻌

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➨㻟ሗ㻌 䝕䞊䝍ධຊ䝅䝇䝔䝮䛾ᨵⰋ㻌ẟ฼᭷ᕼᏊ㻝㻕䠈㛗ᓥ㻌 ṇ㻞㻕䠈୕ᾆ἞㑻㻞㻕䠈ᮌୗྍᏊ㻞㻕䠈す⸨୕⣖Ꮚ㻞㻕䠈ஂಖ⨾ᑑ✑㻝㻕䠈㻌㻌㻌኱ᐙ㤶⧊㻝㻕䠈ΎỈ┿ே㻝㻕䠈➉㔜ᩥ㞝㻞㻕䠈ྜྷỌ࿴㞝㻟㻕䠈㇂ᒸṇ⾜㻠㻕䠈⏣୰ᣅ☻㻡㻕䠈㻌㻌㻌୰ᔱ❳୍㻡㻕䠈ᑠᯘᘓኴ㑻㻡㻕㻌㻌㻌኱㜰኱Ꮫ኱Ꮫ㝔ṑᏛ◊✲⛉㻌 ཱྀ⭍⛉Ꮫᑓᨷ䠄ཱྀ⭍⥲ྜデ⒪㒊㻕㻝䠅㻌㻌㻌኱㜰኱ᏛṑᏛ㒊㝃ᒓ⑓㝔ཱྀ⭍⥲ྜデ⒪㒊 㻞㻕㻘㻌 ᰴᘧ఍♫䝰䝸䝍 㻟㻕㻌 㻌㻌㻌ᰴᘧ఍♫䝙䝑䝅䞁Ⴀᴗᮏ㒊䝬䞊䜿䝔䜱䞁䜾㒊ᩍ⫱䝅䝇䝔䝮㛤Ⓨ䜾䝹䞊䝥 㻠㻕㻌 㻌㻌㻌ᰴᘧ఍♫䝕䝆䝍䝹䞉䝘䝺䝑䝆 㻡㻕㻌 㻌㻌㻝㻝䠖㻝㻜䡚㻝㻝䠖㻞㻜㻌 ఇ᠁㻌㻌㻝㻝㻦㻞㻜䡚㻝㻝㻦㻠㻡㻌

⥲఍㻌

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㻝㻢ྕ㤋㻞䠢⮫ᗋㅮᇽ㻌㛢఍ᘧ㻌 㻌㻌㻌㻌㻝㻢ྕ㤋㻞䠢⮫ᗋㅮᇽ㻌㻌㻌㻝㻝㻦㻠㻡䡚㻝㻞㻦㻜㻜㻌
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ⱝᡭඃ⚽Ⓨ⾲⪅⾲ᙲᘧ㻌ḟᮇ኱఍㛗ᣵᣜ㻌 㻌
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㛢఍䛾㎡㻌㻌㻌㻌㻌➨㻣ᅇ᪥ᮏ⥲ྜṑ⛉Ꮫ఍⥲఍䞉Ꮫ⾡኱఍㻌

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኱఍㛗㻌 ➉㔜㻌 ᩥ㞝㻌➨㻢ᅇ᪥ᮏ⥲ྜṑ⛉Ꮫ఍⥲఍䞉Ꮫ⾡኱఍㻌㻌㻌㻌㻌኱఍㛗㻌 㛗㇂ᕝ㻌 ⠜ྖ㻌―16―․೎⻠Ṷ㩷㩷㩷‫ޟ‬ක≮ߦ߅ߌࠆ̌✚ว̍ߩᗧ⟵ߣ⺖㗴‫ޠ‬㩷㩷㩷೨ᴛ㩷 ᡽ᰴ㩷 ฬ⹷ᢎ᝼㩷㩷ᣣᧄ䊒䊤䉟䊙䊥㪄䉬䉝ㅪวቇળ㩷 ฬ⹷ℂ੐㐳㩷㩷ർ ᶏ㆏ᄢ ቇ 㩷 ฬ⹷ᢎ ᝼ 㩷㩷㩷㩷䋱䋮ක≮䉕ᱡ 䉄䈩䈐䈢䊝䊉㩷㩷 䌗䌈䌏䈲 㪈㪐㪎㪏 ᐕឭ⸒䈚䈢䉝䊦䊙䉝䉺ት⸒䉕ᝄ䉍㄰䈦䈩䇮䇸㪉㪇㪇㪇 ᐕ䉁䈪䈮࿾⃿਄䈱䈜䈼䈩䈱ੱ䉕ஜᐽ䈮䇹䈫䈇䈉䉴䊨䊷䉧䊮䈏ታ⃻䈪䈐䈭䈎䈦䈢䈎䉕⠨ኤ䈚䈢䋨㪉㪇㪇㪎 ᐕ䋩䇯㩷㩷 䈠䈱ⷐ࿃䈲㽲∛㒮ਛᔃਥ⟵䇮㽳ක≮䈱໡ᬺൻ䇮㽴ಽᢿൻ䈮䈅䉎䈫䈚䈢䇯㩷㩷 䉒䈏࿖䈱ක≮䈲䈬䈉䈪䈅䈦䈢䉐䈉䈎䇯ⁿ㘺๟ᐔ䈲䇺∛㒮䈱਎♿䈱ℂ⺰䇻䈱ਛ䈪䇮䉒䈏࿖䈲ක≮䈱䉝䉪䉶䉴䈲䉋䈇䉅䈱䈱䇮⸻ ኤ ᤨ 㑆 䈏⍴ 䈇䈖䈫䇮ᄖ ᧪ ᯏ ⢻ 䈮䈍䈔䉎ᄢ ∛ 㒮 䈫⸻ ≮ ᚲ 䈱┹ ว 䇮䈎䈎䉍䈧䈔ක 䈱ᧂ ⏕ ┙ 䈭䈬䉕䈅䈕䈩䈇䉎䇯ⁿ 㘺 䈲䈖䈱⁁ ᴫ 䉕䇸∛ 㒮 䈱਎ ♿ 䇹䈫๭ 䈶䇮ᰴ ╙ 䈮⚳ Ὣ 䉕ㄫ 䈋䇮੹ ᓟ 䈲ஜ ᐽ ᚢ ⇛ 䈱ォ ឵ 䈫൮ ᜝ 䉬䉝䉲䉴䊁䊛䈏㊀ⷐ䈪䈅䉎䈫ਥᒛ䈜䉎䇯㩷㩷 䈖䈱䉋䈉䈮䉒䈏࿖ 䉅∛㒮 ਛ ᔃ ਥ ⟵ 䈏ㅴ 䉂䇮䊒䊤䉟䊙䊥㪄䉬䉝ㇱ ಽ 䈏⴮ ㅌ 䈜䉎䇯∛ 㒮 ਛ ᔃ ਥ ⟵ 䈲䉁䈢Ꮢ ႐ ේ ℂ䈮ၮ䈨䈒ක≮䈱໡ᬺൻ䈮ᜉゞ䉕䈎䈔䈢䇯⸻≮ႎ㈽䈱಴᧪㜞ᛄ䈇೙䈏ᬌᩏẃ䈔䇮⮎ẃ䈔䈱ක≮䉕↢䉂಴䈚䈢䇯䉁䈢⎇ⓥ⠪䉅⵾⮎ડᬺ䈫⚿䈶䈧䈐䉕ᒝ䉄䈩䈚䉁䈦䈢䇯㩷㩷 ಽ ᢿ ൻ 䈲ኾ 㐷 ⚦ ಽ ൻ 䈱ⴕ 䈐ㆊ 䈑䉕␜ 䈜⸒ ⪲ 䈪䈅䉎䇯ੱ 㑆 ో ૕ 䉕⸻ 䈝䈮∔ ∛ 䈫䈇䈉䊌䊷䉿䉕⸻ 䉎䈖䈫䈮䈭䈦䈩䈚䉁䈦䈩䈇䉎䇯㩷㩷 䈪䈲䈬䈱䉋䈉䈭ක≮䈏੹䇮᳞䉄䉌䉏䈩䈇䉎䈱䈎䋿㩷㩷䋲䋮✚ว⊛䉝䊒䊨䊷䉼䈫䈲㩷㩷 ⿥ 㜞 㦂 ␠ ળ 䈫䈭䉍䇮⧯ ⠪ 䈱⣀ ᒙ ᕈ 䉇ኅ ᣖ 䈱ᖤ ഍ 䈏⋡ ┙ 䈧䉋䈉䈮䈭䈦䈢ᣣ ᧄ 䇯੹ 䇮ක ≮ 䈱䊌䊤䉻䉟䊛䉲䊐䊃䈏᳞䉄䉌䉏䉎䇯↢‛ቇ⊛䈭䉝䊒䊨䊷䉼䈱䉂䈪䈭䈒䇮ᔃℂ␠ળ⊛䈭䉝䊒䊨䊷䉼䈏ᔅⷐ䈪䈅䉎䇯ᖚ⠪䉕↢‛૕䈳䈎䉍䈪䈭䈒䇮ᔃ ℂ 㕙 䉇␠ ળ 㕙 䉕㊀ ⷞ 䈚䈢ో ੱ ⊛ ක ≮ 䇯ක ≮ 䈱䉂䈪䈭䈒⑔ ␩ ੺ ⼔ 䉇଻ ஜ ੍ 㒐 䉕฽ 䉄䈢ᄙ ⡯ ⒳ 䈮䉋䉎൮᜝⊛䉬䉝䇯䈖䉏䉌䉕ታ⃻䈜䉎䈢䉄䈮䈲ᰴ䈱䉋䈉䈭⺖㗴䈮ข䉍⚵䉃䈖䈫䈏᳞䉄䉌䉏䉎䇯㩷䋨䋱䋩୘ੱ䈱ஜᐽ䉕ᒁ䈐಴䈜ක≮ 㩷㩷 ୘ ੱ 䉕✚ ว ⊛ 䈮⸻ 䉎䈫䇮䈢䈫䈋䈠䈱ੱ 䈮∔ ∛ 䈫䈇䈉ᒙ 䉂䈏䈅䈦䈢䈫䈚䈩䉅䇮ᴦ ≹ ജ 䊶↢ ๮ ജ 䉅ẜ ࿷ 䈚䈩䈇䉎䇯කቇ䈲䈖䉏䉁䈪∛ ࿃ ⺰䋨㫇㪸㫋㪿㫆㪾㪼㫅㪼㫊㫀㫊㪀䈮ၫ ⌕䈚䈩䈐䈢䈏䇮ஜᐽ ↢ᚑ ⺰ 㩿㫊㪸㫃㫌㫋㫆㪾㪼㫅㪼㫊㫀㫊䋩䈱ត᳞ 䈮⋡䉕ะ䈔䉎䈼䈐䈪䈅䉎䇯㩷㩷 䉟䉴䊤䉣䊦䈱␠ળቇ⠪ 㪘㫅㫋㫆㫅㫆㫍㫊㫂㫐 䈲䊖䊨䉮䊷䉴䊃⎇ⓥ䈎䉌䇸ᖤᗌ䈭૕㛎䉕䈚䈢䈮䉅䈎䈎䉒䉌䈝䇮ᣂ䈚䈇ੱ↢䈮ㆡ ᔕ 䈚䈩䈇䈒䉫䊦䊷䊒䈱․ ᓽ䇹䈫䈚䈩䇮㪺㫆㫄㫇㫉㪼㪿㪼㫅㫊㫀㪹㫀㫃㫀㫋㫐䇮㫄㪼㪸㫅㫀㫅㪾㪽㫌㫃㫅㪼㫊㫊䇮㫄㪸㫅㪸㪾㪼㪸㪹㫀㫃㫀㫋㫐 䈏⼾ 䈎䈮䈅䉎䈖䈫䉕⷗಴䈚 㫊㪼㫅㫊㪼㩷㫆㪽㩷㪺㫆㪿㪼㫉㪼㫅㪺㪼 䈫ฬ䈨䈔䈢䇯㩷㩷 ർᶏ ㆏ 䈱ዊ䈘䈭↸ 䈮䈍䈔䉎ਛ ᐕ ⁛ り↵ ᕈ 䈱♧ ዩ∛ ᖚ ⠪ ⟲䈪㗼 ⪺䈭⥃ ᐥ⊛ ᡷ ༀ 䉕⚻ 㛎䈚䈢䇯䇸䉪䉴䊥䈮㗬䉌䈭䈇╉㗻䈪Ꮻ䉏䉎ᄖ᧪⸻≮䇹䈲✚ว⸻≮䈱䉄䈙䈜䈵䈫䈧䈱ᆫ䈪䈅䉎䇯㩷㩷 䊒䊤䉟䊙䊥㪄䉬䉝䈱ᩮ ᐩ 䈲䉶䊦䊐䉬䉝䉕䈬䈉䉰䊘䊷䊃䈜䉎䈎䈮䈅䉎䇯䉅䈦䈫䉅䈦䈫䉶䊦䊐䉬䉝䈱ᧄ ⾰ 䈮䉝䊒䊨䊷䉼䈜䈼䈐䈪䈅䉎䇯㩷
䋨䋲䋩∛᳇䈱⌀࿃䉕᣿䉌䈎䈮䈜䉎ක ≮㩷㩷 䇸∝ ⁁ 㵪∔ ᖚ 㵪ේ ࿃ 䇹䉕᣿ ⏕ 䈮⺑ ᣿ 䈪䈐䉎䈖䈫䈏ක ቇ 䈱ၮ ᧄ 䈪䈅䉎䈏䇮ታ 㓙 䈱⸻ ≮ 䈪䈲ේ ࿃ 䈮䈧䈇䈩⠨ ኤ䈜䉎䈖䈫䈭䈚䈮ಣᣇ䉇ಣ⟎䉕䈚䈩⸻≮䉕ᷣ䉁䈞䈩䈇䉎䈖䈫䈏ᄙ䈇䇯㩷㩷 ේ ࿃ 䈱ᄙ 䈒䈲↢ ᵴ ⠌ ᘠ 䈏໧ 㗴 䈪䈅䉎䈏䇮䈠䉏䈲⥄ Ꮖ ⽿ છ 䉋䉎䉅䈱䈳䈎䉍䈪䈲䈭䈇䇯㙃 ⢒ 䇮⚻ ᷣ ⁁ ᴫ 䈭䈬ⅣႺⷐ࿃䉅ዋ䈭䈒䈭䈇䇯㪻㪼㫋㪼㫉㫄㫀㫅㪸㫅㫋㫊㩷㫆㪽㩷㪿㪼㪸㫃㫋㪿 䉅⠨ᘦ䈜䉎ᔅⷐ䈏䈅䉎䇯㩷㩷 ∛᳇䈮䈭䉎ᣇ䇱䈲䇸䈠䉏䈮䉅䈎䈎䉒䉌䈝↢䈐䈩䈐䈢䇹䈱䈪䈅䉎䇯䈠䈱䈖䈫䈻䈱ᢘᗧ䈫ᾲᗧ䈭䈚䈱ක≮䈪䈅䈦䈩䈲䈭䉌䈭䈇䇯⑳䈢䈤䈲ஜᐽᩰᏅ䈮ᢅᗵ䈪䈭䈔䉏䈳䈭䉌䈭䈇䇯㩷―17―䋨䋳䋩⹺⍮∝䈮ኻᔕ䈪䈐䉎ක≮㩷㩷 ⿥㜞㦂␠ ળ䈱⺖㗴䈲⹺⍮∝䈱ੱ 䈮䈬䈉ኻᔕ䈜䉎䈎䈪䈅䉎䇯ᄖ᧪䈪ಣᣇ 䉕䈚䈢䈫䈚䈩䉅᦯⮎▤ℂ䈏䉁䈦䈢䈒䈪䈐䈩䈇䈭䈇଀䈏Ⴧട䈚䈩䈇䉎䇯⹺⍮∝䈮ኻ䈜䉎ኅᣖ䈱ήℂ⸃䈮䉋㕖㔍䇮⯦ᓙ䈱੍㒐䉕฽䉄䈢䉬䉝䈏ᔅⷐ䈪䈅䉎䇯㩷䋨䋴䋩䊜䊮䉺䊦䊓䊦䉴䈮ᒝ䈇ක≮㩷㩷 㪈㪐㪐㪏 ᐕ䈎䉌䉒䈏࿖䈱⥄Ვ⠪ᢙ䈲ᐕ㑆 㪊 ਁੱ䉕⿥䈋䇮䉋䈉䉇䈒 㪉㪇㪈㪉 ᐕ䈮 㪊 ਁੱ䉕ഀ䈦䈢䇯䈉䈧∛䉕䈲䈛䉄䈫䈜䉎ᔃ ℂ ␠ ળ ∔ ᖚ 䈮ኻ 䈜䉎䉬䉝䈪ᩮ ᐙ 䉕䈭䈜䉅䈱䈲૗ 䈪䈅䉎䈎䇯Ⓑ ᧛ ඳ 䇸ᔃ 䈱⚷ ≮ ᴺ 䇹䈮ቇ 䈹䈫䈖䉐ᄢ 䈪䈅䉎䇯㩷䋨䋵䋩࿾ၞ䉕ஜᐽ⊛䈮䈜䉎ක≮㩷㩷 ࿾ၞ ක≮ ፣უ䈏ต 䈳䉏䈩ਭ䈚䈇䈏䇮䉁䈣䉁䈣⌀䈱ᡷༀ ╷ 䈲⻠䈛䉌䉏䈩䈇䈭䈇䇯කᏧ䈱ᢙ䈏ዋ 䈭䈒䈩䉅䈪䈐䉎ක≮䈲⚵䉂┙䈩䉌䉏䉎䈲䈝䈪䈅䉎䇯੍㒐කቇ䊶੍᷹කቇ䇮ᖚ⠪ෳടဳ䈱ක≮䈏㊀ⷐ䈭䉦䉩䉕ី䈦䈩䈇䉎䇯㩷㩷䋳䋮✚วᱤ⑼ ቇ䈻䈱ᦼᓙ 㩷㩷 䉒䈏࿖ 䈪䈲ᱤ ⑼ 䊶ක⑼ 䈱ㅪ ៤ 䉅ਇ ච ಽ 䈪䈅䈦䈢䇯ᦨ ㄭ 䉋䈉䉇䈒㜞 㦂 ⠪ ࿷ ቛ ක ≮ 䈭䈬䈪䇸ญ ⣧ 䉬䉝䇹䈮ὶ ὐ 䈏䈅䈩䉌䉏䈩䈇䉎䇯ᩕ 㙃 䉰䊘䊷䊃䉼䊷䊛䈱ᵴ べ 䉅⪺ 䈚䈇䇯⑳ 䈢䈤ක Ꮷ 䈲ᱤ ⑼ ක Ꮷ 䈎䉌ቇ 䈹䈖䈫䈏ዋ 䈭䈒䈭䈇䇯ญ⣧䉬䉝䈮䉋䈦䈩⹺⍮ᯏ⢻䈏⪺䈚䈒ᡷༀ䈚䈢଀䉅಴ળ䈉䉋䈉䈮䈭䈦䈢䇯㩷㩷 ✚ ว ᱤ ⑼ ቇ 䈏ᐢ 䈇ⷞ ㊁ 䉕ᜬ 䈤䇮ᱤ ⑼ ක ≮ 䉝䉪䉶䉴䈱ᡷ ༀ 䇮ᱤ ⑼ ක ≮ ᩰ Ꮕ 䈱ᤚ ᱜ 䇮ᱤ ⑼ ᡽ ╷ ቇ 䉕ត ᳞ 䈚䇮
ᱤ⑼䈱䉂䈭䉌䈝ක≮ో૕䈱⾰䈱ะ਄䈮ነਈ䈘䉏䉎䈖䈫䉕ᦼᓙ䈚䈢䈇䇯㩷㩷 㩷㩷䇼䈗⇛ᱧ䇽㩷
ᤘ๺䋲䋲ᐕ㩷 ⨙ၔ⋵↢䉏㩷ᤘ๺䋴䋶ᐕ㩷 ᣂẟᄢቇකቇㇱතᬺ㩷ᤘ๺䋵䋹ᐕ㩷 ⥄ᴦක⑼ᄢቇ࿾ၞක≮ቇഥᢎ᝼㩷ᤘ๺䋶䋳ᐕ㩷 ᶗ⼱↸↸᳃ක≮⑔␩䉶䊮䉺䊷ᚲ㐳䊶ᶗ⼱↸࿖଻∛㒮㐳㩷ᤘ๺䋶䋴ᐕ㩷 ⥄ᴦක⑼ᄢቇ㩷 කቇඳ჻㩷ᐔᚑ㩷 䋸ᐕ㩷 ർᶏ㆏ᄢቇᄢቇ㒮කቇ⎇ⓥ⑼ᢎ᝼㩷ᐔᚑ䋲䋰ᐕ㩷 ർᶏ㆏ᄢቇᢎ⢒ቇୃ჻㩷ᐔᚑ䋲䋲ᐕ㩷 ቯᐕㅌ⡯㩷 ർᶏ㆏ᄢቇฬ⹷ᢎ᝼㩷ᐔᚑ䋲䋴ᐕ㩷 ੩ᭂ↸࿖଻⸻≮ᚲᚲ㐳㩷㩷䇼ਥ䈭ᚲዻቇળ䇽㩷ᣣᧄ䊒䊤䉟䊙䊥䊶䉬䉝ㅪวቇળ䋨ฬ⹷ℂ੐㐳䋩㩷ᣣᧄᔃ≮ౝ⑼ቇળ䋨ℂ੐䋩㩷ᣣᧄ䉬䉝䊙䊈䉳䊜䊮䊃ቇળ䋨ℂ੐䋩㩷ో࿖ ࿖଻ ⸻ ≮ᣉ ⸳ද ⼏ ળ䋨ℂ ੐䇮੺ ⼔ᡰ េኾ 㐷 ຬ⎇ ୃะ ਄ ᆔຬ ળᆔ ຬ 㐳䇮੺⼔ ᡰ េኾ 㐷ຬ 㙃 ᚑ䉦䊥䉨䊠䊤䊛䈅䉍ᣇᬌ⸛ળᆔຬ㐳䋩㩷㩷䇼⪺ᦠ䋨✬⪺䊶౒⪺䋩䇽㩷䇺⸻≮ᚲ䈪ᢎ䈋䉎䊒䊤䉟䊙䊥䊶䉬䉝䇻䊒䊥䊜䊄␠㩷䇺ኅᐸක≮ቇ䊊䊮䊄䊑䉾䉪䇻ਛᄖකቇ␠㩷䇺࿾ၞⓨᵢൻᤨઍ䈮䈍䈔䉎ⴕ᡽䈫䊗䊤䊮䊁䉞䉝䇻ਛᄩᴺⷙ಴ 㩷䇺੺⼔ᡰេኾ㐷ຬታോ⎇ୃ䊁䉨䉴䊃䇻㐳ኼ␠ળ㐿⊒䉶䊮䉺䊷㩷 䈭䈬㩷
㩷

㩷

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╙䋶࿁ᣣᧄ✚วᱤ⑼ቇળ䉲䊮䊘䉳䉡䊛㩷㩷䇸✚วᱤ⑼ක䈮᳞䉄䉌䉏䉎䉮䊮䊏䊁䊮䉴㩷䈫⹏ଔ䈱ౕ⃻ൻ䈮䈧䈇䈩䇹㩷㩷㩷㩷䉴䉬䉳䊠䊷䊦㩷
䋱䋱᦬䋱䋶ᣣ䋨࿯䋩㩷 㪈㪋㪑㪇㪇䌾㪈㪌㪑㪊㪇㩷㩷䋱䋮㪈㪋㪑㪇㪇䌾㪈㪋㪑㪈㪉㩷 ၮ⺞⻠Ṷ㩷䇸✚วᱤ⑼ක䈮᳞䉄䉌䉏䉎⢻ജ䉕⠨䈋䉎䇹㩷㪚㫆㫅㫊㫀㪻㪼㫉㪸㫋㫀㫆㫅㩷㫆㪽㩷㫋㪿㪼㩷㪚㫆㫄㫇㪼㫋㪼㫅㪺㪼㩷㫉㪼㫈㫌㫀㫉㪼㪻㩷㪽㫆㫉㩷㫋㪿㪼㩷㪞㪼㫅㪼㫉㪸㫃㩷㪛㪼㫅㫋㫀㫊㫋㫊㩷ᮘญ㩷 ൎⷙ㩷 ᢎ᝼㩷਻Ꮊᄢቇ∛㒮ญ⣧✚ว⸻≮⑼㩷 㩷
㩷
㩷
㩷 㩷 㩷
䋲䋮㪈㪋㪑㪈㪉䌾㪈㪋㪑㪉㪐㩷 ක≮ⴕേ䈮䈧䈇䈩㩷䇸✚วᱤ⑼ක䈮᳞䉄䉌䉏䉎ක≮ⴕേ䈱䉮䊮䊏䊁䊮䉴䇹㩷㪫㪿㪼㩷㪚㫆㫄㫇㪼㫋㪼㫅㪺㪼㫊㩷㪸㪹㫆㫌㫋㩷㫋㪿㪼㩷㫄㪼㪻㫀㪺㪸㫃㩷㪹㪼㪿㪸㫍㫀㫆㫉㩷㪽㫆㫉㩷㫋㪿㪼㩷㪾㪼㫅㪼㫉㪸㫃㩷㪻㪼㫅㫋㪸㫃㩷㫇㫉㪸㪺㫋㫀㫋㫀㫆㫅㪼㫉㫊㩷ᧁየ㩷 ືᦶ㩷 ∛㒮ᢎ᝼㩷 㩷 ਻Ꮊᱤ⑼ᄢቇ㩷 ญ⣧ᯏ⢻ቇ⻠ᐳ㩷 ✚ว⸻≮ቇಽ㊁㩷 㩷㩷 㩷 㩷䋳䋮㪈㪋㪑㪉㪐䌾㪈㪋㪑㪋㪍㩷 ৻⥸ᱤ⑼⸻≮䋨⵬✄♽䋩䈮䈧䈇䈩㩷䇸✚วᱤ⑼ ක䈮䈍䈔䉎ᱤ⑼⵬✄ ቇ 䈱䉮䊮䊏䊁䊮䉴䉕⠨䈋䉎䇹㩷㪚㫆㫅㫊㫀㪻㪼㫉㪸㫋㫀㫆㫅㩷㫆㪽㩷㫋㪿㪼㩷㪚㫆㫄㫇㪼㫋㪼㫅㪺㪼㫊㩷㪽㫆㫉㩷㫋㪿㪼㩷㪧㫉㫆㫊㫋㪿㪼㫋㫀㪺㩷㪛㪼㫅㫋㫀㫊㫋㫉㫐㩷㫆㫅㩷㫋㪿㪼㩷㪞㪼㫅㪼㫉㪸㫃㩷㪛㪼㫅㫋㫀㫊㫋㫊㩷ർᶏ㆏ක ≮ ᄢቇᱤቇ ㇱ 㩷 㜞㦂⠪䊶᦭ ∛⠪ᱤ⑼ ቇ ಽ㊁ 㩷ᳰ↰㩷 ๺ ඳ㩷 ಎᢎ᝼ 㩷㩷 㩷 㩷䋴䋮㪈㪋㪑㪋㪍䌾㪈㪌㪑㪇㪊㩷 ৻⥸ᱤ⑼⸻≮䋨଻ሽ♽䋩䈮䈧䈇䈩 㩷䇸✚วᱤ⑼ක䈮᳞䉄䉌䉏䉎䉮䊮䊏䊁䊮䉴䈫⹏ଔ䈱ౕ૕ൻ䈮䈧䈇䈩㩷䋭৻⥸ᱤ⑼⸻≮䋨଻ሽ♽䋩䈮䈧䈇䈩䋭䇹㩷㪜㫄㪹㫆㪻㫀㫄㪼㫅㫋㩷㫆㪽㩷㪚㫆㫄㫇㪼㫋㪼㫅㪺㪼㩷㪸㫅㪻㩷㫋㪿㪼㩷㪜㫍㪸㫃㫌㪸㫋㫀㫆㫅㩷㪛㪼㫄㪸㫅㪻㪼㪻㩷㪽㫉㫆㫄㩷㫋㪿㪼㩷㪞㪼㫅㪼㫉㪸㫃㩷㪛㪼㫅㫋㫀㫊㫋㫊㩷㩷 䋭㪞㪼㫅㪼㫉㪸㫃㩷㪛㪼㫅㫋㫀㫊㫋㫉㫐㩷㪤㪼㪻㫀㪺㪸㫃㩷㪫㫉㪼㪸㫋㫄㪼㫅㫋㩷㩿㪚㫆㫅㫊㪼㫉㫍㪸㫋㫀㫍㪼㩷㪪㫐㫊㫋㪼㫄㪀㩷 䋭㩷૒⮮㩷 ෹ೣ㩷 ಎᢎ᝼㩷
ᣣᧄᱤ⑼ᄢቇᣂẟ∛㒮✚ว⸻≮⑼㩷
㩷 㩷 㩷䋵䋮㪈㪌㪑㪇㪊䌾㪈㪌㪑㪉㪇㩷 ක≮ㅪ៤䈮䈧䈇䈩㩷䇸࿾ၞක≮䈮䈍䈔䉎✚วᱤ⑼ක䈱┙䈤૏⟎䉕⠨䈋䉎䇹㩷㪚㫆㫅㫊㫀㪻㪼㫉㪸㫋㫀㫆㫅㩷㫆㪽㩷㫋㪿㪼㩷㪧㫆㫊㫀㫋㫀㫆㫅㪸㫃㫀㫋㫐㩷㫆㪽㩷㫋㪿㪼㩷㪞㪼㫅㪼㫉㪸㫃㩷㪛㪼㫅㫋㫀㫊㫋㫊㩷㪸㫋㩷㫋㪿㪼㩷㪚㫆㫄㫄㫌㫅㫀㫋㫐㩷㪤㪼㪻㫀㪺㫀㫅㪼㩷ኴ↰㩷 ⽾㩷 ಎᢎ᝼㩷਻Ꮊᄢቇ∛㒮ญ⣧✚ว⸻≮⑼㩷
㩷 㩷 㩷䋶䋮㪈㪌㪑㪉㪇䌾㪈㪌㪑㪊㪇 䊐䊨䉝䈫䈱⸛⺰㩷
㩷
㩷 㩷
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㩷㩷

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䋱䋮ၮ⺞⻠Ṷ㩷㩷㩷䇸✚วᱤ⑼ක䈮᳞䉄䉌䉏䉎⢻ജ䉕⠨䈋䉎䇹㩷㪚㫆㫅㫊㫀㪻㪼㫉㪸㫋㫀㫆㫅㩷㫆㪽㩷㫋㪿㪼㩷㪚㫆㫄㫇㪼㫋㪼㫅㪺㪼㩷㫉㪼㫈㫌㫀㫉㪼㪻㩷㪽㫆㫉㩷㫋㪿㪼㩷㪞㪼㫅㪼㫉㪸㫃㩷㪛㪼㫅㫋㫀㫊㫋㫊㩷㩷ᮘญ㩷 ൎⷙ㩷 ᢎ᝼㩷㩷਻Ꮊᄢቇ∛㒮ญ⣧✚ว⸻≮⑼㩷 㩷㩷㩷㩷㩷ᣣᧄ✚ว ᱤ ⑼ද⼏ળ䈏ቇળ䈻᣹ᩰ 䈜䉎䈮䈅䈢䉍䋬㐳⼱Ꮉ ᄢ ળ㐳䈱ᓮᅢ ᗧ䈪䇮䇸✚วᱤ⑼ක䈮᳞ 䉄䉌䉏䉎䉮䊮䊏䊁䊮䉴䈫⹏ଔ 䈱ౕ ⃻ ൻ 䈮䈧䈇䈩䇹䈫㗴 䈚䈢䉲䊮䊘䉳䉡䊛䈏㐿 ௅ 䈘䉏䉎ㆇ 䈶䈫䈭䉍䉁䈚䈢䋮ᧄ 䉲䊮䊘䉳䉡䊛䈲䋬ᚒ 䇱✚วᱤ⑼ක 䈏ౕ஻䈜䈼䈐⢻ജ䉇੹ᓟ䈱ቇⴚ⊛䈍䉋䈶ቇ㓙⊛ᵴേ䈮㑐䈜䉎㆏ᮡ䉕䋬ᬌ⸛⼏⺰䈜䉎䈖䈫䉕⋡⊛䈫
䈚䈢㊀ⷐ䈭ᯏળ䈫⠨䈋䉁䈜䋮㩷⮮ ੗ 䉫䊦䊷䊒䈏ⴕ 䈦䈢ᧄ ળ ຬ 䈻䈱䉝䊮䉬䊷䊃⺞ ᩏ 䈪䈲䋬䇸ᖚ ⠪ ਛ ᔃ 䈱ක ≮ 䇹䇸ක ≮ 㕙 ធ 䇹䇸✚ ว ᱤ ⑼ ᴦ ≮ ⸘↹ 䇹䈏ᧄ ળ 䈱䉨䊷䊪䊷䊄䈮䈭䉍䈉䉎䈖䈫䈏␜ ໂ 䈘䉏䉁䈚䈢䋮৻ ⥸ 䈮䈲䇮✚ ว ᱤ ⑼ ක 䈲䊒䊤䉟䊙䊥䉬䉝䉕ਥ ᬺ ോ 䈫䈚䈢ో ੱ ⊛ ක ≮ 䉕ⴕ 䈇䋬⊛ ⏕ 䈮ኾ 㐷 ⸻ ≮ ⑼ 䈻䉮䊮䉺䉪䊃䈪䈐䉎ᱤ ⑼ ක Ꮷ 䈫䈚䈩ℂ ⸃ 䈘䉏䈩䈇䉁䈜䋮৻ ᣇ 䋬␠ ળ 䈱㜞㦂 ൻ 䈮䉋䉎∔ ∛ ᭴ ㅧ 䈱ᄌ ൻ 䈮઻ 䈇䋬ኾ 㐷 ⊛ 䈭⸻ ᢿ 䉇ᴦ ≮ 䋬↢ ᵴ ⠌ ᘠ ∛ ╬ 䈮㑐 ㅪ 䈚䈢ᱤ ⑼ ∔ ᖚ 䈱ᴦ ≮ 䋬࿾ ၞක ≮ 䉇๟ ⴚ ᦼ ญ ⣧ ▤ ℂ ╬ ᄙ ጘ 䈮ᷰ 䉎ኻ ᔕ 䉅᳞ 䉄䉌䉏䉎ᤨ ઍ 䈮䈭䉍䉁䈚䈢䋮䈚䈢䈏䈦䈩䋬ᓥ ᧪ 䈱ኾ 㐷 ቇ ળ 䈫⇣ 䈭䉍䋬ᄙಽ ㊁䈱⍮⼂䈍䉋䈶⸻≮⢻ ജ䉕᦭䈚䈩䈍䈒䈖䈫䈏᳞䉄䉌䉏䉁䈜䋮䈖䈱䉋䈉䈭⢛᥊䉕䉅䈫䈮䋬✚ว ᱤ ⑼ක≮䈮㑐䈜䉎⎇ⓥ䊶⸻≮૕♽䈱⏕┙䈲㊀ⷐ䈭ᬌ⸛㗄⋡䈫䈭䉍䉁䈚䈢䋮㩷એ਄ 䈱ᅤ䈒䋬✚ว ᱤ ⑼䈱⥃ᐥ 䉕ᷓ 䉄䋬✚ ว ⸻ ≮ 䈮㑐 䈜䉎⎇ ⓥផ ㅴ䉕ㅢ 䈚䈩䋬䊒䊨䊐䉢䉾䉲䊢䊅䊦䈫䈚䈩࿖ ᳃䈱ஜᐽ䈮⽸₂䈜䉎૶๮䈲䇮ળຬ䈮䈫䈦䈩༛⑌䈱⺖㗴䈫ᕁ䉒䉏䉁䈜䋮㩷⃻ ࿷ 䈱ቇ ⴚ ᬌ ⸛ ᆔ ຬ ળ 䊶✚ ว ᱤ ⑼ ᛛ ⴚ 䊒䊨䉳䉢䉪䊃䉼䊷䊛䈲䋬ක ≮ ⴕ േ 㪃㩷 ৻ ⥸ ᱤ ⑼ ⸻ ≮ 䋨଻ ሽ ♽䊶⵬ ✄ ♽䋩䋬ㅪ ៤ ⸻ ≮ 䈮ಽ 䈎䉏䈩䈇䉁䈜䋮ฦ 䉼䊷䊛䈮䈲ฦ ኾ 㐷 ಽ ㊁ 䈱ⷞ ὐ 䈎䉌ୄ ⍑ 䈚䈩䈇䈢䈣䈐䋬ో ੱ ⊛ ක ≮ 䇮㜞 㗫 ᐲ ∔ᖚ 䈎䉌․ ᱶ ∔ ᖚ 䉁䈪䈱ᱤ ⑼ ක ≮ 䋬࿾ ၞ ૑ ᳃ 䈻⽸ ₂ 䈜䉎䊓䊦䉴䊒䊨䊝䊷䉲䊢䊮ဳ ᱤ ⑼ ක ≮ 䈎䉌᦭ ∛ ⠪ 䈱ᴦ ≮ 䋬∔∛䈱੍㒐䉇ᄬ䉒䉏䈢ญ⣧ᯏ⢻࿁ᓳ╬ᄙ䈒䈱䈗ᬌ⸛䉕䈍㗿䈇䈚䈩䈇䉁䈜䋮ฦ䉼䊷䊛䈱⽿છ⠪䈪䈅䉎 㪋 ฬ䈱వ↢ᣇ䈮䈲䋬਄⸥䉕ⷞ㊁䈮䈇䉏䈢ቇⴚ䊶⎇ୃ䊶ᢎ⢒䈮㑐䈜䉎䈍⹤䈚䉕䈚䈩䈇䈢䈣䈒੍ቯ䈪䈜䋮㩷 㩷 㩷㩷䇼䈗⇛ᱧ䇽㩷
ᤘ๺䋲䋴ᐕ㩷 ⑔ጟ⋵ᩉᎹᏒ↢䉏㩷ᤘ๺䋴䋹ᐕ㩷 ਻Ꮊᄢቇᱤቇㇱතᬺ㩷ᤘ๺䋵䋳ᐕ㩷 ਻Ꮊᄢቇᄢቇ㒮⎇ⓥ⑼ᱤቇၮ␆♽ኾ᡹ඳ჻⺖⒟තᬺ㩷ᤘ๺䋵䋳ᐕ㩷 ਻Ꮊᄢቇᱤቇㇱ╙৻ญ⣧ᄖ⑼ഥᚻ㩷ᐔᚑ㩷 䋶ᐕ㩷 ࿖┙∛㒮਻Ꮊක≮䉶䊮䉺䊷ᱤ⑼ญ⣧ᄖ⑼ක㐳㩷ᐔᚑ䋱䋴ᐕ㩷 ਻Ꮊᄢቇᱤቇㇱઃዻ∛㒮ญ⣧✚ว⸻≮⑼ᢎ᝼㩷ᐔᚑ䋱䋵ᐕ㩷 ਻Ꮊᄢቇ∛㒮ญ⣧✚ว⸻≮⑼ᢎ᝼㩷 䋨⃻࿷䈮⥋䉎䋩㩷ᐔᚑ䋲䋰ᐕ㩷 䋴᦬䌾䋲䋲ᐕ㩷 䋳᦬㩷 ਻Ꮊᄢቇ∛㒮೽∛㒮㐳㩷㩷䇼ਥ䈭ᚲዻቇળ䇽㩷ᣣᧄ✚วᱤ⑼ද⼏ળ㩿೽ℂ੐㐳㪀㩷ᣣᧄᱤ⑼ᢎ⢒ቇળ㩿ℂ੐㪀㩷ᣣᧄญ⣧ᄖ⑼ቇળ㩿⹏⼏ຬ㪀㩷ᣣᧄญ⣧⑼ቇળ㩿⹏⼏ຬ㪀㩷ᣣᧄ㗶㗻㕙ᄖ்ቇળ㩿⹏⼏ຬ㪀㩷ᣣᧄᱤ⑼ੱ㑆䊄䉾䉪ቇળ㩿ℂ੐㪀㩷ᣣᧄ∛㒮ᱤ⑼ญ⣧ᄖ⑼ද⼏ળ㩿೽ℂ੐㐳㪀㩷ᣣᧄ 㪟㪠㪭 ᱤ⑼ක≮⎇ⓥળ㩿ℂ੐㪀㩷
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䋲䋮ක≮ⴕേ䈮䈧䈇䈩㩷㩷䇸✚วᱤ⑼ක䈮᳞䉄䉌䉏䉎ක≮ⴕേ䈱䉮䊮䊏䊁䊮䉴䇹㩷㪫㪿㪼㩷 㪚㫆㫄㫇㪼㫋㪼㫅㪺㪼㫊㩷 㪸㪹㫆㫌㫋㩷 㫋㪿㪼㩷 㫄㪼㪻㫀㪺㪸㫃㩷 㪹㪼㪿㪸㫍㫀㫆㫉㩷 㪽㫆㫉㩷 㫋㪿㪼㩷 㪾㪼㫅㪼㫉㪸㫃㩷 㪻㪼㫅㫋㪸㫃㩷㫇㫉㪸㪺㫋㫀㫋㫀㫆㫅㪼㫉㫊㩷㩷ᧁየ㩷 ືᦶ㩷 ∛㒮ᢎ᝼㩷㩷
਻Ꮊᱤ⑼ᄢቇ㩷 ญ⣧ᯏ⢻ቇ⻠ᐳ㩷 ✚ว⸻≮ቇಽ㊁㩷 㩷㩷㩷ᣣ ᧄ␠ ળ 䈱↢ ᵴⅣ Ⴚ 䈱ᄌ ൻ䉇ᕆㅦ 䈭㜞 㦂 ൻ䈮䉋䉎∔ ∛᭴ ㅧ䈱ᄌ ൻ䈮䉋䉍䇮ක≮ 䈱ਥ ૕䈏䉨䊠䉝䈎䉌䉬䉝䈻䈫ᄌൻ 䈚䈩䈐䉁䈚䈢䇯䉁䈢䇮ᖚ⠪ 䈱ᮭ ೑ 䉅᣿⏕ 䈫䈭䈦䈩䈐䈢䈖䈫䈪䇮␠ ળ䈱䊆䊷䉵䈫䈚䈩ᓥ ᧪䈱ᱤ⑼ ක ≮䈮ട䈋䈩ญ⣧ 䉬䉝䉇ో ੱ ⊛ ක ≮ 䈏ട 䉒䈦䈩䈐䉁䈚䈢䇯䈖䈱䉋䈉䈭␠ ળ ⊛ ⢛ ᥊ 䈱ਛ 䈪䈖䉏䈎䉌䈱ᱤ ⑼ ක ≮ 䉕⠨ 䈋䈢䈫䈐䈮䊒䊤䉟䊙䊥䊶䉬䉝䉕ⴕ 䈉✚ ว ᱤ ⑼ ක 䈻䈱䊆䊷䉵䈲䈇䈦䈠䈉㜞 䉁䈦䈩䈒䉎䈫⠨ 䈋䉌䉏䉁䈜䇯৻ ᣇ 䇮✚ ว ᱤ ⑼ ක 䈮䈧䈇䈩䈱⇼໧ὐ䈫䈚䈩䇮䇺ᣣᧄ䈱㐿ᬺᱤ⑼ක䈱ᄙ䈒䈲 㪞㪼㫅㪼㫉㪸㫃㩷㪧㫉㪸㪺㫋㫀㫋㫀㫆㫅㪼㫉 䈪䈅䉎䈮䈎䈎䉒䉌䈝䇮ᱤ⑼කᏧ㙃ᚑᯏ㑐䈪䈅䉎ᄢቇ∛㒮䈮䈲 㪉㪇 ᐕ೨䉁䈪✚วᱤ⑼䉇✚ว⸻≮ᱤ⑼䈫䈇䈉⸻≮⑼䈲䈅䉁䉍ሽ࿷䈚䈭䈎䈦䈢䇯䇻䈫䈇䈉੐ታ䈪䈜䇯䈖䉏䈎䉌䈱ᱤ ቇ ㇱ ᄢ ቇ ∛ 㒮䈲䇮␠ ળ 䈱䊆䊷䉵䈮ᔕ 䈋䉎ᱤ ⑼ ක ≮䉕䊥䊷䊄䈜䉎䈢䉄䈮䇮✚ ว ᱤ ⑼ ක 䈱૏ ⟎䈨䈔䉕᣿䉌䈎䈮䈜䉎ᔅⷐ䈏䈅䉎䈫⠨䈋䈩䈇䉁䈜䇯㩷ᚒ 䇱䈱䊪䊷䉨䊮䉫䉫䊦䊷䊒䈪䈲⮮ ੗ 䉫䊦䊷䊒䈱⺞ ᩏ䈪᣿ 䉌䈎䈮䈭䈦䈢✚ ว ᱤ ⑼ ක 䈫䈚䈩䈱䉨䊷䊪䊷䊄䈱䈉䈤䇮䇺ක≮ⴕേ䇻䈮䈧䈇䈩⼏⺰䈚䈩䈐䉁䈚䈢䇯䈲䈛䉄䈮䇮ක≮ⴕേ䈱䉳䊞䊮䊦䉕ක≮㕙ធ䊶䉟䊮䊐䉤䊷䊛䊄䉮䊮䉶䊮䊃䊶⸻ᢿ䊶ផℂផ⺰䊶ᜰዉ䊶▤ℂ䈱 㪍 㗄⋡䈮ಽ䈔䇮㪍 㗄⋡䈠䉏䈡䉏䈮䈍䈇䈩✚วᱤ⑼ක䈫䈚䈩ᔅⷐ䈭䉮䊮䊏䊁䊮䉴䉕೉᜼ 䈚䇮䈠䈱ᓟ 䇮㓸 ⚂ 䈜䉎૞ ᬺ 䉕ⴕ 䈇䉁䈚䈢䇯੹ ࿁ 䈠䈱䊒䊨䉶䉴䈫⚿ ᨐ 䈮䈧䈇䈩䈗ႎ ๔ 䈚䇮⊝ 䈘䉁䈫䈗ᗧ ⷗ 䉕㗂 䈒䈖䈫䈪䇮✚วᱤ⑼ක䈏ᜬ䈧䈼䈐ක≮ⴕേ䈱䉮䊮䊏䊁䊮䉴䈱౒ㅢ⹺⼂䈱㉯ᚑ䈮ข䉍⚵䉂䈢䈇䈫ᕁ䈇䉁䈜䇯㩷㩷䇼䈗⇛ᱧ䇽㩷
ᤘ๺䋳䋴ᐕ㩷 㩷 ᾢᧄ⋵ᾢᧄᏒ↢䉁䉏㩷ᤘ๺䋵䋹ᐕ㩷 㩷 ਻Ꮊᱤ⑼ᄢቇᄢቇ㩷 තᬺ㩷ᤘ๺䋶䋳ᐕ㩷 㩷 ਻Ꮊᱤ⑼ᄢቇᄢቇ㒮ᱤቇ⎇ⓥ⑼㩷 䋨ᱤ⑼⍶ᱜቇኾ᡹䋩ୃੌ㩷ᤘ๺䋶䋳ᐕ㩷 㩷 ਻Ꮊᱤ⑼ᄢቇ㩷 ഥᚻ䋨ᱤ⑼⍶ᱜቇ⻠ᐳ䋩㩷ᐔᚑ㩷 䋲ᐕ㩷 㩷 ਻Ꮊᱤ⑼ᄢቇ㩷 ⻠Ꮷ䋨ቇ㐳ㄉ઎䋩㩷ᐔᚑ䋱䋰ᐕ㩷 㩷 ☨࿖䊪䉲䊮䊃䊮ᄢቇᱤቇㇱ㩷 ቴຬᢎ᝼䋨䌾㪈㪈 ᐕ䋩㩷ᐔᚑ䋱䋸ᐕ㩷 㩷 ౏┙ᄢቇᴺੱ਻Ꮊᱤ⑼ᄢቇ㩷 ⻠Ꮷ㩷 䋨✚ว⸻≮ቇಽ㊁䋩㩷ᐔᚑ䋲䋱ᐕ㩷 㩷 ౏┙ᄢቇᴺੱ਻Ꮊᱤ⑼ᄢቇ㩷 ಎᢎ᝼㩷ᐔᚑ䋲䋵ᐕ㩷 㩷 ਻Ꮊᱤ⑼ᄢቇ㒝ዻ∛㒮㩷 ∛㒮ᢎ᝼䋨⃻࿷䈮⥋䉎䋩㩷㩷䇼ਥ䈭ᚲዻቇળ䇽㩷ᣣᧄ✚วᱤ⑼ද⼏ળ㩷 䋨ℂ੐䇮ቇⴚ╬ᬌ⸛ᆔຬળක≮ⴕേ䊒䊨䉳䉢䉪䊃䉼䊷䊛ᐳ㐳䋩㩷 㩷 㩷
ᣣᧄᱤ⑼කቇᢎ⢒ቇળ䋨⹏⼏ຬ䇮୶ℂ䊶䊒䊨䊐䉢䉾䉲䊢䊅䊥䉵䊛ᆔຬળᆔຬ䋩㩷
ᣣᧄᱤ⑼ක≮▤ℂቇળ䋨ℂ੐䋩㩷ᣣᧄ⍶ᱜᱤ⑼ቇળ㩷ᣣᧄකቇᢎ⢒ቇળ㩷
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䋳䋮৻
৻⥸ᱤ⑼⸻
⸻≮䋨⵬✄♽♽䋩䈮䈧䈇䈩 㩷㩷කᱤ⑼⵬✄ ቇ 䈱䉮䊮䊏䊁䊮䉴䈱䉴䉕⠨䈋䉎䇹䇸 ✚วᱤ⑼ ක䈮䈍䈔䉎ᱤ㪚㫆㫅㫊㫀㪻㪼㫉㪸 㫋㫀㫆㫅㩷㫆㪽㩷㫋㪿㪼㩷㪚㫆㫄㫇㪼㫋㪼㫅㪺 㪼㫊㩷㪽㫆㫉㩷㫋㪿㪼㩷㪧㪧㫉㫆㫊㫋㪿㪼㫋㫀㪺㩷㪛㪛㪼㫅㫋㫀㫊㫋㫉㫐㩷㫆㫅㫅㩷㫋㪿㪼㩷㪞㪼㫅㪼㫉 㪸㫃㩷㪛㪼㫅㫋㫀㫊㫋㫊㩷ᢎ᝼ 㩷ᳰ↰㩷 ๺ ඳ㩷 ಎᢎ㩷㆏ක ≮ ᄢቇቇᱤቇ ㇱ 㩷 㜞 㦂⠪䊶᦭ ∛⠪⠪ᱤ⑼ ቇ ಽ㊁ಽ 㩷ർᶏ㆏㩷ᱤ ⵬ ✄ ቇ䈲䈲䇸⥃ ᐥ ᱤ ⑼ කቇ 䈱৻ ಽ ㊁䈪䇮ᱤ䊶 ญ ⣧䊶㗶 䊶䈠䈠䈱㑐 ㅪ ⚵ ❱ 䈱వ ᄤ ᕈ ᰳ ᅤ䊶ᓟᄤ ᕈ ᰳ ៊䊶༚ ᄬ䉇ᄬ㩷 ᱤ⑼⇣ Ᏹ 䉕ੱ Ꮏ ⵝ ⟎ 䉕↪ 䈇䈩ୃୃ ᓳ 䈚䋬༚ ᄬ 䈚䈢ᒻ ᘒ 䋬 䉁䈢䈲㓚 ኂ 䈘䉏䈢ᯏ ⢻ 䉕࿁ ᓳ 䈜䉎 䈫䈫䉅䈮䋬⛮ ⊒ ∔ ∛ 䈱੍੍㒐䉕࿑࿑ 䉎䈢䉄䈮ᔅ ⷐ 䈭ℂ ⺰ 䈫 ᛛ ⴚ 䉕⠨ ⓥ 䈜䉎ቇ ໧ 䇹䈫䈫ቯ ⟵ 䈘䉏䈩
䈩䈇䉁䈜䇯䈘䉌
䉌䈮䇮ㄭ ᐕ 䈪䈪䈲䇮ᕆ ㅦ 䈮ㅴ䈮 ⴕ 䈜䉎㜞㜞㦂ൻ䈮䈮઻䈉␠ળ᭴
᭴ㅧ䉇∔∛᭴
᭴ㅧ䈱ᄌൻ䉕
䉕⢛᥊䈮䇮ᱤ
ᱤ⑼⵬✄ቇ䈲
䈲↢ᵴ䈱⾰ 䋨㪨㫌㪸㫃㫀㫋㫐㩷㫆㪽㩷㪽 㫃㫀㪽㪼㪃㩷㪨㪦㪣䋩 䉕⛽ᜬ䊶ะ਄਄䈘䈞䉎䉎ஜ ᐽ ⑼ ቇ 䈫䈚䈩䈱஥䈫㕙 䈏ᒝ ⺞ 䈘䉏䉏䉎䉋䈉䈮䈭䈦
䈦䈩䈐䉁䈚䈢䇯 䈜䈭䉒䈤䇮⵬⵬ ✄ ᱤ ⑼ ᴦ ≮ 䈲䇮㗶 ญ ⣧ 䈱ᰳ ៊ 䈮ኻ䈮䈜䉎䉎⵬ ✄ ಣ ⟎ 䈮䉋䈦䈩๰䈮ྨ ᯏ ⢻ 䈱࿁ ᓳ 䉕࿑ 䉎䈖䈫䈫䈲䉅䈤䉐䉖㪃㪃㩷 ⵬ ✄ ⵝ ⟎ 䈏㗶 ญ ⣧ ♽ 䈱䉂䈭䉌䈝䈝ో り 䈱᭽ 䇱䈭䇱ᯏ⢻⢻䉕౞Ṗ䈮䈜
䈜䉎䈢䉄䈱ല
ലᨐ⊛䈭ኻᔕ
ᔕ䉕䉅฽䉖䈪
䈪䈇䉎䈫⸒䈇឵឵䈋䉎䈖䈫䈏 䈪䈐䉁䈜䇯㩷㩷 ✚ วᱤ⑼ක䈮䈮䈍䈔䉎ᱤ⑼⑼⵬✄ቇ䈅䉎
䉎䈇䈲⵬✄ᱤ
ᱤ⑼ᴦ≮䈪䈲
䈲䇮㑐ㅪ䈜䉎
䉎⍮⼂䈫ᘒᐲ
ᐲ䈏⠌ᓧ䈘䉏
䉏䈩䈇䉎䈖䈫䈲
䈲ᒰ䈫䈚䈩䉅䇮䈅䉎 ৻ቯએ਄䈱䈱ᛛ⢻䈏り䈮
䈮䈧䈇䈩䈇䈭
䈭䈔䉏䈳ᖚ⠪⠪䈱 㪨㪦㪣 䈱⛽ᜬ䊶ะ਄䈱䈲ਇน⢻䈪䈪䈅䉎䈫⠨䈋䉁䉁䈜䇯ὼ䈫䈚䈎䈎䈚䇮ᱤ ⑼ ක Ꮷ ࿖ ኅ ⹜ 㛎 䈮⋧ ኻ⹏ ଔ 䈏ዉ ౉䈘䉏䉏䈢ᤨ ᦼ 䈎䉌䉌⥃ᐥ ♽ 䈱ᢎᢎ ⢒ 䈏⍮⼂ ㊀ ⷞ 䈫䈭䉎௑௑ ะ 䈮઻䈇䇮䇮⵬✄ ቇ ታ ⠌ 䈱ౝ ኈ 䉇ᤨ 㑆 䈏 ᷫ ዋ 䈜䉎௑ ะ 䈮䈅䉎䈖䈫䈫䈲ุ 䉄䉁䈞
䈞䉖䇯䈘䉌䈮䇮 ᣣ ᧄ ⵬ ✄ ᱤ ⑼ ቇ ળ ᢎ ⢒ ໧ 㗴 ᬌ ⸛ ㇱળ䈏䈏ᱤ ⑼ක Ꮷ⥃⥃ ᐥ ⎇ ୃ 䈮 䈍䈔䉎⵬ ✄ 㑐 ㅪ 䈱⥄ 㛎଀䉕⺞
㛎
ᩏ 䈚䈢⚿
䈚
ᨐ䇮ක ≮㕙 ធ 䇮ญ ⣧ౝ ⸻ ᩏ䈍䈍䉋䈶᭎ ᒻශශ⽎䈮ኻኻ䈚䈩䇮㕖น ㅒ⊛䈭ญ⣧⣧ౝ䈱ಣ⟎䉇
䉇⵬✄ⵝ⟎䈱
䈱ᛛᎿ䈮㑐䈚
䈚䈩䈲⥄㛎ᢙ
ᢙ䈏ዋ䈭䈒䇮 ቇㇱᢎ⢒䈪䈪䈱⁁ᴫ䈮ടട䈋䈩⥃⥃ᐥ⎇ୃᦼ㑆
㑆䈮䈍䈇䈩䉅
䉅ᛛ⢻ᢎ⢒䈏
䈏චಽ䈮䈭䈘
䈘䉏䈩䈇䈭䈇
䈇⃻⁁䈏᣿䉌
䉌䈎䈮䈭䉍䉁䈚䈚䈢䇯㩷㩷 ᧄ 䉲䊮䊘䉳䉡䊛䊛䈪䈲䇮ᱤ ⑼ ⵬ ✄ ಽ ㊁ 䈱䉮䊮䊏䊁䊮䈱䊮䉴䉕ౣ ⠨ 䈚䇮✚䈚ว ᱤ ⑼ 䈮䈍䈇䈩ౕౕ ஻ 䈜䈼䈐ⷐⷐ ઙ 䈮䈧䈇䈩䈩⊝᭽䈫䈫৻✜䈮ᬌ⸛
⸛䈪䈐䉏䈳䈫 ᕁ䈇䉁䈜䇯㩷㩷䇼 䈗⇛ᱧ䇽㩷䋳䋵ᐕ㩷䉏㩷ർᶏ㆏㩷 ᧅ ᏻᏒ↢䉁䉏
ᤘ๺䋳
ᤘ๺䋶
䋶䋱ᐕ㩷
࿦ᄢቇ㩿⃻䋺ർർᶏ㆏ක≮ᄢ
ᄢቇ㪀ᱤቇㇱ
ㇱතᬺ㩷
᧲ᣣᧄቇ࿦
ᤘ๺䋶
䋶䋲ᐕ㩷
᧲ᣣᧄቇ࿦
࿦ᄢቇ㩿⃻䋺ർർᶏ㆏ක≮ᄢ
ᄢቇ㪀ഥᚻ䋨 ᱤቇㇱᱤ⑼⑼⵬✄ቇ╙ 㪈 ⻠ᐳ䋩㩷ᐔᚑ㩷 䋷ᐕ㩷ർᶏ㆏ක≮≮ᄢቇ⻠Ꮷ䋨䋨ᱤቇㇱᱤ⑼⑼⵬✄ቇ╙䋱䋱⻠ᐳ䋩㩷䋱䋵ᐕ㩷㪫㪿㪼㩷㪬㫅㫀㫍㪼㫉㫉㫊㫀㫋㫐㩷㫆㪽㩷㪙㫉㫀㫋㫀㫀㫊㪿㩷㪚㫆㫃㫌㫄㪹㫀㫀㪸㪃㩷㪝㪸㪺㫌㫃㫋㫐㩷 㫆㪽㩷㪛㪼㫅㫋㫀㫊㫋㫉㫐㫐㪃㩷ᐔᚑ䋱㩷 㩷 㩷 㩷 㩷 㩷 㩷㩷㪭㫀㫊㫀㫋㫀㫅㪾㩷㪘㫊 㫊㫀㫊㫋㪸㫅㫋㩷㪧㫉㫆㪽㪽㪼㫊㫊㫆㫉㩷䋱䋷ᐕ㩷≮ᄢቇ⻠Ꮷ䋨䋨୘૕Ꮕක≮≮⑼ቇ䉶䊮䉺
䉺䊷ᱤቇㇱ㐷
㐷䋩㩷
ᐔᚑ䋱
ർᶏ㆏ක≮
ർᶏ㆏ක≮
≮ᄢቇ∛㒮ᱤ
ᱤ⑼කᏧ⥃ ᐥ⎇ୃ⑼㩷 ೽⑼㐳䋨⃻࿷೽࿷䈮⥋䉎䋩㩷
㩷
ᐔᚑ䋱
䋱䋸ᐕ㩷
ർᶏ㆏ක≮
≮ᄢቇഥᢎ᝼
᝼䋨୘૕Ꮕකක≮⑼ቇ䉶䊮
䊮䉺䊷ᱤቇㇱㇱ㐷䋩㩷㩷 㩷 㩷 㩷 㩷 㩷 㩷
ᣣᧄᱤ⑼ᄢ
ᄢቇ↢๮ᱤቇ
ቇㇱⴡ↢ቇ ᢎቶ㕖Ᏹൕൕ⻠Ꮷ䋨⃻࿷
࿷䈮⥋䉎䋩㩷
䋲䋳ᐕ㩷 㩷
ർᶏ㆏ක≮≮ᄢቇಎᢎ᝼
᝼䋨ᱤቇㇱ↢↢૕ᯏ⢻∛ᘒᘒቇ♽㜞㦂㦂⠪䊶᦭∛⠪ ᱤ⑼ቇಽ㊁㊁䋩㩷ᐔᚑ䋲㩷 㩷 㩷 㩷 㩷 㩷 㩷䋨⃻࿷䈮⥋䉎䉎䋩㩷㩷ቇળ䇽㩷䇼 ਥ䈭ᚲዻቇ
ᣣᧄ⠧⠧ᐕᱤ⑼ක ቇળ䋨⹏⼏ຬຬ䋩䋨ኾ㐷ක
ක䊶ᜰዉක䋩ᣣᧄ⵬⵬✄ᱤ⑼ቇ
ቇળ䋨ኾ㐷ක 䊶ᜰዉක䋩ᣣᧄ๰๰ྨቇળ䋨⹏⹏⼏ຬ䋩㩷ᣣᧄᱤ
ᱤ⑼ක≮▤ ℂቇળ䋨ℂ੐੐䋩䋨ක≮଻
଻㒾ᆔຬ䋩㩷
ᣣᧄᱤ
ᱤ⑼ੱ㑆Ꮏ ቇળ䋨ᐙ੐䋩䋩㩷
ᣣᧄᱤ
ᱤ⑼කቇᢎ
ᢎ⢒ቇળ㩷
ᣣᧄ✚
✚วᱤ⑼ද ⼏ળ㩷―22―䋴䋮৻⥸ᱤ⑼⸻≮䋨଻ሽ♽䋩䈮䈧䈇䈩㩷㩷䇸✚วᱤ⑼ක䈮᳞䉄䉌䉏䉎䉮䊮䊏䊁䊮䉴䈫⹏ଔ䈱ౕ૕ൻ䈮䈧䈇䈩㩷䋭৻⥸ᱤ⑼⸻≮䋨଻ሽ♽䋩䈮䈧䈇䈩䋭䇹㩷㪜㫄㪹㫆㪻㫀㫄㪼㫅㫋㩷㫆㪽㩷㪚㫆㫄㫇㪼㫋㪼㫅㪺㪼㩷㪸㫅㪻㩷㫋㪿㪼㩷㪜㫍㪸㫃㫌㪸㫋㫀㫆㫅㩷㪛㪼㫄㪸㫅㪻㪼㪻㩷㪽㫉㫆㫄㩷㫋㪿㪼㩷㪞㪼㫅㪼㫉㪸㫃㩷㪛㪼㫅㫋㫀㫊㫋㫊㩷 䋭㪞㪼㫅㪼㫉㪸㫃㩷 㪛㪼㫅㫋㫀㫊㫋㫉㫐㩷 㪤㪼㪻㫀㪺㪸㫃㩷 㪫㫉㪼㪸㫋㫄㪼㫅㫋㩷 㩿㪚㫆㫅㫊㪼㫉㫍㪸㫋㫀㫍㪼㩷 㪪㫐㫊㫋㪼㫄㪀㩷䋭㩷㩷૒⮮㩷 ෹ೣ㩷 ಎᢎ᝼㩷㩷ᣣᧄᱤ⑼ᄢቇᣂẟ∛㒮✚ว⸻≮⑼㩷
㩷ዋሶ㜞 㦂ൻ 䈏ടㅦ䈜䉎ਛ䇮ᱤ ⑼ක ≮䉕ข䉍Ꮞ䈒ⅣႺ䈲ᣣ䇱ᄌൻ䈚䈩䈇䉁䈜䇯੍ 㒐䈮ኻ䈜䉎ᗧ⼂ 䈱㜞䉁䉍䈎䉌ዊ ఽ 䈱䈉ⲁ ⟕ ᖚ ₸䈲ᷫ ዋ 䈜䉎৻ ᣇ 䇮ో り䈱ஜ ᐽ 䈫ญ ⣧䈫䈱㑐 ㅪ䉅ᵈ ⋡ 䈘䉏䈩䈇䉁䈜䇯䉁䈢㜞 㦂 ⠪䊶᦭ ∛ ⠪ 䈮ኻ䈜䉎ᱤ⑼䈱ኻᔕᯏળ䈏Ⴧട䈚䈩䈍䉍䇮᭽䇱䈭㈩ᘦ䈏ᔅⷐ䈫䈭䈦䈩䈐䈩䈇䉁䈜䇯㩷䈫䈖䉐䈪ㆊ ෰ 䇮⃻ ࿷ 䇮ᧂ ᧪ 䈫ᱤ ⑼ ක ≮ 䈮᳞ 䉄䉌䉏䉎ⷐ ઙ 䈮䇸ᱤ 䈱଻ ሽ 䇹䈏䈅䉍䉁䈜䇯ᱤ 䈱㐳 ᦼ ⊛ ଻ ሽ 䉕⹜ 䉂䉎਄ 䈪ᩮ ᐙ ⊛ ᓎ ഀ 䈪䈅䉎଻ ሽ ᴦ ≮ 䈲䇮଻ ሽ ୃ ᓳ 䇮ᱤ ౝ ≮ ᴺ 䇮ᱤ ๟ ᴦ ≮ 䈱䋳ಽ ㊁ 䈮䉋䉍᭴ ᚑ 䈘䉏䇮㜞 㗫 ᐲ ᴦ ≮ 䈎䉌࿾ၞක ≮ 䈮㑐ਈ䈜䉎䊓䊦䉴䊒䊨䊝䊷䉲䊢䊮䉁䈪䇮ᄙጘ䈮䉒䈢䉍㑐ਈ䈚䈩䈇䉁䈜䇯䈠䈱䈢䉄ቴⷰ⊛ 䈭ᩮ᜚䈮ၮ 䈨䈒ല ᨐ⊛䈭ᱤ⑼ ⸻ ≮䉕ⴕ䈉䈢䉄䈮ᄙ ಽ㊁ 䈮䉒䈢䉎ၮ ␆⍮ ⼂ 䇮ၮ ᧄ ⊛䈭ฦ⒳ ᬌ ᩏ䇮᭽䇱䈭⸻ ᢿ ᛛⴚ 䈍䉋䈶⸻≮⢻ ജ䉕஻ 䈋䈩䈍䈒䈖䈫䈲ᔅ ⷐ 䈫䈭䉍䉁䈜䇯䈖䉏䉌䈱ὐ 䈎䉌⠨䈋䉎䈮ᣣ Ᏹ ⸻ ≮ 䈮䈍䈇䈩ᄙ ᢙ䉕භ 䉄䉎଻ ሽ ♽ ಽ ㊁ 䈲✚วᱤ⑼⸻≮䈮䈜䈪䈮฽䉁䉏䈢ಽ㊁䈫䉅⸒䈋䉁䈜䇯㩷䈘䈩✚วᱤ ⑼䈮᳞䉄䉌䉏䉎⸻≮䉇ⷐઙ䈫䈲䈬䈱䉋䈉䈭䉅䈱䈏⠨䈋䉌䉏䉎䈪䈚䉊䈉䈎䋿ㄭᐕ䈱ᱤ ⑼ ක≮䈪䈲ᣂ ⷙ㐿⊒䈘䉏䉎ེ᧚䉇䊁䉪䊆䉾䉪䈱ᕲᕺ䉕ฃ䈔䇮ല₸ൻ䉇㔍ᴦᕈ䈮ኻ䈜䉎ኻᔕ䈭䈬䈪ㅴᱠ䉕ㆀ䈕䈩䈇䉁䈜䇯㩷৻ ᣇ 䈪䇮⿥ 㜞 㦂 ൻ ␠ ળ 䈱ਛ 䇮ᚑ 㐳 ⊒ ⢒ 䈫ട 㦂 䈮઻ 䈉ญ ⣧ 䈱ᄌ ൻ 䈮ᨵ エ 䈮ኻ ᔕ 䈚䈭䈏䉌䇮୘ 䇱䈱ᖚ ⠪ 䈮ᔕ 䈛䈢ᦨㆡ䈭ක≮ 䉕ឭଏ䈜䈼䈐䈖䈫䈲⸒䈉䉁䈪䉅䈅䉍䉁䈞䉖䇯䈠䉏䈣䈔䈮⌀䈱✚ วᱤ ⑼ක䉕᳞䉄䈩ⴕ䈒䈮䈲᭽䇱䈭䊊䊷䊄䊦䈏੍ᗐ䈘䉏䉁䈜䇯㩷੹ ࿁ 䈱䉲䊮䊘䉳䉡䊛䈪䈲䇮✚ ว ᱤ ⑼ ක 䈮᳞ 䉄䉌䉏䉎䉮䊮䊏䊁䊮䉴䈮䈧䈇䈩଻ ሽ ♽ ಽ ㊁ 䈮䈍䈔䉎ᩇ 䈫䈭䉎䈼䈐䉅䈱䉕⠨ 䈋䇮᳞ 䉄䉌䉏䉎଻ ሽ ♽ ಽ ㊁ 䈱⍮ ⼂ 䇮⸻ ≮ 䉕ᬌ ⸛ 䈚䇮዁ ᧪ 䈱⹺ ቯ ක ೙ ᐲ 䈮䈧䈭䈏䉎ᬌ ⸛ ੐ 㗄 䈮䈧䈇䈩⠨䈋䈩䉂䉎੐䈫䈚䉁䈜䇯㩷㩷䇼䈗⇛ᱧ䇽㩷
ᤘ๺䋴䋴ᐕ㩷 ᣂẟ⋵ᣂẟᏒ↢䉁䉏㩷ᐔᚑ㩷 䋷ᐕ㩷 ᣣᧄᱤ⑼ᄢቇᣂẟᱤቇㇱතᬺ㩷ᐔᚑ䋱䋱ᐕ㩷 ᣣᧄᱤ⑼ᄢቇᄢቇ㒮ᣂẟᱤቇ⎇ⓥ⑼ඳ჻⺖⒟ୃੌ䇮ᱤቇ䋨ඳ჻䋩㩷ᐔᚑ䋱䋱ᐕ㩷 ᣣᧄᱤ⑼ᄢቇᣂẟᱤቇㇱ㩷 ഥᚻ䋨ᱤ⑼଻ሽቇ╙৻⻠ᐳ䋩㩷ᐔᚑ䋱䋵ᐕ㩷 ᣣᧄᱤ⑼ᄢቇ㩷 ᣂẟᱤቇㇱ㒝ዻ∛㒮㩷 ✚ว⸻≮⑼㩷 ഥᚻ㩷ᐔᚑ䋱䋶ᐕ㩷 ᣣᧄᱤ⑼ᄢቇ㩷 ᣂẟᱤቇㇱ㒝ዻ∛㒮㩷 ✚ว⸻≮⑼㩷 ⻠Ꮷ㩷ᐔᚑ䋱䋸ᐕ㩷 ᣣᧄᱤ⑼ᄢቇ㩷 ᣂẟ∛㒮㩷 ✚ว⸻≮⑼㩷 ක㐳૬છ䋨⃻࿷䈮⥋䉎䋩㩷ᐔᚑ䋱䋸ᐕ㩷 ᣣᧄᱤ⑼ᄢቇ㩷 ᣂẟ∛㒮㩷 ೽⎇ୃ䊒䊨䉫䊤䊛⽿છ⠪૬છ㩷ᐔᚑ䋲䋱ᐕ㩷 ᣣᧄᱤ⑼ᄢቇ㩷 ᣂẟ∛㒮㩷 ✚ว⸻≮⑼㩷 ಎᢎ᝼㩷 䋨⃻࿷䈮⥋䉎䋩㩷ᐔᚑ䋲䋵ᐕ㩷 ᣣᧄᱤ⑼ᄢቇ㩷 ᣂẟ∛㒮㩷 ⎇ୃ䊒䊨䉫䊤䊛⽿છ⠪૬છ㩷䋨⃻࿷䈮⥋䉎䋩㩷
㩷䇼ਥ䈭ᚲዻቇળ䇽㩷
ᣣᧄᱤ⑼଻ሽቇળ㩷ᣣᧄᱤౝ≮ᴺቇળ㩷
ᣣᧄᱤ⑼කቇᢎ⢒ቇળ䋨⹏⼏ຬ䋩㩷ᣣᧄ✚วᱤ⑼ද⼏ળ㩷 䋨⹏⼏ຬ䋩㩷
㩷

㩷
―23―

䋵䋮ක≮ㅪ៤䈮䈧䈇䈩㩷㩷䇸࿾ၞක≮䈮䈍䈔䉎✚วᱤ⑼ක䈱┙䈤૏⟎䉕⠨䈋䉎䇹㩷㪚㫆㫅㫊㫀㪻㪼㫉㪸㫋㫀㫆㫅㩷㫆㪽㩷㫋㪿㪼㩷㪧㫆㫊㫀㫋㫀㫆㫅㪸㫃㫀㫋㫐㩷㫆㪽㩷㫋㪿㪼㩷㪞㪼㫅㪼㫉㪸㫃㩷㪛㪼㫅㫋㫀㫊㫋㫊㩷㪸㫋㩷㫋㪿㪼㩷㪚㫆㫄㫄㫌㫅㫀㫋㫐㩷㪤㪼㪻㫀㪺㫀㫅㪼㩷㩷ኴ↰㩷 ⽾㩷 ಎᢎ᝼㩷㩷਻Ꮊᄢቇ∛㒮ญ⣧✚ว⸻≮⑼㩷
㩷䉒䈏࿖ 䈲⿥ 㜞 㦂 ␠ ળ 䉕ㄫ 䈋䇮✚ ੱ ญ 䈮භ 䉄䉎᦭ ∛ ⠪ 䈱ഀ ว 䈲Ⴧ ട 䈜䉎䈖䈫䈏੍ ᷹ 䈘䉏䈩䈇䉁䈜䇯㜞 㦂 ᦭ ∛⠪䈱↢ᵴ䈱⾰䈱ၮ⋚䈪䈅䉎ຏว䇮๰ྨ䈅䉎䈇䈲ྚਅ䈭䈬ญ⣧ᯏ⢻䈱ะ਄䈲㐳ኼ䈫㘩ᢥൻ䉕ᡰ䈋䉎㊀ⷐ࿃ሶ䈪䈅䉍䇮䈖䉏䈎䉌䈱ᱤ⑼ක≮䈮䈲䇮቟ᔃ䊶቟ో䈭ᱤ⑼ක≮䉰䊷䊎䉴䈱ឭଏ䈏᳞䉄䉌䉏䈩䈇䉁䈜䇯㩷᦭ ∛ ⠪ 䈱ᱤ ⑼ ⸻ ≮ 䈲䇮ᓥ ᧪ 䈲䇮ᄢ ቇ ∛ 㒮 䉇✚ ว ∛ 㒮 䈱ᱤ ⑼ ක Ꮷ 䈏ⴕ 䈉䈱䈏৻ ⥸ ⊛ 䈪䈅䉍䇮࿾ ၞ 䈱ᱤ ⑼ ක㒮 䈪ⴕ 䉒䉏䉎䈖䈫䈲ዋ 䈭䈎䈦䈢䇯䈚䈎䈚䇮㜞 㦂 ൻ 䈏ㅴ 䉂䋬᦭ ∛ ⠪ ᖚ ⠪ 䈏Ⴧ ᄢ 䈜䉎⃻ ⁁ 䈎䉌䇮ో り ⁁ ᘒ 䈮㈩ ᘦ 䈚䈢⸻≮䉕ⴕ䈋䉎✚วᱤ⑼ක䉕⢒ᚑ䈚䈩䈇䈒ᔅⷐ䈏䈅䉍䉁䈜䇯䈘䉌䈮䇮㪉㪇㪈㪉 ᐕ 㪏 ᦬䈮ᚑ┙䈚䈢䇸␠ળ଻㓚䈫⒢䈱৻૕ ᡷ 㕟 䇹䈪䈲䇮䇸∛ 㒮 䇹䈎䉌䇸࿾ ၞ 䇹䈻䇮䇸ක ≮ 䇹䈎䉌䇸੺ ⼔ 䇹䈻䈱䉲䊷䊛䊧䉴䈭ᵹ 䉏䉕䈧䈒䉎䈫䈇䈉ⷰ ᔨ 䈏ද ⺞ 䈘䉏䇮䇸࿾ ၞ ൮ ᜝ 䉬䉝䉲䉴䊁䊛䇹䈏᭴ ▽ 䈘䉏䈧䈧䈅䉍䉁䈜䇯ᓥ ᧪ 䈎䉌䇮ᱤ ⑼ ක Ꮷ 䈲࿾ ၞ ᱤ ⑼ ක ≮ 䉰䊷䊎䉴䉕ታ 〣 䈚䇮࿾ၞ૑᳃䈱ญ ⣧ஜᐽ䈮៤ 䉒䈦䈩䈐䉁䈚䈢䈏䇮੹ᓟ 䈲䇸࿾ၞ൮᜝䉬䉝䉲䉴䊁䊛䇹䈱ᄙ⡯⒳ ㅪ៤䈱䈭䈎䈪䇮⥄䉌䈱┙ 䈤૏⟎䉕⏕┙䈚䈩䈇䈒䈖䈫䈏ᔅⷐ䈫䈭䉍䉁䈜䇯䈢䈫䈋䈳䇮∛㒮䈎䉌䈱ⷐ੺⼔㜞㦂⠪䈏䇮࿷ቛක≮䉇੺⼔⑔␩ᣉ⸳䈮⒖䈦䈢䈫䈐䇮੹䉁䈪䈲䇮⸰໧⸻≮䉇ྚਅ䊥䊊䉕ⴕ䈉৻ㇱ䈱ᱤ⑼කᏧ䈏䈎䈎䉒䈦䈩䈐䉁䈚䈢䇯䈚䈎䈚䇮੹ᓟ䈲⚵❱䈣䈦䈢ข⚵䉂䈏ᔅⷐ䈫䈭䉍䇮㜞䉁䉍䈧䈧䈅䉎࿷ቛ䈱ⷐ੺⼔㜞㦂 ⠪䈱ᱤ⑼䊆䊷䉵䈲䇮࿾ၞᱤ⑼ක≮ 䉕ᜂ䈉✚วᱤ⑼ක䈏ข 䉍⚵ 䉃䈼䈐⺖ 㗴 䈫䈭䈦䈩䈇䉁䈜䇯䈖䈱䉋䈉䈭㜞㦂 ൻ␠ ળ䈱ㅴ ዷ 䇮࿷ቛ ⸰໧ ⸻ ≮䈱㔛 ⷐ䇮๟ⴚ ᦼญ ⣧ ᯏ⢻
▤ ℂ ╬ 䈱␠ ળ ᖱ ൓ 䈱ᄌ ൻ 䈮஻ 䈋䉎䈢䉄䇮ᓥ ᧪ 䈱ᱤ ⑼ ක ≮ 䈱ㆀ ⴕ ⢻ ജ 䈮ട 䈋䈩䇮ో り ⁁ ᘒ 䉇␠ ળ ⊛ ⢛ ᥊ 䉁䈪㈩ᘦ䈜䉎⢻ജ䈏ᔅⷐ䈫䈭䉍䉁䈜䇯㩷ᧄ䉲䊮䊘䉳䉡䊛䈪䈲䇮✚ว ᱤ⑼ක 䈏࿾ ၞ䈪ᄙ⡯ ⒳ 䊶ක≮ㅪ៤ 䉕ታ〣䈚䈩䈇䈒㓙䈮ᔅ ⷐ䈫䈭䉎⢻ ജ䈧䈇䈩ᬌ ⸛䈚䇮੹ᓟ䈱ක≮䈮䈍䈔䉎✚วᱤ⑼ක䈱૶๮䈮䈧䈇䈩ળຬ䈱⊝᭽䈫৻✜䈮⠨䈋䈩䉂䈢䈇䈫ᕁ䈇䉁䈜䇯㩷㩷䇼䈗⇛ᱧ䇽㩷
ᤘ๺䋳䋵ᐕ㩷 ౓ᐶ⋵ᆢ〝Ꮢ↢䉁䉏㩷ᤘ๺䋶䋳ᐕ㩷 ᓼፉᄢቇᱤቇㇱතᬺ㩷ᐔᚑ䋴ᐕ㩷 㩷 ᓼፉᄢቇᄢቇ㒮ᱤቇ⎇ⓥ⑼䋨ዊఽᱤ⑼ቇኾ᡹䋩ୃੌ㩷ᐔᚑ䋴ᐕ㩷 㩷 ᓼፉᄢቇഥᚻ䋨ᱤቇㇱ㩷 ዊఽᱤ⑼ቇ⻠ᐳ䋩㩷ᐔᚑ䋶ᐕ㩷 㩷 ᄢ㒋ᐭ┙ᚑੱ∛䉶䊮䉺䊷䊧䉳䊂䊮䊃㩿ਛᄩᚻⴚ⑼䋨㤗㈮⑼㪀䋩㩷
ᐔᚑ䋷ᐕ㩷 ᐢፉᄢቇഥᚻ䋨ᱤቇㇱ㒝ዻ∛㒮㩷 ᱤ⑼㤗㈮⑼䋩㩷
ᐔᚑ䋱䋲ᐕ㩷 ᐢፉᄢቇഥᚻ䋨ᱤቇㇱ㩷 ᱤ⑼㤗㈮ቇ⻠ᐳ䋩㩷ᐔᚑ䋱䋸ᐕ㩷 ᐢፉᄢቇ∛㒮⸻≮⻠Ꮷ䋨ᱤ⑼㤗㈮⑼䋩㩷 㩷ᐔᚑ䋱䋹ᐕ㩷 ਻Ꮊᄢቇ∛㒮⻠Ꮷ㩿ญ⣧✚ว⸻≮⑼㪀㩷
ᐔᚑ䋲䋲ᐕ㩷 ਻Ꮊᄢቇ∛㒮⸻≮ಎᢎ᝼㩿ญ⣧✚ว⸻≮⑼㪀㩷
㩷 㩷 㩷 㩷 㩷 㩷 㩷 㩷 㩷 䋨⃻࿷䈮⥋䉎䋩㩷㩷䇼ਥ䈭ᚲዻቇળ䇽㩷ᣣᧄዊఽᱤ⑼ቇળ䋨ኾ㐷ක䋩㩷ᣣᧄᱤ⑼㤗㈮ቇળ䋨⹺ቯක䋩㩷 㩷ᣣᧄ㓚ኂ⠪ᱤ⑼ቇળ㩷
ᣣᧄᱤ⑼කቇᢎ⢒ቇળ㩷ᣣᧄ✚วᱤ⑼ද⼏ળ䋨⹏⼏ຬ䇮ቇⴚᬌ⸛ᆔຬળᆔຬ䋩㩷―24―

䊤䊮䉼䊢䊮䉶䊚䊅䊷㩷
ᱤ⑼✚ว⸻≮⢻ജࠍቇ⠌ߢ߈ࠆᢎ⢒⾗Ḯߩ㐿⊒ᳰ↰੝♿ሶ
ᤘ๺ᄢቇᱤቇㇱ ᱤ⑼଻ሽቇ⻠ᐳ ✚ว⸻≮ᱤ⑼ቇㇱ㐷ᤓ੹ߩ࿖㓙⊛ߥක≮ߩ⿲൓ߪ‫ޔ‬නߦ∔∛ࠍᴦ≮ߒ∝⁁ࠍ✭๺ߔࠆߛߌߢߥߊ‫ੱޔ‬㑆ߩᔃりో૕ࠍ⸻ࠆ‫ޟ‬ේ࿃≮ᴺ‫ࠍޠ‬ਛᔃߣߒߚ੍㒐⊛൮᜝⸻≮߇ᔅⷐߢ޽ࠆߣ޿߁⠨߃ᣇߦᕆㅦߦ⒖ⴕߒߡ޿ࠆ‫ߦ․ޕ‬ᱤ⑼ක≮ಽ㊁ߦ߅޿ߡߪ‫⿥ޔ‬㜞㦂␠ળߦะߌߡᴦ≮ߣߒߡߩක≮ߛߌߢߪߥߊ∔∛੍㒐㗔ၞ߽㊀ⷐⷞߐࠇߡ߅ࠅ‫੍ޔ‬㒐⊛൮᜝⸻≮߳ߩᦼᓙᐲߪ⋉‫ޘ‬㜞߹ࠆߣ੍ᗐߐࠇ
ࠆ‫ޕ‬ᱤ⑼∔ᖚߩ․ᓽߣߒߡߘߩᄙߊ߇੍㒐น⢻ߢ޽ࠅ‫ޔ‬ญ⣧ᯏ⢻ࠍ࿁ᓳ࡮⛽ᜬߔࠆߎߣߪߘ
ߩ߹߹ᖚ⠪ߩ 31. ߦ❬߇ࠆߎߣ߆ࠄ‫ޔ‬⤘ࠇ਄߇ࠆක≮⾌ߩᛥ೙ߦߟߥ߇ࠆߎߣ߇ᦼᓙߐࠇࠆ‫ޕ‬৻ᖚ⠪ߩ㐳ኼஜᐽࠍታ⃻ߔࠆߚ߼ߩ੍㒐⊛൮᜝⸻≮ࠍᱤ⑼ක≮ߩಽ㊁߆ࠄታᣉߔࠆߚ߼
ߦߪ↢ߓߡߒ߹ߞߚ∔ᖚߩේ࿃ࠍಽᨆߒ‫ⷐޔ‬࿃ࠍឃ㒰ߔࠆᴦ≮⸘↹߇ᔅ㗇ߢ޽ࠆ‫ߘߡߒߘޕ‬ߩ‫ⷐޟ‬࿃‫ߪޠ‬ญ⣧ౝᚲ⷗߆ࠄផኤߐࠇࠆߎߣ߽⃟ߒߊߥߊ‫ޔ‬ᱤቇㇱᢎ⢒ߦ߅޿ߡߪ⥃ᐥታ⠌ߦ਄߇ࠆ೨ߩᲑ㓏߆ࠄ⏕ታߥญ⣧ౝᚲ⷗ߩⷰኤ࡮ផኤജࠍၭ߁ߎߣ߇㊀ⷐߢ޽ࠆߣ⠨߃ࠆ‫ޕ‬ߘߎߢ੹࿁‫ޔ‬ᄙ↰ల⵨ಎᢎ᝼㧔ᣣᧄᄢቇ㧕‫ޔ‬ጊญඳᐽ⻠Ꮷ㧔㢬⷗ᄢቇ㧕‫◊ ᧄ⚕ޔ‬ಎᢎ᝼㧔ᣣᧄᄢቇ㧕‫᧛ޔ‬਄ᐘ↢ಎᢎ᝼㧔᣿ᶏᄢቇ㧕߅ࠃ߮ ⷺ↰ ᤩ⻠Ꮷ㧔␹ᄹᎹᱤ⑼ᄢቇ㧕ߣߩ౒ห㐿⊒ߦࠃࠆ‫ޔ‬᭽‫ߥޘ‬໧㗴߿∔ᖚࠍ᦭ߔࠆญ⣧ౝࠍᮨဳ਄ߦౣ⃻ߐߖࠆߎߣߢญ⣧ౝ㧔ᮨဳ㧕߆ࠄᓧࠄࠇࠆᖱႎࠍᢛℂߒ‫ޔ‬໧㗴ߩⷐ࿃ࠍផ᷹ߔࠆߣߣ߽ߦ‫ޔ‬൮᜝⊛⸻≮ࠍࠪࡘࡒ࡟࡯
࡚ࠪࡦߢ߈ࠆታ⠌↪ᮨဳࠍ⚫੺ߔࠆ‫ޕ‬⿥㜞㦂␠ળߦะߌߡ࿖᳃߇㐳ኼஜᐽࠍో߁ߔࠆߚ߼ߦߪญ⣧ᯏ⢻ࠍ࿁ᓳ࡮⛽ᜬߔࠆߎߣ߇
㊀ⷐߢ޽ࠅක≮࠴࡯ࡓߩ৻ຬߣߒߡᱤ⑼කᏧ߇ᨐߚߔᓎഀߪᄢ߈޿‫ޕ‬
੹࿁ߪᱤ⑼ߣߪ⇣ߥࠆಽ㊁߆ࠄ‫߽ߡ޿ߟߦޠࡓ࠭࡝࠽࡚ࠪ࠶ࠚࡈࡠࡊޟޔ‬⠨ኤߒߚ޿‫ޕ‬ද⾥ ᩣᑼળ␠ ࠾࠶ࠪࡦ
⇛ᱧ ᐕ ᤘ๺ᄢቇᱤቇㇱතᬺ࡮╙  ᱤ⑼⵬✄ቇᢎቶ౉ዪ
 ᐕ ᤘ๺ᄢቇᄢቇ㒮ᱤቇ⎇ⓥ⑼ୃੌ
 ᐕ ᤘ๺ᄢቇᱤቇㇱ ✚ว⸻≮ᱤ⑼ቇ ഥᢎኾ㐷කᣣᧄ⵬✄ᱤ⑼ቇળ ኾ㐷ක―25―

ཱྀ₇Ⓨ⾲㻌 䠫䠉㻝㻌㻌ึデ་⒪㠃᥋䛻䛚䛡䜛⌧⑓Ṕグ㍕䛸 㻾㻵㻭㻿 䛻䜘䜛㛵ಀゎᯒ䛾ヨ䜏㻌
Relationship analysis of RIAS and current medical history in medical interviewࠐ㟷ᮌఙ୍㑻 㻝㻕㻌㻞㻕䠈Ლᮏ┿⃈ 㻝㻕䠈ᒸᮏᗣ⿱ 㻝㻕㻌㻞㻕䠈ෆ⏣㈗அ 㻝㻕㻌㻞㻕䠈㐲⸨ᘯᗣ 㻝㻕㻌㻞㻕䠈኱ἑ⪷Ꮚ 㻝㻕㻌㻞㻕䠈ከ⏣඘⿱ 㻝㻕㻌㻞㻕䠈㻌ఀ⸨Ꮥカ 㻝㻕㻌㻞㻕㻌᪥ᮏ኱ᏛᯇᡞṑᏛ㒊ṑ⛉⥲ྜデ⒪Ꮫㅮᗙ 㻝㻕䠈᪥ᮏ኱ᏛᯇᡞṑᏛ㒊ཱྀ⭍⛉Ꮫ◊✲ᡤ 㻞㻕㻌 
ࠐShinichiro Aoki㻝㻕㻌㻞㻕, Masumi Kajimoto1), Yasuhiro Okamoto㻝㻕㻌㻞㻕, Takashi Uchida㻝㻕㻌㻞㻕, Hiroyasu Endo㻝㻕㻌㻞㻕,
Seiko Osawa㻝㻕㻌㻞㻕, Mitsuhiro Ohta㻝㻕㻌㻞㻕, Takanori Ito㻝㻕㻌㻞㻕
Dept. of Oral Diagnosis, Nihon University School of Dentistry at Matsudo, Chiba㸪Japan. 1)
Research Institute of Oral Science, Nihon University School of Dentistry at Matsudo2)䛆⥴ゝ䛇㻌་⒪㠃᥋䛻䛚䛡䜛⌧⑓Ṕ䛾⫈ྲྀ䛿䚸デ᩿᥎ㄽ䜔ᝈ⪅䛜⌧ᅾ䛾⑕≧䛛䜙⑌ᝈ䜢䛹䛾䜘䛖䛻ᤊ䛘䛶䛔䜛䛛䜢▱䜛䛯䜑䛻㔜せ䛺デᐹ䛷䛒䜚䚸⫈ྲྀ䛧䛯ෆᐜ䜢䜘䜚ⓗ☜䛻グ㍕䛩䜛䛣䛸䛜ồ䜑䜙䜜䜛䚹䛧䛛䛧䚸ᐇ㝿䛻㝔ෆ⏕䛻ᝈ⪅䛻ᑐ䛧䛶་⒪㠃᥋䛷⌧⑓Ṕグ㍕䜢⾜䜟䛫䜛䛸ⓗ☜䛺⌧⑓Ṕグ㍕䛜䛷䛝䛺䛔䜒䛾䛜䜏䜙䜜䜛䚹་⒪᝟ሗ䛾཰㞟䛿䚸䝁䝭䝳䝙䜿䞊䝅䝵䞁䜢䛸䜚䛺䛜䜙䚸᝟ሗ䜢ྲྀᤞ㑅ᢥ䛧⮫ᗋ᥎ㄽ䜢䛧䛶䛔䜛䛯䜑䛻㞴䛧䛟䚸䝁䝭䝳䝙䜿䞊䝅䝵䞁⬟ຊ䛿኱䛝䛟䛛䛛䜟䜛䚹䛭䛣䛷䚸⌧⑓Ṕグ㍕䛜༑ศ䛻⾜䜟䜜䛶䛔䜛Ꮫ⏕䛸୙༑ศ䛺Ꮫ⏕䛻䛴䛔䛶䚸⌧⑓Ṕグ㍕䛾ෆᐜ䛸་⒪㠃᥋᫬䛾఍ヰ䛾䝁䝭䝳䝙䜿䞊䝅䝵䞁䝇䝍䜲䝹䛻䛹䛾䜘䛖䛺㐪䛔䛜䛒䜛䛛᳨ウ䜢⾜䛳䛯䚹㻌䛆᪉ἲ䛇㻌ᑐ㇟䛿䚸ึデእ᮶ᝈ⪅䛻ᑐ䛧䛶་⒪㠃᥋䜢⾜䛳䛯 㻡 ᖺḟ⏕ 㻝㻞㻞 ྡ䛾䛖䛱䚸⣙ 㻝㻜 ศ㛫⛬ᗘ䛾་⒪㠃᥋䛷䚸⮫ᗋデ᩿ྡ䛜ẚ㍑ⓗ᥎ᐹ䛧䜔䛩䛔ᬛṑ࿘ᅖ⅖༢⊂䛷䚸Ꮫ⏕䛾᥎ᐃデ᩿ྡ䛜୍⮴䛧䛯 㻝㻞 ྡ䛷䛒䜛䚹Ꮫ⏕䛻䛿⮫ᗋデ᩿ྡ䛾᥎ㄽ䚸⌧⑓Ṕ䛺䛹䛾⫈ྲྀ䚸䛭䛾ᚋ䛻་⒪㠃᥋ෆᐜ䜢䜎䛸䜑䜛䛸䛣䜝䜎䛷䜢ึデᐇ⩦䛾ㄢ㢟䛸䛧䛯䚹⌧⑓Ṕ䛾グ㍕㡯┠䛜ከ䛔䜒䛾䛸ᑡ䛺䛔䜒䛾䛸䜢䜾䝹䞊䝥ศ䛡䛧䛯䚹㘓⏬䛧䛯ᫎീ䛛䜙 㻾㻵㻭㻿 䜢⏝䛔䛶ゎᯒ䛧䚸䜾䝹䞊䝥䛾ഴྥ䛻䛴䛔䛶᳨ウ䛧䛯䚹㻌䛆⤖ᯝ䛇㻌⌧⑓Ṕ䛾グ㍕㡯┠䛜ከ䛔䜾䝹䞊䝥䛿䚸䛂⑕≧䛾ᛶ≧䛻㛵䛩䜛ෆᐜ䛃䛾グ㍕䛜ከ䛟䚸ᝈ⪅䛸䛾఍ヰ䛷䛿䛂䛒䛔䛵䛱䛃䛜ከ䛛䛳䛯䚹ᑡ䛺䛔䜾䝹䞊䝥䛿䛂ᙜ㝔䜈䛾ཷデືᶵ䛃䛜ከ䛟䚸䛂䛘䞊䛃䛂䛒䞊䛃䛺䛹䛾䝣䜱䝷䞊䛜ከ䛛䛳䛯䚹㻌䛆⪃ᐹ䛇㻌
グ㍕㡯┠䛜ከ䛔䜾䝹䞊䝥䛻䜏䜙䜜䜛䛂䛒䛔䛵䛱䛃䛿䚸ᝈ⪅䛻Ⓨゝᶒ䜢ጤ䛽䚸䛔䛛䛻ከ䛟䛾᝟ሗ䜢⫈ྲྀ䛧䜘䛖䛸䛩䜛䛂ಁ䛧䛃䜢ຠᯝⓗ䛻⏝䛔䛶䚸ᝈ⪅䛾஦᝟䜢⪃៖䛧䛶䚸ᝈ⪅⮬㌟䛾ゝⴥ䛷⑕≧᥎⛣䜢᣺䜚㏉䜙䛫䜛䛣䛸䜢┠ⓗ䛻⏝䛔䛶䛔䜛ឤ䛜⾲ฟ䛥䜜䛶䛔䛯䚹୍᪉䚸ᑡ䛺䛔䜾䝹䞊䝥䛿䝣䜱䝷䞊䛜ከ䛟䜏䜙䜜䚸఍ヰ䜢ಁ䛩䛣䛸䜘䜚䜒䚸Ꮫ⏕⮬㌟䛾㒔ྜ䛻䜘䛳䛶⾲ฟ䛥䜜䛯Ⓨヰ䛷䛒䜛䛣䛸䛜♧၀䛥䜜䛯䚹㻌
㻌
㻌
―26―

ཱྀ₇Ⓨ⾲㻌 䠫䠉㻞㻌㻌య⣔໬䛥䜜䛯 㻱㼢㼕㼐㼑㼚㼏㼑㻙㻮㼍㼟㼑㼐㻌㻰㼑㼚㼠㼕㼟㼠㼞㼥䞉⮫ᗋ␿Ꮫᩍ⫱䛾ヨ䜏㻌
A systematic educational program for evidence-based dentistry and clinical epidemiology‫ۑ‬ゅ⯓┤ᶞ  㸪ⰼ㇂ᬛဢ  㸪၈ᮌ⣧୍  㸪⚟Ἠ㝯႐  㸪ᮌᑿဴᮁ  㸪すཎ㐩ḟ  ஑ᕞṑ⛉኱Ꮫ໭஑ᕞᆅ༊኱Ꮫ㐃ᦠᩍ⫱◊✲ࢭࣥࢱ࣮ 㸪஑ᕞṑ⛉኱ᏛṑᏛ㒊ṑᏛ⛉⥲ྜᩍ⫱Ꮫศ㔝♫఍ṑ⛉Ꮫ◊✲ᐊ  㸪஑ᕞṑ⛉኱ᏛṑᏛ㒊ṑᏛ⛉⥲ྜデ⒪Ꮫศ㔝  㸪஑ᕞṑ⛉኱ᏛṑᏛ㒊ṑᏛ⛉ឤᰁศᏊ⏕≀Ꮫศ㔝㸲 ‫ۑ‬Naoki Kakudate1), Tomoya Hanatani1), Junichi Karaki1), Takaki Fukuizumi1,2), Tetsuro Konoo3),
Tatsuji Nishihara4)
Educational Cooperation Center, Kyushu Dental University1), Laboratory of Social Dentistry, Division ofGeneral Education, School of Dentistry, Kyushu Dental University 2), Division of Comprehensive Dentistry,
School of Dentistry, Kyushu Dental University 3), Division of Infections and Molecular Biology, School of
Dentistry, Kyushu Dental University4)䛆⥴ゝ䛇㻌㻱㼢㼕㼐㼑㼚㼏㼑㻙㻮㼍㼟㼑㼐㻌 㻰㼑㼚㼠㼕㼟㼠㼞㼥㻌 㻔㻱㻮㻰㻕䛜ᥦၐ䛥䜜䛶䛛䜙⣙ 㻞㻜 ᖺ䛜⤒㐣䛧䚸䛭䛾㔜せᛶ䛻䛴䛔䛶䛿ㄽ䜢ಗ䛯䛺䛔䚹㻱㻮㻰 䜢ᐇ㊶䛩䜛㝿䛻䛿䚸⮫ᗋ␿Ꮫ◊✲䛻䜘䜛䜶䝡䝕䞁䝇䛜ᚲせ䛷䛒䜛䛜䚸ᐇ㝿䛾デ⒪⌧ሙ䛷䛿ཧ⪃䛸䛩䜛䜶䝡䝕䞁䝇䛿୙㊊䛧䛶䛔䜛䚹䜘䛳䛶䜶䝡䝕䞁䝇䛾䛂䛴䛛䛔ᡭ䛃䛸䛂䛴䛟䜚ᡭ䛃䛾୧᪉䜢ᢸ䛖ṑ⛉་ᖌ䜢⫱ᡂ䛩䜛䛯䜑䛻஑ᕞṑ⛉኱Ꮫ䛷ᐇ᪋䛥䜜䛶䛔䜛 㻱㻮㻰䞉⮫ᗋ␿Ꮫᩍ⫱䝥䝻䜾䝷䝮䛾ヨ䜏䛻䛴䛔䛶ሗ࿌䛩䜛䚹㻌䛆᪉ἲ䛇㻌஑ᕞṑ⛉኱Ꮫ 㻠 ᖺḟᏛ⏕䜢ᑐ㇟䛻඲ 㻠 ᅇ䠄㻥㻜 ศ㽢䠐䝁䝬䠅䛾䛂㻱㻮㻰 ₇⩦䛃䜢ᐇ᪋䛧䛯䚹ྛᅇ䛸䜒 㻟㻜 ศ䛾ㅮ⩏䛸㻢㻜 ศ䛾䜾䝹䞊䝥䝕䜱䝇䜹䝑䝅䝵䞁䛛䜙ᵓᡂ䛥䜜䜛䚹ᩍ⫱ෆᐜ䛿䠍䠅␲ၥ䛾ᵓ㐀໬䚸䠎䠅◊✲䝕䝄䜲䞁䚸䠏䠅䜶䝡䝕䞁䝇䛾᳨⣴䚸䠐䠅ᢈุⓗྫྷ࿡䛸䛧䛯䚹䜎䛯䚸஑ᕞṑ⛉኱Ꮫ኱Ꮫ㝔⏕䛚䜘䜃ᩍဨ䜢ᑐ㇟䛻䚸䛂⮫ᗋ␿Ꮫ䞉㻱㻮㻰 䝉䝭䝘䞊䛃䜢ẖ㐌 㻝 ᅇ䠄ྛᅇ 㻢㻜 ศ㛫䠅ᐇ᪋䛧䛶䛔䜛䚹ᮏ䝉䝭䝘䞊䛷䛿䚸㻱㻮㻰 䛻ຍ䛘䛶䚸㻻㻶㼀㻌㻔㻻㼚㻌㼠㼔㼑㻌㻶㼛㼎㻌㼀㼞㼍㼕㼚㼕㼚㼓㻕㻌 ᪉ᘧ䛷ཧຍ⪅ྛ⮬䛾䝸䝃䞊䝏䜽䜶䝇䝏䝵䞁䜢ゎỴ䛩䜛䛯䜑䛾⮫ᗋ␿Ꮫ◊✲䝥䝻䝖䝁䞊䝹సᡂ䛚䜘䜃ㄽᩥ໬䛾ᨭ᥼䜢ᐇ᪋䛧䛶䛔䜛䚹㻌䛆⤖ᯝ䛇㻌㻠 ᖺḟᏛ⏕䜢ᑐ㇟䛸䛧䛯䛂㻱㻮㻰 ₇⩦䛃⤊஢ᚋ䛾ㄪᰝ⤖ᯝ䛛䜙䛿䚸䛂䝕䞊䝍䜔≀஦䜢ᢈุⓗᛮ⪃䛷ぢ䜛஦䛜኱஦䛸⌮ゎ䛧䛯䛃䚸䛂⌧ሙ䛸◊✲䛸䛾䛴䛺䛜䜚䛷⌧ሙ䛜㐍໬䛩䜛䛸ᛮ䛖䛃䚸䛂䜏䜣䛺䛷༠ຊ䛧䛶୍䛴䛾ㄽᩥ䜢ㄞ䜣䛰䛾䛿㈗㔜䛺య㦂䛷䛧䛯䛃䛺䛹䛾ឤ᝿䛜ᚓ䜙䜜䛯䚹኱Ꮫ㝔⏕䛚䜘䜃ᩍဨ䜢ᑐ㇟䛸䛧䛯䛂⮫ᗋ␿Ꮫ䞉㻱㻮㻰 䝉䝭䝘䞊䛃䛷䛿䚸ᇶ♏ⓗ▱㆑䛻㛵䛩䜛ㅮ⩏䞉ᐇ⩦䜢⤊䛘䚸⌧ᅾ䠓䛴䛾デ⒪⛉䛻䛚䛔䛶ᐇ㝿䛻◊✲䝥䝻䝆䜵䜽䝖䛜㛤ጞ䛥䜜䛶䛔䜛䚹㻌䛆⪃ᐹ䛚䜘䜃䜎䛸䜑䛇㻌㻱㻮㻰 䛾⩦ᚓ䛻䜘䜚䚸ᢈุⓗᛮ⪃⬟ຊ䛜㧗䜎䜛ྍ⬟ᛶ䛜♧၀䛥䜜䛯䚹⮫ᗋ␿Ꮫ䞉㻱㻮㻰 䝉䝭䝘䞊䛷䛿䚸ྛデ⒪⛉䛤䛸䛻⮫ᗋ␿Ꮫ◊✲䛻⩦⇍䛧䛯ேᮦ䜢⫱ᡂ䛧䛶䛚䜚䚸ᮏ䝉䝭䝘䞊䛾⥅⥆䛻䜘䜚ྛデ⒪⛉ෆ䛷䛾⮫ᗋ◊✲䛾ಁ㐍䛜ᮇᚅ䛥䜜䜛䚹௒ᚋ䚸䛥䜙䛻య⣔ⓗ䛛䛴ᩍ⫱ຠᯝ䛾㧗䛔⮫ᗋ␿Ꮫ䞉㻱㻮㻰 ᩍ⫱䝥䝻䜾䝷䝮䜢ᵓ⠏䛧䛶䛔䛟ணᐃ䛷䛒
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ཱྀ₇Ⓨ⾲㻌 䠫䠉㻟㻌㻌ᒸᒣ኱Ꮫ⑓㝔䛻䛚䛡䜛◊ಟṑ⛉་䛻ᑐ䛩䜛་⒪Ᏻ඲ᩍ⫱䛾ྲྀ䜚⤌䜏㻌The measure of medical safety education to trainee dentists in Okayama University Hospital䕿ⓑ஭㻌 ⫕ 㻝㻘㻞䠅䚸ሷὠ⠊Ꮚ 㻝㻕䚸Ṋ⏣ᏹ᫂ 㻝㻕䚸኱ሯᜨ⌮ 㻝㻕䚸᱓ᒣ㤶⧊ 㻝㻕䚸㕥ᮌᗣྖ 㻝㻕䚸Ἑ㔝㝯ᖾ 㻝㻕䚸ᑠ᮶⏣⨾㤶 㻝㻕䚸ኴ⏣ளᕼ 㻝㻕䚸ྜྷ⏣ⓏᚿᏊ㻘㻞䠅䚸㫽஭ᗣᘯ 㻝㻕㻌ᒸᒣ኱Ꮫ⑓㝔㻌 ⥲ྜṑ⛉ 㻝㻕㻘ᒸᒣ኱Ꮫ㻌 ་⒪ᩍ⫱⤫ྜ㛤Ⓨ䝉䞁䝍䞊㻔ṑᏛᩍ⫱㒊㛛㻕㻞㻕㻌ࠐHajime Shirai1,2), Noriko Shiotsu1), Hiroaki Taketa1), Eri Ohtsuka1), Kaori Kuwayama1), Kouji Suzuki1),
Takayuki Kono1), Mika Kogita1), Aki Ohta1), Toshiko Yoshida2), Yasuhiro Torii 1)
Comprehensive Dental Clinic, Okayama University Hospital 1), Center for the Development of Medical and
Health Care Education (Dental Education), Okayama University2)䛆⫼ᬒ䛸┠ⓗ䛇㻌་⒪ே䜢⫱ᡂ䛩䜛䛯䜑䛾䜹䝸䜻䝳䝷䝮䛿䚸䛭䛾᫬௦䛾䝙䞊䝈䛻ᛂ䛨㐺ᛂ䛩䜉䛟⤯䛘䛪ኚ໬䛧䛶䛔䜛䚹䇾ᝈ⪅Ᏻ඲䛾ᩍ⫱䛸カ⦎䇿䛾㔜せᛶ䛿䚸ᩘᖺ๓䛛䜙㔜せᛶ䛜ྲྀ䜚ୖ䛢䜙䜜䛶䛿䛔䛯䛜䚸䠎䠌䠍䠍ᖺ䛻 㼃㻴㻻 䛛䜙䇾㼃㻴㻻 ᝈ⪅Ᏻ඲䜹䝸䜻䝳䝷䝮ከ⫋✀∧䠎䠌䠍䠍䇿䛜Ⓨห䛥䜜䚸䜘䛖䜔䛟⥴䛻䛴䛔䛯䛸䛣䜝䛷䛒䜛䚹ᚑ䛳䛶䚸་⒪Ᏻ඲䛾༞ᚋᩍ⫱䛿䛔䜎䛰య⣔໬䛥䜜䛶䛔䛺䛔≧ែ䛷䛒䜛䛸ゝ䛘䜛䚹ᮏᖺᗘ䠓᭶䛻㛤ദ䛥䜜䛯᪥ᮏṑ⛉་Ꮫᩍ⫱Ꮫ఍䛻䛚䛔䛶䚸䛭䛾᪥ᮏㄒ∧䜢ධᡭ䛩䜛ᶵ఍䜢ᚓ䛯䛾䛷䚸䛣䜜䜢ᶵ䛻䚸ᒸᒣ኱Ꮫ⑓㝔༞ᚋ⮫ᗋ◊ಟ䝥䝻䜾䝷䝮䛾་⒪Ᏻ඲䛻㛵䛩䜛㡯┠䜢ぢ┤䛧䚸䠎䠌䠍䠏ᖺᗘ䛛䜙᪂䛯䛺་⒪Ᏻ඲ᩍ⫱䛻㛵䛩䜛䝥䝻䜾䝷䝮䜢ヨ䜏䛶䛔䜛䛾䛷ሗ࿌䛩䜛䚹㻌䛆ྲྀ䜚⤌䜏䛇㻌
䠎䠌䠍䠎ᖺᗘ䜎䛷䛿䚸་⒪Ᏻ඲䛻㛵䛩䜛䝥䝻䜾䝷䝮䛸䛧䛶䛿䚸⑓㝔䛻໅ົ䛩䜛་⒪⫋඲䛶䜢ᑐ㇟䛸䛧䛯་⒪Ᏻ඲
䛻㛵䛩䜛ㅮ₇఍䛻ຍ䛘䛶䚸㐣ཤ䛾ṑ⛉≉᭷䛾䜲䞁䝅䝕䞁䝖䛛䜙䛾䜿䞊䝇䝯䝋䝑䝗ᤵᴗ䛺䜙䜃䛻䜲䞁䝅䝕䞁䝖䝺䝫䞊䝖䛾✚ᴟⓗグ㍕䜢ಁ䛩⛬ᗘ䛾䜒䛾䛷䛒䛳䛯䛜䚸䠎䠌䠍䠏ᖺᗘ䛛䜙䛿䚸◊ಟṑ⛉་䛻ᑐ䛧䛶䇾་⒪䛾Ᏻ඲䜢ᨭ䛘䜛䝜䞁䝔䜽䝙䜹䝹䝇䜻䝹䜢䛔䛛䛻ᩍ⫱䛩䜛䛛䠛䇿䛸䛔䛖䛣䛸䜢䝔䞊䝬䛻䚸ᚑ᮶䛛䜙䛾䝥䝻䜾䝷䝮䛻㏣ຍ䛧䛶䚸䝠䝳䞊䝬䞁䜶䝷䞊䚸ᡃ䛜ᅜ䛾་⒪Ᏻ඲᪋⟇䛾ືྥ䛸ἲⓗၥ㢟䚸་⒪Ᏻ඲䛻㛵䛩䜛 㻰㼂㻰 䛾ど⫈䛸䜾䝹䞊䝥䝽䞊䜽➼䜢⾜䛳䛶䛔
䜛䚹㻌
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་⒪Ᏻ඲䛻ᑐ䛩䜛㛵ᚰ䛿䚸་⒪⌧ሙ䜢య㦂䛧䛶ጞ䜑䛶⏕䛨䜛䜒䛾䛷䛒䜛䚹䛧䛯䛜䛳䛶䚸◊ಟṑ⛉་䛾᫬ᮇ䛻ᩍ⫱䛩䜛䛣䛸䛜㠀ᖖ䛻㔜せ䛷䛒䜛䚹䝉䝭䝘䞊䜢㏻䛨䛶◊ಟṑ⛉་䛿䚸་⒪䝅䝇䝔䝮䛾䛒䜚᪉䛜་⒪䛾㉁䛸Ᏻ඲䛻ᙳ㡪䜢୚䛘䜛䛸䛔䛖䛣䛸䜔䚸䝁䝭䝳䝙䜿䝅䝵䞁䛾୙ഛ䛿᭷ᐖ஦㇟䜔᭦䛻῝้䛺஦ែ䛻⧅䛜䜛䛸䛔䛖䛣䛸䛜ᑡ䛧⌮ゎ䛷䛝䛯ᵝᏊ䛷䛒䛳䛯䚹䛺䛛䛷䜒䚸᪥㡭䛻⮫ᗋᩍ⫱䛻䛚䛔䛶 㻿㻮㻭㻾 䛻㛵䛩䜛▱㆑䛿䚸◊ಟṑ⛉་䛸ᩍဨ㛫䛾䝕䜱䝇䜹䝑䝅䝵䞁䛾㉁䛾ྥୖ䛻⧅䛜䛳䛶䛔䜛䛸ᐇឤ䛧䛶䛔䜛䚹㻌
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ཱྀ₇Ⓨ⾲㻌 䠫䠉㻠㻌㻌⮫ᗋ◊ಟṑ⛉་䛾ᐇែㄪᰝ䠄➨䠎ሗ䠅㻌
Factual investigation of clinical training dentists (Part 2).
㻌䕿ᮧୖᖾ⏕㻘㻌 ᕝ⏣ᮁྐ㻘㻌 ᒸ⏣඾ஂ㻘㻌 ⏣୰ᗉ஧㻘㻌 ୰㔝᠇୍㻘㻌 㧗Ὀᾈ㻘㻌 ୸ᒣ๛ኸ㻘㻌 ஧䝜ᐑⰋᩥ㻘㻌 ⛅⏣⣪ୡᏊ㻘㻌೺▼㞝㻘㻌 ୰Ụၨ᫛㻘㻌 ኱஭ඃ୍㻘㻌 㛵㻌 ຬဢ㻘㻌 ๓ᕝ䜎䜖䛝㻘㻌 㧗ᯇ⣪⪨Ꮚ㻘㻌 ⏣ᮧ㟹Ꮚ㻘㻌 ᪂ᒃᬛᜨ㻘㻌 ⏫㔝Ᏺ㻘㻌 㻌㻌 㻌 ∦ᒣ┤㻌᫂ᾏ኱ᏛṑᏛ㒊㻌 ⑓ែデ᩿἞⒪Ꮫㅮᗙ㻌 ⥲ྜཱྀ⭍デ᩿Ꮫศ㔝㻌䕿Yukio Murakami, Akifumi Kawata, Norihisa Okada, Shoji Tanaka, Kenichi Nakano, Teho Koh, Takehisa
Maruyama, Yoshifumi Ninomiya, Sayoko Akita, Takesi Tateishi, Nobuaki Nakae, Yuichi Ohi, Yuya Seki,
Mayuki Maekawa, Sayako Takamatsu, Seiko Tamura, Tomoe Arai, Mamoru Machino, Tadashi Katayama
Division of Oral diagnosis, Department of Diagnostic &Therapeutic Sciences, Meikai University school of
Dentistry㻌䛆⥴ゝ䛇㻌㻞㻜㻜㻢 ᖺᗘ䛛䜙ṑ⛉་ᖌ⮫ᗋ◊ಟ䛜ᚲಟ໬䛥䜜䚸඲ᅜ䛾◊ಟ᪋タ䛷༞┤ᚋ⮫ᗋ◊ಟ䛜⾜䜟䜜䜛䜘䛖䛻䛺䜚 㻣ᖺవ䜚䛜⤒㐣䛧䛯䚹ᡃ䚻䛿䚸㻞㻜㻜㻥 ᖺᗘ䛻⮫ᗋ◊ಟṑ⛉་䛾◊ಟ≧ἣ䜢ᢕᥱ䛧⥲ྜṑ⛉་⒪䛜ᚲせ䛸䛥䜜䛶䛔䜛◊ಟ་䛾ᩍ⫱䝅䝇䝔䝮䜢䜘䜚඘ᐇ䞉ᙉ໬䛥䛫䜛䛯䜑䛻䚸◊ಟ་ 㻤㻜 ྡ䜢ᑐ㇟䛻䜰䞁䜿䞊䝖ㄪᰝ䜢⾜䛳䛯䚹௒ᅇ䚸㻟ᖺ䜆䜚䛻ྠᵝ䛾䜰䞁䜿䞊䝖ㄪᰝ䜢ᐇ᪋䛧䚸ᅇ⟅䛾ᚓ䜙䜜䛯 㻢㻣 ྡ䛾◊ಟ≧ἣ䜢㞟ィ䞉ศᯒ䜢⾜䛳䛯䛸䛣䜝ⱝᖸ䛾▱ぢ䜢ᚓ䛯䛾䛷ሗ࿌䛩䜛䚹㻌䛆ᑐ㇟䛚䜘䜃᪉ἲ䛇㻌᫂ᾏ኱ᏛṑᏛ㒊௜ᒓ⑓㝔ṑ⛉⥲ྜデ⒪㒊䛻ᡤᒓ䛩䜛༞┤ᚋ⮫ᗋ◊ಟṑ⛉་ᖌ 㻢㻣 ྡ䠄㻿䠖༢⊂ᆺ䠖㻝㻤 ྡ䚸㻹䠖」ྜᆺ䠖㻠㻥 ྡ䠅䜢ᑐ㇟䛸䛧䛯䚹⮫ᗋ◊ಟ⤊஢ᘧ䛾㝿䛻䚸䜰䞁䜿䞊䝖⏝⣬䜢㓄ᕸ䛧䚸↓グྡ䛷䚸䐟ᒚಟ䝥䝻䜾䝷䝮䚸䐠䠍ᖺ㛫䛾◊ಟᮇ㛫䛻䛚䛔䛶ᢸᙜ䛧䛯ᝈ⪅ᩘ䚸䐡◊ಟᮇ㛫୰䛻⤒㦂䛧䛯⑕౛ᩘ䚸䐢◊ಟ䛷‶㊊䛧䛯䛣䛸䚸䐣◊ಟ䛷୙‶䛻ᛮ䛳䛯䛣䛸䚸䐤⤒㦂䛧䛯䝠䝲䝸䞉䝝䝑䝖䜔་⒪஦ᨾ䚸䐤⤥ᩱ䛻䛴䛔䛶ᅇ⟅䜢ᚓ䛯䚹㻌䛆⤖ᯝ䛇㻌䠍䠊◊ಟ་䛜 㻝 ᖺ㛫䛾◊ಟᮇ㛫䛻䛚䛔䛶ᢸᙜ䛧䛯ᝈ⪅ᩘ䛾ᖹᆒ䛿 㻤㻣㻚㻣 ே䛰䛳䛯䚹㻿 䛿 㻣㻟㻚㻟 ྡ䚸㻹 ඲య䛜 㻥㻞㻚㻡ྡ䛷 㻹 䛾᪉䛜ᢸᙜᝈ⪅ᩘ䛿ከ䛛䛳䛯䚹䠎䠊デ⒪ศ㔝䛾୰䛷䛿䚸ಖᏑ⣔ศ㔝䛜୍␒ከ䛟⤒㦂䜢䛧䛶䛚䜚䚸඲య䛾㻡㻡㻚㻝㻠㻑䜢༨䜑䛶䛔䛯䚹䠏䠊୍ேᙜ䛯䜚⑕౛⤒㦂ᩘ䛷䛿䚸ಖᏑ⣔䠄㻿㻦㻝㻢㻥㻚㻣 ౛䚸㻹㻦㻝㻡㻜㻚㻝 ౛䠅䚸⿵⥛⣔䠄㻿㻦㻥㻡㻚㻥 ౛䚸㻹㻦㻣㻡㻚㻟 ౛䠅䚸እ⛉⣔䠄㻿㻦㻡㻠㻚㻝 ౛䚸㻹㻦㻠㻞㻚㻠 ౛䠅䛷䛒䛳䛯䚹䠐䠊㻝 ᖺ㛫䛾◊ಟ䛷‶㊊䛧䛯䛣䛸䛿䚸㻿 䛷䛿Ⰻዲ䛺἞⒪䞉ᡭᢏ䛾⤒㦂䚸㻹 䛷䛿ᆅᇦ་⒪䛷ồ䜑䜙䜜䜛䜒䛾䛺䛹䛷䛒䛳䛯䚹୍᪉䚸㻝 ᖺ㛫䛾◊ಟ䛷୙‶䛾䛣䛸䛿䚸㻿 䛷䛿⤥ᩱ䚸⑕౛ᩘ䛾୙㊊䛺䛹䛷䛒䛳䛯䚹㻹 䛷䛿䚸デ⒪䞉ᣦᑟయไ䚸▷䛔◊ಟᮇ㛫䛺䛹䛷䛒䛳䛯䚹䠑䠊⤒㦂䛧䛯䝠䝲䝸䞉䝝䝑䝖䛿ಟ᚟≀䛾ཱྀ⭍ෆ䜈䛾ⴠୗ䚸἞⒪㒊఩䛾ㄗㄆ䛺䛹䛜䛒䛳䛯䚹㔪่䛧䚸ᅇ㌿ჾල䛾㢋യ䛺䛹䛾་⒪஦ᨾ䛜䛒䛳䛯䚹䠒䠊⤥ᩱ䛿䜋䛸䜣䛹䛾◊ಟṑ⛉་䛜㐺ᙜ䛛ప䛔䛸ᛮ䛳䛶䛔䛯䚹㻌䛆⪃ᐹ䛇㻌௒ᅇ䛾䜰䞁䜿䞊䝖ㄪᰝ䛷䚸ྛ䝥䝻䜾䝷䝮㛫䛷⮫ᗋ◊ಟṑ⛉་䛜⑕౛䜢⤒㦂䛩䜛ᶵ఍䛿䜋䜌ᆒ➼䛷䛒䜛䛣䛸䛜ุ᫂䛧䛯䚹◊ಟṑ⛉་䛾‶㊊ᗘ䛿୍ᵝ䛷䛿䛺䛛䛳䛯䛜䚸἞⒪䛻㛵䛩䜛䛣䛸䜔㛤ᴗ་䛾䛒䜚᪉䛺䛹䛜䛒䛳䛯䚹୍᪉䚸ಟ᚟≀䛾ཱྀ⭍ෆ䜈䛾ⴠୗ䚸㔪่䛧䛺䛹䛜ᩓぢ䛥䜜䛯䚹◊ಟ་䛻デ⒪ᢏ⾡䜔་⒪஦ᨾ䛾㜵Ṇ䜢ྵ䜑䛶䛣䜜䜙䜢ᣦᑟ䛩䜛䛯䜑䛻䛿䚸ᡃ䚻䛿ᖖ䛻ᣦᑟ་䛸䛧䛶䛾䝇䜻䝹䜰䝑䝥䜢ᅗ䜚䚸䜘䜚⥲ྜⓗ䛺ᢏ⾡䛾ྥୖ䜢┠ᣦ䛩䛣䛸䛜ᚲせ䛷䛒䜛䛸⪃䛘䜛䚹㻌㻌
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ཱྀ₇Ⓨ⾲㻌 䠫䠉㻡㻌㻌ᯇᮏṑ⛉኱Ꮫ⑓㝔⥲ྜデ⒪ᐊ䛻䛚䛡䜛⮫ᗋ◊ಟᣦᑟ䛾ヨ䜏㻌
Trial of Postgraduate Training Course at Department of General Dentistry in Matsumoto Dental
University Hospital‫ۑ‬㡢⍆῟୍ 㻝㻘㻞㻘㻟䠅㻘㻌 ఀ⬟ಇஅ 㻞䠅㻘㻌 Ᏻᮾಙ⾜ 㻝䠅㻘㻌 ⸨஭೺⏨ 㻝㻘㻞㻘㻟䠅㻘㻌 㯮ᒾ᫛ᘯ 㻟䠅㻘㻌 ᒣᮏ᫛ኵ 㻟䠅㻌ᯇᮏṑ⛉኱Ꮫ⑓㝔⥲ྜデ⒪ᐊ 㻝䠅㻘㻌 ᯇᮏṑ⛉኱Ꮫ኱Ꮫ㝔೺ᗣቑ㐍ཱྀ⭍⛉Ꮫㅮᗙ 㻞䠅㻘㻌 㻌ᯇᮏṑ⛉኱Ꮫ⑓㝔◊ಟ⟶⌮ጤဨ఍ 㻟䠅㻌‫ۑ‬Jun-ichi Otogoto㻝㻘㻞㻘㻟䠅, Toshiyuki Ino2), Nobuyuki Ando1), Takeo Fujii 㻝㻘㻞㻘㻟䠅, Akio Yamamoto3), Akihiro Kuroiwa3)
Department of Interdiciplinary Dentistry1), Department of general Dentistry2), Committee of Postgraduate
Clinical Training 3), Matsumoto Dental University Hospital䛆⥴ゝ䛇㻌ᖹᡂ 㻞㻠 ᖺᗘ䜘䜚ᯇᮏṑ⛉኱Ꮫ⑓㝔䛷䛿⮫ᗋ◊ಟ䛻䛚䛔䛶ṑ࿘἞⒪䜢ᇶ┙䛸䛧䛯◊ಟ᪉ᘧ䜢᥇⏝䛧䚸➨䠑ᅇ⥲ྜṑ⛉༠㆟఍Ꮫ⾡኱఍䛻䛶ሗ࿌䛧䛯䚹௒ᅇ䛿䛭䛾ึᖺᗘ䛾ᣦᑟ⤖ᯝ䜢ศᯒ䛧䛯䛾䛷ሗ࿌䛩䜛䚹㻌䛆ᑐ㇟䛚䜘䜃᪉ἲ䛇㻌ᑐ㇟◊ಟṑ⛉་䛿ᖹᡂ 㻞㻠 ᖺᗘᯇᮏṑ⛉኱Ꮫ⑓㝔䛻䛚䛡䜛⮫ᗋ◊ಟ䜢ᒚಟ䛧䛯 㻠㻞 ྡ䛷䛒䜛䚹◊ಟṑ⛉་䜢ᣦᑟ་ᡤᒓู䛻ศ㢮䛩䜛䛸ಖᏑ⛉ 㻣 ྡ䚸⿵⥛⛉ 㻝㻡 ྡ䚸ཱྀ⭍እ⛉ 㻝㻜 ྡ䚸ṑ࿘⑓⛉ 㻢 ྡ䛭䛧䛶⥲ྜデ⒪ᐊ䠎ྡ䛷䛒䛳䛯䚹◊ಟ䛿䠍䠅⥲ྜデ⒪ᐊ䛾ึデᴗົ䛷ᝈ⪅㓄ᙜ䚸䠎䠅ṑ࿘἞⒪䛿⥲ྜデ⒪⛉䛻䛶⾜䛔䚸䛥䜙䛻䠏䠅ᣦᑟṑ⛉་䛜ᡤᒓ䛩䜛デ⒪⛉䜢୰ᚰ䛻◊ಟ䜢⾜䛳䛯䚹⥲ྜデ⒪ᐊ䛸⥲ྜデ⒪⛉䛻䛚䛔䛶デ⒪䜢⾜䛖◊ಟṑ⛉་䛸௚䛾◊ಟṑ⛉་䛾ẚ㍑䛿䚸䐟㓄ᙜᝈ⪅ᩘ䚸䐠ᚲಟ⑕౛ᩘ䚸䐡⑕౛ሗ࿌ෆᐜ䛾἞⒪ศ㔝ᩘ䚸䐢⩦⇍⩦ᚓ䝁䞊䝇䛾㐩ᡂ⋡䛷䛭䜜䛮䜜⾜䛳䛯䚹㻌䛆⤖ᯝ䛇㻌ẚ㍑䛩䜛デ⒪⛉䛻䜘䛳䛶㓄ᙜ⑕౛ᩘ䜔ᚲಟ⑕౛ᩘ䛾㐪䛔䛿୍㒊䛻ㄆ䜑䜙䜜䜛䛜䚸ᖹᆒ䛩䜛䛸⥲ྜデ⒪ᐊ䛻䛚䛡䜛◊ಟෆᐜ䛿௚䛾デ⒪⛉䜢䝧䞊䝇䛸䛩䜛◊ಟ⤒㦂䛸ẚ㍑᳨ウ䛧䛯ྛ㡯┠䛸䜒኱䛝䛺ᕪ䜢ㄆ䜑䛪䚸◊ಟ䜢⤊஢䛩䜛䛣䛸䛜䛷䛝䛯䚹㻌䛆⪃ᐹ䛇㻌ᯇᮏṑ⛉኱Ꮫ⑓㝔䛷䛿ᚑ᮶ᣦᑟṑ⛉་䛾デ⒪⛉䜢୰ᚰ䛸䛧䛯⮫ᗋ◊ಟ䛿⥲ྜṑ⛉デ⒪ෆᐜ䛻೫䜚䛜ฟ䜛ྍ⬟ᛶ䛜䛒䛳䛯䛜䜑䚸ᖹᡂ 㻞㻠 ᖺᗘ䜘䜚⥲ྜデ⒪ᐊ䛻䛚䛡䜛ṑ࿘἞⒪䜢ᇶᮏ䛸䛧䛯⮫ᗋ◊ಟ䛜㛤ጞ䛥䜜䛯䚹䛭䛾⤖ᯝ䚸⥲ྜデ⒪ᐊ䜢䛿䛨䜑䛹䛾デ⒪⛉䛻䛚䛔䛶䜒᭱ప㝈䛾⮫ᗋ◊ಟ䛜㐺ษ䛻⾜䜟䜜䛯䚹䛧䛛䛧䚸⥲ྜデ⒪ᐊ䛾䠎ྡ䛸䜒ᚲಟ⑕౛ᒚಟ᏶஢᫬ᮇ䛜䜔䜔㐜䜜䛯䛯䜑䚸䛣䛾Ⅼ䜢ᖹᡂ 㻞㻡 ᖺᗘ௨㝆䛾◊ಟᣦᑟ䛾ὀពⅬ䛸䛧䛯䛔䚹㻌䛆⤖ㄽ䛇㻌⥲ྜデ⒪ᐊ䛾ᣦᑟ་䜢୰ᚰ䛻ᒎ㛤䛧䛯⮫ᗋ◊ಟ䛿༢⊂ᆺ䚸༠ຊᆺ䛻㛵䜟䜙䛪㻌௚䛾デ⒪⛉䛾ᣦᑟ་䜢୰ᚰ䛻ᒎ㛤䛧䛶䛔䛯ᚑ᮶䛾⮫ᗋ◊ಟ䛸ẚ㍑䛧䛶඘ศ䛺⮫ᗋ⤒㦂䜢◊㛑䛷䛝䜛ྍ⬟ᛶ䜢♧၀䛧䛯䚹㻌
㻌
㻌
㻌
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ཱྀ₇Ⓨ⾲㻌 䠫䠉㻢㻌㻌኱㜰ṑ⛉኱Ꮫ㝃ᒓ⑓㝔」ྜᆺ⮫ᗋ◊ಟ䝥䝻䜾䝷䝮䛷ᐇ᪋䛧䛯䝩䞊䝮䝹䞊䝮䛾ព⩏䠉ၥ㢟஦౛䛾ㄪᰝ䠉㻌The meaning of the home room performed on a postgraduate clinical training program of ODU hospital-the investigation of problem cases䕿ᑠฟ㻌 Ṋ 㻝㻕䠈ᯇᮏᑦஅ 㻞㻕䠈ᒸᓮᐃྖ 㻟㻕䠈⏣୰ᫀ༤䠈ᯘ㻌 ᏹ⾜ 㻡㻕䠈᳃⏣❶௓ 㻢㻕䠈ぬ㐨೺἞ 㻣㻕㻌኱㜰ṑ⛉኱Ꮫ㝃ᒓ⑓㝔⥲ྜデ⒪䞉デ᩿⛉ 㻝㻕㻌 䠈኱㜰ṑ⛉኱Ꮫṑ⛉▹ṇᏛㅮᗙ 㻞㻕䠈㻌኱㜰ṑ⛉኱ᏛḞᦆṑิ⿵⥛ညྜᏛㅮᗙ 㻟㻕㻌 䠈኱㜰ṑ⛉኱Ꮫ᭷ṑ⿵⥛ညྜᏛㅮᗙ 㻠㻕䠈㻌኱㜰ṑ⛉኱Ꮫཱྀ⭍἞⒪Ꮫㅮᗙ 㻡㻕䠈኱㜰ṑ⛉኱Ꮫཱྀ⭍እ⛉Ꮫ➨୍ㅮᗙ 㻢㻕䠈㻌኱㜰ṑ⛉኱Ꮫཱྀ⭍እ⛉Ꮫ➨஧ㅮᗙ 㻣㻕㻌‫ۑ‬Takeshi Koide, Naoyuki Matsumoto, Joji Okazaki3), Masahiro Tanaka4), Hiroyuki Hayashi5), Shosuke Morita6),
Kenji Kakudo7)
Department of Interdisciplinary Dentistry & Oral Diagnosis. Osaka Dental University Hospital1),Department ofOrthodontics, Osaka Dental University2),Department of Removable Prosthodontics and Occlusion. Osaka
Dental University 3),Department of Fixed Prosthodontics and Occlusion. Osaka Dental University4),Departmentof Endodontics. Osaka Dental University5),First Department of Oral and Maxillofacial Surgery. Osaka Dental
University6),Second Department of Oral and Maxillofacial Surgery. Osaka Dental University7)䛆┠ⓗ䛇㻌
ᖹᡂ 㻝㻤 ᖺᗘ䛾ṑ⛉་ᖌ⮫ᗋ◊ಟ䛾ᚲಟ໬䛻䛸䜒䛺䛔䚸༢⊂᪉ᘧ䛻䜘䜛◊ಟ䝥䝻䜾䝷䝮䛻ຍ䛘䛶䚸༠ຊᆺ᪋タ䛸䛾」ྜ᪉ᘧ䛾◊ಟ䝥䝻䜾䝷䝮䜢㛤ጞ䛧䛯䚹⟶⌮ᆺ᪋タ䛸༠ຊᆺ᪋タ䛸䛾㐃ᦠ䛾ᙉ໬䛚䜘䜃◊ಟṑ⛉་䛾䝯䞁䝍䝹䝦䝹䝇䜿䜰䛾୍⎔䛸䛧䛶䝩䞊䝮䝹䞊䝮䜢㛤ദ䛧䚸◊ಟṑ⛉་䛾䝇䝖䝺䝇せᅉ䛺䛹䜢ᢕᥱ䛧䚸◊ಟ୙ㄪ䜢ᮍ↛䛻㜵䛠䜘䛖ດ䜑䛶䛔䜛䚹௒ᅇ䛿䚸ᖹᡂ 㻞㻜 ᖺᗘ䛛䜙 㻞㻠 ᖺᗘ䜎䛷䛾 㻡 ᖺ㛫䛻䝩䞊䝮䝹䞊䝮䛷ᐇ᪋䛧䛯䜰䞁䜿䞊䝖ㄪᰝ⤖ᯝ䛾䛖䛱䚸䛸䛟䛻୰᩿䛻㛵䛩䜛㡯┠䜢୰ᚰ䛻ሗ࿌䛩䜛䚹㻌䛆᪉ἲ䛇㻌ᮏ䝥䝻䜾䝷䝮䛷◊ಟ䜢⾜䛳䛯◊ಟṑ⛉་ᩘ䛿䚸ᖹᡂ 㻞㻜 ᖺᗘ 㻣㻜 ྡ䚸㻞㻝 ᖺᗘ 㻤㻞 ྡ䚸㻞㻞 ᖺᗘ 㻥㻤 ྡ䚸㻞㻟 ᖺᗘ 㻤㻤ྡ䚸㻞㻠 ᖺᗘ 㻣㻠 ྡ䛷䛒䛳䛯䚹䝩䞊䝮䝹䞊䝮䛿䚸㻡 䛛᭶䛻䛚䜘䜆༠ຊᆺ᪋タ䛷䛾◊ಟ୰䚸᭶䛻୍ᗘ䛾๭䜚ྜ䛔䛷㛤ദ䛧䚸◊ಟṑ⛉་඲ဨ䜢⟶⌮ᆺ᪋タ䛻࿧䜃ᡠ䛧䚸㠃ㄯ䛚䜘䜃䜰䞁䜿䞊䝖䛻䜘䜚䚸◊ಟ≧ἣ䜔◊ಟṑ⛉་⮬㌟䛾
ᝎ䜏䛺䛹䜢ㄪᰝ䛧䛯䚹୰᩿䛻㛵䛩䜛㉁ၥ䛿䚸ᖹᡂ 㻞㻜 ᖺᗘ䛛䜙 㻞㻞 ᖺᗘ䛿䚸᭱⤊ᅇ䛾䜰䞁䜿䞊䝖ㄪᰝ䛷䛾䜏⾜䛳䛯䚹ᖹᡂ 㻞㻟 ᖺᗘ䛛䜙䛿㉁ၥ䛩䜛ᅇᩘ䜢ቑ䜔䛧䚸䝩䞊䝮䝹䞊䝮䛾඲ᮇ㛫䜢㏻䛨䛶⾜䛳䛯䚹㻌䛆⤖ᯝ䛇㻌䛄୰᩿䜢⪃䛘䛯䛣䛸䛜䛒䜚䜎䛩䛛䛅䛻ᑐ䛧䚸䛄ᛮ䛖䛅䚸䛄䜔䜔ᛮ䛖䛅䛸⟅䛘䛯䜒䛾䛿䚸ᖹᡂ 㻞㻜 ᖺᗘ 㻝㻝 ྡ䚸㻞㻝 ᖺᗘ 㻝㻝ྡ䚸㻞㻞 ᖺᗘ 㻝㻜 ྡ䛷䛒䛳䛯䚹㉁ၥᅇᩘ䜢ቑ䜔䛧䛯ᖹᡂ 㻞㻟 ᖺᗘ௨㝆䛿䚸㻞㻟 ᖺᗘ 㻞㻞 ྡ䚸㻞㻠 ᖺᗘ 㻝㻤 ྡ䛸䛭䜜䛮䜜ቑຍ䛧䛯䚹䜎䛯䚸ᮇ㛫୰䛄ᛮ䛖䛅䚸䛄䜔䜔ᛮ䛖䛅䛸 㻞 ᅇ௨ୖ⟅䛘䛯䜒䛾䛿ᖹᡂ 㻞㻟 ᖺᗘ 㻝㻞 ྡ䚸㻞㻠 ᖺᗘ 㻥 ྡ䛷䛒䛳䛯䚹䝩䞊䝮䝹䞊䝮䛾ព⩏䛻㛵䛩䜛䜰䞁䜿䞊䝖ㄪᰝ䛷䛿⫯ᐃⓗ䛺ពぢ䛜ከ䛛䛳䛯䚹㻌䛆⪃ᐹ䛇㻌ᖹᡂ 㻞㻟 ᖺᗘ௨㝆䚸୰᩿䛻㛵䛩䜛㉁ၥ䜢䝩䞊䝮䝹䞊䝮㛤ദẖ䛻ᐇ᪋䛧䛯䛣䛸䛷䚸༠ຊᆺ᪋タ䛷䛾◊ಟ㛤ጞ┤ᚋ䛛䜙䚸䜋䜌 㻝 䛛᭶ẖ䛻◊ಟ᫬䛾ၥ㢟Ⅼ䜢ᢕᥱ䛩䜛䛣䛸䛜䛷䛝䛯䚹䛣䛾䛯䜑䚸◊ಟṑ⛉་䛾䝇䝖䝺䝇䜢᪩ᮇ䛻Ⓨぢ䛩䜛䛸䛸䜒䛻䚸䛭䛾⤒㐣䜢ぢᏲ䜛䛣䛸䛜ྍ⬟䛸䛺䜚䚸䛔䛟䛴䛛䛾ၥ㢟஦౛䛷◊ಟ୙ㄪ䜢ᮍ↛䛻㜵䛠䛣䛸䛜䛷䛝䛯䚹㻌
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ཱྀ₇Ⓨ⾲㻌 䠫䠉㻣㻌㻌Ᏻ඲䛺䜶䞁䝗䛾୕ゅ㝖ཤ⏝䝗䝸䝹䛾㛤Ⓨ䛸౑⏝ୖ䛾ᕤኵ㻌Invention of the dental drill to remove the endodontic cervical dentinal triangle‫ۑ‬ᑠཎ㻌 ຾ 㻝㻘㻞㻕䠈኱ᯘὈ஧ 㻝㻕䠈す㻌 ⿱⨾ 㻝㻕䠈⏣୰Ⰻ἞ 㻝㻕䠈᪥㔝Ꮥ᐀ 㻞㻕䠈ᑠᕝဴḟ 㻝㻕㻌ᗈᓥ኱Ꮫ⑓㝔㻌 ཱྀ⭍⥲ྜデ⒪⛉ 㻝㻕䠈ᗈᓥ኱Ꮫ⑓㝔㻌 ṑ⛉デ⒪ᡤ 㻞㻕‫ۑ‬Masaru Ohara㻝㻘㻞㻕, Taiji obayashi1), Hiromi Nishi1), Yoshiharu Tanaka1), Takamune Hino2), Tetsuji Ogawa1)
Hiroshima University Hospital, Department of Advanced General Dentistry1), Hiroshima University Hospital,
Dental Clinic2)䛆⫼ᬒ䛇㻌ᢤ㧊䞉ឤᰁ᰿⟶἞⒪᫬䛾᰿⟶ཱྀ᫂♧䛿᰿⟶἞⒪䛾ᚲ㡲䛾⾜⛬䛷䛒䜛䚹≉䛻ୖୗ኱⮻ṑ㏆ᚰᙃ᭤᰿䛻䛚䛔䛶䚸᰿⟶ୖ㒊䠍㻛㻟 䛾䝸䞊䝬䞊ᤄධゅᗘ䛜ṑ㍈䛻ᆶ┤䛷䛒䜛䜋䛹䠄඲య䛾䝸䞊䝬䞊䛾ᙃ᭤ᗘ䛜ᑡ䛺䛔䜋䛹䠅᰿⟶ᣑ኱᫬䛻䛚䛡䜛䝸䞊䝬䞊◚ᢡ㜵Ṇ䛻ᙺ❧䛴䛸⪃䛘䜙䜜䜛䚹䛭䛾䛯䜑䛻䛿䜶䞁䝗䛾୕ゅ䜢Ᏻ඲䛻㝖ཤ䛩䜛䛣䛸䛜ᚲせ䛸䛥䜜䜛䚹㻌
⌧᫬Ⅼ䛷䛾䜶䞁䝗䛾୕ゅ㝖ཤ䞉᰿⟶ཱྀ᫂♧ἲ䛿䚸䝢䞊䝋䞊䝸䞊䝬䞊䜒䛧䛟䛿䝀䞊䝒䝞䞊䜢⏝䛔䛯⾡⪅䛾ᡭᣦឤぬ䛻䜘䜛᪉ἲ䛜⾜䜟䜜䛶䛔䜛䚹䛣䛾᪉ἲ䛿ษ๐᪉ྥ䜢ㄗ䜛䛸᰿⟶ཱྀ௜㏆䛾䝇䝔䝑䝥ᙧᡂ䜔✸Ꮝ䜢㉳䛣䛧䜔䛩䛔Ḟ
Ⅼ䜢ᣢ䛴䚹䛭䛣䛷᰿⟶ཱྀ௜㏆䛾䝇䝔䝑䝥ᙧᡂ䜔✸Ꮝ䜢㉳䛣䛩䛣䛸䛺䛟䜶䞁䝗䛾୕ゅ㝖ཤ䞉᰿⟶ཱྀ᫂♧䛺䜙䜃䛻䝸䞊䝬䞊䛾ᙃ᭤᫝ṇ䜢⾜䛖䝗䝸䝹䜢⪃᱌䛧䛯䛾䛷ᥦ᱌䛩䜛䚹㻌䛆䝗䝸䝹䛾≉ᚩ䛇㻌㻝㻚䝗䝸䝹䛿⦪㍈᪉ྥ䛻㈏㏻Ꮝ䛜䛒䜚䚸䝸䞊䝬䞊㻔㻏㻝㻡㼪㻞㻜㻕䛜ෆ✵䜢㏻䜚䚸䝸䞊䝬䞊䛾䜺䜲䝗䛻ᚑ䛳䛶ษ๐䛜⾜䜟䜜䜛䚹㻌㻞㻚䝸䞊䝬䞊䜢㏻䛧䛯䝗䝸䝹䜢ᣑ኱䛧䛯䛔᰿⟶䛻ᤄධ䛧౑⏝䛩䜛䚹㻌㻟㻚๐䜚䛯䛔㒊఩䠄䛯䛸䛘䜀㏆ᚰ᪉ྥ䠅䜈ຊ䜢ຍ䛘䛺䛜䜙ᮏ䝗䝸䝹䜢ᅇ㌿䛥䛫䜛䛣䛸䛻䜘䜚᰿⟶ཱྀ௜㏆䛾䝇䝔䝑䝥ᙧᡂ䜔✸Ꮝ䜢㉳䛣䛩䛣䛸䛺䛟䚸䜶䞁䝗䛾୕ゅ䛾㝖ཤ䛜ྍ⬟䛸䛺䜛䚹㻌䛆ᐇ㝿䛾౑⏝䛇㻌ᢤཤṑ∳䜢⏝䛔䚸ኳ⵹㝖ཤᚋ䚸ୖグ䝥䝻䝖䝁䝹䛻ᚑ䛳䛶䚸䜶䞁䝗䛾୕ゅ䜢㝖ཤ䛧䛯䛸䛣䜝䚸Ᏻ඲䛛䛴䝇䝮䞊䝈䛻ྠ㒊䛾㝖ཤ䛜ྍ⬟䛷䛒䛳䛯䚹㻌䛆౑⏝᫬䛾ᕤኵ䛇㻌䝸䞊䝬䞊䜢㏻䛧䛯䝗䝸䝹䜢ᣑ኱䛧䛯䛔᰿⟶䛻ᤄධ䛩䜛䛣䛸䛜ᅔ㞴䛺⑕౛䛻ᑐ䛧䚸௨ୗ䛾ᕤኵ䜢⾜䛳䛯䚹䛩䛺䛿䛱䚸୧➃䛻┤㔪䛜௜୚䛥䜜䛯እ⛉⏝䝘䜲䝻䞁⦭ྜ⣒䜢⏝䛔䚸୍➃䜢᰿⟶ෆ䛻ᤄධ䛩䜛䚹௚➃䜢ཱྀ⭍እ䛷䜶䞁䝗䛾୕
ゅ㝖ཤ⏝䝗䝸䝹ෆ䛻ᤄධ䛧䚸⦭ྜ⣒䜢䜺䜲䝗䛻ཱྀ⭍ෆ䛻䝗䝸䝹䜢ᤄධ䛩䜛䛣䛸䛻䜘䜚ୖグၥ㢟䛻ᑐฎྍ⬟䛸䛺䜛䚹㻌Ⓨ⾲䛷䛿ୖグ䛻ຍ䛘䚸ྠ䝗䝸䝹䛾ၥ㢟Ⅼ䞉ᑗ᮶䛾ྍ⬟ᛶ䜢⪃ᐹ䛩䜛ணᐃ䛷䛒䜛䚹㻌
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ཱྀ₇Ⓨ⾲㻌 䠫䠉㻤㻌㻌኱㜰ṑ⛉኱Ꮫ⮫ᗋ◊ಟᩍ⫱⛉䛻䛚䛡䜛ṑ⛉⏝䝁䞊䞁䝡䞊䝮 㻯㼀 䛾฼⏝≧ἣ㻌
Evaluation of cone-beam computed tomography㸦CBCT㸧use in the department of postgraduate clinicaltraining at osaka dental university‫⳥ۑ‬ụඃᏊ䠍䠅䠈୰ᓥ᭷ెᏊ䠎䠅䠈ᅄ஭㈨㝯䠎䠅䠈໭㔝ᛅ๎䠍䠅䠈኱஭἞ṇ䠍䠅䠈ᑠᕝᩥஓ䠍䠅䠈⤃஭ᣑ㝯䠍䠅䠈ΎỈ㇂බᡂ䠎䠅䠈㻌㻌 㻌 ๓⏣↷ኴ䠍䠅㻌኱㜰ṑ⛉኱Ꮫ㻌 ⮫ᗋ◊ಟᩍ⫱⛉䠍䠅䠈኱㜰ṑ⛉኱Ꮫ㻌 ṑ⛉ᨺᑕ⥺Ꮫㅮᗙ䠎䠅㻌‫ۑ‬Yuko Kikuchi1),
1)

Yukako Nakashima2),
1)

Ogawa , Hirotaka Kon‘i ,Yoritaka Yotsui2),
2)

Kimishige Shimizutani ,Tadanori Kitano㸯 ),Teruta Maeda

Harumasa Oi1),

Fumiya1)

Department of Postgraduate Clinical Training, Osaka Dental University1)㸪Department of Oral Radiology,
Osaka Dental University2)ṑ⛉䛷䛾౑⏝䜢๓ᥦ䛸䛩䜛ṑ⛉⏝䝁䞊䞁䝡䞊䝮 㻯㼀䠄௨ୗ 㻯㻮㻯㼀 䛸␎䛩䠅⿦⨨䛜㛤Ⓨ䛥䜜䛶⣙ 㻝㻜 ᖺ䛜⤒㐣䛧䛯䚹௒᪥䛷䛿」ᩘ䛾ᅜෆእ䛾௻ᴗ䛜䛣䛾✀䛾⿦⨨䜢Ⓨ኎䛧䛶䛔䜛䚹᭱㏆䛷䛿䝟䝜䝷䝬䜶䝑䜽䝇⥺᧜ᙳ⿦⨨䛻䛣䛾ᶵ⬟䜢ᣢ䛯䛫䚸䝟䝜䝷䝬䜶䝑䜽䝇⥺෗┿䛸 㻯㻮㻯㼀 䜢୍ྎ䛾ᶵᲔ䛷᧜ᙳ䛷䛝䜛」ྜᶵ䛸䛧䛶Ⓨ኎䛥䜜䛶䛔䜛䜒䛾䜒ぢ䜙䜜䜛䚹䜎䛯䚸᧜ᙳ䛥䜜䛯୕ḟඖⓗ䛺⏬ീ⾲♧䛿ᚑ᮶䛾஧ḟඖⓗ䛺⏬ീ⾲♧䜘䜚⌮ゎ䛧䜔䛩䛔䛸ሗ࿌䛥䜜䛶䛚䜚䚸㻯㻮㻯㼀 䛿ṑ⛉⮫ᗋ䛻ᬑཬ䛧䛶䛝䛶䛔䜛䚹㻌㻯㻮㻯㼀䛾㐺ᛂ䛿䚸䐟᰿ᑤᛶṑ࿘⅖䛺䛹䛾⑌ᝈ㻌 䐠ṑ᰿◚ᢡ㻌 䐡ᇙఅ䠄ᬛ䠅ṑ䛾఩⨨☜ㄆ㻌 䐢䜲䞁䝥䝷䞁䝖䛾⾡๓䞉⾡ᚋ᳨ᰝ㻌 䐣ṑᵴ㦵䛾⑌ᝈ㻌 䛺䛹䛜䛒䛢䜙䜜䜛䚹䜲䞁䝥䝷䞁䝖䜢୰ᚰ䛸䛧䛯἞⒪䜔䚸ཱྀ⭍እ⛉䛺䛹䛾ᑓ㛛ᛶ䛾㧗䛔἞⒪௨እ䛻䜒䚸䛔䜟䜖䜛୍⯡ṑ⛉デ⒪䛷᭷ຠ฼⏝䛷䛝䜛䚹ᮏᏛ䛻䛚䛔䛶䜒⌧ᅾ஧ྎ䛾㻯㻮㻯㼀䛜タ⨨䛥䜜䚸᪥ᖖ䛾⮫ᗋ䜔◊✲䛻฼⏝䛥䜜䛶䛔䜛䚹㻌ᮏᏛ㝃ᒓ⑓㝔༢⊂ᆺ⮫ᗋ◊ಟ䛷䛿䚸ᇶᮏⓗ䛻୍⯡ṑ⛉デ⒪䜢୰ᚰ䛻◊ಟ䜢ᐇ᪋䛧䛶䛔䜛䚹䛣䛾䜘䛖䛺◊ಟ䛾ሙ䛻䛚䛔䛶䜒䚸๓㏙䛧䛯⑕౛䛻㐼㐝䛩䜛䛣䛸䛜䛒䜚䚸」ᩘ䛾⑕౛䛻 㻯㻮㻯㼀 䛜⏝䛔䜙䜜䛶䛔䜛䚹㻯㻮㻯㼀 䛾≉ᚩ䛷䛒䜛୕ḟඖⓗ䛺⏬ീ⾲♧䛻䜘䜚䚸⑕౛䛾ṇ☜䛺≧ἣᢕᥱ䚸䛭䜜䛻ᇶ䛵䛔䛯᫂☜䛺ᝈ⪅ㄝ᫂䛸ጇᙜᛶ䛾㧗䛔἞⒪䜢⾜䛖䛣䛸䛜䛷䛝䜛䛸⪃䛘䜙䜜䜛䚹㻌䛭䛣䛷௒ᅇ䛿䚸㻞㻜㻜㻥 ᖺ 㻠 ᭶䛛䜙 㻞㻜㻝㻟 ᖺ 㻤 ᭶ᮎ䜎䛷䛻ᙜ⛉䜢ཷデ䛧䛯ᝈ⪅䜢ᑐ㇟䛻䚸㻯㻮㻯㼀 䜢฼⏝䛩䜛䛣䛸䛻䛺䛳䛯⑕౛䛾✀㢮䛸ᐇᩘ䜢ㄪᰝ䛧䛯䚹㻌䛭䛾⤖ᯝ䚸㻯㻮㻯㼀 䜢฼⏝䛧䛯⑕౛ᩘ䛿䚸㻞㻜㻜㻥 ᖺ 㻟㻜 ⑕౛䚸㻞㻜㻝㻜 ᖺ 㻟㻟 ⑕౛䚸㻞㻜㻝㻝 ᖺ 㻞㻟 ⑕౛䚸㻞㻜㻝㻞 ᖺ 㻟㻞 ⑕౛䚸㻞㻜㻝㻟 ᖺ䠄㻤 ᭶ᮎ䜎䛷䠅㻞㻞 ⑕౛䛷䛒䛳䛯䚹඲䛶䛾ᖺᗘ䛷᰿ᑤᛶṑ࿘⅖䛺䛹䛾⑌ᝈ䚸ḟ䛔䛷ṑ᰿◚ᢡ䛾デ᩿䛻฼⏝䛧䛯ሙྜ䛜ከ䛛䛳䛯䚹㻌⮫ᗋ⤒㦂䛾ὸ䛔⮫ᗋ◊ಟṑ⛉་䛜ᚑ᮶䛾஧ḟඖⓗ䛺䝟䝜䝷䝬䜶䝑䜽䝇⥺᧜ᙳ䜔ཱྀෆἲ᧜ᙳ䛻ຍ䛘 㻯㻮㻯㼀 䜢฼⏝䛩䜛䛣䛸䛷䚸䜘䜚Ⰻ䛔◊ಟຠᯝ䛜ᚓ䜙䜜䛶䛔䜛䛸⪃䛘䜛䚹㻌
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―33―

ཱྀ₇Ⓨ⾲㻌 䠫䠉㻥㻌㻌ṑෆ἞⒪䛻䛚䛡䜛ṑ⛉⏝䝁䞊䞁䝡䞊䝮 㻯㼀 䛾฼⏝㻌
Usage of dental cone-beam computed tomography for endodontics䕿୰ᓥ᭷ెᏊ 㻞䠅䠈⳥ụඃᏊ 㻝䠅䠈ᅄ஭㈨㝯 㻞䠅䠈໭㔝ᛅ๎ 㻝䠅䠈኱஭἞ṇ 㻝䠅䠈ᑠᕝᩥஓ 㻝䠅䠈⤃஭ᣑ㝯 㻝䠅䠈ΎỈ㇂බᡂ 㻞䠅䠈๓⏣↷ኴ 㻝䠅㻌
኱㜰ṑ⛉኱Ꮫ㻌 ⮫ᗋ◊ಟᩍ⫱⛉ 㻝㻕䠈኱㜰ṑ⛉኱Ꮫ㻌 ṑ⛉ᨺᑕ⥺Ꮫㅮᗙ 㻞䠅㻌‫ۑ‬Yukako Nakashima2), Yuko Kikuchi1), Yoritaka Yotsui2), Tadanori Kitano1), Harumasa Oi1), Fumiya Ogawa1),
Hirotaka Kon’i1), Kimishige Shimizutani2), Teruta Maeda1)
Department of Postgraduate Clinical Training, Osaka Dental University1), Department of Oral Radiology,
Osaka Dental University2)䛆ㅖゝ䛇㻌ṑ⛉㡿ᇦ䛻䛚䛡䜛䜶䝑䜽䝇⥺デᰝ䛿䚸ṑ䜔㢡㦵䛺䛹◳⤌⧊䛾⣽㒊䛾ᥥฟ䛜ᚲせ䛷䛒䜛䚹ᚑ᮶䜘䜚䝟䝜䝷䝬䜶䝑䜽䝇⥺᧜ᙳ䜔ཱྀෆἲ᧜ᙳ䛜㢖⦾䛻฼⏝䛥䜜䛶䛝䛯䚹㏆ᖺ䚸஧ḟඖⓗ⏬ീ䛻ẚ䜉䛶䚸䜘䜚ヲ⣽䛺ほᐹ䛜ྍ⬟䛺୕ḟඖⓗ⏬ീ䜢ᵓ⠏䛷䛝䜛ṑ⛉⏝䝁䞊䞁䝡䞊䝮 㻯㼀 ⿦⨨䠄௨ୗ 㻯㻮㻯㼀䠅䛜㛤Ⓨ䛥䜜䛯䚹䛣䛾⿦⨨䛿ṑ᰿䛾ᙧែ䜔᰿⟶ᩘ䜢ண䜑ᢕᥱ䛩䜛䛣䛸䛜ྍ⬟䛺䛯䜑䚸≉䛻ṑෆ⒪ἲ㡿ᇦ䛾デ᩿⢭ᗘ䛾ྥୖ䛻ᐤ୚䛧䛶䛔䜛䚹䛣䛾䛣䛸䜘䜚୍⯡デ⒪䛾⮫ᗋ䛻䛚䛔䛶䚸㻯㻮㻯㼀 䛾᭷⏝ᛶ䛿㧗䛟ホ౯䛥䜜䛶䛔䜛䚹㻌௒ᅇ䚸⚾䛾⮫ᗋ◊ಟᮇ㛫୰䛻ᢸᙜ䛧䛯ୗ㢡ᑠ⮻ṑ㒊䛾ṑෆ἞⒪䛷䚸㻯㻮㻯㼀 䛾᭷⏝ᛶ䜢ㄆ㆑䛧䛯 㻟 ⑕౛䛻䛴䛔䛶ሗ࿌䛩䜛䚹㻌䛆⑕౛䛇㻌ୗ㢡➨୍ᑠ⮻ṑ䛻ཱྀෆἲ᧜ᙳ䛸 㻯㻮㻯㼀 䜢ే⏝䛧䚸ṑෆ἞⒪䜢⾜䛳䛯 㻟 ⑕౛䚹㻌䛆⤖ᯝ䛇㻌ᇶᮏⓗ䛻ୗ㢡➨୍ᑠ⮻ṑ䛾ከ䛟䛿༢᰿⟶䛷䛒䜛䛜䚸㻞 ᰿⟶ᛶ䜒 㻞㻟䡚㻞㻡㻑䛒䜛䛸ሗ࿌䛥䜜䛶䛚䜚䚸䛣䜜䜢ᢕᥱ䛧デᰝ䞉デ᩿䜢㐍䜑䛶䛔䛛䛺䛡䜜䜀ぢⴠ䛸䛧䛶䛧䜎䛖ྍ⬟ᛶ䛜䛒䜛䚹᪥ᖖ䛾ཱྀෆἲ᧜ᙳ䛷䛿ീ䛾㔜✚䛜㉳䛣䜚䚸⑓ኚ㒊఩䜔⑓ᕢ⠊ᅖ䛾≉ᐃ䜢䛩䜛䛾䛻ᅔ㞴䛺ሙྜ䛜ከ䛔䚹஧ḟඖ䛾᧜ᙳ᪉ྥ䛷䛿೫ᚰᢞᙳ䜢⾜䛳䛯䛸䛧䛶䜒⑓ኚ䛾㏱㐣ീ䛥䛘☜ㄆ䛷䛝䛺䛔᫬䜒䛒䜚䚸ṑෆ䞉ṑ࿘⑌ᝈ䛾デ᩿䛿㞴䛧䛔ሙྜ䛜ከ䛟䛒䛳䛯䚹㻌௒ᅇ䛾⑕౛䛻䛚䛔䛶䜒䚸἞⒪๓䛾ཱྀෆἲ᧜ᙳ䛷䛿䚸㢋⯉ⓗ᪉ྥ䛾ㄆ㆑䛜ᅔ㞴䛷䛒䜚䚸ṑ᰿䛾ᙧែ䜔᰿⟶ᩘ䛜ᢕᥱ䛷䛝䛺䛛䛳䛯䚹䛧䛛䛧䚸㻯㻮㻯㼀 䜢⏝䛔䜛䛣䛸䛷デ᩿⢭ᗘ䜢ྥୖ䛥䛫䜛஦䛜䛷䛝䛯䚹㻌䛆䜎䛸䜑䛇㻌
ᚑ᮶䛾஧ḟඖⓗ䛺䝟䝜䝷䝬䜶䝑䜽䝇⥺᧜ᙳ䜔ཱྀෆἲ᧜ᙳ䛷䛿ᢕᥱ䛩䜛䛣䛸䛜୙ྍ⬟䛺ゎ๗Ꮫⓗᵓ㐀䜔⑓ኚ䛾⌮ゎ䛻䚸㻯㻮㻯㼀 䛾฼⏝䛿኱ኚ᭷⏝䛷䛒䛳䛯䚹≉䛻⮫ᗋ◊ಟṑ⛉་䛾䜘䛖䛻ㄞᙳ⤒㦂䛜ὸ䛔ṑ⛉་ᖌ䛻䛸䛳䛶䛿䚸䜘䜚Ⰻ䛔᝟ሗ䛜ᚓ䜙䜜䜛䛸⪃䛘䜛䚹㻌
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―34―

ཱྀ₇Ⓨ⾲㻌 䠫䠉㻝㻜㻌㻌ႍᜥᝈ⪅䛾ṑ⛉デ⒪䛻䛚䛡䜛ὀពⅬ㻌
The notes in an asthmatic's dental clinic.
ࠐᮡᮏዉኸ 㻝㻕㻘㻌 ୹⃝ᙬ 㻝㻕㻘㻌 ၈ᮌᡂᏊ 㻝㻕㻘㻌 Ỉὠ⨾㭯 㻝㻕㻘㻌 ୰ᮧோ⨾ 㻝㻕㻘㻌 㐲⏣ளᏘᏊ 㻝㻕㻘㻌 㕥ᮌ෪Ἃ 㻝㻕㻘㻌 ⏣ᓥ䛛䛚䜚 㻝㻕㻘㻌῝℩ಟ୍ 㻝㻕㻘㻌 ⯪ὠኴ୍㑻 㻝㻕㻘㻌 ᪥㧗ீᙪ 㻝㻕㻘㻌 ᒣཱྀ༤ᗣ 㻝㻕㻘㻌 ᒣᮏⱥ㞝 㻝㻕㻘㻌 ᒣᮏ⏤⨾Ꮚ䠏䠅㻘㻌 Ꮚᓥ₶ 㻞䠅㻘㻌 ᑠᯘ㤾 㻟䠅㻌㭯ぢ኱ᏛṑᏛ㒊⥲ྜṑ⛉䠎㻝㻕㻘㭯ぢ኱ᏛṑᏛ㒊ෆ⛉Ꮫㅮᗙ 㻞㻕㻘㻌㭯ぢ኱ᏛṑᏛ㒊ཱྀ⭍㢡㢦㠃ᨺᑕ⥺䞉⏬ീデ᩿Ꮫㅮᗙ 㻟㻕㻌
ࠐNao Sugimoto1), Aya Tanzawa1), Nariko Thoki1), Mitsuru Suizu1), Hitomi Nakamura1), Akiko Toda1), Saesa
Suzuki1), Kaori Tajima1), Shuuichi Fukase1), Taichiro Funatsu1), Yukihiko Hidaka1), Hiroyasu Yamaguchi1),
Hideo Yamamoto1), Yumiko Yamamoto3),
Jun Nejima2), Kaoru Kobayashi3).
Department of General Dentistry and Clinical Education1), Department of Internal Medicine2), Department ofOral and Maxillofacial Radiology and Diagnosis3), Tsurumi University School of Dental Medicine.
࠙⥴ゝࠚ㭯ぢ኱ᏛṑᏛ㒊㝃ᒓ⑓㝔⥲ྜṑ⛉ 㸦༞ᚋ◊ಟᩍ⫱㸧࡛ࡣ඲㌟⑌ᝈࢆక࠺デ⒪ෆᐜ࡟㛵ࡍࡿ࢝ࣥࣇ࢓
ࣞࣥࢫࢆ⾜࠺ࡇ࡜࡟ࡼࡾ᭷⑓⪅ࡢ⑓ែࢆ⌮ゎࡋඹ᭷໬ࡋ࡚࠸ࡿࠋᮏ⛉࡛ࡣࡇࡢෆᐜ࡟ࡘ࠸࡚◊ಟ་ࡀࣉࣞࢮࣥࢸ࣮ࢩࣙࣥࢆ⾜࠸ࠊࡇࡢྲྀࡾ⤌ࡳ࡟ࡘ࠸࡚ᮏ఍࡛ሗ࿌ࡋ࡚ࡁࡓࠋ௒ᅇࡣႍᜥᝈ⪅࡜ṑ⛉デ⒪࡟ࡘ
࠸࡚ᑐࡍࡿṑ⛉἞⒪ࡢὀពⅬ࡟ࡘ࠸࡚ሗ࿌ࡍࡿࠋ
࠙⑕౛ࠚ ṓ⏨ᛶ
࠙୺ッࠚᕥୗࡢዟṑࡀ③࠸ࠋ࠙᪤ ṔࠚႍᜥЍᑠඣႍᜥࡼࡾ⛣⾜ࠋ᭱⤊Ⓨస㸸⣙㸰ᖺ๓ࠊ࢔ࢺࣆ࣮ᛶ⓶⭵⅖࠙᭹⸆≧ἣࠚࣟ࢖ࢥࢺ࢚ࣜࣥᣕᢠ⸆ࠊࣄࢫࢱ࣑ࣥ + ᣕᢠ๣ࠊࣅࢱ࣑ࣥ๣ ࠊࢫࢸࣟ࢖ࢻ㌾⭯㸦እ⏝⸆㸧࠙⌧⑕ࠚ࣏ࢣࢵࢺࡣ㸲PP ௨ୗ࡛඲㢡ⓗ࡟ಟ᚟≀ࠊ࢚࢝ࣜࢫࡶከᩘṑ࡟ㄆࡵࡽࢀࡓࠋ
࠙デᰝࠚṑ࿘⢭ᐦ᳨ᰝࠊཱྀ⭍஝⇱デᰝ㸦࣒࢞ἲࠊཱྀ⭍Ỉศィ㸧࿧྾ᶵ⬟㸦3()㸸ࣆ࣮ࢡࣇ࣮ࣟ㸧࠙デ᩿ࠚ៏ᛶ㎶⦕ᛶṑ࿘⅖㸦㍍ᗘ㸧ࠊ&㸸ྑୖ㸸㸶㸵㸱㸰ᕥୖ㸸㸰㸱ᕥୗ㸸㸱㸳㸴㸵ᬛṑ࿘ᅖ⅖ྑୖ㸶
3&5 ⤖ᯝࡣ 㸣࡛ࠊ๓ṑ㒊㞄᥋㠃ࠊ⮻ṑ㒊࡟☻ࡁṧࡋࡀㄆࡵࡽࢀࡓࠋ
ཱྀ⭍஝⇱࠾ࡼࡧၚᾮศᕸపୗࡀ␲ࢃࢀࡓࠋႍᜥࡣ㍍⑕㛫Ḟᆺ࡟ศ㢮ࡉࢀࡓࠋ
࠙἞⒪ィ⏬ࠚ
ṑ࿘ᇶᮏ἞⒪ࠊ࠺⼃⑕➨㸰ᗘ㸸&5ࠊࢢࣛࢫ࢔࢖࢜ࣀ࣐࣮඘ሸࠋ
἞⒪࡟㝿ࡋႍᜥࡣ㍍⑕㛫Ḟᆺ࡛࠶ࡾࠊⓎసࡢཎᅉ≀㉁ࡣ≉ᐃࡉࢀ࡚࡞࠸ࠋẼ⟶ᨭᣑᙇ⸆ࡣ౑⏝ࡋ࡚࠸࡞࠸ࡀࠊṤ࡝ࡢႍᜥ⑕౛࡛ࡣ྾ධș㸰่⃭⸆౑⏝౛ࡀከࡃࠊ἞⒪࡟㝿ࡋࠊ࢚ࣆࢿࣇࣜࣥྵࡲࢀ࡚࠸࡞࠸㯞㓉⸆ࢆ౑⏝ࡍࡿࠋᢠ⳦๣ᢞ୚࡟࠶ࡓࡗ࡚ࡣ࣐ࢡࣟࣛ࢖ࢻ࡜ࢽ࣮ࣗ࢟ࣀࣟࣥࡀࢸ࢜ࣇ࢕ࣜࣥᚎᨺᛶ๣⾑୰⃰ᗘࢆୖ᪼ࡉࡏࡿࡢ࡛ཎ๎౑⏝ࡋ࡞࠸ࡀ୍⯡ⓗ࡛࠶ࡿࠋᾘ⅖㙠③⸆ 16$,'㹱⚗ᚷ ࡛࠶ࡿࡀࠊ࢔ࢭġ ࢔࣑ࣀࣇ࢙ࣥࠊሷᇶᛶᢠ⅖⑕⸆ࢆ౑⏝ࡍࡿࠋᮏ⑕౛ሗ࿌࡛ࡣႍᜥ㔜⑕ᗘศ㢮࡜ࣜࢫࢡࠊṑ⛉἞⒪๓ࠊ୰ࠊⓎస᫬ࡢᑐᛂࠊཱྀ⭍⟶⌮࡛ὀពࡍࡿⅬ࡟ࡘ࠸࡚ሗ࿌ࡍࡿࠋ
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ཱྀ₇Ⓨ⾲㻌 䠫䠉㻝㻝㻌㻌᪂䛧䛔᪉ᘧ䜢⏝䛔䛯㠀᥋ゐᘧ 㻟 ḟඖᙧ≧ィᶵ䛾㛤Ⓨ㻌

Development of the Optical 3D Non-contact Measuring Machine with New Analysis Method䕿኱ᕝᩄỌ 㻝㻕䠈Ᏻ㝙㻌 ᫴ 㻝㻕䠈ᒸ㻌 ㅬḟ 㻝㻕䠈㔝ཱྀ┤ே 㻞㻕䠈ᮧୖឡ⏤ 㻝㻕䠈Ἑ㔝ᩥ᫛ 㻞㻕㻌ᚨᓥ኱Ꮫ⑓㝔⥲ྜṑ⛉デ⒪㒊 㻝㻕䠈ᚨᓥ኱Ꮫ኱Ꮫ㝔䝦䝹䝇䝞䜲䜸䝃䜲䜶䞁䝇◊✲㒊⥲ྜデ⒪ṑ⛉Ꮫศ㔝 㻞㻕‫ۑ‬Toshinori Ohkawa1)㸪Susumu Abe1)㸪Kenji Oka1)㸪Naoto Noguchi2)㸪Ayu Murakami 1)㸪Fumiaki Kawano2)
Tokushima University Hospital Department of Oral Care and Clinical Education1)
Department of Comprehensive Dentistry㸪The University of Tokushima Graduate School2)䛆┠ⓗ䛇㻌㏆ᖺ䠈㻯㻭㻰㻛㻯㻭㻹 ᢏ⾡䛾Ⓨᒎ䛻䜘䜚䠈ከ䛟䛾ගᏛᙧ≧ィᶵ䛜㛤Ⓨ䛥䜜䠈ṑ⛉⏺䛷䜒ᗈ䛟⮫ᗋ䛾ሙ䛷ᛂ⏝䛥䜜䛶䛔䜛䠊䛧䛛䛧䠈䛭䜜䜙䛿」㞧䛺⮬⏤᭤㠃䜢䜒䛴ኳ↛ṑ䛾ィ䛻䛿༑ศ䛻䛭䛾ᛶ⬟䜢ά⏝䛩䜛஦䛜ᅔ㞴䛷䛒䜛䠊䛭䛣䛷䠈ᡃ䚻䛿᪂䛧䛔᪉ᘧ䜢⏝䛔䛯㠀᥋ゐᘧ 㻟 ḟඖᙧ≧ィᶵ䠄௨ୗ 㻻㻼㼀䠅䜢㛤Ⓨ䛧䠈䛭䛾⢭ᗘ䛻䛴䛔䛶᥋ゐᘧ 㻟 ḟඖᙧ≧ィᶵ䠄௨ୗ 㻲㻺䠅䛸ẚ㍑᳨ウ䛧䛯䠊㻌䛆᪉ἲ䛇㻌ᡃ䚻䛜㛤Ⓨ䛧䛯 㻻㻼㼀 䛿ගᏛ䝁䝜䝇䝁䝢䝑䜽䡡䝩䝻䜾䝷䝣䜱䡡䝉䞁䝃䞊䜢⏝䛔䛯䝺䞊䝄䞊䝉䞁䝃䞊䠄㻯㼛㼚㼛㻼㼞㼛㼎㼑㻌㻱㻯㻝㻜㻜㻜䠅䛸䠈ศゎ⬟䞉෌⌧⢭ᗘ䛾㧗䛔 㻟 ㍈ไᚚ䛾䝇䝔䞊䝆䠄㻸㼕㼚㼕㼑㼞㻌㻼㼛㼟㼕㼠㼕㼛㼚㼕㼚㼓㻌㻿㼠㼍㼓㼑㻌㻹㻙㻡㻟㻝䡡㻡㻿䠅䛷ᵓᡂ䛥䜜䛶䛔䜛䠊㻻㻼㼀 䛾ไᚚ䛿䠈㞽఩ἲ䛷⾜䛖䛯䜑䠈᪂䛻ᐃ⏝ゎᯒ䝋䝣䝖䜢㛤Ⓨ䛧䛯䠊ィ፹య䛸䛧䛶༙ᚄ 㻡䡉䡉䛾┿⌫ᗘ䛾㧗䛔⋢㍈ཷ⏝㗰⌫䠄㻞㻤 ➼⣭䠖ኳ㎷㗰⌫♫〇䠅䜢 㻡 ಶ⏝ព䛧䠈༳㇟⢭ᗘ䛾㧗䛔䝅䝸䝁䞊䞁༳㇟ᮦ䠄䜲䞁䝥䝸䞁䝖䊡䝷䜲䝖䝪䝕䜱䠗䠖㻟㻹㻌 㻱㻿㻼㻱䠈㻱㼄㻭㻲㻵㻺㻱㻌 㻼㻭㼀㼀㼅㻌 㼀㼅㻼㻱䠖㻳㻯䠅䛷㗰⌫䛾༳㇟䜢᥇ᚓ䛧䛯䠊䛭䛾ᚋ䠈㉸◳▼⭯䠄㻺㻱㼃㻌㻲㼁㻶㻵㻾㻻㻯㻷䠖㻳㻯䠅䜢⏝䛔䛶┿⌫ᶍᆺ䜢స〇䛧䠈㻻㻼㼀 䛸 㻲㻺 䛷ィ䜢⾜䛳䛯䠊䛭䜜䛮䜜┿⌫ᶍᆺ䛾⾲㠃ᗙᶆ䛛䜙௵ព䛻 㻝㻜㻜 Ⅼ䜢㑅ᢥ䛧䠈᭱ᑠ⮬஌ἲ䜢⏝䛔䛶⌫䛾༙ᚄ䜢ồ䜑䛯䠊䛣䜜䜢 㻝㻜㻜㻜 ᅇ⧞䜚㏉䛧䠈ᚓ䜙䜜䛯ᖹᆒ್䛸ᶆ‽೫ᕪ䜢ẚ㍑䛧䛯䠊㻌
䛆⤖ᯝ䛇㻌
┿⌫ᶍᆺ䛾
ィ

ᐃ᫬㛫䛿 㻲㻺 䛷⣙ 㻝㻢 ᫬㛫䠈㻻㻼㼀 䛷⣙ 㻞 ᫬㛫༙䛷䛒䜚䠈㻻㻼㼀 䛷䛿䠈㻲㻺 䛾⣙ 㻝㻛㻢 䛾సᴗ᫬㛫䛷䜢⾜䛖䛣䛸䛜䛷䛝䛯䠊㻲㻺 䛸 㻻㻼㼀 䛷ᐃ䛧䛯┿⌫ᶍᆺ䛾༙ᚄ䛾ᕪ䛿᭱ᑠ䛷 㻝㻚㻟㻣䃛㼙 䛷᭱኱䛷 㻝㻣㻚㻣㻟䃛㼙 䛷䛒䛳䛯䠊䜎䛯ᶆ‽೫ᕪ䛿䠈㻠㻚㻠㻟䃛㼙 䛛䜙 㻞㻟㻚㻣㻤䃛㼙 䛾⠊ᅖ䛻཰䜎䛳䛯䠊㻌䛆⤖ㄽ䛇㻌㻻㻼㼀 䛷䛿䠈㻲㻺 䛻ẚ䜉䛶▷᫬㛫䛷䛾ィ䛜ྍ⬟䛻䛺䜚䠈⢭ᗘ䜒 㻲㻺 䛸䜋䜌ྠ➼䛷䛒䛳䛯䠊௒ᅇ⏝䛔䛯㞽఩ἲ䛿䝺䞊䝄䞊䝉䞁䝃䞊䛾≉ᛶ䛸䝇䝔䞊䝆䛾ᛶ⬟䜢༑ศ䛻ᘬ䛝ฟ䛫䜛᪉ἲ䛷䛒䜚䠈㧗⢭ᗘ䛾ィ
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䛜ྍ⬟䛸⪃䛘䜙䜜䜛䠊㻌ཱྀ₇Ⓨ⾲㻌 䠫䠉㻝㻞㻌㻌ṑ࿘἞⒪䛻㛵㐃䛩䜛䝫䞊䝖䝣䜷䝸䜸䛛䜙ぢ䛯◊ಟṑ⛉་䛾᣺䜚㏉䜚䛻䛴䛔䛶㻌
Reflection of trainee dentists-Analysis of the portfolios related to periodontal treatment‫ۑ‬Ἑ㔝㝯ᖾ 1㸧㸪᱓ᒣ㤶⧊ 1㸧㸪኱ሯᜨ⌮ 1㸧㸪ሷὠ⠊Ꮚ 1㸧㸪Ṋ⏣ᏹ᫂ 1㸧㸪ኴ⏣ளᕼ 1㸧㸪ᑠ᮶⏣⨾㤶 1㸧㸪㕥ᮌᗣྖ 1㸧㸪ⓑ஭ ⫕ 1㸧㸪ྜྷ⏣ⓏᚿᏊ 2㸧㸪㫽஭ᗣᘯ 1㸧ᒸᒣ኱Ꮫ⑓㝔㻌 ⥲ྜṑ⛉ 㻝䠅㻌ᒸᒣ኱Ꮫ㻌 ་⒪ᩍ⫱⤫ྜ㛤Ⓨ䝉䞁䝍䞊㻔ṑᏛᩍ⫱㒊㛛㻕㻞䠅㻌‫ۑ‬Takayuki Kono1), Kaori Kuwayama1), Eri Ohtsuka1), Noriko Shiotsu1), Hiroaki Taketa1), Aki Ohta1),
Mika Kogita1), Koji Suzuki1), Hajime Shirai1), Toshiko Yoshida2), Yasuhiro Torii1)
Comprehensive Dental Clinic, Okayama University Hospital1), Center for the Development of Medical and
Health Care Education (Dental Education), Okayama University2)䛆ㅖゝ䛇㻌ᒸᒣ኱Ꮫ⑓㝔䛾⮫ᗋ◊ಟ䛷䛿䠈◊ಟṑ⛉་䛻デ⒪䛤䛸䛻㟁Ꮚ䝫䞊䝖䝣䜷䝸䜸䛻ෆᐜ䜔ឤ᝿䛾グ㍕䜢ồ䜑䠈Ẽ௜䛝䜔᣺䜚㏉䜚䜢ಁ䛩䜘䛖䛻䛧䛶䛔䜛䚹௒ᅇ䠈◊ಟṑ⛉་䛜グ㍕䛧䛯䝫䞊䝖䝣䜷䝸䜸䛛䜙ṑ࿘἞⒪䛻㛵㐃䛩䜛஦㡯䜢ᢳฟ䛧䠈䝔䜻䝇䝖䝬䜲䝙䞁䜾䛻䜘䛳䛶ᙼ䜙䛾᣺䜚㏉䜚䛾ෆᐜ䛸䛭䛾⤒᫬ⓗ䛺ኚ໬䛻䛴䛔䛶ㄪ䜉䛯䚹㻌䛆᪉ἲ䛇㻌㻴㻞㻞䡚㻴㻞㻠 ᖺᗘ䛻◊ಟṑ⛉་䛜ṑ࿘἞⒪䜢⾜䛳䛯㝿䛻ධຊ䛧䛯䝫䞊䝖䝣䜷䝸䜸䜢ᢳฟ䛧䠈㻝䠊ධຊ᫬ᮇ䜢◊ಟ๓ᮇ䠈◊ಟ୰ᮇ䠈◊ಟᚋᮇ䛻ศ䛡䠈ᢏ⾡㛵㐃䠄㞴䛧䛔䠈ⱞປ䠈ኻᩋ䠈ᮍ⇍䠈ᡭ㛫䠅䠈▱㆑㛵㐃䠄䜟䛛䜙䛺䛔䠈ᝎ䜐䠅䠈ែᗘ㛵㐃䠄↔䜛䠈⥭ᙇ䠈ᚰ㓄䠈཯┬䠅䛾⾜ື䛾༢ㄒ䜢ྵ䜐䝫䞊䝖䝣䜷䝸䜸䛾๭ྜ䜢ㄪ䜉䛯䚹㻞䠊ධຊ᫬ᮇ䛸᣺䜚㏉䜚䛻㛵䛩䜛༢ㄒ䛾㛵㐃ᛶศᯒ䛾䛯䜑䛻䠈㼃㼛㼞㼐㻹㼕㼚㼑㼞㻌 䜢⏝䛔䛶ᑐᛂศᯒ䛸᭷ពᛶ䝔䝇䝖䜢⾜
䛳䛯䚹㻌
䛆⤖ᯝ䛇㻌
᣺䜚㏉䜚⾜ື䛾༢ㄒ䜢ྵ䜐䝫䞊䝖䝣䜷䝸䜸䛾๭ྜ䛿䠈◊ಟ๓ᮇ䠈୰ᮇ䠈ᚋᮇ䛻䛚䛔䛶䠈㻠㻝㻚㻤㻑䠈㻟㻡㻚㻝㻑䠈㻟㻜㻚㻞㻑䛷䠈ᑐᛂศᯒ䛾⤖ᯝ䠈◊ಟ๓ᮇ䛸཯┬䠈ⱞປ䠈ᮍ⇍䠈ኻᩋ䛜䠈◊ಟ୰ᮇ䛸ᚰ㓄䠈ᝎ䜐䛸㛵㐃ᛶ䛜♧䛥䜜䛯䚹᭷ពᛶ䝔䝇䝖䛾⤖ᯝ䠈◊ಟ๓ᮇ䛷䛿⥭ᙇ䠈ᡭ㛫䠈ኻᩋ䛜䠈◊ಟ୰ᮇ䛷䛿ᝎ䜐䠈ᚰ㓄䠈䜟䛛䜙䛺䛔䛜䠈◊ಟᚋᮇ䛷䛿䜟䛛䜙䛺䛔䛸䛔䛳䛯༢ㄒ䛜᭷ព䛻ྵ䜎䜜䛶䛔䛯䚹䜎䛯䠈๓ᮇ䛷䛿୍⯡ⓗ἞⒪䛻㛵䛩䜛༢ㄒ䠄ᝈ⪅䠈䝰䝏䝧䞊䝅䝵䞁䠈デ᩿➼䠅䜔ṑ࿘἞⒪䛾ึṌⓗ䛺༢ㄒ䠄䝥䝻䞊䝤䠈䝇䜿䞊䝸䞁䜾䠈䝫䜿䝑䝖➼䠅䛜ከ䛟䠈୰䞉ᚋᮇ䛷
䛿⅖⑕䠈௜╔䠈㦵྾཰➼䛾ṑ࿘⑓䛻≉໬䛧䛯༢ㄒ䛜ㄆ䜑䜙䜜䛯䚹㻌䛆⪃ᐹ䛇㻌◊ಟ๓ᮇ䛻䛚䛔䛶䛿⮫ᗋ⤒㦂䛜ὸ䛟䠈ᢏ⾡䛜ᮍ⇍䛷䛒䜛䛣䛸䛛䜙᣺䜚㏉䜚⾜ື䛻㛵䛩䜛༢ㄒ䛜ከ䛟ぢ䜙䜜䛯䛜䠈◊ಟ䛜㐍䜐䛻䛴䜜᣺䜚㏉䜚䜢♧䛩༢ㄒ䛜ῶᑡ䛧䛶䛔䛯䚹䛧䛛䛧䠈୰䞉ᚋᮇ䛷䜒䜟䛛䜙䛺䛔䜔ᝎ䜐䛸䛔䛖▱㆑⾜ື䛻㛵䛩䜛༢ㄒ䜔䠈ከ䛟䛾ṑ࿘⑓䛻≉໬䛧䛯༢ㄒ䛜ぢ䜙䜜䠈ᢏ⾡ⓗ᣺䜚㏉䜚䛛䜙▱㆑ⓗ᣺䜚㏉䜚䛻⛣⾜䛧䛶䛔䜛䛸ᛮ䜟䜜䛯䚹㻌
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ཱྀ₇Ⓨ⾲㻌 䠫䠉㻝㻟㻌㻌㻿㼠㼞㼑㼜㼠㼛㼏㼛㼏㼏㼡㼟㻌㼙㼡㼠㼍㼚㼟㻌 䛾⑓ཎᛶ䛻䛚䛡䜛 㼟㼏㼞㻭 㑇ఏᏊ䛾ᙺ๭㻌
Roles of scrA gene in pathogenicity of Streptococcus mutans‫ۑ‬ᮌᮧ㻌 ᬛᏊ䠍䠅䠈ᑿᓮ㻌 ࿴⨾䠎䠅䠈‫‮‬ᮏ㻌 ᾈ㏻䠏䠅䠈ᮧୖ㻌 ᆂྐ䠐䠅䠈Ⳣཎ㻌 ༓ᜨᏊ䠍䠅䠈⠛ཎ㻌 ༓ᑜ䠍䠅䠈Ṋᕝ㻌 ᜨ⨾䠑䠅䠈㻌㻌 㻌 ୕Ꮿ㻌 ὒ୍㑻䠐䠅䠈ᯇᑿ㻌 ᩗᚿ䠏䠅䠈Ἑ㔝㻌 ᩥ᫛䠍䠅㻌ᚨᓥ኱Ꮫ኱Ꮫ㝔㻌 䝦䝹䝇䝞䜲䜸䝃䜲䜶䞁䝇◊✲㒊㻌 ⥲ྜデ⒪ṑ⛉Ꮫศ㔝䠍䠅㻌ᚨᓥ኱Ꮫ኱Ꮫ㝔㻌 䝦䝹䝇䝞䜲䜸䝃䜲䜶䞁䝇◊✲㒊㻌 ཱྀ⭍ಖ೺Ꮫ⛉㻌 ཱྀ⭍ಖ೺ᨭ᥼Ꮫㅮᗙ䠎䠅㻌ᚨᓥ኱Ꮫ኱Ꮫ㝔㻌 䝦䝹䝇䝞䜲䜸䝃䜲䜶䞁䝇◊✲㒊㻌 ṑ⛉ಖᏑᏛศ㔝䠏䠅㻌ᚨᓥ኱Ꮫ኱Ꮫ㝔㻌 䝦䝹䝇䝞䜲䜸䝃䜲䜶䞁䝇◊✲㒊㻌 ཱྀ⭍ឤᰁ⑕Ꮫศ㔝䠐䠅㻌ᚨᓥ኱Ꮫ኱Ꮫ㝔㻌 䝦䝹䝇䝞䜲䜸䝃䜲䜶䞁䝇◊✲㒊㻌 ⏕యᮦᩱᕤᏛศ㔝䠑䠅㻌‫ۑ‬Tomoko Kimura1)㸪Kazumi Ozaki2)㸪 Hiromichi Yumoto3)㸪Keiji Murakami4)㸪Chieko Sugawara1)㸪
Chihiro Shinohara1)㸪Emi Takegawa5)㸪Yoichiro Miyake4)㸪Takashi Matsuo3)㸪Fumiaki Kawano1)
Department of Comprehensive Dentistry,

Institute of Health Biosciences,1)

Graduate School , Department of Oral Health Care Promotion,

The University of Tokushima

Institute of Health Biosciences,

University of Tokushima Graduate School2), Department of Conservative Dentistry,
Biosciences,

Institute of Health

3)

The University of Tokushima Graduate School , Department of Oral Microbiology,

Health Biosciences,
Bioengineering,

The

Institute of

The University of Tokushima Graduate School4), Department of Biomaterials andInstitute of Health Biosciences,

The University of Tokushima Graduate School5)䛆┠ⓗ䛇㻌䛖⼃ཎᛶ⣽⳦䛾୍䛴䛷䛒䜛 㻿㼠㼞㼑㼜㼠㼛㼏㼛㼏㼏㼡㼟㻌㼙㼡㼠㼍㼚㼟 䛿䠈䝇䜽䝻䞊䝇䛛䜙㠀Ỉ⁐ᛶ䜾䝹䜹䞁䛚䜘䜃Ỉ⁐ᛶ䜾䝹䜹䞁䜢ྜᡂ䛧ṑ㠃䜈௜╔䛧䛶䝞䜲䜸䝣䜱䝹䝮䜢ᙧᡂ䛩䜛䚹ᮏ◊✲䛷䛿䠈㻿㻚㼙㼡㼠㼍㼚㼟 䛾䝩䝇䝩䜶䝜䞊䝹䝢䝹䝡䞁㓟౫Ꮡ⢾䝩䝇䝩䝖䝷䞁䝇䝣䜵䝷䞊䝊⣔䠄㻼㼀㻿 ⣔䠅䛻䛚䛡䜛䝇䜽䝻䞊䝇䜶䞁䝄䜲䝮䊡㑇ఏᏊ䠄㼟㼏㼞㻭䠅䛻╔┠䛧䠈㼟㼏㼞㻭 䜢Ḟኻ䛥䛫䛯㑇ఏᏊᨵኚᰴ䜢స〇䛧䛶䠈ṑ㠃䜈䛾ึᮇ௜╔䜔䝞䜲䜸䝣䜱䝹䝮ᙧᡂ䛻䛚䛡䜛 㼟㼏㼞㻭 㑇ఏᏊ䛾ᙺ๭䛻䛴䛔䛶᳨ウ
䛧䛯䚹㻌
䛆᪉ἲ䛇㻌

㻿㻚㻌 㼙㼡㼠㼍㼚㼟㻌 㼁㻭㻝㻡㻥 ᰴ䜢ぶᰴ䛸䛧䠈┦ྠ⤌᥮䛘䛻䜘䜚䜶䝸䝇䝻䝬䜲䝅䞁⪏ᛶ䛾 㼟㼏㼞㻭 㑇ఏᏊᨵኚᰴ䜢స〇䛧䛯䚹䛣䛾ᨵኚᰴ䜢⏝䛔䛶䠈䝝䜲䝗䝻䜻䝅䜰䝟䝍䜲䝖㻔㻴㻭㻕ᯈ䜈䛾⳦䛾ึᮇ௜╔䛻䛴䛔䛶ぶᰴ䛸ẚ㍑᳨ウ䜢⾜䛳䛯䚹ḟ䛻䠈ぶᰴ䛸ᨵኚᰴ䛾䛭䜜䛮䜜䜢ᠱ⃮䛧䛯ᇵ㣴ᾮ䠄䠑䠂䝇䜽䝻䞊䝇ྵ᭷䠅୰䛻䜴䝅㇟∳㉁ᯈ䜢ᢞධ䛧䛶 㻠㻤 ᫬㛫㟼⨨䛧䠈㇟∳㉁ᯈ䛻௜╔䛧䛯㠀Ỉ⁐ᛶ䜾䝹䜹䞁䛾ྜᡂ㔞䜢䝣䜵䝜䞊䝹◲㓟ἲ䜢⏝䛔䛶ᐃ䛧䛯䚹䜎䛯䠈㻿㻱㻹 䛻䛶䝞䜲䜸䝣䜱䝹䝮⾲ᒙ䛾ほᐹ䜢⾜䛔䠈ẚ㍑᳨ウ䛧䛯䚹㻌䛆⤖ᯝ䛸⪃ᐹ䛇㻌ၚᾮ䝁䞊䝔䜱䞁䜾䜢⾜䛳䛯 㻴㻭 ᯈ䛻ᑐ䛩䜛 㼟㼏㼞㻭 㑇ఏᏊᨵኚᰴ䛾ึᮇ௜╔⋡䛿䠈ぶᰴ䛾⣙ 㻝㻠䠂䛸䛺䜚᭷ព䛻ῶᑡ䛧䛯䚹䛣䛾䛣䛸䜘䜚䠈㼟㼏㼞㻭 㑇ఏᏊ䛜䝞䜲䜸䝣䜱䝹䝮ᙧᡂ䛾ึᮇ䛻ᙳ㡪䜢୚䛘䛶䛔䜛䛣䛸䛜♧䛥䜜䛯䚹㻌㇟∳㉁ᯈ䛻௜╔䛧䛯㠀Ỉ⁐ᛶ䜾䝹䜹䞁ྜᡂ㔞䛿䠈㼟㼏㼞㻭 ᨵኚᰴ䛿ぶᰴ䛻ẚ䜉᭷ព䛻ప䛔್䜢♧䛧䛯䚹䜎䛯䠈䝞䜲䜸䝣䜱䝹䝮⾲ᒙ䛾 㻿㻱㻹 ീ䛻䛚䛔䛶䠈㼟㼏㼞㻭 㑇ఏᏊᨵኚᰴ䛾௜╔ᛶ䜾䝹䜹䞁䛿ぶᰴ䛸ẚ㍑䛧䛶⢒䛺䜾䝸䝁䜹䝸䝑䜽䝇ᵝᵓ㐀䜢࿊䛧䛶䛚䜚䠈ඛ䛾㔞ⓗ⤖ᯝ䛸୍⮴䛧䛯䚹௨ୖ䛾⤖ᯝ䜘䜚䠈㼟㼏㼞㻭 㑇ఏᏊ䛜 㻿㻚㻌 㼙㼡㼠㼍㼚㼟 䛾䝞䜲䜸䝣䜱䝹䝮ᙧᡂ䛻䛚䛔䛶㔜せ䛺ᙺ๭䜢ᢸ䛳䛶䛔䜛䛣䛸䛜♧၀䛥䜜䛯䚹㻌
㻌
㻌
―38―

ཱྀ₇Ⓨ⾲㻌 䠫䠉㻝㻠㻌㻌ேᕤ⾑⟶⨨᥮䞉ேᕤ㛵⠇ᝈ⪅䛾ṑ⛉デ⒪㻌
Dental clinic of blood vessel prosthesis implantation and an artificial joint patient䚽ᑠ㔝ி 㻝䠅㻘▼ሯᛅᘯ 㻝䠅㻘Ᏻಸᗣ἞ 㻝䠅㻘஭⃝ᆂモ 㻝䠅㻘▼ᕝ๛ᝆ 㻝䠅㻘⊦Ꮚᬛ༤ 㻝䠅㻘➟㛫㝯ே 㻝䠅㻘ᒸᮏளᕼᏊ 㻝䠅㻘㻌 㔠Ꮚዉኸ 㻝䠅㻘బ㈏༓ኟ 㻝䠅㻘㔛ᮧᬛ❶ 㻝䠅㻘⋢ཱྀ㐍୍ 㻝䠅㻘ᒣᮏⱥ㞝 㻝䠅㻘ᒣཱྀ༤ᗣ 㻝䠅㻘Ꮚᓥ₶ 㻞䠅㻘ᒣᮏ⏤⨾Ꮚ 㻟䠅㻘ᑠᯘ㤾 㻟䠅㻌㭯ぢ኱ᏛṑᏛ㒊⥲ྜṑ⛉䠎㻝䠅㻘㭯ぢ኱ᏛṑᏛ㒊ෆ⛉Ꮫㅮᗙ 㻞䠅㻘㻌 㻌㭯ぢ኱ᏛṑᏛ㒊ཱྀ⭍㢡㢦㠃ᨺᑕ⥺䞉⏬ീデ᩿Ꮫㅮᗙ 㻟䠅㻌ࠐMiyako Ono㻝䠅, Tadahiro Ishizuka㻝䠅, Kouji Abe, Keishi Izawa㻝䠅, Hisachika Ishikawa㻝䠅, Tomohiro Inoko㻝䠅, Ryuto
Kasama㻝䠅, Akiko Okamoto㻝䠅, Nao Kaneko㻝䠅, Chinatsu Sanuki㻝䠅, Tomoaki Satomura㻝䠅, Shinichi Tamaguchi㻝䠅,Hiroyasu Yamaguchi㻝䠅, Hideo Yamamoto㻝䠅, Jun Nejima㻞㻕, Yumiko Yamamoto㻟䠅, Kaoru Kobayashi㻟㻕Department of General Dentistry and Clinical Education㻝䠅, Department of Internal Medicine2), Department ofOral and Maxillofacial Radiology and Diagnosis 3), Tsurumi University School of Dental Medicine㻌䛆⥴ゝ䛇㻌㭯ぢ኱ᏛṑᏛ㒊㝃ᒓ⑓㝔⥲ྜṑ⛉ 㻞䠄༞ᚋ◊ಟᩍ⫱䠅䛷䛿඲㌟⑌ᝈ䜢క䛖デ⒪ෆᐜ䛻㛵䛩䜛䜹䞁䝣䜯䝺䞁䝇䜢⾜䛖䛣䛸䛻䜘䜚᭷⑓⪅䛾⑓ែ䜢⌮ゎ䛧䚸䛣䛾ෆᐜ䛻䛴䛔䛶◊ಟ་䛜䝥䝺䝊䞁䝔䞊䝅䝵䞁䜢⾜䛔䚸䛣䛾ྲྀ䜚⤌䜏䛻䛴䛔䛶ᮏ఍䛷ሗ࿌䛧䛶䛝䛯䚹㻌ᮏ⑕౛ሗ࿌䛷䛿ேᕤ⾑⟶䚸ேᕤ㛵⠇䛜タ⨨䛥䜜䛯ᝈ⪅䛻ᑐ䛩䜛ṑ⛉἞⒪䛾ὀពⅬ䛻䛴䛔䛶ሗ࿌䛩䜛䚹㻌䛆⑕౛䛇㻌 㻡㻣 ṓ⏨ᛶ㻌䛆୺ッ䛇㻌 ⥅⥆἞⒪䠖๓ᢸᙜ་䜘䜚๓ṑ㒊䛾ⴭ䛧䛔ည⪖䛾⤒㐣ほᐹ䛸ᕥୖ䠒䛾 㻱㼄㼀㻌
䛆඲㌟ⓗ᪤ Ṕ䛇㻌㻞㻜㻜㻡 ᖺ㻌 ឤᰁᛶ⭡㒊኱ື⬦⒗䛾䛯䜑ேᕤ⾑⟶⨨᥮⾡䚸㻞㻜㻜㻥 ᖺ㻌 ᕥ㊊㤳䛾ឤᰁ䛻䜘䜚ேᕤ㛵⠇ᡭ⾡㻌䛆ṑ⛉ⓗ᪤ Ṕ䛇㻌 ᢤṑ⤒㦂䠄䠇䠅ṑ⛉㯞㓉⤒㦂䠄䠇䠅␗ᖖ䠄䠉䠅㻌䛆ᢞ⸆≧ἣ䛇㻌
ᕥ㊊⑊③㑇ṧ䛾䛯䜑䠖䝯䝏䝁䝞䞊䝹㘄䞉䝯䜻䝅䝏䞊䝹䜹䝥䝉䝹䞉䜲䞁䝔䝞䞁䜽䝸䞊䝮䠍䠂䞉䝻䜻䝋䝙䞁㘄䞉䝮䝁䝇䝍㘄䞉䝸䝸䜹䜹䝥䝉䝹㻌㧗⾑ᅽ䞉౽⛎⑕䛾䛯䜑䠖䜰䝮䝻䝆䝢䞁㘄䞉䝬䜾䝷䝑䜽䝇㘄㻌䛆⌧⑕䛇㻌ཱྀ⭍ෆᡤぢ㻌
デ᩿䠖඲㢡䛻䜟䛯䜛៏ᛶ㎶⦕ᛶṑ࿘⅖㻌 ᕥୖ 㻢䠖ṑ᰿◚ᢡ㻌 ည⪖ᦶ⪖⑕㻌䛆἞⒪ィ⏬䛇㻌
㻝䠅ṑ࿘἞⒪㻌 㻞䠅ᕥୖ 㻢 ᢤṑ䞉㒊ศᗋ⩏ṑస〇㻌 㻟䠅ྑୗ 㻢 ᢤṑ䞉⿵⥛ฎ⨨ 㻠䠅䝯䞁䝔䝘䞁䝇㻌䛆ᑐデ⤖ᯝ䛇㻌 ෆ⛉䜘䜚䠖⾑ᅽ䝁䞁䝖䝻䞊䝹Ⰻዲ䚸⾑⟶እ⛉་䚸䝸䜴䝬䝏་䜘䜚እ⛉ฎ⨨䛻㝿䛧ண㜵ⓗᢠ⳦ᢞ୚䜢ᣦ♧䚸ᕥୖ 㻢 䛾ṑෙ◚ᢡ䛾ᢤṑ䛻㝿䛧⾡๓ᢞ୚䛸䛧䛶䚸䜰䝰䜻䝅䝅䝸䞁㻌 㻞㻡㻜䡉䡃䚸㻤䠿䚸⾡ᚋ䛻䜰䝰䜻䝅䝅䝸䞁 㻞㻡㻜䡉䡃䚸㻟䠿䚸ẖ㣗ᚋ 㻟 ᪥ศ䚸䜰䝉䝖䜰䝭䝜䝣䜵䞁㘄 㻟㻜㻜䡉䡃䚸㻞䠰⑊③᫬䚸䠏ᅇศฎ᪉䛧䛯䚹㻌䛆἞⒪䞉⤒㐣䛇㻌 ⌧ᅾ䚸ṑ࿘἞⒪ᚋ䚸ᕥୖᢤṑ⤒㐣Ⰻዲ䚸⥅⥆἞⒪୰䛷䛒䜛䚹㻌䛆⤖ㄽ䛇㻌 ᚰෆ⭷⅖䜈䛾ண㜵ᢞ୚䛿ṑ⛉་ᖌ䛻࿘▱䛥䜜䛶䛔䜛䛜䚸యෆ䛻ேᕤ≀䛜タ⨨䛥䜜䛶䛔䜛ሙྜ䜒ṑ⛉
἞⒪䜢⾜䛖᫬䛻䛿⪃៖䛩䜛ሙྜ䜒䛒䜛䚹ேᕤ⾑⟶䞉ேᕤ㛵⠇䛾ሙྜ䚸ண㜵ᢞ୚䛾ᚲせᛶ 㻝䚸㻞䠅䛜᫂☜䛻䛥䜜䛶䛺䛔䛜䚸἞⒪䛾㝿䛿䚸䛛䛛䜚䛴䛡་䛻ᑐデ䛧䚸ண㜵ᢞ୚䛾ᚲせᛶ䜢┦ㄯ䛧䛯ୖ䛷䛩䛩䜑䛶䛔䛟䛣䛸䛜኱ษ䛷䛒䜛䚹㻌䛆ᩥ⊩䛇㻌 㻝㻕㻶㻌㻭㼙㻌㻰㼑㼚㼠㻌㻭㼟㼟㼛㼏㻚㻌㻞㻜㻜㻟㻧㻝㻟㻠㻦㻤㻥㻡㻙㻥㻚㻞㻕㻶㻌㻭㼙㻌㻰㼑㼚㼠㻌㻭㼟㼟㼛㼏㻚㻌㻞㻜㻜㻠㻧㻝㻟㻡㻦㻠㻤㻠㻙㻣㻚㻌―39―

ཱྀ₇Ⓨ⾲㻌 䠫䠉㻝㻡㻌㻌䝠䝜䜻䝏䜸䞊䝹㓄ྜ䝆䜵䝹䜢⏝䛔䛯ཱྀ⭍䜿䜰䛾ཱྀ⮯ᨵၿຠᯝ㻌
Improvement effect of mouth cleaning by hinokitiol-containing gel on oral malodor䕿ఀἼᖾస 㻝㻕㻘㻌 㕥ᮌዉኸ 㻝㻕㻘㻌 ⡿⏣㞞⿱ 㻞㻕㻘㻌 ᒣ⏣࿴ᙪ 㻝㻕㻘㻌 ᒾඖ▱அ 㻝㻕㻘㻌 ᱝᑿ㝧௓ 㻝㻕㻘㻌 ⸨ᮏᬡỤ 㻝㻕㻘㻌 ℩㔝ᜨ⾰ 㻝㻕㻘㻌 㻌㻌 㻌 ᫓ྡ୍ே 㻝㻕㻘㻌 Ᏻ㻌 ᛅ኱ 㻝㻕㻘㻌 ධỤ୹ెᏊ 㻝㻕㻘㻌 すཎဴୡ 㻝㻕㻘㻌 ௰すᏹ௓ 㻝㻕㻘㻌 ᘅ⸨༟㞝 㻝㻕㻌⚟ᒸṑ⛉኱Ꮫ㻌 ⥲ྜṑ⛉Ꮫㅮᗙ㻌 ⥲ྜṑ⛉Ꮫศ㔝 㻝㻕䚸⚟ᒸṑ⛉኱Ꮫ㻌 ཱྀ⭍་⒪䝉䞁䝍䞊㻞㻕㻌‫ۑ‬Iha K1), Suzuki N1), Yoneda M2), Yamada K1), Iwamoto T1), Masuo Y1), Fujimoto A1), Seno K1), Haruna K1),
Yasu T1), Irie T1), Nishihara T1), Nakanishi K1), Hirofuji T1)
Section of General Dentistry, Department of General Dentistry, Fukuoka Dental College1),
Center for Oral Diseases, Fukuoka Dental College2)䛆⥴ゝ䛇㻌䝠䝜䜻䝏䜸䞊䝹䛿ඃ䜜䛯ᢠ⳦άᛶ䜢ᣢ䛱䚸ཱྀ⭍䛷䛿ṑ࿘⑌ᝈ἞⒪๣䛸䛧䛶฼⏝䛥䜜䛶䛔䜛䚹ཱྀ⮯䛾୺ᡂศ䛷䛒䜛᥹Ⓨᛶ◲໬≀㻌 㻔㼂㻿㻯㻕㻌 䛿䚸⯉ⱏ䜔ṑ࿘䝫䜿䝑䝖䛻᳇ᜥ䛩䜛᎘Ẽᛶ⳦䛻䜘䜛䝍䞁䝟䜽ศゎ⏘≀䛷䛒䜛䚹ᮏ◊✲䛷䛿䚸ཱྀ⮯䛻㛵㐃䛩䜛᎘Ẽᛶ⳦䛻ᑐ䛩䜛䝠䝜䜻䝏䜸䞊䝹䛾ᢠ⳦ᛶ䜢ホ౯䛧䚸䝠䝜䜻䝏䜸䞊䝹㓄ྜ䝆䜵䝹䛻䜘䜛ཱྀ⭍䜿䜰䛾ཱྀ⮯ᨵၿຠᯝ䜢䚸䝠䝜䜻䝏䜸䞊䝹↓㓄ྜ䝆䜵䝹䛸ẚ㍑᳨ウ䛧䛯䚹㻌䛆᪉ἲ䛇㻌㻼㼛㼞㼜㼔㼥㼞㼛㼙㼛㼚㼍㼟㻌㼓㼕㼚㼓㼕㼢㼍㼘㼕㼟㻌㻔㻼㼓㻕䚸㻼㼞㼑㼢㼛㼠㼑㼘㼘㼍㻌㼕㼚㼠㼑㼞㼙㼑㼐㼕㼍㻌㻔㻼㼕㻕䚸㻲㼡㼟㼛㼎㼍㼏㼠㼑㼞㼕㼡㼙㻌㼚㼡㼏㼘㼑㼍㼠㼡㼙㻌㻔㻲㼚㻕㻌 䛾ᶆ‽⳦ᰴ䜢ᑐ㇟䛻㜼Ṇ෇ᐇ㦂䜢⾜䛳䛯㻌 㻔㻹㻵㻯㻕䚹䜎䛯 㻼㼓 䛻ᑐ䛧䛶᭱ᑠẅ⳦⃰ᗘ㻌 㻔㻹㻮㻯㻕㻌 䛺䜙䜃䛻⤒᫬ⓗ䛺ᢠ⳦άᛶ䜢ㄪ䜉䛯䚹⮫ᗋⓗ᳨ウ䛷䛿䚸ཱྀ⮯እ᮶䜢ཷデ䛧䛯┿ᛶཱྀ⮯⑕ᝈ⪅ 㻝㻤 ྡ䜢ᑐ㇟䛻䝷䞁䝎䝮໬ẚ㍑ヨ㦂䜢⾜䛳䛯䚹⿕㦂⪅䜢
↓సⅭ䛻䝠䝜䜻䝏䜸䞊䝹㓄ྜ䝆䜵䝹⩌㻌 㻔ᐇ㦂⩌䚸㻥 ྡ㻕㻌 䛸䝠䝜䜻䝏䜸䞊䝹↓㓄ྜ䝆䜵䝹⩌㻌 㻔ᑐ↷⩌䚸㻥 ྡ㻕㻌 䛻๭䜚ᙜ䛶䚸㻝 ᪥ 㻟 ᅇẖ㣗ᚋ䛻ཱྀ⭍䜿䜰䜢⾜䛖䜘䛖ᣦ♧䛧䛯䚹౑⏝㛤ጞ๓㻌 㻔㻰㻮㻕㻌 䛸 㻠 㐌ᚋ䛻ཱྀ⮯᳨ᰝ㻌 㻔ᐁ⬟᳨ᰝ䞉䜺䝇䜽䝻䝬䝖䜾䝷䝣ศᯒ㻕㻌 䛸ཱྀ⭍ෆデᰝ㻌 㻔ṑ࿘䝫䜿䝑䝖㻌 㻔㻼㻼㻰㻕䞉䝥䝻䞊䝡䞁䜾᫬ฟ⾑㻌 㻔㻮㻻㻼㻕䞉䝥䝷䞊䜽䜲䞁䝕䝑䜽䝇㻌㻔㻼㼘㻵㻕䞉⯉ⱏ䝇䝁䜰䞉⯉⾲㠃䛾ಖ‵ᗘ㻕㻌 䜢ᐇ᪋䛧䛯䚹㻌䛆⤖ᯝ䛸⪃ᐹ䛇㻌䝠䝜䜻䝏䜸䞊䝹䛾 㻹㻵㻯 䛿 㻼㼓㻦㻌㻜㻚㻜㻜㻞㻑㻘㻌㻼㼕㻦㻌㻜㻚㻝㻑㻘㻌㻲㼚㻦㻌㻜㻚㻜㻡㻑䛷䛒䜚䚸㻼㼓 䛻ᑐ䛩䜛 㻹㻮㻯 䛿 㻜㻚㻜㻝㻢㻑䛷䛒䛳䛯䚹䜎䛯 㻼㼓䛻ᑐ䛩䜛ᢠ⳦άᛶ䛿⤒᫬ⓗ䛻㐍䜏䚸⃰ᗘ౫Ꮡⓗ䛷䛒䜛䛣䛸䛜䜟䛛䛳䛯䚹⮫ᗋⓗ᳨ウ䛷䛿䚸ᐇ㦂⩌䛸ᑐ↷⩌䛾㛫䛷 㻰㻮 䛾ཱྀ⮯䝺䝧䝹䛸ཱྀ⭍ෆ≧ែ䛻⤫ィᏛⓗ㐪䛔䛿䜏䜙䜜䛺䛛䛳䛯䚹㻰㻮 䛸 㻠 㐌ᚋ䜢ẚ㍑䛧䛯䛸䛣䜝䚸ཱྀ⮯᳨ᰝ䛷䛿ᐇ㦂⩌䛷ᐁ⬟䝇䝁䜰䛸 㼂㻿㻯 䛻᭷ព䛺ᨵၿ䛜䚸ᑐ↷⩌䛷ᐁ⬟䝇䝁䜰䛻᭷ព䛺ᨵၿ䛜ㄆ䜑䜙䜜䛯䚹ཱྀ⭍ෆデᰝ䛻䛚䛔䛶䛿䚸ᐇ㦂⩌䛷 㻼㻼㻰䚸㻮㻻㻼䚸㻼㼘㻵 䛜᭷ព䛻ῶᑡ䛧䛯䛾䛻ᑐ䛧䚸ᑐ↷⩌䛷䛿᭷ព䛺ኚ໬䛿䜏䜙䜜䛺䛛䛳䛯䚹⯉ⱏ䝇䝁䜰䛸⯉⾲㠃䛾ಖ‵ᗘ䛿୧⩌䛸䜒䛻ኚ໬䛧䛺䛛䛳䛯䚹㻌䛆䜎䛸䜑䛇㻌
䝠䝜䜻䝏䜸䞊䝹䛿ཱྀ⮯䛻㛵㐃䛩䜛᎘Ẽᛶ⳦䛻ᑐ䛧䛶ᢠ⳦άᛶ䜢♧䛧䛯䚹䝠䝜䜻䝏䜸䞊䝹㓄ྜ䝆䜵䝹䛻䜘䜛ཱྀ⭍䜿䜰䛿䚸ṑ࿘⤌⧊䛸ཱྀ⮯䛾ᨵၿ䜢䜒䛯䜙䛧䛯䚹㻌
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―40―

ཱྀ₇Ⓨ⾲㻌 䠫䠉㻝㻢㻌㻌ᆅᇦ་⒪䛻䛚䛡䜛⥲ྜṑ⛉デ⒪䛾ᯝ䛯䛩ᙺ๭䛸䛭䛾ሗ࿌㻌The Role of Comprehensive Dentistry in Community Medicine䕿ụ⏣ဴ 㻝㻘㻞㻕䠈㛗㇂ᕝ⠜ྖ 㻝㻕䠈ఀబὠඞᙪ 㻝㻕䠈ụ⏣᪼ 㻞㻕䠈ụ⏣䜎䜚䛣 㻞㻕㻌᫛࿴኱Ꮫṑ⛉ಖᏑᏛㅮᗙ⥲ྜデ⒪ṑ⛉㒊㛛 㻝㻕䠈་⒪ἲே♫ᅋ㻌 ụ⏣ṑ⛉䜽䝸䝙䝑䜽 㻞㻕㻌‫ۑ‬Satoshi Ikeda, Tokuji Hasegawa, Katsuhiko Isatsu, Noboru Ikeda, Mariko Ikeda
Department of Conservative Dentistry, Division of Comprehensive Dentistry, Showa University School of
Dentistry1), Ikeda dental clinic2)
䛆ㅖゝ䛇㻌⌧≧䛾㧗㱋⪅ᨭ᥼䛿䛂Ⓨ⑕䛧䛯⑌ᝈ䛃䜢ᑐ㇟䛸䛧䛯་ᴗ㐃ᦠ䛻䛚䛔䛶ᐇ᪋䛥䜜䚸䛂㍍ᗘ䛾⑌ᝈ䛃䜔䛂ᮍ⑓≧ែ䛃䛾㧗㱋⪅䛜ᚲ䛪䛧䜒㐺ษ䛺᫬ᮇ䛻㐺ษ䛺♫఍ⓗᨭ᥼䜢ᚓ䛶ᏳᚰᏳ඲䛻⏕ά䛷䛝䛶䛔䜛䜟䛡䛷䛿䛺䛔䚹㻌䛂ᐙᗞ་䛃䛿⥲ྜデ⒪ṑ⛉Ꮫ䛾㔜せ䛺ศ㔝䛷䛒䜚䚸༑ศ䛺་Ꮫᑓ㛛▱㆑䛻䜘䛳䛶䚸ᐙ᪘䜔ᆅᇦఫẸ䛸䛿㐪䛖ぢ㆑䛷♫఍ⓗᨭ᥼䛜ᚲせ䛺᫬ᮇ䛺䛹䜢ุ᩿䛧ᚓ䜛❧ሙ䛻䛒䜛䚹㻌₇⪅䛿䚸ᐙᗞ་䛸䛧䛶ᆅ᪉බඹᅋయ䛸䛸䜒䛻᪂䛧䛔䛂་බ㐃ᦠ䛻䜘䜛㧗㱋⪅ᨭ᥼䝅䝇䝔䝮䛃䜢ᥦၐ䚸ᐇ㊶䛧䛶䛔䜛䛾䛷ሗ࿌䛩䜛䚹㻌
䛆⪃ᐹ䛇㻌་⛉࡜ẚ㍑ࡋ࡚ࡢṑ⛉་⒪ࡢ≉␗ᛶ࡜ࡋ࡚ࠊᝈ⪅࡜ࡢᑐ㠃᫬㛫ࡢ㛗ࡉࠊ☜❧ࡋࡓண⣙デ⒪ไࠊእ⛉ฎ⨨ࡀከ࠸ࡇ࡜ࠊ἞⒪ෆᐜ࡟ࢫࢺࣞࢫࢆឤࡌࡿฎ⨨ࡀከ࠸ࡇ࡜ࠊࡲࡓࠊゼၥデ⒪➼ࡶేࡏ࡚ᝈ⪅ࡢᐙ᪘ࡸ௓
ຓ⪅࡜᥋ࡍࡿᶵ఍ࡀከ࠸ࡇ࡜࡞࡝࠿ࡽࠊᝈ⪅ࡢ㌟యⓗ࣭⢭⚄ⓗ≧ែࡸᝈ⪅ࡢ⫼ᬒࡢᢕᥱ࡟㐺ࡋࡓ఩⨨࡟࠶ࡿ࡜⪃࠼ࡽࢀࡿࠋ  ࡋࡓࡀࡗ࡚ࠊṑ⛉་⒪ᚑ஦⪅ࡀࠕṑ⛉἞⒪⪅ࠖ࡜ࡋ࡚࡛ࡣ࡞ࡃࠕᐙᗞ་ࠖ࡜ࡋ࡚ࠊ᪥㡭࠿ࡽᝈ⪅ࡢ≧ែࡢኚ໬࡟␃ពࡋ࡚࠸ࢀࡤࠊᝈ⪅⑓ែࡢኚ໬࡟࠸ࡕ᪩ࡃẼ௜ࡃྍ⬟ᛶࡀ㧗࠸࡜⪃࠼ࡽࢀࠊᆅᇦࡢࢭ࣮ࣇࢸ
࢕࣮ࢿࢵࢺ࡟ࡑࡢ᝟ሗࢆࡼࡾ᪩ࡃᥦ౪࡛ࡁࡿࠋຍ࠼࡚ࠊ௒ᅇᵓ⠏࣭㐠Ⴀࡋࡓࢭ࣮ࣇࢸ࢕࣮ࢿࢵࢺ࡟ࡣ་⒪⣔࡛࡞࠸௚⫋✀ࡶཧ⏬ࡋ࡚࠾ࡾࠊᆅᇦ་⒪ࡢ୰࡛௚⫋✀࡜ࡢ㐃ᦠࡀࡼࡾࢫ࣒࣮ࢬ࡟࡞ࡗࡓ࡜ᐇឤࡋ࡚
࠸ࡿࠋ䛆䜎䛸䜑䛇㻌
ᙜ㝔ࡀṑ⛉Ⓨ࡛ᥦၐࡋࡓ་බ㐃ᦠࡢࢭ࣮ࣇࢸ࢕࣮ࢿࢵࢺࠊ
ࠕჶ࣑ࣥࢢࢿࢵࢺࠖࠊࡢᵓ⠏࡜㐠Ⴀ࡟ࡘ࠸࡚
ሗ࿌ࡋࡓࠋᆅᇦ་⒪࡟࠾ࡅࡿ⥲ྜデ⒪ṑ⛉་࡟ࡣࠊࠕᐙᗞ་ࠖ࡜ࡋ࡚ࠊᝈ⪅ࡢ㌟㏆࡛࠸ࢁ࠸ࢁ࡞஦㇟࡟
ࡘ࠸࡚ໟᣓⓗ࡟ᑐᛂ࡛ࡁࡿᑐᛂຊ࡜࣐ࢿࢪ࣓ࣥࢺຊࡀồࡵࡽࢀ࡚࠸ࡿ࡜⪃࠼ࡽࢀࡿࠋ㻌
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ཱྀ₇Ⓨ⾲㻌 䠫䠉㻝㻣㻌㻌⮫ᗋᐇ⩦䞉⮫ᗋ◊ಟ㐃ᦠ䝻䜾䝤䝑䜽䛾㟁Ꮚ໬㻌 ➨䠏ሗ㻌 䝕䞊䝍ධຊ䝅䝇䝔䝮䛾ᨵⰋ㻌
Electronic logbook for cooperation of clinical plactice and a clinical training, Part 3 Improvement of thedata recording system‫ۑ‬ẟ฼᭷ᕼᏊ 㻝㻕㻘㻌 㛗ᓥ㻌 ṇ 㻞㻕㻘㻌 ୕ᾆ἞㑻 㻞㻕㻘㻌 ᮌୗྍᏊ 㻞㻕㻘㻌 す⸨୕⣖Ꮚ 㻞㻕㻘㻌 ஂಖ⨾ᑑ✑ 㻝㻕㻘㻌 ኱ᐙ㤶⧊ 㻝㻕㻘㻌 㻌㻌 㻌 ΎỈ┿ே 㻝㻕㻘㻌 ➉㔜ᩥ㞝 㻞㻕㻘㻌 ྜྷỌ࿴㞝 㻟㻕㻘㻌 ㇂ᒸṇ⾜ 㻠㻕㻘㻌 ⏣୰ᣅ☻ 㻡㻕㻘㻌 ୰ᔱ❳୍ 㻡㻕㻘㻌 ᑠᯘᘓኴ㑻 㻡㻕㻌 㻌኱㜰኱Ꮫ኱Ꮫ㝔ṑᏛ◊✲⛉㻌 ཱྀ⭍⛉Ꮫᑓᨷ䠄ཱྀ⭍⥲ྜデ⒪㒊䠅㻝㻕䠈㻌኱㜰኱ᏛṑᏛ㒊㝃ᒓ⑓㝔ཱྀ⭍⥲ྜデ⒪㒊 㻞㻕䠈㻌 ᰴᘧ఍♫䝰䝸䝍 㻟㻕䠈㻌ᰴᘧ఍♫䝙䝑䝅䞁Ⴀᴗᮏ㒊䝬䞊䜿䝔䜱䞁䜾㒊ᩍ⫱䝅䝇䝔䝮㛤Ⓨ䜾䝹䞊䝥 㻠㻕䠈㻌ᰴᘧ఍♫䝕䝆䝍䝹䞉䝘䝺䝑䝆 㻡㻕㻌‫ۑ‬Yukiko Mori1), Tadashi Nagashima2), Jiro Miura2), Yoshiko Kinoshita2), Mikiko Nishifuji2), Mizuho Kubo1),
Kaori Oya1), Masato Shimizu1), Fumio Takeshige2), Kazuo Yoshinaga3), Masayuki Tanioka4), Takuma Tanaka5),
Ryuichi Nakajima5), Kentaro Kobayashi5)
Osaka University Graduate School of Dentistry, Course for Oral Science(Division for Interdisciplinary
Dentistry)1), Osaka University Dental Hospital Division for Interdisciplinary Dentistry2), Japan Morita
Corporation3), Nissin Dental Products Inc. Marketing Department Education System Development Group4),
Digital-Knowledge Co.,Ltd.5)䛆┠ⓗ䛇㻌ᡃ䚻䛿䠈ᡭ㍍䛻ಙ㢗ᛶ䛾㧗䛔᝟ሗ䛜⵳✚䛷䛝䜛㟁Ꮚ∧⮫ᗋᐇ⩦䞉⮫ᗋ◊ಟ㐃ᦠ䝻䜾䝤䝑䜽䠄㼑㻙㼘㼛㼓㼎㼛㼛㼗䠅䛾㛤Ⓨ䜢⾜䛳䛶䛚䜚䠈ヨస䝅䝇䝔䝮䛾ᴫせ䜢➨ 㻟㻞 ᅇ᪥ᮏṑ⛉་Ꮫᩍ⫱Ꮫ఍⥲఍䛺䜙䜃䛻Ꮫ⾡኱఍䛻䛶Ⓨ⾲䛧䛯䠊௒ᅇ䠈኱㜰኱Ꮫ䛻䛶ᐇ㝿䛻ヨ⏝䛧䛯⤒㦂䜢㋃䜎䛘䠈䜘䜚᧯సጣ䜢㧗䜑䜛䛸䛸䜒䛻䝅䝇䝔䝮䜢౑⏝䛩䜛Ꮫ⏕䛾‶㊊ᗘ䛜ྥୖ䛩䜛䜘䛖䝅䝇䝔䝮䛾ᨵ㐀䜢⾜䛳䛯䛾䛷䠈䛭䛾ᴫせ䛻䛴䛔䛶ሗ࿌䛩䜛䠊㻌䛆᪉ἲ䛇㻌ᮏ䝅䝇䝔䝮䛷䛿䠈ᡭ㍍䛻ධຊ䛷䛝䜛䛣䛸䜢ඃඛ䛧䛶ᦠᖏ➃ᮎ䠄䝇䝬䞊䝖䝣䜷䞁䜒䛧䛟䛿ᑠᆺ䛾䝍䝤䝺䝑䝖➃ᮎ䠅䜢᥇⏝䛧䛯䠊䛥䜙䛻䠈⌧ᅾὶ㏻䛧䛶䛔䜛ᵝ䚻䛺ᶵ✀䛻ᑐᛂ䛷䛝䠈ᚲ䛪䛧䜒ྠ୍䛾᪋タ䛻䛶ᐇ᪋䛥䜜䜛䛸䛿㝈䜙䛺䛔⮫ᗋᐇ⩦䛸⮫ᗋ◊ಟ䛻䜒ᑐᛂ䛥䛫䜛䛯䜑䠈䜽䝷䜴䝗ᆺ 㼃㻱㻮 䝅䝇䝔䝮䛸䛧䛶㛤Ⓨ䜢⾜䛳䛯䠊䝅䝇䝔䝮䛻ධຊ䛩䜛ෆᐜ䛿䠈ᐇ⩦᪥䠈ᐇ⩦ෆᐜ䠈ศ㢮䠄⮬㦂䠈௓ຓ䠈ぢᏛ➼䠅䠈ᣦᑟ་ 㻵㻰䠈ᣦᑟ་䛻䜘䜛☜ㄆ䠈☜ㄆ᪥䛾ྛ㡯┠䛸䛧䠈ᝈ⪅䛾ಶே᝟ሗ䛿୍ษグ㘓䛧䛺䛔௙ᵝ䛸䛧䛯䠊䛥䜙䛻䠈䝇䝬䞊䝖䝣䜷䞁䠈䝍䝤䝺䝑䝖➃ᮎ䜢౑䛳䛶ຠ⋡䜘䛟ṇ☜䛺䝕䞊䝍䛜ධຊ䛷䛝䜛䜘䛖䠈ヨ⏝䛧䛯ᣦᑟ་䜔Ꮫ⏕䛾ពぢ䜢཯ᫎ䛧䠈䛺䜛䜉䛟ᑡ䛺䛔䝍䝑䝥ᩘ䛷ධຊ䛜᏶஢䛩䜛䜘䛖ᕤኵ䛧䛯䠊䜎䛯䠈␗䛺䜛኱Ꮫ䛷䛾✀䚻䛾䜹䝸䜻䝳䝷䝮䛻ᑐᛂ䛥䛫䜛䛯䜑䠈Ꮫ⩦㡯┠ྡ䛾䜶䜲䝸䜰䝇ᶵ⬟䜢㏣ຍ䛩䜛䛸ඹ䛻䠈ᣦᑟ་䛾ᡤᒓデ⒪⛉䛤䛸䛻⾲♧䛩䜛Ꮫ⩦㡯┠ྡ䜢㑅ᢥྍ⬟䛸䛧䛯䠊㻌䛆⤖ᯝ䛺䜙䜃䛻⪃ᐹ䛇㻌㻌 ᏶ᡂ䛧䛯䝅䝇䝔䝮䛷䛿䠈⣬䝧䞊䝇䛾ᡭᖒ䛻᳨༳䜢䛩䜛ឤぬ䛷Ꮫ⏕䛜ධຊ䛧䛯┤ᚋ䛾⏬㠃䛷ᣦᑟ་䛻䜘䜛ㄆド䛜ྍ⬟䛷䛒䜛䛣䛸䛛䜙䠈ᝈ⪅䛾ಶே᝟ሗ䜢ྲྀ䜚ᢅ䜟䛪䛻ಙ㢗ᛶ䛾㧗䛔䝕䞊䝍䛜ᐜ᫆䛻ධຊ䛷䛝䜛䠊䜎䛯䠈ධຊ䛧䛯䝕䞊䝍䛾㞟ィᶵ⬟䜢᭷䛧䛶䛔䜛䛣䛸䛛䜙䠈ᣦᑟ་䛚䜘䜃Ꮫ⏕䛻䛸䛳䛶䛿ᐇ⩦䛾㐍ᤖ≧ἣ䛜䜋䜌䝸䜰䝹䝍䜲䝮䛻ᢕᥱ䛷䛝䠈Ꮫ⩦ຠᯝ䛾ྥୖ䛻኱䛝䛟ᐤ୚䛩䜛䜒䛾䛸ᛮ䜟䜜䜛䠊௒ᚋ䠈⮫ᗋ◊ಟ䛸䛾㐃ᦠ䛻ྥ䛡䛯㛤Ⓨ䜢⥆䛡䜛ணᐃ䛷䛒䜛䠊㻌㻌㻌―42―䝫䝇䝍䞊Ⓨ⾲㻌 㻼㻙㻝㻌㻌᪥ᮏṑ⛉኱Ꮫ᪂₲⑓㝔䛻䛚䛡䜛ゼၥṑ⛉デ⒪ᐇ⩦䛾䜹䝸䜻䝳䝷䝮㻌The Curriculum of Home Dental Care Clinical Training in the Nippon Dental University Niigata Hospital䕿㭯㇂㻌 ⥤Ꮚ 㻝㻘㻞㻘㻟㻕㻘㻌 ྜྷᒸ㻌 ⿱㞝 㻝㻘㻞㻕㻘㻌 ᖹ㈼ஂ 㻝㻘㻞㻕㻘㻌 ୖ⏣₶ 㻝㻘㻠㻕㻘㻌 㧗ᶫ㟹அ 㻝㻘㻟㻕㻘㻌 ⓑ㔝⨾࿴ 㻝㻘㻞㻕㻘㻌 ᚋ⸨ᇶ㄃ 㻝㻘㻞㻕㻘㻌 ᑠᯘⱥ୕㑻 㻝㻘㻠㻕㻘㻌ᾏ⪁ཎ㝯㻌 㻞㻕㻘㻌 ⸨஭୍⥔ 㻟㻕㻘㻌 㯮ᕝ⿱⮧ 㻝㻘㻞㻕㻘㻌 ᒣཱྀ᫭ 㻠㻕㻘㻌 㛵ᮏᜏኵ 㻡㻕㻘㻌 ୰ཎἨ 㻢㻕㻌᪥ᮏṑ⛉኱Ꮫ᪂₲⑓㝔㻌 ᅾᏯṑ⛉ デ䜿䜰䝏䞊䝮䠍䠅㻘᪥ᮏṑ⛉኱Ꮫ᪂₲⑓㝔㻌 ⥲ྜデ⒪⛉䠎䠅㻘㻌᪥ᮏṑ⛉኱Ꮫ᪂₲⑓㝔㻌 ṑ⛉㯞㓉䞉඲㌟⟶⌮⛉䠏䠅㻘᪥ᮏṑ⛉኱Ꮫ᪂₲⑓㝔㻌 ཱྀ⭍እ⛉䠐䠅㻘㻌᪥ᮏṑ⛉኱Ꮫ᪂₲⏕࿨ṑᏛ㒊㻌 ᑠඣṑ⛉Ꮫㅮᗙ䠑䠅㻘᪥ᮏṑ⛉኱Ꮫ䠒䠅㻌‫ۑ‬Ayako Tsurugawa1,2,3), Hiroo Yoshioka1,2), Yoshihisa Taira1,2), Jun Ueda1,4, Yasuyuki Takahashi1,3), Miwa Shirono1,2),
Mototaka Gotoh1,2), Eizaburo Kobayashi1,4), Takashi Ebihara2),Kazuyuki Fujii3), Hiroomi Kurokawa1,2),Akira Yamaguchi4),
Tsuneo Sekimoto5), Sen Nakahara6),
The Nippon Dental University Niigata Hospital, Home Dental Care Team1),, The Nippon Dental University Niigata Hospital,
Comprehensive Dental Care2), , The Nippon Dental University Niigata Hospital, Dental Anesthesia and General HealthManagement clinic3),, The Nippon Dental University Niigata Hospital, Oral & Maxillofacial Surgery4), , The Nippon Dental
University School of Life Dentistry at Niigata, Department of Pediatric Dentistry5), , The Nippon Dental University6)㻌䛆⥴ゝ䛇㻌㏆ᖺ䚸ゼၥṑ⛉デ⒪䛾ໟᣓⓗ䛺ᩍ⫱䛿ṑ⛉་Ꮫᩍ⫱䛾⥭ᛴ䛛䛴㔜せ䛺ㄢ㢟䛸䛺䛳䛶䛔䜛䚹ᮏᏛ䛷䜒䚸ᚑ๓䛛䜙䛣䜜䛻✚ᴟⓗ䛻ྲྀ䜚⤌䜏䚸ᅾᏯ་⒪䛻ᑐᛂ䛷䛝䜛ṑ⛉་ᖌ䜢⫱ᡂ䛧䛶䛔䜛䚹㻌䛣䛾䜘䛖䛺⫼ᬒ䜢㋃䜎䛘䚸➨䠑Ꮫᖺ⮫ᗋᐇ⩦䛻䛚䛡䜛䜹䝸䜻䝳䝷䝮䛾୍㒊ኚ᭦䛸ホ౯᪉ἲ䛾ಟṇ䜢ᖹᡂ 㻞㻠 ᖺᗘ䛻ᐇ᪋䛧䚸ゼၥṑ⛉デ⒪䛾᭦䛺䜛ᩍ⫱䛾඘ᐇ䜢ᅗ䛳䛶䛔䜛䚹㻌௒ᅇᡃ䚻䛿䚸䛣䛾䜹䝸䜻䝳䝷䝮ኚ᭦Ⅼ䜢⤂௓䛩䜛䛸䛸䜒䛻䚸ゼၥṑ⛉デ⒪ᐇ⩦䜢ಟ஢䛧䛯⮫ᗋᐇ⩦⏕䜢ᑐ㇟䛻䚸ゼၥṑ⛉デ⒪䜈䛾ព㆑䜢ㄪᰝ䛧䛯䛾䛷ⱝᖸ䛾⪃ᐹ䜢ຍ䛘ሗ࿌䛩䜛䚹㻌䛆ኚ᭦㡯┠䛇㻌ᖹᡂ 㻞㻠 ᖺᗘ䜘䜚୍⯡┠ᶆ䜢䛄ᅾᏯ་⒪䛻䛚䛡䜛ṑ⛉䛾ᯝ䛯䛩ᙺ๭䜢⌮ゎ䛩䜛䛯䜑䛻ᅾᏯṑ⛉ デ䜿䜰䝏䞊䝮䛾୍ဨ䛸䛧䛶デ⒪䛻ཧຍ䛧䚸せ௓ㆤ⪅䜢Ᏻ඲䛻デ⒪䛩䜛䛯䜑䛾▱㆑䞉ᢏ⬟䞉ែᗘ䜢ಟᚓ䛩䜛䚹䛅䛸䛧䛶䚸デ⒪ཧຍᆺ䜈ኚ᭦䛧䛯䚹䜎䛯䚸ホ౯䛻䛴䛔䛶䛿䚸ゼၥṑ⛉デ⒪ᐇ⩦䛾⾜ື┠ᶆ䛷䛒䜛ゼၥデ⒪䛾ὶ䜜䞉ෆᐜ䛾⌮ゎ䚸せ௓ㆤ⪅䛾඲㌟≧ែ䛾ᢕᥱ䛸␃ពⅬ䚸ཱྀ⭍䜿䜰䛾ᐇ᪋䜢୰ᚰ䛻䚸ᐇ⩦᪥ẖ䛻⾜䛖䛣䛸䛸䛧䛯䚹㻌ゼၥṑ⛉デ⒪䜈䛾ព㆑ㄪᰝ䛸䛧䛶䚸ᖹᡂ 㻞㻠 ᖺᗘ⮫ᗋᐇ⩦⏕ 㻣㻢 ྡ䜢ᑐ㇟䛻䚸ᐇ⩦ಟ஢᫬䛻䜰䞁䜿䞊䝖䜢ᐇ᪋䛧䛯䚹㻌䛆⤖ᯝ䞉⪃ᐹ䛇㻌䛣䜜䜎䛷䛿䚸せ௓ㆤ⪅䛾ṑ⛉デ⒪ୖ䛾␃ពⅬ䚸ᚰ⌮䞉♫఍ⓗ⫼ᬒ䚸ཱྀ⭍䜿䜰䛾ព⩏䚸ᅾᏯ་⒪䛻䛚䛡䜛ṑ⛉䛾ᯝ䛯䛩ᙺ๭䜢⌮ゎ䛩䜛䛣䛸䛻㔜Ⅼ䜢⨨䛔䛶䛔䛯䚹䜹䝸䜻䝳䝷䝮䛾୍㒊ኚ᭦ᚋ䚸䝏䞊䝮䛾୍ဨ䛸䛧䛶デ⒪䛻ཧຍ䛥䛫䜛䛣䛸䜘䜚䚸Ꮫ⏕⮬㌟䛜
⮬Ⓨⓗ䛻ఱ䜢䛧䛺䛡䜜䜀䛺䜙䛺䛔䛛䜢ㄆ㆑䛷䛝䜛䜘䛖䛻䛺䛳䛯䛸⪃䛘䜛䚹䜎䛯䚸ホ౯䛿ែᗘ䛻㔜䜏䜢⨨䛟䛸䛸䜒䛻」ᩘ䛾ᩍဨ䛜ホ౯䛧䜔䛩䛔䜘䛖᥇Ⅼᙧᘧ䜈ኚ᭦䛧䛯䚹㻌䜰䞁䜿䞊䝖ㄪᰝ䛷䛿 㻤㻤䠂䛾⮫ᗋᐇ⩦⏕䛜䛂ᐇ⩦䛾ཧຍ䛜᭷ព⩏䛷䛒䛳䛯䛃䛸ᅇ⟅䛧䚸㛵ᚰ䛾㧗䛥䜢♧䛩⤖ᯝ䛸䛺䛳䛯䚹㻌
㻌
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䝫䝇䝍䞊Ⓨ⾲㻌 㻼㻙㻞㻌㻌ᯇᮏṑ⛉኱Ꮫ⑓㝔༢⊂ᆺ⮫ᗋ◊ಟ䛾༙ᖺ⤒㐣ሗ࿌㻌
Evaluation of clinical training facilities during six months at Postgraduate Training Course in Matsumoto Dental University
Hospital㻌䕿ẚ␃㛫ᬒᏊ 㻝㻘㻞䠅㻘኱ᮌ⤮⨾ 㻞䠅㻘ᑠୖᑦஓ 㻞䠅㻘㡢⍆῟୍ 㻝㻘㻞䠅㻘⸨஭೺⏨ 㻞䠅㻌ᯇᮏṑ⛉኱Ꮫ⑓㝔⥲ྜデ⒪⛉ 㻝㻕䠈ᯇᮏṑ⛉኱Ꮫ⑓㝔⥲ྜデ⒪ᐊ 㻞䠅
䕿Keiko Hiruma1,2), Emi Oki2), Naoya Ogami2), Jun-ichi Otogoto1,2)䠈Tateo Fujii2)
Department of Interdiciplinary Dentistry1), Department of general Dentistry2), Matsumoto Dental University Hospital㻌䛆⥴ゝ䛇㻌ᖹᡂ 㻞㻡 ᖺᗘ䛾༢⊂ᆺ⮫ᗋ◊ಟ䛿 㻥 ᭶ᮎ䛷༙ᖺ䜢⤒㐣䛧䛯䚹Ⓨ⾲⪅䛜⥲ྜデ⒪ᐊ䛾ᣦᑟ་䛾ୗ䚸䛹䛾䜘䛖䛺◊ಟෆᐜ䜢ᒚಟ䛧䛶䛝䛯䛛䜢⑕౛ෆᐜ䜢஺䛘䛺䛜䜙ሗ࿌䛩䜛䚹㻌䛆ᑐ㇟䛚䜘䜃᪉ἲ䛇㻌ᑐ㇟⪅䠖ᮏᖺᗘ䠐᭶䠍᪥䛛䜙⮫ᗋ◊ಟ䜢㛤ጞ䛧䛯⮫ᗋ◊ಟṑ⛉་䛷䛒䜛䚹⮫ᗋᐇ⩦⤊஢䛛䜙䠍ᖺ༙䜋䛹䛾䝤䝷䞁䜽䛜䛒䛳䛯䚹㻌◊ಟ᪉ἲ䠖䠍㐌㛫䛾䜸䝸䜶䞁䝔䞊䝅䝵䞁ᚋ䚸䠎㐌┠䛛䜙⥲ྜデ⒪ᐊ䛾ึデᴗົ䜢୰ᚰ䛸䛧䛯◊ಟ䛜㛤ጞ䛥䜜䚸ྠ᫬䛻ṑ࿘ᇶᮏ἞⒪䛻ᚲせ䛺ಖ㝤ㄳồ䚸デᰝ䚸デ᩿䚸ཱྀ⭍ෆ෗┿᧜ᙳ䚸䝇䜿䞊䝸䞁䜾䛺䛹䛾ᢏ⾡◊ಟ䛜⾜䜟䜜䛯䚹ಖ㝤་Ⓩ㘓䛜⤊䜟䛳䛯䠐᭶ᮎ䛛䜙㓄ᙜ䛜㛤ጞ䛥䜜䛯䚹㓄ᙜᝈ⪅䛿㓄ᙜṑ⛉་ᖌ䛺䜙䜃䛻ᣦᑟṑ⛉་ᖌ䛸἞⒪ィ⏬䜢᳨ウ䛧䛶἞⒪䜢⾜䛳䛯䚹἞⒪䛿
ྠ䛨⥲ྜデ⒪ᐊᣦᑟ་䛷䛒䜛◊ಟṑ⛉་䛸䠎ே䠍⤌䛷デ⒪䜢⾜䛳䛯䚹䜎䛯䠓᭶ᮎ䜎䛷䛻⿵⥛䞉ಖᏑ䞉ཱྀ⭍እ⛉䛾デ⒪⛉䛻䛚䛔䛶ึᮇᢏ⾡◊ಟಟ஢ヨ㦂䜢⾜䛳䛯䚹㻌㻌 䠐᭶䛛䜙༙ᖺ㛫䛾◊ಟᡂᯝ䛿䚸㓄ᙜᩘ䚸ᚲಟ⑕౛㐍ᤖ≧ἣ䛻䛚䛔䛶௚䛾デ⒪⛉䛾ᣦᑟṑ⛉་䛾ୗ䛷◊ಟ䜢⾜䛳䛶䛔䜛◊ಟṑ⛉་䛸ẚ㍑䜢⾜䛳䛯䚹㻌䛆⤖ᯝ䛇㻌◊ಟ༙ᖺ㛫䛻䛚䛡䜛ᝈ⪅㓄ᙜᩘ䛿 㻞㻞 ྡ䛷䚸඲䛶ṑ࿘἞⒪䝧䞊䝇䛻デ⒪䛜⾜䜟䜜䛯䚹୰᩿䛿䠍ྡ䚸䝯䜲䞁䝔䝘䞁䝇䛻௨㝆䛧䛶䛔䜛䛾䛿䠑ྡ䛷䛒䜛䚹ᝈ⪅㓄ᙜᩘ䚸ṑ࿘ᇶᮏ἞⒪䛾⑕౛ᩘ䛸䜒䛻௚䛾◊ಟṑ⛉་䛸ẚ㍑䛧䛶ከ䛔䛣䛸䛜♧䛥䜜䛯䚹㻌䛆⪃ᐹ䛇㻌Ⓨ⾲⪅䛜⥲ྜデ⒪ᐊ䛾ᣦᑟ་䜢㑅ᢥ䛧䛯䛾䛿ᑗ᮶䚸୍⯡ṑ⛉デ⒪䜢ᚿྥ䛧䛶䛔䛯⌮⏤䛛䜙䛷䛒䜛䚹἞⒪䛿⾜䛖䜋䛹䚸⮬ศ䛾ᢏ⾡ⓗ䛺ᮍ⇍䛥䜢ឤ䛨䜛䛣䛸䛜ከ䛔䜒䛾䛾䚸䠎ྡ䠍⤌䛷⾜䛖⮫ᗋ䛿཮᪉䛾⮫ᗋෆᐜ䜢⿵䛔䚸௓ຓ䛻䜘䜛἞⒪䛩䜛ど㔝䛾ᗈ䛜䜚䜒ឤ䛨䛯䚹ṧ䜚䛾◊ಟᮇ㛫䛷䛿䛥䜙䛻ᢏ⾡ྥୖ䜢ᅗ䜚䚸ᝈ⪅䛥䜣䜔⑓㝔䛻ᐤ୚䛧䛯䛔䛸⪃䛘䜛䚹㻌䛆⤖ㄽ䛇㻌⥲ྜデ⒪ᐊ䛻䛚䛡䜛ึデᴗົ䛸ṑ࿘ᇶᮏ἞⒪䜢䝧䞊䝇䛸䛧䛯⮫ᗋ◊ಟ䛿༙ᖺ䜢⤒㐣䛧䚸⑕౛ᩘ䜔⑕౛ෆᐜ䛿௚䛾◊ಟṑ⛉་䛸ẚ㍑䛧䛶඘ศ䛻⾜䛘䛶䛔䛯䚹㻌

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䝫䝇䝍䞊Ⓨ⾲㻌 㻼㻙㻟㻌㻌ᘧ᰿ᓥ䛻䛚䛡䜛ṑ⛉་ᖌ⮫ᗋ◊ಟ䛾⤒㦂㻌
Experience of dental training program in Shikine Island䕿┾⏣῟ኴ㑻 㻝㻕㻘㻌 ఀ⸨ᑑ඾ 㻝㻕㻘㻌 ᕝᮏㄹ 㻞㻕㻘㻌 ᮧᒣⰋ௓ 㻞㻕㻘㻌 㰺⸨㑥Ꮚ 㻟㻕㻘㻌 㛵ၨ௓ 㻟㻕㻘㻌 ➉ෆ⩏┿ 㻟㻕㻘㻌 ྂᆅ⨾ె 㻟㻕㻘㻌 ⣬ᮏ⠜ 㻟㻕㻌᪥ᮏ኱ᏛṑᏛ㒊௜ᒓṑ⛉⑓㝔⥲ྜデ⒪⛉ 㻝㻕㻘㻌 ᪥ᮏ኱ᏛṑᏛ㒊ಖᏑᏛᩍᐊṑ⛉ಖᏑᏛ➨ 㻝 ㅮᗙ 㻞㻌㻕㻘㻌᪥ᮏ኱ᏛṑᏛ㒊㝃ᒓṑ⛉⑓㝔⣔༞┤ᚋ◊ಟศ㔝 㻟㻕㻌䕿Juntaro Sanada1), Hisanori Ito1), Ryo Kawamoto2), Ryosuke Murayama2), Kuniko Saito3) , Keisuke Seki3), Yoshimasa Takeuchi3),
Mika Furuchi 3), Atsushi Kamimoto 3)
Nihon University School of Dentistry Dental Hospital1),
Department of Operative Dentistry, Nihon University School of Dentistry2),
Nihon University School of Dentistry Dental Hospital General Practice Residency 3)䛆䛿䛨䜑䛻䛇㻌㻌 ᪥ᮏ኱ᏛṑᏛ㒊௜ᒓṑ⛉⑓㝔䛷䛿䚸ᖹᡂ 㻝㻤 ᖺᗘ䜘䜚ṑ⛉་ᖌ⮫ᗋ◊ಟ䛾୍⎔䛸䛧䛶㞳ᓥデ⒪◊ಟ䜢⾜䛳䛶䛔䜛䚹௒ᅇ䚸◊ಟ༠ຊ᪋タ䛷䛒䜛ᮾி㒔᪂ᓥᮧᅜẸ೺ᗣಖ㝤ᘧ᰿ᓥデ⒪ᡤ䛻䚸ᖹᡂ㻞㻡 ᖺ㻣 ᭶㻝㻟 ᪥䛛䜙 㻞㻜 ᪥ཬ䜃 㻥 ᭶㻝㻠 ᪥䛛䜙 㻞㻝 ᪥䛾 㻞ᅇ䛻䜟䛯䜚◊ಟ䜢⾜䛖ᶵ఍䛜ᚓ䜙䜜䚸ⱝᖸ䛾▱ぢ䜢ᚓ䛯䛯䜑䛣䜜䜢ሗ࿌䛩䜛䚹㻌㻌䛆ᮾி㒔᪂ᓥᮧᅜẸ೺ᗣಖ㝤ᘧ᰿ᓥデ⒪ᡤ䛷䛾◊ಟ䛇㻌㻌 ᘧ᰿ᓥ䛿䚸ᮾி䛛䜙༡䛻⣙ 㻝㻢㻜㻌 㻌 㻷㼙 䛻఩⨨䛧䚸ேཱྀ⣙ 㻢㻜㻜 ே䛾ᓥ䛷䛒䜛䚹ᮾி㻌 㻌 㻌 ᘧ᰿ᓥ㛫䛾஺㏻ᡭẁ䛿䚸ኟᏘᮇ㛫䛷䛿㻝 ᪥ 㻞 ౽䛾ᐃᮇ⯪䛜୺䛷䛒䜛䚹㻌㻌 㛤㝔ᮇ㛫䛿䚸᮶㝔ᝈ⪅ᩘ䛾㛵ಀ䜘䜚ẖ᪥䛷䛿䛺䛟 㻝 䞃᭶㛫䛾䛖䛱 㻞 㐌㛫䛾䜏䛸㝈ᐃ䛥䜜䚸ᛴᛶ⑕≧䜘䜚៏ᛶ⑕≧䜢୺䛸䛧䛶 㻝᪥ᖹᆒ 㻝㻢 ே䛾ᝈ⪅䛜᮶㝔䛩䜛䚹ᮏᏛṑ⛉ಖᏑᏛ➨ 㻝 ㅮᗙ䛾◊ಟᣦᑟṑ⛉་䛸䛸䜒䛻デ⒪䜢⾜䛔䚸◊ಟṑ⛉་䛾ᴗົ䛿୺䛻ᣦᑟṑ⛉་䛾⿵ຓ䛷䛒䛳䛯䚹ึデ䞉෌デᝈ⪅䛻ᑐ䛩䜛ၥデ䛻ጞ䜎䜚䝯䜲䞁䝔䝘䞁䝇἞⒪䜔ᓥෆ䛾ᗂ⛶ᅬ䞉ᑠ୰Ꮫᰯ䛷䛾᳨デ䞉㼀㻮㻵 ཬ䜃ṑ⛉ᢏᕤ䜢⾜䛳䛯䚹デ⒪㠃䛻䛚䛡䜛㞳ᓥデ⒪ᡤ䛸኱Ꮫ௜ᒓṑ⛉⑓㝔䛷䛾┦㐪Ⅼ䛿䚸㞳ᓥデ⒪䜢⾜䛖ᢸᙜ་䛜㐌䛻䜘䛳䛶஺௦䛩䜛䛯䜑䚸ᢸᙜ་㛫䛾ᘬ䛝⥅䛞ෆᐜ䛜≉䛻㔜せ䛷䛒䜛஦䜔䚸⿵⥛἞⒪䛷䛿ᓥෆ䛻ṑ⛉ᢏᕤᡤ䛜Ꮡᅾ䛫䛪䚸㒔ෆ䛻
㒑㏦䛩䜛≉Ṧ≧ἣ䛾䛯䜑䚸ᝈ⪅䛜㐌䛻」ᩘᅇ᮶㝔䛩䜛䛸䛔䛖Ⅼ䛜ᣲ䛢䜙䜜䜛䚹㻌㻌䛆㞳ᓥデ⒪◊ಟ䛾ὶ䜜䛇㻌㻌 ᖹᡂ 㻞㻡 ᖺ 㻠 ᭶䛾ึᮇ◊ಟᮇ㛫䛻㞳ᓥ◊ಟ䛻㛵䛩䜛ㅮ⩏䜢ཷㅮ䛧䛯䚹ᐇ㝿䛾◊ಟ๓䛻䚸◊ಟ┠ᶆ䜢᫂☜䛻䛧䛶⮬ᕫ☜ㄆ䜢⾜䛳䛯䚹◊ಟ୰䛿◊ಟయ㦂䝅䞊䝖䜢ẖ᪥ 㻝 ᯛグ㍕䛧䚸ẖ᪥䛾䜅䜚䛛䛘䜚䜢⾜䛖䛣䛸䛻ຍ䛘 㻝 㐌㛫䛾⥲ᣓⓗ⮬ᕫホ౯⾲䜢グ㍕䛧䛯䚹⟶⌮ᆺ᪋タ䛻ᡠ䛳䛯䛾䛱䚸㞳ᓥデ⒪ሗ࿌᭩ཬ䜃จ⦰䝫䞊䝖䝣䜷䝸䜸䜢ᥦฟ䛧䛯䚹㻌䛆䜎䛸䜑䛇㻌㞳ᓥデ⒪◊ಟ䜢㏻䛧䛶䚸ఫẸ䛸䛾䝁䝭䝳䝙䜿䞊䝅䝵䞁⬟ຊ䜢⩦ᚓ䛧䚸䝙䞊䝈䛻ᑐᛂ䛧䛯ᆅᇦ་⒪䛾ᙺ๭䛚䜘䜃ᚲせᛶ䜢⌮ゎ䛩䜛䛣䛸䛜䛷䛝䛯䚹㻌
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䝫䝇䝍䞊Ⓨ⾲㻌 㻼㻙㻠㻌㻌᪥ᮏṑ⛉኱Ꮫ᪂₲⑓㝔◊ಟṑ⛉་䛾ಖ೺ᡤ◊ಟ䛻䛴䛔䛶㻌
Training Curriculum in Public Health and Sanitation Center for Dental Trainee of The Nippon Dental University Niigata
Hospital䕿⠛ཎ㝯௓䠍䠅㻘㻌 ኱➉⏤ెᏊ䠍䠅㻘㻌 Ṋ஭ᚭ䠍䠅㻘㻌 ෆ἟ⱱᶞ䠍䠅㻘㻌 ⸨ᒣ཭⣖ 㻞䠅㻘㻌 ୰ᮧಇ⨾䠍䠅㻘㻌 బ⸨཭๎䠍䠅㻘㻌 Ᏹ㔝Ύ༤䠍䠅㻌᪥ᮏṑ⛉኱Ꮫ᪂₲⑓㝔⥲ྜデ⒪⛉ 㻝䠅㻘㻌 ᪂₲ᕷಖ೺ᡤ೺ᗣቑ㐍ㄢ 㻞䠅㻌‫ۑ‬Ryusuke Shinohara䠍䠅, Yukako Otake䠍䠅, Toru Takei䠍䠅, Shigeki Uchinuma䠍䠅, Yuki Fujiyama2),
Toshimi Nakamura䠍䠅, Tomonori Satoh䠍䠅, Kiyohiro Uno䠍䠅
Comprehensive Dental Care, The Nippon Dental University Niigata Hospital1㸧,Public Health and Sanitation Center Health Improvement Division, City of Niigata2㸧䛆⥴ゝ䛇㻌㻌 ᪥ᮏṑ⛉኱Ꮫ᪂₲⑓㝔⮫ᗋ◊ಟ䛷䛿䚸᪂₲኱Ꮫ་ṑᏛ⥲ྜ⑓㝔◊ಟṑ⛉་䛸䛸䜒䛻䚸◊ಟ༠ຊ᪋タ䛷䛒䜛᪂₲ᕷ䛚䜘䜃᪂₲┴ಖ೺ᡤ䛷䛾◊ಟ䜢ྲྀ䜚ධ䜜䛶䛔䜛䚹ಖ೺ᡤ◊ಟ䛿㑅ᢥ◊ಟ䛸䛧䛶⾜䜟䜜䚸ᖹᡂ 㻞㻡 ᖺᗘ䛿᪂₲ᕷಖ೺ᡤ䛷 㻠 ྡ䚸䠐䞄ᡤ䛾᪂₲┴ಖ೺ᡤ䛷ྛ 㻝 ྡ䛾ィ 㻤 ྡ䛜◊ಟ䜢⾜䛺䛳䛯䚹㻌㻌 ௒ᅇ䛿䚸ᙜ㝔◊ಟṑ⛉་䛾᪂₲ᕷಖ೺ᡤ䛻䛚䛡䜛◊ಟෆᐜ䛻䛴䛔䛶ሗ࿌䛩䜛䚹㻌䛆◊ಟෆᐜ䛇㻌㻌 ◊ಟ䛿ಖ೺ᡤ䜘䜚ᣦᐃ䛥䜜䛯᫬ᮇ䛻⥅⥆䛧䛶 㻝 㐌㛫⾜䛳䛯䚹◊ಟ䛻ඛ❧䛳䛶ಖ೺ᡤ䛛䜙◊ಟ䜹䝸䜻䝳䝷䝮䛜㏦௜䛥䜜䚸◊ಟᴫせ䛜☜ㄆ䛷䛝䜘䛖䛻㓄៖䛥䜜䛶䛔䜛䚹㻌㻌 ◊ಟෆᐜ䛿ṑ⛉ಖ೺䚸㣗⫱䚸ேཱྀືែ䞉་ົ⸆஦䞉ឤᰁ⑕䚸⎔ቃ⾨⏕䚸බ⾗⾨⏕䚸ẕᏊಖ೺䚸ᐖ⹸㥑㝖䛺䛹䛻㛵䛩䜛ㅮ⩏䚸䛣䛣䜝䛾೺ᗣ䝉䞁䝍䞊䚸㣗⫗⾨⏕᳨ᰝᡤ䚸⾨⏕⎔ቃ◊✲ᡤ䚸ື≀ឡㆤ䝉䞁䝍䞊䛷䛾ぢᏛ䛸ㅮ⩏䚸ㄪ๣⸆ᒁ䛷䛾⸆ᒁᴗົᐇ⩦䛸䛺䛳䛶䛔䜛䚹䜎䛯䚸᭱⤊᪥䛻䛿ᆅᇦ䛾ಖ೺⚟♴䝉䞁䝍䞊䛺䛹䜢ゼၥ䛧䛶䚸ᕷẸྥ䛡ㅮヰ䜢ᐇ᪋䛧䛯䚹㻌㻌 ᕷẸྥ䛡ㅮヰ䛷䛿䛭䜜䛮䜜䝔䞊䝬䛜୚䛘䜙䜜䚸ᣦᑟᢸᙜ⪅䛾ᣦᑟ䛾䜒䛸䛷᪂₲኱Ꮫ◊ಟṑ⛉་䛸䛸䜒䛻㈨ᩱ䛾సᡂ䛛䜙⾜䛳䛯䚹ㅮヰ᫬㛫䛿 㻟㻜䡚㻠㻜 ศ⛬ᗘ䛷䚸䝔䞊䝬䛿䛂ཱྀ⭍࿘ᅖ䛾య᧯䛻䛴䛔䛶䛃䚸䛂ධ䜜ṑ䛾ṇ䛧䛔౑䛔᪉䛻䛴䛔䛶䛃䛺䛹䛷䛒䛳䛯䚹㻌䛆⪃ᐹ䞉䜎䛸䜑䛇㻌㻌 ᪂₲ᕷಖ೺ᡤ䛷䛿䚸◊ಟᣦᑟᢸᙜ⪅䛻䜘䜛ィ⏬ⓗ䛛䛴⇕ᚰ䛺ᣦᑟ䛾䜒䛸䚸㣗⫗⾨⏕᳨ᰝᡤ䛾ぢᏛ䜔ㄪ๣⸆ᒁᐇ⩦䛸䛔䛳䛯ṑ⛉་ᖌ䛸䛧䛶㏻ᖖ䛿య㦂䛷䛝䛺䛔䚸ᵝ䚻䛺ศ㔝䛻䛴䛔䛶䛾◊ಟ䜢⾜䛖䛣䛸䛜䛷䛝䛯䚹䜎䛯䚸ᕷẸྥ䛡ㅮヰ䛷䛿༞ᴗᚋ㛫䜒䛺䛔◊ಟṑ⛉་䛾ㄝ᫂䜢䚸ཧຍ⪅䛾᪉䚻䛜⇕ᚰ䛻⫈ㅮ䛟䛰䛥䜚䚸ᆅᇦṑ⛉ಖ೺άື䛾୍➃䜢ᢸ䛖䛣䛸䛾‶㊊ឤ䜢ᚓ䜛䛣䛸䛜䛷䛝䛯䚹㻌㻌 ṑ⛉ಖ೺䛻㝈䜙䛺䛔ᗈ⠊䛺ศ㔝䛾ᆅᇦಖ㝤䚸බ⾗⾨⏕άື䛻㛵䛩䜛ಖ೺ᡤ◊ಟ䛿䚸◊ಟṑ⛉་䛻䛸䛳䛶኱ኚ᭷┈䛷䛒䜛䛸⪃䛘䜙䜜䜛䚹㻌
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䝫䝇䝍䞊Ⓨ⾲㻌 㻼㻙㻡㻌㻌◊ಟṑ⛉་䛸ᣦᑟṑ⛉་䛾⌮᝿䛸䛩䜛◊ಟ་ീ䛾┦㐪㻌
Differences of ideal dental trainee model between trainees and instructors㻌䕿୰ᓥ⣖୍㑻 㻝㻕㻘㻌 ྂᕝ࿘ᖹ 㻝㻕㻘㻌 ໭ᮧඃዉ 㻝㻕㻘㻌 㤿ΏᫍⰋ 㻝㻕㻘㻌 Ἑ㔝༤ྐ 㻝㻕㻘㻌 ᒾୗὒ୍ᮁ 㻞㻕㻘㻌 ⏣ཱྀ๎ᏹ 㻝㻘㻞㻕㻌㮵ඣᓥ኱Ꮫ་Ꮫ㒊䞉ṑᏛ㒊㝃ᒓ⑓㝔㻌 ṑ⛉⥲ྜデ⒪㒊 㻝㻕㻌㮵ඣᓥ኱Ꮫ኱Ꮫ㝔་ṑᏛ⥲ྜ◊✲⛉㻌 ṑ⛉་Ꮫᩍ⫱ᐇ㊶Ꮫศ㔝 㻞㻕㻌
䕿Kiichiro Nakajima1), Syuhei Furukawa1), Yuna Kitamura1), Seira Mawatari1), Hiroshi Kono1), Yoichiro Iwashita2),
Norihiro Taguchi1,2)
General Dentistry, Kagoshima University Medical and Dental Hospital1),
Department of Dental Education, Kagoshima University Graduate School of Medical and Dental Sciences2)㻌䛆⥴ゝ䛇㻌㻌 ◊ಟṑ⛉་䠄௨ୗ䚸◊ಟ་䠅䛿䚸⮫ᗋ䛾ሙ䛷᪥䚻◊㛑䜢✚䜣䛷䛔䜛䚹䛭䛾୰䛷ᣦᑟṑ⛉་䠄௨ୗ䚸ᣦᑟ་䠅䛿◊ಟ་䛻୍య䛹䛾⛬ᗘ䛾䝺䝧䝹䜎䛷㐩䛩䜛䛣䛸䜢ồ䜑䛶䛔䜛䛾䛛䚸䛹䛾䜘䛖䛺◊ಟ་䜢ḧ䛧䛶䛔䜛䛾䛛⯆࿡䜢ᣢ䛳䛯䚹௒ᅇ䛿◊ಟ་䛸ᣦᑟ་䛾ᛮ䛔ᥥ䛟⌮᝿䛾◊ಟ་ീ䛾┦㐪䛻䛴䛔䛶䜰䞁䜿䞊䝖ㄪᰝ䜢⾜䛔᳨ウ䛧䛯䚹㻌䛆᪉ἲ䛇㻌㻌 ᖹᡂ 㻞㻡 ᖺᗘ㮵ඣᓥ኱Ꮫ་Ꮫ㒊ṑᏛ㒊㝃ᒓ⑓㝔◊ಟ་ 㻞㻟 ྡ䛸඲ 㻝㻞 ⛉ྜィ 㻣㻝 ྡ䛾ᣦᑟ་䛻↓グྡᘧ䜰䞁䜿䞊䝖ㄪᰝ䜢⾜䛔䚸⥲ィ 㻤㻟 ྡ䛾ᅇ⟅䜢ᚓ䛯䚹⮬⏤ᅇ⟅ᙧᘧ䚸ホ౯䝇䜿䞊䝹ᙧᘧ䚸㡰఩ᅇ⟅ᙧᘧ䛾䜰䞁䜿䞊䝖䜢సᡂ䛧䚸⌮᝿䛾◊ಟ་ീ䛻䛴䛔䛶ᑜ䛽䛯䚹㻌
䛆⤖ᯝ䛸⪃ᐹ䛇㻌㻌 ┠ᣦ䛩䜉䛝◊ಟ་ീ䛿䛹䛾䜘䛖䛺䜒䛾䛛䛸䛔䛖㉁ၥ䛛䜙䚸◊ಟ་䛿䛂ᇶᮏⓗ䛺ᢏ⾡䜢㌟䛻䛴䛡䛶䛔䜛䛣䛸䛃䚸ᣦᑟ་䛿䛂ᝈ⪅䛸䛾䝁䝭䝳䝙䜿䞊䝅䝵䞁䛜䛸䜜䜛䛣䛸䛃䜢ồ䜑䜛ഴྥ䛜ఛ䜟䜜䛯䚹䠍ᖺ㛫䛾◊ಟ⏕ά䛷䛹䛾⛬ᗘ䛾⬟ຊ䜎䛷㌟䛻䛴䛡䜛䜉䛝䛛䛸䛔
䛖㉁ၥ䛛䜙䛿䚸◊ಟ་䚸ᣦᑟ་䛸䜒䛻䛂἞⒪ィ⏬䛾❧᱌䛃䛂ᇶᮏⓗ䛺ᢏ⾡䛃䜢㔜ど䛩䜛ഴྥ䛜ఛ䜟䜜䛯䚹◊ಟ་䛜⌮᝿䛾◊ಟ་ീ䜢㐩ᡂ䛩䜛䛯䜑䛻䛿䛹䛾䜘䛖䛺䛣䛸䛜ᚲせ䛛䛸䛔䛖㉁ၥ䛛䜙䛿䚸◊ಟ་䛿䛂◊ಟ䛻✚ᴟⓗ䛻ྲྀ䜚⤌䜐ጼໃ䛃䚸ᣦᑟ་䛿䛂ከ䛟䛾⑕౛䚸ᝈ⪅䛻ゐ䜜ᐇ㊶⤒㦂䜢✚䜐䛣䛸䛃䜢㔜ど䛩䜛ഴྥ䛜ఛ䜟䜜䛯䚹㻌◊ಟ䛾⌮᝿䛾㐍䜑᪉䛻䛴䛔䛶䛿䚸◊ಟ་䛿䛂䜖䛳䛟䜚୎ᑀ䛻䛃䚸䛂▱㆑䛃䜘䜚䜒䛂ᢏ⾡䛃䜢㌟䛻䛴䛡䚸䛂⑕౛䜢ᩘከ䛟䜏䜛䛃䛣䛸䜢ᮃ䜐⪅䛜ከ䛛䛳䛯䚹୍᪉䚸ᣦᑟ་䛿䛂䜖䛳䛟䜚୎ᑀ䛻䛃䚸䛂ᢏ⾡䛃䜢㌟䛻䛴䛡䚸䛂୍䛴䛾⑕౛䜢῝䛟䜏䜛䛃䛣䛸䜢ᮃ䜐⪅䛜ከ䛛䛳䛯䚹㻌୍デ⒪䛻㈝䜔䛩᫬㛫䛻䛴䛔䛶䛿䚸◊ಟ་䚸ᣦᑟ་䛸䜒䛻䛂ணᐃ᫬㛫䜢㐣䛞䛶䜒⌮᝿䛾἞⒪䜢⾜䛖䜉䛝䛃䛸⪃䛘䜛⪅䛜ከ䛛䛳䛯䚹⮬⏤᫬㛫䛾౑䛔᪉䛻䛴䛔䛶䛿䚸◊ಟ་䛿䛂䝅䝭䝳䝺䞊䝅䝵䞁䛃㔜ど䚸ᣦᑟ་䛿䛂䜰䝅䝇䝖䛃㔜ど䛾ഴྥ䛻䛒䛳䛯䚹㻌௨ୖ䛾⤖ᯝ䛛䜙䚸◊ಟ་䛸ᣦᑟ་䛾⪃䛘䛻┦㐪䛜䛒䜛䛣䛸䛜᫂䜙䛛䛸䛺䛳䛯䚹㻌
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䝫䝇䝍䞊Ⓨ⾲㻌 㻼㻙㻢㻌㻌᫛࿴኱Ꮫṑ⛉⑓㝔⥲ྜデ⒪ṑ⛉䛻䛚䛡䜛䝕䞊䝍䛾ά⏝㻌䠉◊ಟṑ⛉་䛾⑕౛ሗ࿌䛛䜙䠉㻌
Effective Use of Data in Comprehensive Dentistry, Showa University Dental Hospital ʊA Clinical Report of a Trainee Dentistʊ㻌䕿㫽ᒃ㯞⳯㻘㻌 ຾㒊┤ே㻘㻌 㛗㇂ᕝ⠜ྖ㻌᫛࿴኱ᏛṑᏛ㒊㻌 ṑ⛉ಖᏑᏛㅮᗙ㻌 ⥲ྜデ⒪ṑ⛉Ꮫ㒊㛛㻌
䕿Mana Torii, Naoto Katsube, Tokuji Hasegawa
 Department of Conservative Dentistry, Division of Comprehensive Dentistry, Showa University School of Dentistry㻌䛆⥴ゝ䛇㻌㻌 ṑ⛉䛻䛚䛡䜛⥲ྜデ⒪䜢⾜䛖ୖ䛷䚸⥲ྜデ⒪ィ⏬䛾❧᱌䛿ᚲ㡲䛷䛒䜚䚸デᐹ䜔᳨ᰝ䛻䜘䛳䛶཰㞟䛧䛯㈨ᩱ䜢ᇶ䛻䛧䛶ၥ㢟Ⅼ䛾せᅉศᯒ䜢⾜䛔䚸ᢳฟ䛥䜜䛯せᅉ䜢㐺ษ䛺㡰ᗎ䛷ゎỴ䛩䜛஦䛜㔜せ䛷䛒䜛䚹୍᪉㈨ᩱ䛻཯ᫎ䛥䜜䛯䝕䞊䝍䛿⑓ኚ䛾ືែ䛾୍Ⅼ䛻䛩䛞䛪䚸⤒ᖺⓗ䛺㈨ᩱ䛾ẚ㍑䛻䜘䜙䛺䛡䜜䜀デ⒪䛾⮫ᗋุ᩿䛜ฟ᮶䛺䛔஦䜒ᑡ䛺䛟䛺䛔䚹䛧䛯䛜䛳䛶䚸㐣ཤ䛾ཱྀ⭍ෆ෗┿䜔䝺䞁䝖䝀䞁䛺䛹䛾䝕䞊䝍䛾⤒ᖺⓗኚ໬䜢ẚ㍑᳨ウ䛩䜛䛣䛸䛿௒ᚋ䛾἞⒪ィ⏬❧᱌䛾㉁䜢᭷ព䛻ྥୖ䛩䜛䛸⪃䛘䜙䜜䜛䚹ᮏሗ䛷䛿◊ಟṑ⛉་䛾ሗ࿌䛛䜙䚸ᮏᏛ⥲ྜデ⒪⛉䛻䛚䛡䜛⥲ྜデ⒪䛻㛵䛩䜛䝕䞊䝍䛾ά⏝౛䜢ሗ࿌䛩䜛䚹㻌
䛆⑕౛䛇㻌

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ᝈ⪅䛿ᮏᏛ▹ṇ⛉䛻 㻝㻟 ᖺ๓䜘䜚 㻡 ᖺ㛫䛻ர䜚▹ṇ἞⒪䜢ཷデ䛧䚸㻢 ᖺ๓䜘䜚ᙜ⛉䛻䛶デ⒪䛸 㻝 ᖺẖ䛾ᐃᮇ᳨デ䜢ཷ䛡䛶䛔䜛䚹௒ᅇ᮶㝔᫬䛾୺ッ䛿ୖ㢡ᑠ⮻ṑ㒊䛾▱ぬ㐣ᩄ䛷䛒䛳䛯䛜䚸䝤䝷䝑䝅䞁䜾ᅽ䛾ᣦᑟ䛸▱ぬ㐣ᩄฎ⨨䜢᪋⾡䛧䛶䜒ᨵၿ䛜䜏䜙䜜䛺䛛䛳䛯䚹䛭䛣䛷෌ᗘᝈ⪅䛾ゎ㔘䝰䝕䝹䜢☜ㄆ䛧䛯䛸䛣䜝䛂ᩘᖺ๓䛛䜙ヰ䛧䛵䜙䛟䛺䛳䛶䛝䛯䛃䛂ᜥ䛜䜒䜜䜛Ẽ䛜䛩䜛䛃䛸䛔䛳䛯௚䛾୺ッ䜢⫈ྲྀ䛩䜛䛣䛸䛜ฟ᮶䚸㻢 ᖺ๓䛾㈨ᩱ䛸ẚ㍑᳨ウ䛻䜘䜚ṑ࿘⑓䛾㐍⾜䛻䜘䜛ṑ⫗㏥⦰䜔⯉⩦Ⓑ䛻䜘䜛ṑ㛫㞳㛤䛸䛔䛳䛯せᅉ䜢☜ㄆ䛩䜛஦䛜䚸ྍ⬟䛸䛺䛳䛯䚹䛧䛯䛜䛳䛶䝘䜲䝖䜺䞊䝗䛾స〇䜢἞⒪᪉㔪䛻ຍ䛘䜛䛸䛸䜒䛻᰿ᮏ἞⒪䛻䛿෌▹ṇ἞⒪䜢⾜䛖ᚲせ䛜䛒䜛䛸ุ᩿䛩䜛஦䛜ฟ᮶䛯䚹㻌䛆⤖ᯝ䛚䜘䜃⪃ᐹ䛇㻌ᮏᏛ⥲ྜデ⒪ṑ⛉䛷䛿ໟᣓⓗṑ⛉་⒪䛾ᐇ㊶䜢┠ⓗ䛻䝕䞊䝍䜢䇾⤒ᖺⓗ䛺ุ᩿ᇶ‽䇿䇾ᣦᑟ䇿䇾ண㜵⟶⌮䛸୪⾜䛧䛯἞⒪௓
ධ䇿䇾἞⒪⤊஢ᚋ䛾⟶⌮䇿䛻ά⏝䛧䛶䛔䜛䚹㻌ᮏ⑕౛䛷䜏䜙䜜䛯䜘䛖䛻䚸⤒ᖺⓗ䛻䝕䞊䝍䜢ẚ㍑䛩䜛஦䛻䜘䜚ᝈ⪅䛾ཱྀ⭍ෆ⎔ቃ䜢ṇ䛧䛟ㄆ㆑䛷䛝䚸䜎䛯௒ᚋ䛾ཱྀ⭍ෆ䛾ኚ໬䜢ண᝿䛩䜛஦䜢ྍ⬟䛻䛩䜛䛸⪃䛘䜙䜜䛯䚹㻌
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䝫䝇䝍䞊Ⓨ⾲㻌 㻼㻙㻣㻌㻌㮵ඣᓥ኱ᏛᏛ⏕ṑ⛉᳨デ䛻䛚䛡䜛Ꮫ⏕ᑐ㇟䜰䞁䜿䞊䝖⤖ᯝ㻌The questionnaire of Dental check up for Kagoshima University students㻌䕿ᯇᮏ♸Ꮚ 㻝㻕㻘㻌 ྜྷ⏣♩Ꮚ 㻝㻕㻘㻌 ㄶゼ⣲Ꮚ 㻝㻕㻘㻌 ᚿ㔝ஂ⨾Ꮚ 㻝㻕㻘㻌 Ἑ㔝༤ྐ 㻝㻕㻘㻌 ᒾୗὒ୍ᮁ 㻞㻕㻘㻌 ⏣ཱྀ๎ᏹ 㻝㻘㻞㻕㻌㮵ඣᓥ኱Ꮫ་Ꮫ㒊䞉ṑᏛ㒊㝃ᒓ⑓㝔㻌 ṑ⛉⥲ྜデ⒪㒊 㻝㻕㻘㻌㮵ඣᓥ኱Ꮫ኱Ꮫ㝔་ṑᏛ⥲ྜ◊✲⛉㻌 ṑ⛉་Ꮫᩍ⫱ᐇ㊶Ꮫศ㔝 㻞㻕㻌
䕿Yuko Matsumoto1), Reiko Yoshida1), Motoko Suwa1), Kumiko Shino1), Hiroshi Kono1), Yoichiro Iwashita2),
Norihiro Taguchi1,2)
General Dentistry, Kagoshima University Medical and Dental Hospital1), Department of Dental Education,
Kagoshima University Graduate School of Medical and Dental Sciences2)㻌䛆⥴ゝ䛇㻌㮵ඣᓥ኱Ꮫ䛷䛿䚸ẖᖺ㻠᭶䛻Ꮫ㒊⏕䛸኱Ꮫ㝔⏕䜢ᑐ㇟䛻ᐃᮇ೺ᗣデ᩿䜢ᐇ᪋䛧䛶䛔䜛䚹ᖹᡂ㻞㻞ᖺᗘ䛛䜙䚸ಖ೺⟶⌮䝉䞁䝍䞊䛾༠ຊ䜢ᚓ䛶ᕼᮃ⪅䜢ᑐ㇟䛸䛧䛯ṑ⛉᳨デ䜢ᑟධ䛧䛯䚹ᖹᡂ 㻞㻡 ᖺᗘ䛾೺ᗣデ᩿ཷデ⪅ᩘ䛻䛚䛡䜛ṑ⛉᳨デཷデ⋡䛿 㻞㻝䠂䛷䛒䛳䛯䚹௒ᅇ䚸Ꮫ⏕䛾ṑ⛉᳨デ䜈䛾ព㆑䜢ㄪᰝ䛩䜛┠ⓗ䛷䚸䜰䞁䜿䞊䝖䜢ᐇ᪋䛧䛯䛾䛷ሗ࿌䛩䜛䚹㻌
䛆ᑐ㇟䛸᪉ἲ䛇㻌㻌 ᑐ㇟䛿䚸ṑ⛉᳨デ䜢ཷデ䛧䛯Ꮫ⏕ 㻝㻥㻝㻠 ྡ䛷䚸ཷデ᫬䛻䜰䞁䜿䞊䝖ㄪᰝ䜢ᐇ᪋䛧䛯䚹ᅇ⟅᪉ἲ䛿ከ⫥㑅ᢥᘧ䛸䛧䛯䚹㻌䛆⤖ᯝ䞉⪃ᐹ䛇㻌㻌 䜰䞁䜿䞊䝖ᅇ཰⋡䛿 㻝㻜㻜䠂䛷䛒䛳䛯䚹ṑ⛉᳨デ䛾ཷデ⌮⏤䛿䚸䛂່ㄏ䛥䜜䛯䛛䜙䛃䛜 㻠㻠㻑䛸୍␒ከ䛟䚸Ꮫ⏕⮬㌟䛾
⮬Ⓨⓗ䛺ཷデព㆑䛾ప䛥䛜ㄆ䜑䜙䜜䛯䚹㻌ཱྀ䛾୰䛷Ẽ䛻䛺䛳䛶䛔䜛䛣䛸䛜䛒䜛䛸ᅇ⟅䛧䛯 㻝㻜㻟㻥 ே୰䚸䛂⹸ṑ䛃䛜 㻠㻞䠂䛷୍␒ከ䛟䚸䛂ぶ▱䜙䛪䛃㻞㻟䠂䚸䛂ṑ୪䜃䛃㻞㻞䠂䛸⥆䛔䛯䚹㻌䛂ṑ⛉᳨デ䜢ཷ䛡䛶䛹䛖䛰䛳䛯䛛䛃䛻ᑐ䛩䜛ᅇ⟅䛿䛂䜘䛛䛳䛯䛃䛜 㻥㻢䠂䛷䛒䜚䚸䛂᮶ᖺ䜒ṑ⛉᳨デ䜢ཷ䛡䛯䛔䛛䛃䛻ᑐ䛩䜛ᅇ⟅䜒䛂ཷ䛡䛯䛔䛃䛜 㻥㻡䠂䛸䚸ṑ⛉᳨デ䛻ᑐ䛩䜛‶㊊ᗘ䛿㧗䛔⤖ᯝ䛸䛺䛳䛯䚹㻌ṑ⛉ཷデ䜢່䜑䜙䜜䛯Ꮫ⏕䛾䛖䛱䛂ཷデ䛩䜛䛃䛸ᅇ⟅䛧䛯⪅䛿 㻥㻝䠂䛷䚸ཷデ䛩䜛ணᐃඛ䛿䚸䛂䛛䛛䜚䛴䛡䛾ṑ⛉་㝔䛃㻠㻜䠂䚸䛂኱Ꮫ⑓㝔䛃㻟㻥䠂䚸䛂䜟䛛䜙䛺䛔䛃㻝㻥䠂䛷䛒䛳䛯䚹᪂ධ⏕䛾䛂䛛䛛䜚䛴䛡ṑ⛉་㝔䛃䛾๭ྜ䛜௚Ꮫᖺ䛸ẚ
㍑䛧䛶䜔䜔ప䛛䛳䛯䛜䚸≉䛻௚┴ฟ㌟⪅䛿ᘬ㉺䛧䛶䛛䜙㛫䛜䛺䛟䚸䜎䛰䛛䛛䜚䛴䛡ṑ⛉་㝔䛜䛺䛔䛣䛸䛻䜘䜛䜒䛾䛸ᛮ䜟䜜䜛䚹㻌
ᐇ㝿䛻኱Ꮫ⑓㝔䛻᮶㝔䛧䛯Ꮫ⏕ᩘ䛿䚸䛂኱Ꮫ⑓㝔䜢ཷデ䛩䜛䛃䛸䛧䛯ᅇ⟅ᩘ䛾䠍๭ᮍ‶䛷䛒䜚䚸䛣䛾䛣䛸䛛䜙඲య䛾ṑ⛉ཷデ⋡䜒ప䛔䛣䛸䛜ᠱᛕ䛥䜜䚸Ꮫ⏕䜢ཷ⒪⾜ື䜈ྥ䛛䜟䛫䜛᪂䛯䛺᪉⟇䛾᳨ウ䛜ᚲせ䛸ᛮ䜟䜜䛯䚹㻌᮶ᖺ௨㝆䜒⥅⥆ⓗ䛻Ꮫ⏕䛻ᑐ䛩䜛䜰䞁䜿䞊䝖䜢ᐇ᪋䛧䚸䛭䛾⤖ᯝ䜢ṑ⛉᳨デᐇ᪋䛻⏕䛛䛧䛺䛜䜙䚸㮵ඣᓥ኱ᏛᏛ⏕䛾ṑ⛉䛻ᑐ䛩䜛ᐇែㄪᰝ㈨ᩱ䛸䛧䛶⵳✚䛧䛶䛔䛟ணᐃ䛷䛒䜛䚹㻌
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䝫䝇䝍䞊Ⓨ⾲㻌 㻼㻙㻤㻌㻌᪥ᮏṑ⛉኱Ꮫ㝃ᒓ⑓㝔⥲ྜデ⒪⛉䛾⌧ᅾ㻌
Present status of the division of general dentistry in The Nippon Dental University Hospital at Tokyo䖣ⲡ㛫༤ᩥ 㻝㻕䠈ᶓ⃝㻌 ⱱ 㻝㻕䠈▼⏣㕲ග 㻝㻕䠈▼஭㝯㈨ 㻝㻕䠈ᑠᕝᬛஂ 㻝㻕䠈኱⃝㖟Ꮚ 㻝㻕䠈௰㇂㻌 ᐶ 㻝㻕䠈ᒸ⏣ᬛ㞝 㻝㻕䠈୕௦෤ᙪ 㻝㻕䠈⩚ᮧ㻌 ❶ 㻞㻕㻌᪥ᮏṑ⛉኱Ꮫ㝃ᒓ⑓㝔 㻝㻕䠈᪥ᮏṑ⛉኱Ꮫ⏕࿨ṑᏛ㒊 㻞㻕㻌‫ۑ‬Kusama Hirofumi1), Yokozawa Shigeru1), Ishida Kanemitsu1), Ishii Takashi1), Ogawa Tomohisa1), Oosawa Ginko1), Nakaya Hiroshi1),
Okada Tomoo1), Hamura Akira2)
The Nippon Dental University Hospital at Tokyo1), The Nippon Dental University, School of Life Dentistry at Tokyo2)㻌 ᪥ᮏṑ⛉኱Ꮫ䛿ᖹᡂ㻝㻟ᖺ䠍᭶䛻⾜䛳䛯ᶵᵓᨵ㠉䛻䛸䜒䛺䛔䚸㝃ᒓ⑓㝔䠄ᪧ⛠䠖ṑᏛ㒊㝃ᒓ⑓㝔䠅䛸᪂₲ṑ⛉⑓㝔䠄ᪧ⛠䠖᪂₲ṑᏛ㒊㝃ᒓ⑓㝔䠅䛻⥲ྜデ⒪⛉䜢タ⨨䛧䛯䚹㻌㻌 㝃ᒓ⑓㝔ෆ䛷䛾⥲ྜデ⒪⛉䛿䚸ᝈ⪅༢఩䛷䛾⮫ᗋᐇ⩦䜢ᐇ⌧䛩䜛┠ⓗ䛷᫛࿴ 㻡㻞 ᖺ䛻タ⨨䛥䜜䛯䛜䚸ᙜึ䛿኱Ꮫෆ䛾ྛㅮᗙ䛻ᡤᒓ䛩䜛ᩍဨ䛜䝟䞊䝖䝍䜲䝮䛷ᐇ⩦䛾ᣦᑟ䛻䛒䛯䜛䜒䛾䛷䚸ே஦ⓗ䛺⤌⧊䛷䛿䛺䛟䚸䛭䛣䛷䛾ᴗົ䜔ᴗ⦼䛜㔜䛟ホ౯䛥䜜䜛䛣䛸䜒䛺䛛䛳䛯䚹ᶵᵓᨵ㠉䛷䛿Ꮫ㒊䛸⑓㝔䛜ே஦ⓗ䛻ษ䜚㞳䛥䜜䛯䛸ྠ᫬䛻䚸㝃ᒓ⑓㝔䛷䛿䛭䜜䜎䛷䛾ಖᏑᏛ䚸⿵⥛Ꮫ䚸ṑ࿘⑓Ꮫ䚸㧗㱋⪅ṑ⛉Ꮫ䚸ண㜵ṑ⛉Ꮫ䛾ྛㅮᗙ䛾デ⒪ᶵ⬟䜢䜂䛸䛴䛻䜎䛸䜑䚸䜎䛯ཱྀ⭍እ⛉Ꮫㅮᗙ䚸ṑ⛉㯞㓉Ꮫㅮᗙ䛛䜙䜒ᑡᩘ䛺䛜䜙ேဨ䜢⛣⡠䛧䛶䚸㻝㻜㻜 ே௨ୖ䛾ᩍဨ䛜⮫ᗋ◊ಟṑ⛉་䛸デ⒪ཧຍᆺ⮫ᗋᐇ⩦䚸䛥䜙䛻䛿⮫ᗋᐇ⩦㛤ጞ๓䛾ᇶ♏ᐇ⩦䛾ᣦᑟ䜢ᢸᙜ䛩䜛኱つᶍ䛺⤌⧊ᨵ⦅䛸䛺䛳䛯䚹䛭䛾ᚋ䚸◊ಟᚲಟ໬䜢ྵ䜐ᵝ䚻䛺ᩍ⫱ᨵ㠉䚸⑓㝔䛾ᨵ⠏䜔እ㒊ホ౯䛾ཷᑂ䚸Ꮫ㒊䞉⑓㝔䛾ྡ⛠ኚ᭦䛺䛹䜢⤒䛶䚸ᨵ⦅ᚋ䛻⮫ᗋᐇ⩦䜢ᒚಟ䛧䚸ᚲಟ໬ᚋ䛾⮫ᗋ◊ಟ䜢⤒㦂䛧䛯ୡ௦䛜䚸ຓᩍ䞉ㅮᖌ䛸䛧䛶ḟୡ௦䜢ᣦᑟ䛩䜛ẁ㝵䛻ධ䛳䛶䛔䜛䚹㻌㻌 ⌧ᅾ䚸ᅜෆ௚᪋タ䛾⥲ྜデ⒪⛉䛸ྠᵝ䛻䚸⮫ᗋᩍ⫱䛻㛵䛩䜛ᴗົ䛾ከ䛟䜢ᢸ䛔䛺䛜䜙䚸䜎䛯デ⒪䛻䛚䛔䛶䛿኱Ꮫ⑓㝔䛻ᮇᚅ䛥䜜䜛ᑓ㛛ᛶ䜢䛔䛛䛻ᢸಖ䛧䚸⤌⧊䛾୰䛻ேᮦ䜢⫱䛶䛶⾜䛟䛛䚸䜎䛯⑓㝔䛸䛧䛶ᆅᇦ♫఍䛸䛹䛾䜘䛖䛻ᜉാ䛧䛶䛔䛟䛾䛛䚸ከ䛟䛾ၥ㢟䛸ྥ䛝ྜ䛳䛶䛔䜛䚹㻌㻌 䛭䛣䛷௒ᅇ䛿⥲ྜデ⒪⛉䛾ᴗົ䜔ே஦ⓗ䛺᝟ሗ䛾௚䚸Ꮫ㒊䞉⑓㝔䜢ྵ䜑䛯⤌⧊䚸ጤဨ఍ᶵ⬟䛺䛹䛾ᙧែ䚸デ⒪䜔◊ಟ䛾≧ἣ䛻䛴䛔䛶ሗ࿌䛩䜛䚹㻌
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䝫䝇䝍䞊Ⓨ⾲㻌 㻼㻙㻥㻌㻌㐺ษ䛺䜲䞁䝣䜷䞊䝮䝗䝁䞁䝉䞁䝖䛻䜘䛳䛶䝰䝏䝧䞊䝅䝵䞁䛜ྥୖ䛧䛯ᝈ⪅䛾⤒㦂㻌
An Experience with a patient motivated by proper informed consent䕿ᅧศ༤Ꮚ 㻝㻕䚸ዠᮧᬸ᪦ 㻞㻕䚸୰ᓥ㈗Ꮚ 㻞㻕䚸▼ᓮ⿱Ꮚ 㻞㻕䚸ఀ⸨ᬕỤ 㻞㻕䚸⸨஭つᏕ 㻞㻕㻌᪂₲኱Ꮫ་ṑᏛ⥲ྜ⑓㝔㻌 ◊ಟṑ⛉་ 㻝㻕䠈㻌 ᪂₲኱Ꮫ་ṑᏛ⥲ྜ⑓㝔ṑ⛉⥲ྜデ⒪㒊 㻞㻕㻌‫ۑ‬Kokubu Hiroko1), Okumura Nobuaki2), Nakajima Takako2), Ishizaki Hiroko2), Itou Harue2), Fujii Noritaka2)
Trainee Dentist, Niigata University Medical and Dental Hospital1)
General Dentistry and Clinical Education Unit, Niigata University Medical and Dental Hospital2)㻌䛆⥴ゝ䛇㻌ᛂᛴⓗ䛺ᑐᛂ䜢ᕼᮃ䛧䛶䛔䛯ᝈ⪅䛻㛗ᮇⓗ἞⒪ィ⏬䜢ᥦ♧䛧䚸▷ᮇⓗ䛺ཱྀ⭍ෆ䛾ᨵၿ䛻䜘䜚䝰䝏䝧䞊䝅䝵䞁䜢ྥୖ䛥䛫䚸᭱⤊⿵⥛䜲䝯䞊䝆䛾ඹ᭷䛻䜘䜚䝰䝏䝧䞊䝅䝵䞁䜢⥔ᣢ䛧䛺䛜䜙䚸✚ᴟⓗ䛻௓ධ䛧๓ṑ㒊⿵⥛䜢⾜䛳䛯⑕౛䛻䛴䛔䛶ሗ࿌䛩䜛䚹㻌䛆ᝈ⪅ᴫせ䛇㻌
ᝈ⪅䠖㻣㻣㻌 ṓ䠈⏨ᛶ㻌 ึデ᪥䠖㻞㻜㻜㻡㻌 ᖺ 㻝㻞 ᭶ 㻞㻜㻌 ᪥㻌୺ッ䠖ዟṑ䛾䜐䛧ṑ䜢἞⒪䛧䛶ḧ䛧䛔㻌⌧⑓Ṕ䠖ୖグ୺ッ䛻ᑐ䛧ึデ䜘䜚 㻯 ฎ⨨䜢⾜䛳䛯䛜䚸㻞㻜㻜㻢 ᖺ 㻣 ᭶䛻㻏㻝㻝㻘㻞㻝㻘㻞㻞㻮㼞 ⬺㞳䛧䚸㻞㻜㻜㻣 ᖺ 㻝㻝 ᭶䛻෌〇స䛧䛯䚹㻞㻜㻜㻥ᖺ 㻝 ᭶䛻ୗ㢡๓ṑ䛾✺䛝ୖ䛢䛜ཎᅉ䛸ᛮ䜟䜜䜛ྠ㒊⬺㞳䛜⏕䛨䛯䛜䚸ᑐ⑕⒪ἲ䜢ᕼᮃ䛧෌⿦╔䜢⾜䛳䛯䚹䛭䛾ᚋ䜒ᩘᅇ⬺㞳䛜⏕䛨䚸䛭䛾㐣⛬䛷㻏㻞㻞 ṑ᰿◚ᢡ䛜␲䜟䜜䛯䛜䚸㏻㝔ᅔ㞴䛸䛾⌮⏤䛛䜙෌⿦╔䛷ᑐᛂ䛧䛶䛔䛯䚹㻞㻜㻝㻟 ᖺ㻠 ᭶䛻ᢸᙜ་஺௦ᚋ
ྠ㒊⬺㞳䛷᮶㝔䛧䛯㝿䚸㻏㻞㻞 ṑ᰿◚ᢡ䜢☜ㄆ䛧ಖᏑᅔ㞴䛷䛒䜛䛣䛸䜢ㄝ᫂䚸἞⒪㛤ጞ䛻ྠព䜢ᚓ䛯䚹㻌䛆἞⒪᪉㔪䛇㻌㻌 ▷ᮇⓗ䛺ཱྀ⭍ෆ䛾ᨵၿ䛻䜘䜚䝰䝏䝧䞊䝅䝵䞁䜢ྥୖ䛥䛫䚸᭱⤊⿵⥛䜲䝯䞊䝆䛾ඹ᭷䛻䜘䜚䝰䝏䝧䞊䝅䝵䞁䜢⥔ᣢ䛧䛺䛜䜙䚸ୖ㢡๓ṑ㒊䛾ᶵ⬟ⓗ䞉ᑂ⨾ⓗᅇ᚟䜢ᅗ䜛㻌䛆἞⒪⤒㐣䛇㻌
㻝㻚㻏㻝㻝㻘㻞㻝㻘㻞㻞㻮㼞䊻㻏㻝㻝㻘㻞㻞㼀㼑㼏㻌㻞㻚㻏㻝㻠㻘㻏㻝㻡㻲㻹㻯 〇స㻌㻟㻚㻏㻞㻞㻱㼤㼠㻌㻠㻚㻏㻞㻝㻘㻞㻞 ᤼ิヨ㐺䊻㻏㻝㻝㼀㼑㼏 ㄪᩚ䚸㻏㻝㻞㻯㻾㻌㻡㻚㻏㻝㻝 ๓⿦ෙ〇స㻌㻢㻚ୖ㢡 㻼㻰 〇స㻌䛆⪃ᐹ䛇㻌ᝈ⪅䛿἞⒪䛻ᾘᴟⓗ䛷䚸䛣䜜䜎䛷䛾ᢸᙜ་䛜௓ධᅔ㞴䛷䛒䛳䛯䛜䚸⬺㞳䜢⧞䜚㏉䛩๓ṑ㒊 㻮㼞 䛾ணᚋ䛻୙Ᏻ䜢ឤ䛨䛶䛔䛯䛣䛸䛜ண᝿䛥䜜䜛䚹๓ṑ㒊䛾㛗ᮇⓗணᚋ䜢ᚓ䜛䛯䜑䛾ྍ᧔ᛶ⿵⥛䜈䛾㌿᥮䛻ᑐ䛧䚸ᝈ⪅䛻㈇ᢸ䛾䛺䛔἞⒪ィ⏬䜢ᥦ♧䛩䜛䛣䛸䛷⌮ゎ䜢ᚓ䜙䜜䛯䛸䛸䜒䛻䚸᪩ᮇ䛾๓ṑ㒊ᬻ㛫⿵⥛䛚䜘䜃⮻ṑ㒊䛾༢ෙ⿵⥛䛻䜘䛳䛶䚸㏻㝔䛻䜘䜛ཱྀ⭍ෆ䛾ᨵၿ䜢ᐇឤ䛧䚸ྥୖ䛧䛯䝰䝏䝧䞊䝅䝵䞁䜢ලయⓗ䛺᭱⤊⿵⥛䛾䜲䝯䞊䝆ඹ᭷䛻䜘䜚⥔ᣢ䛧䚸ᝈ⪅⮬㌟䛾἞⒪⥅⥆䛸἞⒪ཧຍ䜈䛾ព㆑䛾ኚ໬䛜✚ᴟⓗ἞⒪௓ධ䜢ྍ⬟䛻䛧䛯䛸⪃䛘䛶䛔䜛䚹㻌㻌
―51―䝫䝇䝍䞊Ⓨ⾲㻌 㻼㻙㻝㻜㻌㻌デ᩿䛻ⱞ៖䛧䛯⯉⭘⒆䛾 㻝 ౛㻌A case of tongue tumor that proved difficult to diagnose䕿㭯㇂㻌 ࿴᫂ 㻝㻘㻞㻌䠈౫⏣㻌 ⱥಇ 㻝㻌䠈ᒸᮏ㻌 ♸ 㻝㻌䠈஧ᐑ㻌 ୍ᬛ 㻞㻌䠈Ṋ⏣㻌 ᖾᙪ 㻝㻌䠈Ᏹ㔝㻌 Ύ༤ 㻞㻌㻌᪂₲┴❧୰ኸ⑓㝔ṑ⛉ཱྀ⭍እ⛉ 㻝㻌䠈᪥ᮏṑ⛉኱Ꮫ᪂₲⑓㝔㻌 ⥲ྜデ⒪⛉ 㻞㻌㻌‫ۑ‬Kazuaki Tsurugaya1,2), Hidetoshi Yoda1), Yuichi Okamoto1), Kazutomo Ninomiya2), Yukihiko Takeda1), Kiyohiro Uno2)
Department of Oral and maxillofacial Surgery,Niigata Prefectural Central Hospital1)㸪
The Nippon Dental University Niigata Hospital,Comprehensive Dental Care2)䛆⥴ゝ䛇ཱྀ⭍㡿ᇦ䛻䛿✀䚻䛾⑌ᝈ䛜Ꮡᅾ䛧䛶䛚䜚䚸᫬䛻デ᩿䛻㞴῰䛩䜛⑕౛䛻㐼㐝䛩䜛䚹ṑ⛉་⒪䛻䛚䛔䛶㱘⼃䜔ṑ࿘⑌ᝈ䛻䛴䛔䛶デ᩿䜔἞⒪䜢ṇ☜䛻⾜䛖䛣䛸䛿ᴟ䜑䛶㔜せ䛷䛒䜛䛜㻘⢓⭷⑌ᝈ䜔㌾⤌⧊⑌ᝈ䛻䛴䛔䛶ṇ☜䛺デ᩿䜢⾜䛖䛣䛸䜒㔜せ䛺஦㡯䛷䛒䜛䚹௒ᅇ⮫ᗋ◊ಟ་䛸䛧䛶デᐹ䛧䛯ึデ᫬䛾⑕౛䛻䛚䛔䛶デ᩿䛻ⱞ៖䛧䛯⑕౛䜢⤒㦂䛧䛯䛾䛷䛭䛾ᴫせ䜢ሗ࿌䛩䜛䚹㻌䛆⑕౛䛇㻌ᝈ⪅䠖㻣㻜 ṓ௦㻌 ዪᛶ䠊㻌᪤ Ṕ䠖㧗⾑ᅽ⑕䚸㦵⢒㧼⑕䚸᳝㛫ᯈ䝦䝹䝙䜰㻌⌧⑓Ṕ䠖㻞㻜㻝㻟 ᖺ 㻢 ᭶㡭ᕥഃ⯉ഃ⦕䛻⑊③䜢⮬ぬ䛧㏆་䠄ṑ⛉་㝔䠅䜢ཷデ䚸⑊③䛾ཎᅉ䛸⪃䛘䜙䜜䛯ᕥഃୗ㢡➨୍኱⮻ṑ䛾ᢤṑ⾡䜢᪋⾜䛥䜜䛯䚹䛭䛾ᚋ䜒⑕≧䛾ᨵၿ䜢ㄆ䜑䛺䛔䛯䜑௚㝔䠄ṑ⛉་㝔䠅䜢ཷデ䚸㻞㻜㻝㻟 ᖺ㻌 㻥 ᭶䛻ᙜ㝔䜈⤂௓䛥䜜᮶㝔䛸䛺䛳䛯䚹㻌ึデ᫬ᡤぢ㻌
඲㌟≧ែ䠖≉グ஦㡯䛺䛧㻌ཱྀ⭍ෆᡤぢ䠖ᕥഃ⯉⦕䛻Ⓨ㉥䜢క䛖 㻟㻜㽢㻟㻜 䟚䛾◳⤖䜢ㄆ䜑䛯䛜䚸᫂䜙䛛䛺₽⒆ᵝᡤぢ䛿ㄆ䜑䜙䜜䛺䛛䛳䛯㻌ཱྀ⭍እᡤぢ䠖㢕㒊䝸䞁䝟⠇⭘⬽䜢ゐ▱䛫䛪䚸䛭䛾௚䛻䜒␗ᖖᡤぢ䜢ㄆ䜑䛺䛛䛳䛯䚹㻌⮫ᗋデ᩿䠖⯉⭘⒆㻌
䛆ฎ⨨䛚䜘䜃⤒㐣䛇㻌ධ㝔ୗ䛻඲㌟≧ែ䜢ྵ䜑䛶✀䚻䛾᳨ᰝ䜢⾜䛳䛯䚹㻌⏬ീᡤぢ䠖㻹㻾㻵 䛻䛶ᕥഃ⯉䛻 㼀䠍ᙉㄪ⏬ീ䛻䛶పಙྕ䚸㼀㻞 ᙉㄪ⏬ീ䛻䛶㧗ಙྕ䛾ᙉ䛟㐀ᙳ䛥䜜䜛㒊ศ䜢క䛖㎶⦕୙ᩚ䛺⑓ኚ䜢ㄆ䜑䛯䚹㻌㻯㼀 䛚䜘䜃㢕㒊䜶䝁䞊䛛䜙䛿᫂䜙䛛䛺䝸䞁䝟⠇⭘኱䛿ㄆ䜑䛺䛛䛳䛯䚹㻌⾑ᾮ᳨ᰝᡤぢ䠖⭘⒆䝬䞊䜹䞊䠄㻿㻯㻯䠅䜢ྵ䜑䛶␗ᖖ್䛿ㄆ䜑䛺䛛䛳䛯䚹㻌⏕᳨䠖ึデ䜘䜚⣙ 㻝 㐌㛫ᚋ䛻⏕᳨䜢⾜䛔⑓⌮⤌⧊Ꮫⓗデ᩿䛻䛶ᡥᖹୖ⓶⒴䛸デ᩿䛥䜜䛯䚹㻌☜ᐃデ᩿䠖⯉⒴䠄ᡥᖹୖ⓶⒴䠅㼀㻞㻺㻜㻹㻜㻌䛆⪃ᐹ䛇㻌௒ᅇ༠ຊᆺ᪋タ䛻䛚䛔䛶㠀ᐃᆺⓗ䛺ᡤぢ䜢࿊䛩䜛⯉⭘⒆䜢⤒㦂䛧䛯䚹௒ᚋṑ⛉་ᖌ䛸䛧䛶ᮏ⑕౛䛾䜘䛖䛺⑌ᝈ䛻㐼㐝䛧䛯ሙྜ䛻䚸༑ศ䛺᳨ᰝ䚸デ᩿䛜⾜䛘䜛䛛䛜㔜せ䛷䛒䜛䚹䛭䛾䛯䜑ṑ⑌ᝈ䜔ṑ࿘⑌ᝈ䛾䜏䛺䜙䛪䚸⢓⭷⑌ᝈ䜔඲㌟ⓗ⑌ᝈ䛺䛹䛾⌮ゎ䜢῝䜑䜛஦䛜⮫ᗋ◊ಟ་᫬䜘䜚ᚲせ䛸䛥䜜䜛䜒䛾䛷䛒䜛䛸⪃䛘䜙䜜䜛䚹㻌
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䝫䝇䝍䞊Ⓨ⾲㻌 㻼㻙㻝㻝㻌㻌ୖ၁䛻⏕䛨䛯ᑠၚᾮ⭢ၚ▼⑕䛾୍౛㻌
A case of sialolithiasis in the minor sarivary gland duct of the upper lip䕿㛵㞝௓䠎䠅㻘㻌 ᑠ⏣ษṇ⥘䠎䠅㻘㻌 ᑠෆ䛥䛟䜙䠎䠅㻘㻌 ᐑஂಖ䛒䜔Ꮚ䠍䠅㻘㻌 ᯇ஭ᗉᖹ䠍䠅㻘㻌 Ἀளభ⨾䠍䠅㻘㻌 ྜྷ⏣♸Ꮚ䠍䠅㻘ᑠᯘⱸ฼ዉ䠍䠅㻘㻌 㟷ᒣ៞ኴ䠍䠅㻘㻌㏆⸨ᆂ♸䠍䠅㻘㻌 Ọᑿᗣ䠍䠅㻘㻌 䝬䜲䝲䞊䝇୕ᜨ䠍䠅㻘㻌 㛗㇂ᕝ⠜ྖ䠎䠅㻘㻌 ୸ᒸ㟹ྐ䠍䠅㻌᫛࿴኱ᏛṑᏛ㒊䝇䝨䝅䝱䝹䝙䞊䝈ཱྀ⭍་Ꮫㅮᗙᆅᇦ㐃ᦠṑ⛉Ꮫ㒊㛛 㻝䠅䠈㻌᫛࿴኱ᏛṑᏛ㒊ṑ⛉ಖᏑᏛㅮᗙ⥲ྜデ⒪ṑ⛉Ꮫ㒊㛛 㻞䠅㻌
䕿Yusuke Seki2), Masatsuna Odagiri2), Sakura Onai2), Ayako Miyakubo1), Syohei Matsui1),Ayumi Oki1), Yuko Yoshida1),
Marina Kobayashi1), Keita Aoyama1), Keisuke Kondou1), Yasushi Nagao1), Mie MYERS1), Tokuji Hasegawa2),
Yasubumi Maruoka䠍䠅Division of Community Based Comprehensive Dentistry of Special Needs Dentistry, School of Dentistry, Showa University1),
Department of Conservative Dentistry, Division of Comprehensive Dentistry, Showa University School of Dentistry2)䛆⥴ゝ䛇㻌ၚ▼⑕䛿ṑ⛉⮫ᗋ䛻䛚䛔䛶䛧䜀䛧䜀㐼㐝䛩䜛⑌ᝈ䛷䛒䜛䛜䚸ዲⓎ㒊఩䛿኱ၚᾮ⭢䛷䚸≉䛻㢡ୗ⭢䛻Ⓨ⏕䛩䜛㢖ᗘ䛜㧗䛔䛜ᑠၚᾮ⭢䛷䛿㠀ᖖ䛻ᕼ䛷䛒䜛䚹௒ᅇ䜟䜜䜟䜜䛿㻠㻜ṓ䛾ዪᛶ䛾ୖ၁䛻Ⓨ⏕䛧䛯ᑠၚᾮ⭢ၚ▼⑕䜢⤒㦂䛧䛯䛯䜑䚸ᩥ⊩ⓗ⪃ᐹ䜢ຍ䛘䛶ሗ࿌䛩䜛䚹㻌䛆⑕౛䛇㻌㻠㻜 ṓዪᛶ䚹ᕥഃୖ၁㒊䛾⭘⬽䜢୺ッ䛻㏆ṑ⛉་㝔䜢ཷデ䚹⢭ᰝ౫㢗䛷ᙜ⛉䜢⤂௓ཷデ䚹ึデ᫬䚸㢦ㇺᡤぢ䛸䛧䛶ᕥഃ㢋㒊⭘⬽䜢ㄆ䜑䚸ᕥഃୖ㢡≟ṑ┦ᙜ㒊㢋⢓⭷䛻ᙎᛶ◳䛾⭘⒗䜢ゐ▱䛧䛯䚹᪤ Ṕ䚸⾑ᾮ᳨ᰝ⤖ᯝ䛻≉グ஦㡯䛿䛺䛟䚸య 䛿㻟㻣㻚㻜 ᗘ䛷䛒䛳䛯䚹䜎䛯䝟䝜䝷䝬 㼄 ⥺䛻䛚䛔䛶䜒≉グ஦㡯䜢ᚓ䛺䛛䛳䛯䚹㉸㡢Ἴ⏬ീ䛷䛿䚸⭘⒗㒊䛿 㻝㻟㼙㼙㽢㻣㼙㼙 ⛬ᗘ䚸࿘ᅖ䛻䛿ୗཱྀ၁௜㏆䜎䛷ཬ䜆㎶⦕୙ṇ䛺ప䜶䝁䞊㡿ᇦ䜢ㄆ䜑䛯䚹⭘⒗䛾ᙳ㡪䜢ཷ䛡䛯࿘ᅖ䛾ཱྀ၁⭢䛻ၚᾮ䛾㈓␃䛜⏕䛨䛶䛚䜚䚸ཱྀ၁⭢⏤᮶䛾⭘⒗䛸䛾デ᩿䛷䛒䛳䛯䚹䜎䛯䚸㻹㻾㻵 䛷䛿ᕥഃୖ㢡ᑠ⮻ṑ௜㏆ୖཱྀ၁ෆ䛻 㻝㻞䡉䡉⛬ᗘ䛾ẚ㍑ⓗቃ⏺䛾䛒䜛⤖⠇ᛶ⑓ኚ䜢ㄆ䜑䚸㼀㻞 ᙉㄪ⏬ീ㍍ᗘ㧗ಙྕ䚸㼀㻝 ᙉㄪ⏬ീపಙྕ䚸ᣑᩓᙉㄪ⏬ീ㧗ಙྕ䚸㻭㻰㻯 పୗ䜢♧䛧䛯䚹࿘ᅖ䛻䛿㍍ᗘ 㼀㻞ᙉㄪ⏬ീ㧗ಙྕᇦ䛜䛒䜚䚸⅖⑕䛺䛔䛧䛿ᾋ⭘ᛶኚ໬䛜⪃䛘䜙䜜䛯䚹⭘⒆ᙧᡂ䛿ྰᐃⓗ䛷䛒䜛䛜䚸㚷ู䛜ᅔ㞴䛷䛒䛳䛯䛯䜑᦬ฟ䛚䜘䜃⏕᳨䜢ணᐃ䛧䛯䚹㻌䛆ฎ⨨䛇㻌ᒁᡤ㯞㓉ୗ䛻᦬ฟ⾡䜢⾜䛳䛯䚹⑓ኚ䛿୍ሢ䛾⭘⒗䛸䛧䛶᦬ฟ䛥䜜䚸ෆ㒊䛻ၚ▼䛸ᛮ䜟䜜䜛◳ᅛ≀䜢ᐜ䜜䛶䛔䛯䚹⑓⌮⤌⧊デ᩿䛿ୖ၁㒊䛾៏ᛶᑠၚᾮ⭢⅖䛸ၚ▼⑕䛷䛒䛳䛯䚹㻌䛆⪃ᐹ䛇㻌ၚ▼⑕䛾Ⓨ⏕㢖ᗘ䛿㢡ୗ⭢䛜 㻤㻜䡚㻥㻞䠂䚸⪥ୗ⭢䛜༑ᩘ䠂䡚㻢䠂䛸኱ၚᾮ⭢䛷 㻥㻡䠂௨ୖ䜢༨䜑䚸⯉ୗ⭢ཬ䜃ᑠၚᾮ⭢䛷䛿ᩘ䠂䡚㻞䠂䛸ẚ㍑ⓗᕼ䛷䛒䜛䛸ゝ䜟䜜䛶䛔䜛䚹䛧䛛䛧䚸ᮏ⑕౛䛻䛚䛔䛶䜒⑓⌮⤌⧊デ᩿䜢䛩䜛䜎䛷☜ᐃデ᩿䛜䛷䛝䛺䛛䛳䛯䜘䛖䛻䚸㠀ᖖ䛻㚷ู䛜㞴䛧䛔⑕౛䛷䛒䜛䛯䜑⅖⑕䛸䛧䛶ぢ㐣䛤䛥䜜䜛䜿䞊䝇䜒䛒䜛䚹௒ᚋ䛿䚸ୖ၁䛾⭘⒗䛻䛴䛔䛶䛿ၚ▼⑕䛾ྍ⬟ᛶ䜒⪃䛘䛶デ᩿䛸ฎ⨨䜢⾜䛖䛣䛸䛜㔜せ䛸⪃䛘䜙䜜䜛䚹㻌
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䝫䝇䝍䞊Ⓨ⾲㻌 㻼㻙㻝㻞㻌㻌ṑ⫗⦕ୗ㱘⼃䜢᭷䛩䜛ᑠ⮻ṑ䛻ᑐ䛧䛶▹ṇⓗ᣿ฟฎ⨨䜢⾜䛳䛯୍⑕౛㻌
Orthodontic extrusion for a premolar with subgingival caries : a case report䚽⚟஭⿱Ꮚ 㻝㻕㻘㻌 ෠ᕝ࿴ဢ 㻞㻕㻘㻌 ᵽཱྀ຾つ 㻞㻕㻌஑ᕞ኱Ꮫ⑓㝔㻌 ⮫ᗋ◊ಟ䝉䞁䝍䞊㽄㻕㻘㻌 ஑ᕞ኱Ꮫ⑓㝔㻌 ཱྀ⭍⥲ྜデ⒪⛉ 㻞㻕㻌
䚽Yuko㻌 Fukui1),㻌 Kazuya㻌 Tomikawa2),㻌 Yoshinori Higuchi2)
Clinical education center, Kyushu University Hospital¹Ί,General Oral Care, Kyushu universityHospital²Ϳ㻌䛆䛿䛨䜑䛻䛇㻌
㱘⼃䜢㝖ཤ䛧䛯⤖ᯝ䠈ṧᏑṑ㉁䛜ṑ⫗⦕ୗ䛻఩⨨䛩䜛ṑ䛿ከ䛔䚹䛣䛾≧ែ䛿䠈䝬䞊䝆䞁䛜ṑ⫗⦕ୗ䛸䛺䜚䠈ᙧᡂ䜔༳㇟䛜ᅔ㞴䛸䛺䜛䚹䜎䛯䠈⏕≀Ꮫⓗᖜᚄ䜢౵く䛩䜛䛯䜑䠈⿵⥛≀䛾ணᚋ䛿ᝏ䛟䛺䜛䚹௒ᅇ䠈ṑ⫗⦕ୗ䛻㱘⼃䛜ཬ䜣䛰 㻝 ᮏ䛾ᑠ⮻ṑ䛻ᑐ䛧䛶䠈▹ṇ἞⒪䛻䜘䜛᣿ฟฎ⨨䜢⾜䛔䠈⿵⥛἞⒪䜢㐍䜑䛶䛔䜛⑕౛䜢Ⓨ⾲䛩䜛䚹㻌䛆ᝈ⪅䛇㻌㻠㻜 ṓ䠈ዪᛶ㻌 ึデ䠖㻞㻜㻝㻟 ᖺ 㻠 ᭶㻌 ୺ッ䠖③䜐ṑ䛾἞⒪䜢䛧䛶ḧ䛧䛔㻌 ඲㌟⑌ᝈ䠖㻔㻌㻙㻌㻕㻌 ᪤ Ṕ䠖┣⭠䠈✺Ⓨᛶ㞴⫈䠈Ꮚᐑ➽⭘㻌䛆デᰝ䞉᳨ᰝᡤぢ䛇㻌㻞㻡 䛻⮬Ⓨ③䠈ညྜ③䛚䜘䜃ᡴデ③䜢ㄆ䜑䜛䚹䝕䞁䝍䝹 㼄 ⥺䛷ṑ㧊⭍䛻㐩䛩䜛㏱㐣ീ䛜䜏䜙䜜䛯䚹䝥䝷䞊䜽䝁䞁䝖䝻䞊䝹䛿୙Ⰻ䛷䠈ୖୗ㢡ᕥྑ኱⮻ṑ㒊䛻 㻠㻌㼙㼙 ௨ୖ䛾ṑ࿘䝫䜿䝑䝖䛜Ꮡᅾ䛧䛯䚹㻌䛆デ᩿䛇㻌㻞㻡 䛾ᛴᛶ໬⮋ᛶṑ㧊⅖䛚䜘䜃៏ᛶṑ࿘⅖㻌
἞⒪ィ⏬䠖㻝㻕㻌㻞㻡 䛾᰿⟶἞⒪䠈㻞㻕㻌 䝥䝷䞊䜽䝁䞁䝖䝻䞊䝹䛾ᨵၿ䠈㻟㻕㻌㻞㻡 䛾᣿ฟ䠈㻠㻕㻌 㻌 㻿㻾㻼䠈㻌 㻡㻕㻌 ṑ࿘እ⛉἞⒪䠈㻢㻕⿵⥛ಟ᚟἞⒪䠈㻣㻕㻌 䝯䜲䞁䝔䝘䞁䝇㻌䛆἞⒪⤒㐣䛇㻌㻞㻡 䛾㱘⼃䜢㝖ཤ䛩䜛䛸䠈ཱྀ⵹ഃṑ㉁䛜ṑ⫗⦕ୗ 㻟㻌㼙㼙 䛻఩⨨䛧䛯䚹䛭䛾ᚋ䠈䝥䝷䞊䜽䝁䞁䝖䝻䞊䝹䜢☜❧䛧䛶䠈ㄪᩚ䛜ᐜ᫆䛺䜽䝷䝇䝥ᆺ䛾᣿ฟ⿦⨨䜢⿦╔䛧䛯䚹᣿ฟ㛤ጞᚋ㻝䛛᭶༙䛷㻟㻌㼙㼙䛾᣿ฟ㔞䛜ᚓ䜙䜜䛯䛾䛷䠈ṑෙ㛗ᘏ㛗⾡䜢⾜䛳䛯䚹⾡୰䛻༑ศ䛺ཱྀ⵹ഃṑ㉁䛾᣿ฟ䜢☜ㄆ䛷䛝䛯䛯䜑䠈㦵ษ㝖䛾ᚲせ䛿䛺䛛䛳䛯䚹ṑ࿘እ⛉ᡭ⾡ᚋ䛿ಖᐃ⿦⨨䜢⿦╔䛧䛯䚹㻌䛆䜎䛸䜑䛇㻌
௒ᅇ䠈ṧᏑṑ㉁䛜ṑ⫗⦕ୗ䛻䛚䜘䜆㱘⼃䛻⨯ᝈ䛧䛯ᑠ⮻ṑ䛻ᑐ䛧䛶䠈᣿ฟ䛸ṑ࿘እ⛉἞⒪䜢⾜䛖䛣䛸䛻䜘䜚䠈⿵⥛᧯స䜢⾜䛔䜔䛩䛔ṑ࿘⎔ቃ䜢ᵓ⠏䛩䜛䛣䛸䛾㔜せᛶ䜢Ꮫ䜣䛰䚹◊ಟṑ⛉་䛸䛧䛶䠈▹ṇ἞⒪䛾୰䛷᭱䜒ᇶᮏⓗ䛸䛺䜛᣿ฟฎ⨨䜢⤒㦂䛷䛝䛯䛣䛸䛿䠈ᑗ᮶▹ṇṑ⛉་䜢ᚿ䛩⚾䛻䛸䛳䛶䠈୍⯡ṑ⛉἞⒪䛻䛚䛡䜛▹ṇ἞⒪䛾ᙺ๭䜢▱䜛⣲ᬕ䜙䛧䛔ᶵ఍䛸䛺䛳䛯䚹ᮏ⑕౛䜢㏻䛧䛶▹ṇ἞⒪䛾ዟ῝䛥䜢ឤ䛨䠈䜘䜚୍ᒙṑ⛉἞⒪䛻㛵ᚰ䜢ᣢ䛴䛣䛸䛜䛷䛝䛯䚹㻌

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䝫䝇䝍䞊Ⓨ⾲㻌 㻼㻙㻝㻟㻌㻌ከᩘṑḞᦆ⑕౛䛻䛚䛡䜛⩏ṑ䛾Ᏻᐃ䛸ṧᏑṑ䛾ືᦂ䛻㛵䛩䜛⪃ᐹ㻌
Discussion on the Denture Stabilization and the Mobility of Remaining Teeth in a Case of Multiple Teeth Missing䚽ஂಖΎ㤶 㻝㻕㻘㻌 ⸨஭つᏕ 㻞㻕㻘㻌 ୰ᓥ㈗Ꮚ 㻞㻕㻘㻌 ▼ᓮ⿱Ꮚ 㻞㻕㻘㻌 ఀ⸨ᬕỤ 㻞㻕㻘㻌 ዠᮧᬸ᪦ 㻞㻕㻌 㻌᪂₲኱Ꮫ་ṑᏛ⥲ྜ⑓㝔㻌 ◊ಟṑ⛉་ 㻝㻕㻘㻌 ᪂₲኱Ꮫ་ṑᏛ⥲ྜ⑓㝔ṑ⛉⥲ྜデ⒪㒊 㻞㻕ࠐKubo Sayaka1), Fujii Noritaka2), Nakajima Takako2), Ishizaki Hiroko2), Itou Harue2), Okumura Nobuaki2)
Trainee Dentist, Niigata University Medical and Dental Hospital1),
General Dentistry and Clinical Education Unit, Niigata University Medical and Dental Hospital2)䛆⥴ゝ䛇㻌ୖ㢡䛻 㻲㻰䚸ୗ㢡䛻 㻼㻰 䛾ከᩘṑḞᦆ⑕౛䛻䛚䛔䛶䚸⩏ṑ䛾Ᏻᐃ䛜ṧᏑṑ䛾ືᦂ䛻୚䛘䜛ᙳ㡪䜢⪃䛘䛺䛜䜙἞⒪䜢㐍䜑䛶䛝䛯䚹௒ᅇ䛿䚸䛣䜜䜎䛷䛻ᚓ䜙䜜䛯⤖ᯝ䛻䛴䛔䛶⪃ᐹ䛧䚸௒ᚋணᐃ䛧䛶䛔䜛἞⒪ィ⏬䜢ྵ䜑䛶ሗ࿌䛩䜛䚹㻌䛆ཱྀ⭍ෆᡤぢ䛇㻌䝂䝅䝑䜽䜰䞊䝏䛻䜘䜚㢡఩䛾Ỵᐃ䛧䛯἞⒪⏝⩏ṑ䠄ୖ㢡 㻲㻰 ୗ㢡 㻼㻰䠅䜢 㻴㻞㻡䠊㻟 䛻⿦╔῭䚹ேᕤṑ㓄ิ䞉ညྜᖹ㠃䛻䜔䜔஘䜜䛒䜚䚹䠀㻠㻟 䛿 㻹㻻䠙㻞 䝬䞊䝆䞁ୗ䜹䝸䜶䝇䚸䠀㻟㻟 䛿 㻹㼛㻩㻜 ෙ୙㐺ྜ䞉䝬䞊䝆䞁ୗ䜹䝸䜶䝇䚸䠀㻟㻠 䛿 㻹㼛㻩䠌᰿ᑤ㒊䛻୙㏱㐣ീ䜢ㄆ䜑䜛䚹㻌
䛆἞⒪ィ⏬䛇㻌
᭱ึ䛻ୗ㢡ṧᏑṑ䛾ṑෆ䞉ṑ࿘἞⒪䜢᪋䛧䚸㼀㼑㼏 䜢⿦╔䛧䛯≧ែ䛷ୖ㢡⻽⩏ṑ䜢〇స䛩䜛䚹ḟ䛻䚸ୖ㢡䛾ညྜᖹ㠃䛻ᇶ䛵䛔䛶ୗ㢡ṧᏑṑ䛾᭱⤊⿵⥛⿦⨨䠄㻲㻹㻯䠅䜢〇స䛧䚸᏶ᡂ䛧䛯 㻲㻹㻯 䜢௬╔䛧䛯≧ែ䛷ୗ㢡⩏ṑ䛾᭱⤊༳㇟䚸ᶍᆺ〇స䜢⾜䛔䚸᭱⤊ⓗ䛻ୖୗ⩏ṑ䚸㻲㻹㻯 䜢ྠ᫬䛻⿦╔䛩䜛䚹㻌䛆⪃ᐹ䛇㻌௒ᅇ䚸ୗ㢡 㻼㻰 䛾㖋ṑ䛷䛒䜛ṧᏑṑ䠄䠀㻠㻟䠅䛿䚸㻹㼛㻩㻞 䛸኱䛝䛺ືᦂ䛜ㄆ䜑䜙䜜䜛䛜ಖᏑ䛩䜛᪉㔪䛷἞⒪䜢㛤ጞ䛧䛯䚹἞⒪⏝⩏ṑ䛻䜘䛳䛶㢡఩䛿Ᏻᐃ䛧䛶䛔䛯䛜䚸ୗ㢡ṧᏑṑ䛿᣿ฟ䛧䛶䛚䜚䚸ညྜᖹ㠃䛾஘䜜䛜ṧᏑṑ䛾ືᦂ䛻ᙳ㡪䜢ཬ䜌䛧䛶䛔䜛ྍ⬟ᛶ䜢␲䛳䛯䚹䛣䛾ၥ㢟䜢ゎỴ䛩䜛䛯䜑䛻䚸䜎䛪䚸἞⒪⏝⩏ṑ䛻䛚䛔䛶୧ഃᛶᖹ⾮ညྜ䛾⋓ᚓ䜢┠ᣦ䛧䛯䛸䛣䜝䚸⩏ṑ䛚䜘䜃ṧᏑṑ䛾ືᦂ䛾㍍ῶ䛜䜏䜙䜜䛯䚹≉䛻㻏㻠㻟 䛻䛴䛔䛶䛿ṑෆ⒪ἲ䜒ᚲせ䛷䛒䛳䛯䛜䚸䛿䛨䜑䛻ືᦂ䜢ᢚไ䛩䜛䛣䛸䛜䛷䛝䛯䛯䜑䚸኱䛝䛺ၥ㢟䜒䛺䛟἞⒪䜢㐍䜑䜙䜜䛯䛸ᛮ䜟䜜䜛䚹ୗ㢡ṧᏑṑ䛾἞⒪ᚋ䚸ୖ㢡䛿⌮᝿ⓗ䛺ညྜᖹ㠃䜢ᇶ‽䛻⻽⩏ṑ〇సẁ㝵䜎䛷㐍䜑䚸䛣䛾⻽⩏ṑ䜢ᑐྜṑ䛸䛧䚸ୗ㢡䛾 㻲㻹㻯 䜢〇స䛩䜛䛣䛸䛻䜘䛳䛶ညྜᖹ㠃䛾᫝ṇ䛜ྍ⬟䛷䛒䜛䛸⪃䛘䛯䚹㻌௒ᅇ䛾⤒㦂䛻䜘䜚䚸ညྜᖹ㠃䛾஘䜜䛿ṧᏑṑ䛒䜛䛔䛿ேᕤṑ䛾᪩ᮇ᥋ゐ䜢ច㉳䛧䚸⩏ṑ䜔㖋ṑ䛾ᶵ⬟᫬䛾ືᦂ䜢ㄏⓎ䛩䜛䛣䛸䜢ᐇឤ䛧䛯䚹䜎䛯䚸୧ഃᛶᖹ⾮ညྜ䛾⋓ᚓ䛿ညྜຊ䜢ศᩓ䛥䛫䜛䛯䜑䛻୙ྍḞ䛷䛒䜛䛣䛸䜢ᨵ䜑䛶ㄆ㆑䛧䛯䚹㻌
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―55―

䝫䝇䝍䞊Ⓨ⾲㻌 㻼㻙㻝㻠㻌㻌䝏䞊䝮་⒪䛻䜘䜚἞⒪䜢⾜䛳䛯䝡䝇䝣䜷䝇䝣䜷䝛䞊䝖〇๣㛵㐃㢡㦵ቯṚ䛾 㻝 ౛㻌A case study;Team approach to treatment of Bisphosphonate-related Osteonecrosis of jaw䕿⬟ໃ䛺䛴䜏 2)㻘㻌 ㎷㻌 ῄᜨ 2)㻘㻌 Ṋ⸨⏤᲍ 2)㻘㻌 ᯇ஭ᗉᖹ 1)㻘㻌 ᐑஂಖ䛒䜔Ꮚ 1)㻘㻌 ୕Ꮿ⌮Ꮚ 1)㻘㻌 Ἀளభ⨾ 1)㻘㻌 ᑠᯘⱸ฼ዉ 1)㻘
ྜྷ⏣♸Ꮚ 1)㻘㻌 㟷ᒣ៞ኴ 1)㻘㻌 ㏆⸨ᆂ♸ 1)㻘㻌 Ọᑿᗣ 1)㻘㻌 䝬䜲䝲䞊䝇୕ᜨ 1)㻘㻌 㛗㇂ᕝ⠜ྖ 2)㻘㻌 ୸ᒸ㟹ྐ 1)㻌
᫛࿴኱ᏛṑᏛ㒊䝇䝨䝅䝱䝹䝙䞊䝈ཱྀ⭍་Ꮫㅮᗙᆅᇦ㐃ᦠṑ⛉Ꮫ㒊㛛 1)㻘㻌᫛࿴኱ᏛṑᏛ㒊ṑ⛉ಖᏑᏛㅮᗙ⥲ྜデ⒪ṑ⛉Ꮫ㒊㛛 2)㻌
䕿Natsumi Nose2), Yoshie tsuji2), Yuri Muto2), Syohei Matsui1), Ayako Miyakubo1), Satoko Miyake1), Ayumi Oki1), Marina Kobayashi1),
Yuko Yoshida1), Keita Aoyama1), Keisuke Kondo1), Yasushi Nagao1), Mie MYERS1), Tokuji Hasegawa2), Yasubumi Maruoka1)
Division of Community Based Comprehensive Dentistry of Special Needs Dentistry, School of Dentistry, Showa University1),
Department of Conservative Dentistry, Division of Comprehensive Dentistry, Showa University School of Dentistry2)䛆ㅖゝ䛇㻌䝡䝇䝣䜷䝇䝣䜷䝛䞊䝖㻔㻮㻼㻕㛵㐃㢡㦵ቯṚ㻔㻮㻾㻻㻺㻶㻕䛿䚸Ⓨ⏕ᶵᗎ䛿䜎䛰᫂䜙䛛䛻㻌 㻌䛥䜜䛶䛔䛺䛔䛜 㻮㻼 〇๣䛾㛗ᮇᢞ୚䛻䜘䜛๪స⏝䛸䛧䛶ฟ⌧䛧䚸㞴἞ᛶ䛷䛒䜛䛣䛸䛜ၥ㢟䛸䛺䛳䛶䛔䜛䚹ከ䛟䛾⑕౛䛿ᝏᛶ⭘⒆䛻ᑐ䛧䛶ᢞ୚䛥䜜䜛 㻮㻼 ὀᑕ⸆䛻䜘䜛䜒䛾䛷䛒䜛䛜䚸㢖ᗘ䛿ప䛔䜒䛾䛾 㻮㻼 ⤒ཱྀ⸆䛷䜒Ⓨ⑕䛩䜛䛣䛸䛜ሗ࿌䛥䜜䛶䛔䜛䚹௒ᅇᡃ䚻䛿䚸㻮㻼 ὀᑕ⸆䚸⤒ཱྀ⸆ᢞ୚Ṕ䛾䛒䜛ᝈ⪅䛾 㻮㻾㻻㻺㻶 䛻ᑐ䛧䛶௚⛉䛸䛾་⒪㐃ᦠ䜢㏻䛧䛶Ⰻዲ䛺⤒㐣䜢ᚓ䛯⑕౛䜢⤒㦂䛧䛯䛾䛷䛭䛾ᴫせ䛻䛴䛔䛶ሗ࿌䛩䜛䚹㻌䛆ᝈ⪅䛇㻢㻥 ṓዪᛶ㻌䛆ึデ䛇㻞㻜㻝㻟 ᖺ 㻥 ᭶㻌䛆୺ッ䛇ཱྀ⭍ෆฟ⾑䚸ୖ㢡ᑠ⮻ṑ㒊䛾㦵㟢ฟ䛜Ẽ䛻䛺䜛㻌䛆᪤ Ṕ䛇ங⒴䚸㦵⢒䛧䜗䛖⑕䚸⭜᳝㦵ᢡ䚸⊃ᚰ⑕䚸㦵㌿⛣䠄኱⭣㦵䚸⭜᳝䠅㻌䛆ᐙ᪘Ṕ䛇≉グ஦㡯䛺䛧㻌䛆⌧⑓Ṕ䛇㻌
㻞㻜㻝㻞 ᖺ 㻝 ᭶䛻ୖ㢡ᕥഃ➨୍䚸➨஧ᑠ⮻ṑ䛾ືᦂ䛜኱䛝䛛䛳䛯Ⅽ䚸⮬ᕫᢤཤ䚹㻡 ᭶ 㻟㻝 ᪥䚸ྠ㒊㦵㟢ฟ䜢ㄆ䜑䚸ங⭢እ⛉䛻䛶䝌䝺䝗䝻䞁㓟Ỉ࿴≀䠄䝌䝯䝍㻌 䠅䚸䜰䝺䞁䝗䝻䞁㓟䝘䝖䝸䜴䝮Ỉ࿴≀䠄䝪䝘䝻䞁㻌 䠅ఇ⸆䚹㻞㻜㻝㻟 ᖺ 㻥 ᭶ 㻡 ᪥䛻䚸㢡㦵ቯṚ䛾⢭ᰝ䚸ຍ⒪䛷ᙜ⛉⤂௓䚸ཷデ䛸䛺䛳䛯䚹㻌䛆ฎ⨨䞉⤒㐣䛇㻌
㻞㻜㻝㻟 ᖺ㻥 ᭶㻡㻌 ᪥䛻ᙜ⛉ཷデ䚹ཱྀ⭍እᡤぢ䜘䜚ᕥഃ㢋㒊䛾⭘⬽䚸䝟䞁䝖䝰ᡤぢ䜘䜚ୖ㢡ᕥഃ➨୍ᑠ⮻ṑ䚸➨஧ᑠ⮻ṑ㒊䛾⭉㦵ᙧᡂീ䚸ᕥഃୖ㢡Ὕᗏ⥺䛾ᾘኻ䚸ᕥഃୖ㢡Ὕ䛾୙㏱㐣ീ䚸㻯㼀 ᡤぢ䜘䜚ୖ㢡ᕥഃᑠ⮻ṑ㒊ᢤṑ❐ᗏ䛸ୖ㢡Ὕ䛸䛾஺㏻䚸ୖ㢡Ὕ㦵ቨ䛾⫧ཌ◳໬䜢ㄆ䜑䛯Ⅽ䚸ᕥഃୖ㢡㦵㦵㧊⅖䛚䜘䜃ᕥഃṑᛶୖ㢡Ὕ⅖䛸デ᩿䛧䛯䚹ᕥഃ๪㰯⭍䛻㛵䛧䛶䛿䚸᫛࿴኱Ꮫ⪥㰯ဗႃ⛉䜈⤂௓䚸㻯㼀 ᡤぢ䜘䜚៏ᛶ๪㰯⭍⅖䛸デ᩿䚹㻥 ᭶㻝㻞 ᪥ᙜ⛉䛻䛶䚸ᩘᅇ䛻䜘䜛ᒁᡤὙί䛻䜘䜚⭉㦵⬺ⴠ䛜䜏䜙䜜䛯䚹௒ᅇᝈ⪅䛿 㻮㻾㻻㻺㻶 䛸⪃䛘䜙䜜䚸⌧ᅾ䜒ᙜ⛉䛷⤒㐣ほᐹ䚸ཱྀ⭍䜿䜰䜢⾜䛳䛶䛔䜛䚹㻌䛆ཧ⪃ᩥ⊩䛇㻌
ᾆฟ㞞⿱㻦ங⒴デ⒪䛸ṑ⛉ཱྀ⭍እ⛉䛾㐃ᦠ㻌 ⸆≀ㄏⓎ㢡㦵ቯṚ䛸䛭䛾ᑐᛂ㻔⥲ㄝ㻕㻚ங⒴䛾⮫ᗋ㻔㻜㻥㻝㻝㻙㻞㻞㻡㻝㻕㻞㻤 ᕳ 㻞 ྕ㻌㻼㼍㼓㼑㻝㻠㻡㻙㻝㻡㻟㻔㻞㻜㻝㻟㻚㻜㻠㻕㻌ᑎἑྐ㄃䠖䝡䝇䝣䜷䝇䝩䝛䞊䝖〇๣㛵㐃㢡㦵ቯṚ䛾⭉㦵㝖ཤ⾡ᚋ㛤ᨺ๰䛻䜘䜚἞⒵䜢┠ᣦ䛧䛯 㻝 ౛㻚ṑ⛉⸆≀⒪ἲ
㻔㻜㻞㻤㻤㻙㻝㻜㻝㻞㻕㻟㻝 ᕳ 㻟 ྕ㻌 㻼㼍㼓㼑㻝㻟㻤㻙㻝㻟㻥㻔㻞㻜㻝㻞㻚㻝㻞㻕㻌
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䝫䝇䝍䞊Ⓨ⾲㻌 㻼㻙㻝㻡㻌㻌㖋ṑ䛸䛧䛶୙฼䛺ṧᏑṑ䜢ಖᏑ䛧䛯⩏ṑ〇స㻌
A case of removal partial denture with a few periodontally weakened clasp-anchored teeth㻌䕿బ⸨ᆂ♸ 㻝㻕㻘㻌 ୰ᓥ㈗Ꮚ 㻞㻕㻘㻌 ▼ᓮ⿱Ꮚ 㻞㻕㻘㻌 ఀ⸨ᬕỤ 㻞㻕㻘㻌 ዠᮧᬸ᪦ 㻞㻕㻘㻌 ⸨஭つᏕ 㻞㻕㻌᪂₲኱Ꮫ་ṑᏛ⥲ྜ⑓㝔㻌 ◊ಟṑ⛉་ 㻝㻕䠈㻌 ᪂₲኱Ꮫ་ṑᏛ⥲ྜ⑓㝔ṑ⛉⥲ྜデ⒪㒊 㻞㻕㻌
䕿Sato Keisuke1), Nakajima Takako2), Ishizaki Hiroko2), Itou Harue2), Okumura Nobuaki2), Fujii Noritaka2)
Trainee Dentist, Niigata University Medical and Dental Hospital1)
General Dentistry and Clinical Education Unit, Niigata University Medical and Dental Hospital2)㻌䛆⥴ゝ䛇㻌㛗ᖺṑ⛉་䛻䛛䛛䜙䛪⩏ṑ䜢౑⏝䛧䛶䛔䛺䛔ᝈ⪅䛻ᑐ䛩䜛⩏ṑ〇స䛻䛴䛔䛶ሗ࿌䛩䜛䚹㻌䛆ึデ䛇㻌㻢㻞 ṓዪᛶ䚹㻞㻜㻝㻟 ᖺ䠓᭶ධ䜜ṑ䜢స䜚䛯䛔䛸䛔䛖୺ッ䛷᮶㝔䚹㻌䛆デᰝ䞉᳨ᰝᡤぢ䛇㻌ṧᏑṑ䛿ୖ㢡㻞 ṑ䚸ୗ㢡㻠 ṑ䚹ୗ㢡䛾 㻞 ṑ䛿ᾋ㐟ṑ䛾≧ែ䛸䛺䛳䛶䛚䜚䚸䛭䛾௚䛾ṧᏑṑ䛻䛴䛔䛶䜒ṑ࿘≧ែ䛿㠀ᖖ䛻ᝏ䛟䚸㼄 ⥺ᡤぢ䛻䛶 㻣㻜䠂⛬ᗘ䛾㦵྾཰䜢ㄆ䜑䜛䚹䜎䛯䚸⩏ṑ䜢౑⏝䛧䛶䛔䛺䛔䛯䜑䚸⯉䛿ཱྀ⭍๓ᥦ䛻䜎䛷ᗈ䛜䜚䚸㢡఩䜒Ᏻᐃ䛧䛶䛔䛺䛔䚹ୖୗ㢡ሐ䛻ⴭ䛧䛔྾཰䛿ㄆ䜑䜙䜜䛺䛔䛜䚸ୗ㢡䛾㢡ሐ䛿⣽䛟䛺䛳䛶䛔䜛䚹㻌䛆἞⒪᪉㔪䛇㻌
ᬻ㛫⩏ṑ䜢⏝䛔䛶䚸᪩ᮇ䛻ညྜ䞉ᑂ⨾ᛶ䛾ᅇ᚟䜢ᅗ䜛䚹ṧᏑṑ䜢ಖᏑ䛩䜛䛣䛸䛻䜘䜚䚸ṑ⛉἞⒪䜈䛾䝇䝮䞊䝈䛺ᑟධ䚸䝰䝏䝧䞊䝅䝵䞁䛾ྥୖ䜢ᅗ䜛䚹㻌䛆἞⒪ィ⏬䛇㻌
ᾋ㐟ṑ䛿ᢤṑ䛧䚸┤䛱䛻ୖୗᬻ㛫⩏ṑ䛾〇స䜢⾜䛖䚹ṧᏑṑ䛾⤒㐣䜢䜏䜛䛸䛸䜒䛻䚸㢡఩䛜Ᏻᐃ䛧䛯ᚋ䚸᭱⤊⩏ṑ䛾〇స䜢⾜䛖䚹㻌䛆἞⒪⤒㐣䛇㻌ᖹᡂ 㻞㻡 ᖺ㻚㻣 ᭶䠖㻌 㻏㻠㻝䚸㻏㻠㻢㻱㼤㼠䚹㻤 ᭶䠖ୖୗ㢡༳㇟䚸ညྜ᥇ᚓ䚹㻥 ᭶䠖᤼ิヨ㐺䚸⩏ṑ⿦╔䚹㻌䛆⪃ᐹ䞉䜎䛸䜑䛇㻌἞⒪᪉㔪䞉ィ⏬❧᱌䛻䛚䛔䛶䚸㖋ṑ䛸䛧䛶୙฼䛺ṧᏑṑ䜢ಖᏑ䛩䜛䛛䚸䜎䛯䛹䛾䜘䛖䛻฼⏝䛩䜛䛛䛻␃ព䛧䛯䚹㻠 ᮏ䛾ṧᏑṑ䛿ືᦂ䚸ṑ㍈ഴᩳ䛜䛒䜚䚸ညྜᖹ㠃䛛䜙ⴭ䛧䛟᣿ฟ䛧䛶䛔䜛≧ែ䛷䛒䛳䛯䚹ಖᏑ䛩䜛ሙྜ䛻䛿䚸⩏ṑ䛾╔⬺᪉ྥ䚸ேᕤṑ᤼ิ䛻ไ㝈䛜⏕䛨䜛䛜䚸ṧᏑṑ䛾ಖᏑ䛸䛔䛖䝯䝸䝑䝖䛜䛒䜛䚹୍᪉䚸఩⨨⛣ື䛾ⴭ䛧䛔 㻞 ᮏ䜢ᢤṑ䛩䜛䛣䛸䛷䚸⩏ṑ䛾タィ䛾⮬⏤ᗘ䛿ᗈ䛜䜛䛜䚸἞⒪ᅇᩘ䛜ቑ䛘䜛䚹௒ᅇ䛿㛗ᖺ⩏ṑ䜢౑⏝䛧䛶䛔䛺䛔䛣䛸䛛䜙䚸᭱ᑠ㝈䛾἞⒪ᅇᩘ䛷⩏ṑ䜢⿦╔䛧䛯䛔䛣䛸䚸᪩ᮇ䛾ᢤṑ䜢㑊䛡䜛䛣䛸䛷ṑ⛉἞⒪䜈䛾䝇䝮䞊䝈䛺ᑟධ䜢ᅗ䜚䚸䝰䝏䝧䞊䝅䝵䞁䛾⥔ᣢ䛻䛴䛺䛢䛯䛔䛣䛸䛛䜙䚸㻠 ṑ䜢ಖᏑ䛧䛶ᬻ㛫⩏ṑ䛾〇స䜢⾜䛳䛯䚹ேᕤṑ᤼ิ䛿ṧᏑṑ䛸ྍཬⓗ䛻ㄪ࿴䜢ᅗ䜛䛸䛸䜒䛻䚸ṧᏑṑ䛿ညྜ᥋ゐ䛥䛫䛺䛔䜘䛖䛻䛧䛯䚹ṧᏑṑಖᏑ䛾ྍྰ䛻䛴䛔䛶䛿䚸ᬻ㛫⩏ṑ⿦╔ᚋ䛾᳨ウ஦㡯䛷䛒䜛䚹㻌
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䝫䝇䝍䞊Ⓨ⾲㻌 㻼㻙㻝㻢㻌㻌⥲ྜṑ⛉デ⒪⛉䛻䛚䛡䜛⣽⬊デ䛾ᐇ㊶㻌
Cytopathological approaches for the general dentistry㻌䕿℩㔝㻌 ᜨ⾰䠍㻘䠎㻕㻌 㻘㻌 ኱㔝㻌 ⣧䠎㻕㻘㻌 ᒣ⏣㻌 ࿴ᙪ䠍㻕㻘㻌 ㇂ཱྀ㻌 ዉኸ䠍㻕㻘㻌 ᘅ⸨㻌 ༟㞝䠍㻕㻌⚟ᒸṑ⛉኱Ꮫ⥲ྜṑ⛉Ꮫㅮᗙ⥲ྜṑ⛉Ꮫศ㔝 㻝㻕㻘㻌 ⏕యᵓ㐀Ꮫㅮᗙ⑓ែᵓ㐀Ꮫศ㔝䠎㻕㻌
䕿Kei Seno1),2), Jun Ohno2), Kazuhiko Yamada1), Nao Taniguchi1),Takao Hirofuji1)
Department of General Dentistry, Division of General Dentistry1), Department of Biologicalmorphology, Division of Pathology2)㻌㻌䛆ㅖゝ䛇㻌⣽⬊デ䛿㻘⤌⧊䛚䜘䜃య⭍ᾮ䛛䜙⣽⬊䜢᥇ྲྀ䛧䚸⣽⬊䛾ᛶ≧ኚ໬䜢ほᐹ䛩䜛䛣䛸䜢┠ⓗ䛸䛧䛶䛔䜛䚹୍⯡ⓗ䛻䛿䚸ᝏᛶ⭘⒆
䛾䝇䜽䝸䞊䝙䞁䜾䛸䛧䛶䚸፬ே⛉㡿ᇦ䛷㢖⏝䛥䜜䛶䛚䜚䚸ཱྀ⭍㡿ᇦ䛻䛚䛔䛶䜒䚸ཱྀ⭍እ⛉䛷䛾⏕᳨๓䛾ཱྀ⭍⒴䝇䜽䝸䞊䝙䞁䜾䛻౑⏝䛥䜜䛶䛔䜛䚹⣽⬊デ䛾฼Ⅼ䛿䚸ᝈ⪅䜈䛾౵く䛜ᑡ䛺䛟ẚ㍑ⓗᐜ᫆䛻⣽⬊䜢᥇ྲྀ䛷䛝䜛䛣䛸䛷䛒䜚䚸⥲ྜṑ⛉䛚䜘䜃㛤ᴗṑ⛉་䛷䜒䚸ᐇ㊶䛜ྍ⬟䛷䛒䜛䚹ᑐ㇟⑓ኚ䛻㛵䛧䛶䜒䚸⣽⬊ᛶ≧䜢ほᐹ䛷䛝䜛䛣䛸䛛䜙䚸ᝏᛶ⭘⒆䛾䝇䜽䝸䞊䝙䞁䜾௨እ䛻䚸ṑ⫗⅖䜔ṑ࿘⅖䚸⢓⭷⑓ኚ䛾἞⒪⤒㐣ほᐹ䜔ຍ㱋䞉ႚ↮䛺䛹䛾⏕ά⩦័䛻䜘䜛ཱྀ⭍⢓⭷䛾ኚ໬䜢⣽⬊䝺䝧䝹䛷᳨ウ䛩䜛䛣䛸䜈䛾ᛂ⏝䜒ྍ⬟䛷䛒䜛䚹䛭䛣䛷䚸ᮏⓎ⾲䛷䛿⣽⬊デ䛾⤂௓䜢⾜䛔䚸⏕ά⩦័䛾ᙳ㡪䜢᳨ウ䛩䜛┠ⓗ䛷䚸ႚ↮⪅䛸㠀ႚ↮⪅䛾ཱྀ⭍⢓⭷䛻䛚䛡䜛⣽⬊ᛶ≧䛾㐪䛔䜢ẚ㍑᳨ウ䛩䜛䚹㻌䛆᪉ἲ䛇㻌ᑐ㇟䠖ႚ↮⪅䛚䜘䜃㠀ႚ↮⪅䚹ཱྀ⭍ෆ෗┿᧜ᙳ䚸ṑ࿘⤌⧊᳨ᰝ䜢⾜䛔䚸⮫ᗋⓗኚ໬䛻ᕪ䜢ㄆ䜑䛺䛔⪅䜢୧⪅䛾⿕㦂⪅䛸䛩䜛䚹㻌⣽⬊デ䠖᥇ྲྀ㒊఩䠖㢋䚸⯉⦕䚸ṑ⫗⢓⭷㻌⣽⬊᥇ྲྀἲ䠖䝃䜲䝖䝤䝷䝅䛻䜘䜛᧿㐣㻌ᶆᮏసᡂస〇ἲ䠖ሬἓἲ䛚䜘䜃 㻸㻮㻯㻔㻸㼕㼝㼡㼕㼐㻌㼎㼍㼟㼑㼐㻌㼏㼥㼠㼛㼘㼛㼓㼥㻕ἲ㻌ᅛᐃἲ䠖䠕䠑䠂䜶䝍䝜䞊䝹㻌ᰁⰍἲ䠖䝟䝟䝙䝁䝻䜴ᰁⰍ㻌䛆⤖ᯝ䞉⪃ᐹ䛇㻌䠍䠅㠀ႚ↮⪅䠖㠀ゅ໬ᆺ⾲⓶⣽⬊䛜୺య䛷䚸⯉䛚䜘䜃ṑ⫗⢓⭷䛷䛿㘒ゅ໬ᆺ⣽⬊䛾ΰᅾ䜢ㄆ䜑䛯䚹㻌䠎䠅ႚ↮⪅䠖㠀ႚ↮⪅䛾⢓⭷䛸ẚ㍑䛩䜛䛸䚸ゅ໬ᆺ⣽⬊䛾ฟ⌧⋡䛜ୖ᪼䛧䛯䚹ゅ໬ᆺ⣽⬊䛾୰䛻䛿䚸ṇゅ໬ᆺ䛾⣽⬊䛜ྵ䜎䜜䜛ഴྥ䛻䛒䛳䛯䚹䛥䜙䛻䚸⣽⬊㞟ሢ䜢ᙧᡂ䛩䜛ഴྥ䜒䜏䜙䜜䛯䚹㻌㻌 ௨ୖ䛾⤖ᯝ䛛䜙䚸ႚ↮䛻䜘䜛㧗⇕䛸↮䛜ཱྀ⭍⢓⭷䛻ゅ໬ஹ㐍䜢୺య䛸䛧䛯ኚ໬䜢ᘬ䛝㉳䛣䛩䛣䛸䜢♧䛧䚸ཱྀ⭍⢓⭷␗ᙧᡂ⑕䜔ṑ࿘⑓䛾ㄏⓎ䛻㛵୚䛩䜛䛣䛸䛜♧၀䛥䜜䛯䚹㻌
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䝫䝇䝍䞊Ⓨ⾲㻌 㻼㻙㻝㻣㻌㻌἞⒪䛻༠ຊⓗ䛷䛺䛔㧗㱋ᝈ⪅䛻ᑐ䛧䛶䝁䝭䝳䝙䜿䞊䝅䝵䞁䜢ᕤኵ䛧ညྜ෌ᵓᡂ䜢క䛖⿵⥛ⓗྲྀ䜚⤌䜏㻌
A Case of Prosthetic Treatment with Occlusal Reconstruction by Keeping Good Communication with an Old-Age Patient
who is not Cooperative㻌䕿ྜྷ✚⮫ኴ㑻㻘㻌 ຾㒊┤ே㻘㻌 㛗㇂ᕝ⠜ྖ㻌᫛࿴኱ᏛṑᏛ㒊㻌 ṑ⛉ಖᏑᏛㅮᗙ㻌 ⥲ྜデ⒪ṑ⛉Ꮫ㒊㛛㻌
䕿Rintaro Yoshizumi, Naoto Katsube, Tokuji Hasegawa
Department of Conservative Dentistry, Division of Comprehensive Dentistry, Showa University School of Dentistry㻌㻌䛆⥴ゝ䛇㻌䝁䞁䝥䝷䜲䜰䞁䝇䛾ᝏ䛔㧗㱋ᝈ⪅䛻䛚䛔䛶ညྜ෌ᵓᡂ䜢క䛖㛗ᮇ㛫䛾἞⒪䛿ᅔ㞴䛷䛒䜛䚹ᮏሗ䛷䛿἞⒪䛻༠ຊⓗ䛷䛺䛔㧗㱋ᝈ⪅䜈䛾䝁䝭䝳䝙䜿䞊䝅䝵䞁䜢ᕤኵ䛧䚸ညྜᖹ㠃䛸ညྜ㧗ᚄ䛾᫝ṇ䛻ᬻ㛫⿕そෙ䛸἞⒪⏝⩏ṑ䜢⏝䛔䛶ညྜ෌ᵓᡂ䛧䛯⿵⥛ⓗྲྀ䜚⤌䜏䜢ሗ࿌䛩䜛䚹㻌 㻌
䛆⑕౛䛇㻌

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ᝈ⪅䛿ึデ᫬ 㻤㻣 ṓ䛾⏨ᛶ䚸ୖ㢡⩏ṑ䛾⬺ⴠ䜢୺ッ䛻᮶㝔䛧䛯䚹ୖ㢡䛿⥲⩏ṑ䚸ୗ㢡䛿ቑṑቑᗋಟ⌮䛧䛯㒊ศᗋ⩏ṑ䛷㻝㻜 ᖺ௨ୖ౑⏝䛧䛶䛔䛯䚹ᝈ⪅䛻䛿೺ᛀ⑕䛜䛒䜚⃭㧗䛧䜔䛩䛔ᛶ᱁䜢᭷䛧䛶䛔䛯䚹㻢㻠㻌 㻟 䛾ṧᏑṑ䛿᣿ฟ䛧䛶䛚䜚䚸ୖୗ⮻ṑ㒊ேᕤṑ䛾ည⪖䛻క䛔䚸๓ṑ㒊䛻䜘䜛ୖ㢡⩏ṑ䛾✺䛝ୖ䛢䛜⏕䛨䛶䛔䛯䚹㻌୺ッ䛷䛒䜛ୖ㢡⩏ṑ䛾⬺ⴠ䛿䚸⩏ṑ䛾ᚋ⦕ᑒ㙐䛾ᾘኻ䛻䜘䜚⏕䛨䛶䛚䜚䚸ညྜᖹ㠃䛸ညྜ㧗ᚄ䛾᫝ṇ䛜ᚲせ䛸デ᩿䛧䛯䚹㻌⥭ᛴฎ⨨䛸䛧䛶ᬻ㛫ⓗ䛻 㻟 䛾ညྜㄪᩚ䜢⾜䛔䚸ୖ㢡⮻ṑ㒊ேᕤṑညྜ㠃䛻䝺䝆䞁ῧຍ䛧ညྜ㠃෌ᵓᡂ䜢⾜䛳䛯䚹㻟 䛾ṑෙ㧗ᚄ䜢㐺ṇ䛻䛩䜛䛯䜑䛻䚸ษ⦕㒊䛾๐ྜ䛸ྠ᫬䛻㟢ฟ䛧䛯㇟∳㉁㠃䜢䝁䞁䝫䝆䝑䝖䝺䝆䞁䛻䛶⿕そ䛧䛯䚹ୖୗ䛾἞⒪⏝⩏ṑ䜢స〇䛧䚸ညྜᣲୖ䛻ᝈ⪅䛜㐺ᛂ䛩䜛䛛☜ㄆ䛧䛯ᚋ䚸᣿ฟ䛧䛶䛔䜛 㻢㻠 䜢ᬻ㛫⿕そෙ䛻⨨䛝᥮䛘䛶἞⒪⏝⩏ṑ䜢ྵ䜑䛶ညྜᖹ㠃䜢᫝ṇ䛧䛯䚹⩏ṑ䜢ྵ䜐ཱྀ⭍ෆ䛾Ᏻᐃ䜢☜ㄆ䛧䚸⌧ᅾ᭱⤊⿵⥛≀䜢స〇୰䛷䛒䜛䚹ᝈ⪅䛾Ẽ㉁ⓗ䛺ᑐᛂ䛸䛧䛶䚸ഴ⫈ⓗ䛺ែᗘ䜢䛸䜚䚸἞⒪⤒㐣䛾ㄝ᫂䛻෗┿௜䛝䛾㈨ᩱ䜢ά⏝䛧䚸἞⒪䛾ᗘ䛻ᝈ⪅䛸䛭䛾ᐙ᪘䛻ㄝ᫂䛧ゎỴ䜢ᅗ䛳䛯䚹䜎䛯ᐙ᪘䛛䜙䚸༗๓୰䛾᪉䛜⢭⚄ⓗ䛻Ᏻᐃ䛧䛶䛔䜛䛸䛾᝟ሗ䜢ᚓ䛶䚸デ⒪ண⣙᫬㛫䜢㓄៖䛧䛯䚹㻌䛆⤖ᯝ䛚䜘䜃⪃ᐹ䛇㻌ᬻ㛫⿕そෙ䛸἞⒪⏝⩏ṑ䛻䜘䜚ညྜᖹ㠃䜢᫝ṇ䛧㐺ṇ䛺ညྜ䜢௜୚䛧䛯⤖ᯝ䚸ᝈ⪅䛾ឤ᝟䛿Ᏻᐃ䛧䚸ᑂ⨾ⓗ䛻䜒ᶵ⬟ⓗ䛻䜒‶㊊䜢ᚓ䜛䛣䛸䛻ᡂຌ䛧䛯䚹௒ᅇ䚸἞⒪䛻༠ຊⓗ䛷䛺䛟ጾᅽⓗ䛺ᝈ⪅䛻ᑐ䛧䛶䚸ゝㄒ䞉㠀ゝㄒⓗ䛺ാ䛝䛛䛡䜢ᝈ⪅䛸䛭䛾ᐙ᪘䛻ᑐ䛧䛶䜒⾜䛖䛣䛸䛷䚸ᝈ⪅䛸䝷䝫䞊䝹ᙧᡂ䛜ྍ⬟䛸䛺䜚䚸἞⒪䛾ᡂຌ䛻⧅䛜䜛䛣䛸䜢Ꮫ䜉䛯䚹㻌
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䝫䝇䝍䞊Ⓨ⾲㻌 㻼㻙㻝㻤㻌㻌ཱྀ⭍୙ᐃឋッᝈ⪅䛻ᑐ䛩䜛ṑ⛉ⓗᑐᛂ㻌Dental Support to Patients with Oral Indefinite Complaints㻌䕿ᒾぢỤ฼⳹㻘㻌 ㎮ᕭᾈ㝯㻘㻌 ᑠฟṊ㻘㻌 ᯇᮏ᫭୍㻘㻌 ⡿㇂⿱அ㻘㻌 ㎷୍㉳Ꮚ㻘㻌 ⡿⏣ㆤ㻘㻌 ኱す᫂㞝㻘㻌 ᵽཱྀᜤᏊ㻘㻌୰஭ᬛຍ㻘㻌 ⛳⏣ල⨾㻌኱㜰ṑ⛉኱Ꮫ㻌 ⥲ྜデ⒪䞉デ᩿⛉㻌‫ۑ‬Erika Iwami, Hirotaka Tatsumi, Takeshi Koide, Koichi Matsumoto, Hiroyuki Kometani, Ikiko Tsuji,
Mamoru Komeda, Akio Ohnishi, Kyoko Higuchi, Chika Nakai, Kumi Hieda
Department of Interdisciplinary Dentistry and Oral Diagnosis, Osaka Dental University䛆⥴ゝ䛇㻌㏆ᖺ㻘ከ䛟䛾ṑ⛉་⒪ᶵ㛵䛷ཱྀ⭍୙ᐃឋッᝈ⪅䛾ᑐᛂ䛻ⱞ៖䛧䛶䛔䜛䛾䛜ᐇ᝟䛷䛒䜛䚹௒ᅇ䚸⚾䛯䛱䛿ཱྀ⭍୙ᐃឋッᝈ⪅䛾⑕౛䜢⤒㦂䛧䚸䛭䛾ṑ⛉ⓗᑐᛂ䛻䛴䛔䛶⪃ᐹ䛧䛯䛾䛷ሗ࿌䛩䜛䚹㻌䛆⑕౛䛇㻌ᝈ⪅䛿 㻢㻜 ṓዪᛶ䚹⯉䛸ဗ㢌㒊䛾㐪࿴ឤ䜢୺ッ䛻᮶㝔䛧䛯䚹⣙㻞 ᖺ๓䚸୍⯡ṑ⛉㛤ᴗ་䛷䝺䝆䞁඘ሸ䛾ฎ⨨䜢ཷ䛡䛯䚹䛭䛾ᚋ䚸⯉䛸ဗ㢌㒊䛾㐪࿴ឤ䜢ッ䛘䛯䛯䜑䚸䝺䝆䞁䜰䝺䝹䜼䞊䜢␲䛔䚸ᮏ㝔䛷䛾⢭ᰝ䜢౫㢗䛥䜜᮶㝔䛧䛯䚹ཱྀ⭍ෆ䛿ṑ㢁㒊䛾䝺䝆䞁඘ሸ䛸ṑ⫗㏥⦰䛜䜏䜙䜜䚸䝟䝜䝷䝬䜶䝑䜽䝇⥺෗┿䛷䛿඲㢡ⓗ䛻୰➼ᗘ䛾ṑᵴ㦵྾཰䛜ㄆ䜑䜙䜜䛯䚹䜎䛯䚸ෆ⛉䜔⪥㰯⛉䛾ᡤぢ䛻␗ᖖ䛿䜏䜙䜜䛺䛛䛳䛯䚹㻌䛆デ᩿䛚䜘䜃἞⒪᪉㔪䛇㻌䜎䛪䚸ᙜ⛉䛷ṑ⛉ᮦᩱ䛾䝟䝑䝏䝔䝇䝖ヨᩱ䜢స〇䛧䛯䛾䛱䚸᯾⑓㝔⓶⭵⛉䛻᳨ᰝ౫㢗䛧䛯䚹᳨ᰝᚋ䚸ᝈ⪅䛻ᑐ䛧䛶༑ศ䛺䜲䞁䝣䜷䞊䝮䝗䝁䞁䝉䞁䝖䜢ᚓ䛯䛾䛱䚸デ᩿ⓗ἞⒪䛸䛧䛶୺ッ䛾ṑ㢕㒊䝺䝆䞁䜢㝖ཤ䛧䚸ᵝ䚻䛺䝟䝑䝏䝔䝇䝖㝜ᛶ䛾ṑ⛉ᮦᩱ䛻⨨᥮䛧䛯䚹⨨᥮ẖ䛻ᡭ㊊䛾䛧䜃䜜䜔࿧྾ᅔ㞴䛺䛹䛾⑕≧䜢ッ䛘䚸༑ᩘᅇ䛻ཬ䜆⨨᥮䛸㝖ཤ䜢⧞䜚㏉䛧䚸ṑ⛉἞⒪䛜ᅔ㞴䛸䛺䛳䛯䚹ᝈ⪅䛾⑕≧䜔ッ䛘䚸䛚䜘䜃᯾་⛉኱Ꮫ⓶⭵⛉䛾䝉䜹䞁䝗䜸䝢䝙䜸䞁䛾㏉ಙ⤖ᯝ䛛䜙ᚰᅉᛶ䛸⪃䛘䚸᯾⑓㝔ᚰ⒪ṑ⛉䜈⢭ᰝ౫㢗䛧䛯䚹㻌
䛆⤖ᯝ䛚䜘䜃⪃ᐹ䛇㻌ᮏ⑕౛䛿䚸ᝈ⪅䜈䛾ධᛕ䛺ഴ⫈䛸ඹឤ䜢ᚰ䛜䛡䚸㻱㻮㻹䛸㻺㻮㻹䛻ᇶ䛵䛟䜰䝥䝻䞊䝏䜢䛧䛶䝷䝫䞊䝹䛾ᙧᡂ䜢⠏䛝デ⒪䜢⾜䛳䛯䚹䛭䛾⤖ᯝ䚸ᙜึ䚸ᣄྰ䛧䛶䛔䛯ᚰ⒪ෆ⛉䜈䛾ཷデ䜢ᝈ⪅䛿ᢎㅙ䛧ᑐデ䛩䜛䛻⮳䛳䛯䚹㻌௒ᅇ䚸ཱྀ⭍୙ᐃឋッᝈ⪅䜈䛾ṑ⛉ⓗᑐᛂ䛸䛧䛶䚸ୖグ䜰䝥䝻䞊䝏䛾䜋䛛䛻䚸ᝈ⪅䛜せồ䛩䜛἞⒪䛻䛿Ᏻ᫆䛻ᛂ䛨䛺䛔䛣䛸䚸་ᖌ䛸䛾㐃ᦠ䜎䛷䛿デ᩿ⓗ἞⒪䛷⤒㐣ほᐹ䜢䛚䛣䛺䛖䛣䛸䚸䛚䜘䜃ᚰ⒪ෆ⛉䛺䛹䛸䛾䝁䞁䝃䝹䝔䞊䝅䝵䞁䞉䝸䜶䝌䞁䛜኱ษ䛷䛒䜛䛸⪃䛘䜙䜜䛯䚹䜎䛯䚸ྠ⛉䛷䛾἞⒪䛸୪⾜䛧䛶ṑ⛉䜈ᐃᮇⓗ䛻ཷデ䛥䛫䚸ᝈ⪅䛾ྲྀ䜚ᕳ䛟⫼ᬒ䜢⪃៖䛧ཱྀ⭍⟶⌮䜢⾜䛖䛣䛸䜒㔜せ䛷䛒䜛䛸⪃䛘䜙䜜䛯䚹㻌
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䝫䝇䝍䞊Ⓨ⾲㻌 㻼㻙㻝㻥㻌㻌ṑิ୙ṇ䜢క䛖୰➼ᗘṑ࿘⅖䜢᭷䛩䜛ᝈ⪅䛻ᑐ䛩䜛ᡓ␎ⓗᢤṑ䛸⿵⥛἞⒪䛻䜘䜛ྲྀ䜚⤌䜏㻌
Efforts by prosthetic treatment and strategic tooth extraction for patients with moderate periodontitis with odontoparallaxis䕿ὸぢᣅဢ㻘㻌 ຾㒊┤ே㻘㻌 㛗㇂ᕝ⠜ྖ㻌᫛࿴኱ᏛṑᏛ㒊㻌 ṑ⛉ಖᏑᏛㅮᗙ㻌 ⥲ྜデ⒪ṑ⛉Ꮫ㒊㛛㻌‫ۑ‬Takuya Asami, Naoto Katsube, Tokuji Hasegawa
Department of Conservative Dentistry, Division of Comprehensive Dentistry, Showa University School of Dentistry㻌䛆⥴ゝ䛇㻌ṑ࿘⑓䛾㐍⾜䛻క䛳䛶ညྜຊ䜢ᨭᣢ䛷䛝䜛ṑ∳䛜ῶᑡ䛩䜛䚹䛣䛾ᝏᚠ⎔䛻䜘䜚ညྜᨭᣢᇦ䛜ῶᑡ䛩䜛⤖ᯝ䚸ညྜᔂቯ䜢㉳䛣䛧䛶䛔䜛䜿䞊䝇䛿ᑡ䛺䛟䛺䛔䚹௒ᅇ䚸ṑ࿘⑓䛾㐍⾜䛸⩏ṑ䛾୙౑⏝䛻䜘䜚䚸ညྜᔂቯ䜢⏕䛨䛯ᝈ⪅䛻ᑐ䛧䛶䚸ᡓ␎ⓗᢤṑ䛸⿵⥛἞⒪䛻䜘䜚⌮᝿ⓗ䛺ညྜᵝᘧ䛾௜୚䜢⾜䛔䚸࿪ᄮᶵ⬟䛸๓ṑ㒊䛾ᑂ⨾ⓗ䛺ᅇ᚟䜢ᅗ䛳䛯⑕౛䛻䛴䛔䛶ሗ࿌䛩䜛䚹㻌䛆⑕౛䛇㻌ᝈ⪅䛿 㻢㻠 ṓ䛾ዪᛶ䚸࿪ᄮ୙Ⰻ䛚䜘䜃๓ṑ㒊䛾ᑂ⨾୙Ⰻ䜢୺ッ䛻᮶㝔䛧䛯䚹㻌䠏ᖺ๓䛻㒊ศᗋ⩏ṑ䜢స〇䛧䛯䛜୙౑⏝䛷䛒䜚䚸ṑ⛉ཷデ䜒⁫䛳䛶䛔䛯䛸䛔䛖䚹䜶䝑䜽䝇⥺෗┿䜘䜚඲㢡ⓗ䛻୰➼ᗘṑ࿘⅖䛜☜ㄆ䛥䜜䚸ཱྀ⭍ෆ䜢ほᐹ䛧䛯䛸䛣䜝 㻣㻢㻡 䛾Ḟᦆ䜢ᨺ⨨䛧䛶䛔䛯䛯䜑䛻ᑐྜṑ䛜᣿ฟ䛧䛶ᆶ┤ⓗ䛺ညྜᖹ㠃୙ṇ䛸䛺䛳䛶䛔䜛䛰䛡䛷䛿䛺䛟䚸๓ṑ㒊ྀ⏕䛷஺ཫညྜ䛻䜘䜚Ỉᖹⓗ䛻⯉ഃ㌿఩䛧䛯ṑ䛜ほᐹ䛥䜜䛯䚹㻌䛆デ᩿ཬ䜃἞⒪᪉㔪䛇㻌඲㢡ⓗ䛻୰➼ᗘ䛾ṑ࿘⅖䚸ྀ⏕䚸ညྜᖹ㠃୙ṇ䛸デ᩿䛧䛯䚹୺ッ䛾ᑂ⨾୙Ⰻ䛿๓ṑ㒊䛾ྀ⏕䚸࿪ᄮ୙Ⰻ䛿 㻣㻢㻡 Ḟᦆ䛾ᨺ⨨䛻క䛔ᑐྜṑ䛜᣿ฟ䛧䛯⤖ᯝ䚸ညྜᖹ㠃䛜୙ṇ䛸䛺䜚⩏ṑ䛜౑⏝䛷䛝䛪䚸ညྜᨭᣢ୙㊊䛛䜙ṑ࿘⑓䛜ቑᝏ䛧䛯஦䛻䜘䜚⏕䛨䛯䛸⪃ᐹ䛧䛯䚹㻌἞⒪᪉㔪䛸䛧䛶䛿䚸ṑ࿘⑓䛾ᨵၿ䛾Ⅽ䛻䝥䝷䞊䜽䝁䞁䝖䝻䞊䝹䛾ᨵၿ䜢䛿䛛䛳䛯ᚋ䚸ṑิ୙ṇ䜢⏕䛨䛶䛔䜛ṑ䛾ᡓ␎ⓗ䛺ᢤṑ䛸⿵⥛἞⒪䛻䜘䜚䚸ညྜ୙ṇ䛸ྀ⏕䛾ᨵၿ䜢ィ⏬䛧䛯䚹㻌䛆⤖ᯝ䛸⪃ᐹ䛇㻌ึデ᫬ 㻼㻯㻾 䛿 㻥㻠㻑䛛䜙ṑ࿘ึᮇ἞⒪ᚋ䛻 㻝㻣㻑䛻ᨵၿ䛧䛯䚹ୖୗྑഃ⮻ṑ㒊䛾ညྜᖹ㠃᫝ṇ䛧䛯䝥䝻䝡䝆䝵䝘䝹䝺䝇䝖䝺䞊䝅䝵䞁䛻⨨䛝᥮䛘䚸ညྜ䛾Ᏻᐃ䜢ᅗ䛳䛯ᚋ䚸᭱⤊⿵⥛≀䜢స〇䛧䚸⮻ṑ㒊䛾ညྜ䜢☜❧䛧䛯䚹ṑิ䜘䜚㌿఩䛧䛶䛔䜛 㻝㻌 㻌 㻞㻌 㻌 㻞㻌䜢ᢤṑ䛧䚸ᑂ⨾ᛶᨵၿ䛸ညྜᏳᐃ䜢☜ㄆ䛧䛯䛾䛱䜽䝻䝇䝬䜴䞁䝖䝥䝻䝅䞊䝆䝱䞊䛻ṑෙ⿵⥛≀䜢స〇䛧䚸ᶵ⬟ⓗ䛻䜒ᑂ⨾ⓗ䛻䜒ᝈ⪅䛾‶㊊䛜ᚓ䜙䜜䛯䚹㻌἞⒪᪉㔪䜢⪃䛘䜛䛻䛒䛯䛳䛶ᝈ⪅䛾ᕼᮃ䚸Ⰻ㉁䛺䜶䝡䝕䞁䝇䚸⾡⪅䛾䝇䜻䝹䜢⪃៖䛧Ỵᐃ䛧䛶䛔䛟䛣䛸䛜㔜せ䛷䛒䜛䛸ឤ䛨
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䝫䝇䝍䞊Ⓨ⾲㻌 㻼㻙㻞㻜㻌㻌⩏ṑ⿦╔䛷䛾㢦ㇺᨵၿ䛻䜘䜛ᝈ⪅䛾 㻽㻻㻸 䛾ྥୖ㻌
Improvement of the QOL of the patient by the countenance change with denture䕿ኴ⏣ளᕼ 㻝㻘㻞䠅䠈᱓ᒣ㤶⧊ 㻞䠅䠈㕥ᮌᗣྖ 㻞䠅䠈Ἑ㔝㝯ᖾ 㻞䠅䠈ⓑ஭㻌 ⫕ 㻞䠅䠈㫽஭ᗣᘯ 㻞䠅㻌㻌 㻌 ᒸᒣ኱Ꮫ⑓㝔䝺䝆䝕䞁䝖 㻝㻕㻘㻌 ᒸᒣ኱Ꮫ⥲ྜṑ⛉ 㻞㻕㻌‫ۑ‬Aki Ohta1,2㸧, Kaori Kuwayama2㸧, Koji Suzuki2㸧, Takayuki Kono2㸧, Hajime Shirai2㸧, Yasuhiro Torii2㸧
Senior resident, Okayama University Hospital 1), Comprehensive Dental Clinic㸪Okayama University Hospital2)㻽㼡㼍㼘㼕㼠㼥㻌㼛㼒㻌㼘㼕㼒㼑䠄㻽㻻㻸䠅䛸䛿ே⏕䛾㉁䜔⏕ά䛾㉁䛾䛣䛸䛷䚸䛹䜜䛰䛡ே䛜⮬ศ䜙䛧䛔⏕ά䜢㏦䜚䚸ே⏕䛻ᖾ⚟䜢ぢฟ䛧䛶䛔䜛䛛䜢㔜ど䛩䜛ᴫᛕ䛷䛒䜛䚹་⒪䛿⑌⑓἞⒵䛜┠ⓗ䛷䛒䜛䛜䚸ྠ᫬䛻⏕ά䛾㉁䜢ྥୖ䛥䛫䜛䜒䛾䛷䛺䛡䜜䜀䛺䜙䛺䛔䚹ṑ⛉་⒪䚸
≉䛻⿵⥛ฎ⨨䛿䚸⑌ᝈ䛾἞⒪䛸䛔䛖䜘䜚䜒୺䛸䛧䛶࿪ᄮᶵ⬟䛾ᅇ᚟䜔䛭䛾௚䛷⏕ά䛾㉁䜢ྥୖ䛥䛫䜛䜒䛾䛷䛿䛺䛔䛰䜝䛖䛛䚹⩏ṑ䛾⿦╔䛷 㻽㻻㻸 ྥୖ䛻ᐤ୚䛧䛯䛸ᛮ䜟䜜䜛⑕౛䜢ሗ࿌䛧䛯䛔䚹㻌ᝈ⪅䛿 㻢㻡 ṓዪᛶ䛷䚸ከᩘṑḞᦆ䛩䜛䜒ᨺ⨨䛧䛶䛔䛯䛜䚸Ꮮ䛻䛂㢦䛜ᛣ䛳䛶䛔䜛䛃䛸ᣦ᦬䛥䜜ᑂ⨾㞀ᐖ䜢୺ッ䛸䛧䛶ᒸᒣ኱Ꮫ⑓
㝔䜢ཷデ䛧䛯䚹ṧᏑṑ䛿ୖ㢡䠑ᮏ䚸ୗ㢡䠓ᮏ䛷 㻝㻠 䛸 㻠㻠 䛾䜏䛷ညྜ䛧䛶䛔䛯䚹ညྜ㧗ᚄ䛾పୗ䛻䜘䜚ཱྀ⭍࿘ᅖ➽䛜ᘱ⦆䛧䚸㢋䛜ⴠ䛱㎸䜏ཱྀゅ䛜ୗᆶ䛧䛯⪁ேᵝ䛾㢦ㇺ䜢࿊䛧䛶䛔䛯䚹䜎䛯䚸ከ㔞䛾ṑ▼䛜௜╔䛧ṑ⫗≧ែ䛿୙Ⰻ䛷䛒䛳䛯䚹ከᩘṑḞᦆ䛻䜘䜛ᑂ⨾㞀ᐖ䚸㔜ᗘṑ࿘⅖䚸㱘⼃䛸デ᩿䛧䛯䚹ึデ᫬䛿䚸໬⢝䛺䛟↓ឡ᝿䛺༳㇟䜢ཷ䛡䚸ಖᏑ୙ྍ⬟䛺ṑ䛾ᢤṑᚋ⩏ṑ⿦╔䛾ᥦ᱌䛻ᛌㅙ䜢ᚓ䜙䜜䛯䜒䛾䛾ཱྀ⭍ෆ䛾㛵ᚰ䛿ᴟ䜑䛶ప䛛䛳䛯䚹ᢤṑᚋ䛿䝬䝇䜽䜢╔⏝䛩䜛䜘䛖䛻䛺䜚䚸㢋䛾ⴠ䛱㎸䜏䛸ཱྀゅୗᆶ䛻୙‶䜢䜒䛳䛶䛔䛯䚹㢡఩䛾Ỵᐃ䛿䚸㻝㻠䠈㻠㻠 䛿ᩳ㠃䛷ညྜ䛧䛶䛔䜛Ⅽ䚸⥲⩏ṑ䛾ညྜ᥇ᚓ䛻‽䛨䛶⾜䛳䛯䚹䜎䛯䚸⩏ṑ〇స⮬య䛜ጞ䜑䛶䛾⤒㦂䛷䛒䜛䛯䜑䚸⩏ṑᗋ◊☻㠃䛾㇏㝯ᗘ䛾Ỵᐃ䛿䚸ညྜ᥇ᚓ᫬䛻ᝈ⪅䛻㙾䛷ぢ䛶䜒䜙䛔䛺䛜䜙⾜䛔䚸⩏ṑ䜢⿦╔䛩䜛䛣䛸䛻䜘䛳䛶㢦ㇺ䛜ᅇ᚟䛩䜛䛣䛸䜢䜲䝯䞊䝆䛥䛫䛯䚹⩏ṑ⿦╔᫬䛿኱ኚ႐䜃䚸ḟᅇ᮶㝔᫬䛛䜙䛿䝬䝇䜽䜢እ䛧䚸໬⢝䜒䛧䚸᫂䜛䛔Ⰽ䛾᭹䛷䚸⾲᝟䜒᫂䜛䛟䛺䛳䛯䚹Ꮮ䛻䛂⾲᝟䛜Ⰻ䛟䛺䛳䛯䛃䛸ゝ䜟䜜䛯䚸䛷䛝䛺䛛䛳䛯➗㢦䛜䛷䛝䜛䜘䛖䛻䛺䛳䛯䛸㏙䜉䚸ᝈ⪅䛾ⱞ䛧䜏䜢ᑡ䛧䛷䜒ᨵၿ䛷䛝䛯䛣䛸䛻⾡⪅䛸䛧䛶䜒႐䜃䜢ឤ䛨䛯䚹ṑ⛉་⒪䛿⑌ᝈ἞⒪䛾䜏䛺䜙䛪䚸ᝈ⪅䛾 㻽㻻㻸ྥୖ䛻኱䛝䛟ᐤ୚䛷䛝䜛䛣䛸䜢ᮏ⑕౛䛷Ꮫ䜆䛣䛸䛜䛷䛝䛯䚹㻌
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䝫䝇䝍䞊Ⓨ⾲㻌 㻼㻙㻞㻝㻌㻌㐣ປ䜢క䛖៏ᛶṑ࿘⑓ᝈ⪅䛻ᑐ䛧䛶ໟᣓⓗ䛻䜰䝥䝻䞊䝏䛧䛯 㻝 ౛㻌A Case Report: A Case of Comprehensive Approach for Chronic Periodontitis Patiant with Overfatigue.

㻌䕿ྜྷ┤኱భ㻘㻌 ఀబὠඞᙪ㻘㻌 㛗㇂ᕝ⠜ྖ㻌᫛࿴኱ᏛṑᏛ㒊㻌 ṑ⛉ಖᏑᏛㅮᗙ㻌 ⥲ྜデ⒪ṑ⛉Ꮫ㒊㛛㻌
䕿Daisuke Yoshinao, Katsuhiko Isatsu, Tokuji Hasegawa
Department of Conservative Dentistry, Division of Comprehensive Dentistry, Showa University School of Dentistry㻌䛆⥴ゝ䛇㻌ṑ࿘⑓䛿ከᅉᏊᛶ⑌ᝈ䛷䛒䜚䚸ṑ࿘⑓ཎᛶ⣽⳦䜢୺䛸䛩䜛⑓ཎᛶᅉᏊ䚸ཱྀ⭍Ύᤲ⩦័䛻௦⾲䛥䜜䜛⩦័ᅉᏊ䚸㑇ఏ䞉ච␿䜢ྵ䜐ಟ㣭ᅉᏊ䚸⢭⚄ⓗ䜔㌟యⓗ䛺㈇䛾䝇䝖䝺䝇ᅉᏊ䛺䛹䚸඲䛶䛾ᅉᏊ䛻䜰䝥䝻䞊䝏䛩䜛䛣䛸䛜㔜せ䛷䛒䜛䛜䚸ᝈ⪅䛻䜘䛳䛶䛿㞴䛧䛔ሙྜ䜒䛒䜛䚹ᮏ⑕౛䛷䛿ᖖែⓗ䛺㐣ປ䛻䜘䜛㈇䛾䝇䝖䝺䝇ᅉᏊ䜢ᢪ䛘䛯ᝈ⪅䛻ᑐ䛧䛶䚸䛭䛾௚ 㻟 䛴ᅉᏊ䛾ᨵၿ䛻䜘䜚ໟᣓⓗ䛻ṑ࿘⑓䜢䝁䞁䝖䝻䞊䝹䛧䜘䛖䛸ヨ䜏䛯⑕౛䛻䛴䛔䛶ሗ࿌䛩䜛䚹㻌䛆⑕౛䛇㻌ᝈ⪅䛿 㻠㻣 ṓ䛾⏨ᛶ䚸ṑ⫗䛛䜙䛾ฟ⾑䛸࿪ᄮ㞀ᐖ䜢୺ッ䛸䛧䛶᮶㝔䚹䠀㻞㻞䚸㻞㻟 ៏ᛶ᰿ᑤᛶṑ࿘⅖䚸䠀㻞㻠 ṑ᰿◚ᢡ䚸䠀㻠㻢䚸㻠㻣 䛾ṑෙᔂቯ䜢క䛖୰➼ᗘ៏ᛶṑ࿘⅖䛷䛒䛳䛯䚹䜎䛪ṑ࿘ᇶᮏ἞⒪䛸ඹ䛻ឤᰁ᰿⟶἞⒪䚸ᢤṑ䛸༶᫬⩏ṑ䜢᪋⾡䛧䛯䚹䝇䜿䞊䝸䞁䜾䝹䞊䝖䝥䝺䞊䝙䞁䜾ᚋ䛻෌ホ౯䜢⾜䛳䛯䛸䛣䜝䚸༑ศ䛺⦕ୗṑ▼䛾㝖ཤ䛜☜ㄆ䛥䜜䛯䛻䜒㛵䜟䜙䛪䝥䝻䇷䝡䞁䜾᫬䛾ฟ⾑䜔 㻠䡉䡉௨ୖ䛾ṑ࿘䝫䜿䝑䝖䛾㒊఩䛿䝇䜿䞊䝸䞁䜾ᚋ䛾෌ホ౯᫬䜘䜚ቑຍ䛧䚸៏ᛶⓗ䛺㐣ປ䜢ᢪ䛘䚸ṑ࿘⑓䛾ᨵၿ䛜༑ศ䛷䛺䛔䛣䛸䛜☜ㄆ䛥䜜䛯䛣䛸䛛䜙䚸᪂䛯䛻ཱྀ⭍ෆ⣽⳦᳨ᰝ䜢⾜䛔䚸἞⒪ィ⏬䜢෌⪃䛧䛯䚹἞⒪᪉㔪䛸䛧䛶䛿䚸ཱྀ⭍Ύᤲ୙Ⰻ䜢ྵ䜐୙㐺ษ䛺⏕ά⩦័䚸᪂䛯䛻㟁ືṑ䝤䝷䝅䜢⏝䛔䛯ཱྀ⭍Ύᤲᣦᑟ䜔䚸ᢠ⳦⸆䛾඲㌟ᢞ୚䜢⾜䛔䚸⣽⳦Ꮫⓗ䜰䝥䝻䞊䝏䜢⾜䛳䛯䚹䜎䛯䚸ཱྀ⭍⩦Ⓑ䛾᫝ṇ䛸ୗ㢡Ḟᦆ㒊䛻ᑐ䛧䛶䝔䞁䝫䝷䝸䞊䝤䝸䝑䝆䜢⿦╔䛩䜛䛣䛸䛷୺ッ䛷䛒䜛࿪ᄮ㞀ᐖ䛾ᨵၿ䜒ィ⏬䛧䛯䚹㻌䛆⤖ᯝ䛸⪃ᐹ䛇㻌ᮏ⑕౛䜘䜚ṑ࿘⑓䛿ከᅉᏊᛶ⑌ᝈ䛷䛒䜛䛣䛸䛛䜙ໟᣓⓗ䛺䜰䝥䝻䞊䝏䛜ᚲせ䛷䛒䜚䚸⏕ά⩦័䜒୍䛴䛾㔜せ䛺ᅉᏊ䛷䛒䜛䚹䛧䛛䛧ാ䛝┒䜚䛾ᝈ⪅䛻ᑐ䛧䛶䛹䛣䜎䛷⏕ά⩦័䛾ᨵၿ䜢ồ䜑䜛䛛䛿㞴䛧䛔ᡤ䛷䛒䜚䚸ሙྜ䛻䜘䛳䛶䛿∗ᶒ୺⩏䛻㝗䜚䛛䛽䛺䛔䚹ᝈ⪅䛜ᛂ䛨䜙䜜䜛⠊ᅖ䛷⏕ά⩦័䛾᫝ṇ䜢⾜䛔௚䛾ᅉᏊ䛻ᑐ䛧䚸ໟᣓⓗ䛻䜰䝥䝻䞊䝏䛩䜛䛣䛸䛻䜘䜚ṑ࿘⑓䜢䝁䞁䝖䝻䞊䝹䛩䜛䛣䛸䜒ከᅉᏊᛶ䛷䛒䜛ṑ࿘⑓἞⒪䛻䛿᭷ຠ䛰䛸Ꮫ䜣䛰䚹㻌
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䝫䝇䝍䞊Ⓨ⾲㻌 㻼㻙㻞㻞㻌㻌䝷䜲䝣䜲䝧䞁䝖䜢ᶵ䛻䜰䝗䝠䜰䝷䞁䝇䜢ྥୖ䛥䛫䛶ṑ࿘἞⒪䜢⾜䛳䛶䛔䜛⑕౛㻌
A case of inducing motivation for periodontal treatment in an opportunity of patient’s life event䚽ᘅ℩຾ಇ㻌㻌㻘෠ᕝ࿴ဢ㻌㻌㻘ὠ⏣⦆Ꮚ㻌㻌㻘ᵽཱྀ຾つ㻌㻌㻌஑ᕞ኱Ꮫ⑓㝔㻌 ⮫ᗋᩍ⫱䝉䞁䝍䞊㻌㻌㻘஑ᕞ኱Ꮫ⑓㝔㻌 ཱྀ⭍⥲ྜデ⒪⛉㻌㻌㻌ࠐKatsutoshi Hirose1), Kazuya Tomikawa2), Hiroko Tsuda2), Yoshinori Higuchi2)
Clinical education center, Kyushu University Hospital1), General oral care, Kyushu University Hospital2)㻌䛆䛿䛨䜑䛻䛇㻌
ṑ࿘⑓䛿䚸៏ᛶ⑌ᝈ䛷ከ䛟䛾ቑᝏᅉᏊ䛜Ꮡᅾ䛩䜛䛣䛸䛛䜙䚸㛗ᮇⓗ䛺඲㢡἞⒪䜢せ䛩䜛ᝈ⪅䛜ከ䛔䚹୍᪉䚸ṑ࿘⑓䛾ዲⓎᖺ㱋䛷䛒䜛୰ᖺᮇ௨㝆䛿ከ䛟䛾䝷䜲䝣䜲䝧䞁䝖䛜䛒䜚䠈✚ᴟⓗ䛺ṑ⛉἞⒪䜢ཷ䛡䜛వ⿱䛜䛺䛔ᝈ⪅䜒ከ䛔䚹௒ᅇ䚸䛭䛾䜘䛖䛺⫼ᬒ䜢᭷䛩䜛ᝈ⪅䛻䚸䝷䜲䝣䜲䝧䞁䝖䛾ኚ໬䜢ᶵ䛻䜰䝗䝠䜰䝷䞁䝇䜢ྥୖ䛥䛫䚸ṑ࿘἞⒪䜢㐍䜑䛶䛔䜛⑕౛䜢Ⓨ⾲䛩䜛䚹㻌䛆ᝈ⪅䛇㻌㻢㻟 ṓ㻌 ዪᛶ㻌 ึデ᪥䠖㻞㻜㻜㻣 ᖺ 㻝㻜 ᭶㻌 ୺ッ䠖ᕥୖ䛾๓ṑ䛜䛠䜙䛠䜙䛩䜛㻌᪤ Ṕ䠖⫶₽⒆㻌
䛆デᰝ䞉᳨ᰝᡤぢ䛇㻌㛗ᮇ䛻Ώ䛳䛶ṑ⛉ཷデ䜢䛧䛶䛔䛯䛻䜒䛛䛛䜟䜙䛪䚸䝥䝷䞊䜽䝁䞁䝖䝻䞊䝹䛿୙Ⰻ䛷䚸඲㢡ⓗ䛻㔜ᗘ䛾㦵྾཰䛜䜏䜙䜜䛯䚹ṑ࿘䝫䜿䝑䝖䛜 㻡㻌 䟚௨ୖ䛾ṑ䛜ከᩘᏑᅾ䛧䚸㻮㻻㻼 䛿 㻣㻜䠂䛷䛒䛳䛯䚹㻌䠘ᝈ⪅⫼ᬒ䠚㻞㻜㻝㻝 ᖺ 㻟 ᭶䜎䛷㛗ᖺ䛻Ώ䛳䛶ẕぶ䛾௓ㆤ䜢⥆䛡䚸䛭䛾㛫䛾ṑ⛉἞⒪䛿ᑐ⑕⒪ἲ䛷䛒䛳䛯䚹㻌䛆デ᩿䛇㻌ᗈỗᆺ㔜ᗘ៏ᛶṑ࿘⅖㻌䛆἞⒪᪉㔪䛇㻌
௓ㆤ⤊஢䜢ᶵ䛻䚸⌧≧䛚䜘䜃௒ᚋ᝿ᐃ䛥䜜䜛ཱྀ⭍ෆ䛾ኚ໬䛻㛵䛩䜛⌮ゎ䜢ᚓ䛺䛜䜙䚸ᝈ⪅䛾ᕼᮃ䛻ἢ䛖἞⒪ィ⏬䜢ᥦ♧䛩䜛䚹䛭䛾㛫䚸ᢤṑ䜢ྵ䜑䛯ឤᰁ※㝖ཤ䜢⾜䛖䚹ᢤṑᚋ䚸᭱⤊⿵⥛タィ䜢ᶍೌ䛧䛯ᬻ㛫⿵⥛≀䛻䜘䜛ᶵ⬟ᅇ᚟䛻䜘䛳䛶䚸እയຊ䜢䝁䞁䝖䝻䞊䝹䛩䜛䚹䛭䛾ᚋ䚸ᚭᗏⓗ䛻ឤᰁ※㝖ཤ䜢⾜䛔䚸䝯䜲䞁䝔䝘䞁䝇䛻ᑟ䛟䚹㻌䛆἞⒪⤒㐣䛇㻌
ᝈ⪅䛾ᕼᮃ䠖䛣䜜௨ୖṑ䜢႙ኻ䛧䛯䛟䛺䛔䚸ᅛᐃᘧ䛾⿵⥛≀䛻䛧䛯䛔㻌䠍䠅ṑ࿘ᇶᮏ἞⒪䠄㼀㻮㻵䠈ᢤṑ䠈ᬻ㛫⿵⥛䛺䛹䠅䚸䠎䠅ṑ࿘እ⛉἞⒪䚸䠏䠅䜲䞁䝥䝷䞁䝖἞⒪䚸䠐䠅ṑ࿘⤌⧊෌⏕⒪ἲ䚸䠑䠅᭱⤊⿵⥛἞⒪䚸䠒䠅䝯䜲䞁䝔䝘䞁䝇㻌䛆䜎䛸䜑䛇㻌
௒ᅇ䚸௓ㆤ䛸䛔䛖⫼ᬒ䛛䜙䚸ṑ⛉἞⒪䜢ཷ䛡䜛ᚰ⌮ⓗవ⿱䛜䛺䛛䛳䛯ᝈ⪅䛻ᑐ䛧䛶䚸䝷䜲䝣䜲䝧䞁䝖䛾ኚ໬䜢ᶵ䛻ṑ࿘἞⒪䜈䛾䜰䝗䝠䜰䝷䞁䝇䜢ྥୖ䛥䛫䜛䛣䛸䛜䛷䛝䛯䚹ᮏ⑕౛䛛䜙䚸ṑ⛉་ᖌ䛿ᝈ⪅䛾ே⏕䜢㛗ᮇⓗ䛻ᤊ䛘䚸἞⒪௓ධ䛾䝍䜲䝭䞁䜾䜢ぢᴟ䜑䜛䛣䛸䛾㔜せᛶ䜢Ꮫ䜣䛰䚹㻌 㻌 㻌 㻌 㻌 㻌 㻌 㻌 㻌 㻌 㻌 㻌 㻌 㻌 㻌 㻌 㻌 㻌 㻌 㻌
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䝫䝇䝍䞊Ⓨ⾲㻌 㻼㻙㻞㻟㻌㻌἞⒪䛾㑅ᢥ⫥䛾⮬ᕫỴᐃ䛻⣡ᚓฟ᮶䛺䛛䛳䛯ᝈ⪅䛻ᑐ䛧䛶䝘䝷䝔䜱䝤䜢⪃៖䛧䛯᥼ຓ䜢ヨ䜏䛯⑕౛㻌
A case of narrative support for a patient who was not understand her own self-determination of the treatment plan       䕿ᯈᐙᮁ㻘㻌 ⏣୰᐀㻘㻌 ᮌᑿဴᮁ㻌஑ᕞṑ⛉኱Ꮫ㻌 ⥲ྜデ⒪Ꮫศ㔝㻌䕿Akira Itaya, Hajime Tanaka, Tetsuro Konoo
Division of Comprehensive Dentistry, Department of Science of Oral Function, Kyushu Dental University䛆⥴ゝ䛇㻌ᝈ⪅䛿⑓Ẽ䛛䜙䛾ゎᨺ䜢ᮃ䜏་⒪ᶵ㛵䜢ཷデ䛩䜛䛜デ᩿䛸἞⒪䛻䛚䛔䛶䛿ಶ䚻䛾ᝈ⪅䛾ゎ㔘䝰䝕䝹䜢ᢕᥱ䛩䜛஦䛜㔜せ䛷䛒䜛䚹㻌
ཌ⏕ປാ┬䛻䜘䜛ᖹᡂ 㻞㻟 ᖺᗘཷ㡿⾜ືㄪᰝ䛻䜘䜛䛸እ᮶ᝈ⪅䛷་ᖌ䛛䜙䛂ㄝ᫂䜢ཷ䛡䛯䛃䛸ᅇ⟅䛧䛯ᝈ⪅䛿 㻤㻢㻚㻝䠂䚸ㄝ᫂䜢ཷ䛡䛯ᝈ⪅䛜␲ၥ䜔ពぢ䜢་ᖌ䛻䛂༑ศ䛻ఏ䛘䜙䜜䛯䛃䛸ᅇ⟅䛧䛯ᝈ⪅䛿 㻢㻤㻚㻣㻑䛷䛒䜚እ᮶ᝈ⪅䛾⣙㻠 ๭䛿༑ศ䛻⣡ᚓ䛜䛷䛝䛶䛔䛺䛔䚹㻢 ᖺ㛫䛻䜟䛯䛳䛶๓ṑ䛾ညྜ᥋ゐ䛜Ẽ䛻䛺䜛䛜䚸⮬㌟䛜Ỵᐃ䛧䛯἞⒪᪉㔪䛻䛭䛾ᚋ䚸⣡ᚓ䛷䛝䛺䛛䛳䛯ᝈ⪅䛾䝘䝷䝔䜱䝤䛻㓄៖䛧䛯᥼ຓ䜢ヨ䜏䛯䛾䛷ሗ࿌䛩䜛䚹㻌㻌䛆⑕౛䛇㻌㻴㻝㻥 ᖺ㻟 ᭶ึデ䚸⌧ᅾ㻢㻟 ṓዪᛶ䚸㻴㻝㻥 ᖺ㻣 ᭶䜘䜚䛂๓ṑ䛜ᙜ䛯䛳䛶Ẽ䛻䛺䜛䛃䛸ッ䛘᮶㝔୰䚹⥲ྜデ⒪⛉䜔▹ṇṑ⛉䛻䛶἞⒪䛾㑅ᢥ⫥䜢ᥦ♧䛧䛯䛜୺ッ䛾✚ᴟⓗ἞⒪䛻⮳䜙䛪䚸୺䛻ṑ࿘἞⒪䚸ᩘᅇ䛾ညྜㄪᩚ䜢⾜䛔⌧ᅾ䛻⮳䜛䚹ཱྀ⭍ෆᡤぢ䛸䛧䛶㻟㻝䚸㻟㻞䚸㻠㻞 ⯉ഃഴᩳ䚸㻝㻝䚸㻠㻝 ၁ഃഴᩳ䛜ㄆ䜑䜙䜜䛯䚹㻌㻌䛆デ᩿䚸἞⒪᪉㔪䛇㻌䜸䞊䝞䞊䝞䜲䝖䛜῝䛟 㻟㻝䚸㻟㻞䚸㻠㻞 䛜⯉ഃഴᩳ䛧 㻠㻝 䛜၁ഃഴᩳ䛧䛶䛔䜛䚹㻠㻝 䛸᥋ゐ䛩䜛 㻝㻝 䜒၁ഃഴᩳ䛧๓ṑ㒊ྀ⏕䜢࿊䛧䛶䛔䜛䚹㻢ᖺ㛫䛻䜟䛯䜚䚸✚ᴟⓗ἞⒪䛻㋃䜏ฟ䛫䛪䛻ᝈ⪅䛜ᢪ䛔䛶䛔䜛୙‶䚸ᕼᮃ䚸⫼ᬒ䜢⫈ྲྀ䛧䚸䠐䛴䛾἞⒪᪉㔪䐟⤒㐣ほᐹ䛾⥅⥆䐠㻠㻝 ᢤṑᚋ⤒㐣ほᐹ䐡㻠㻝 ᢤṑᚋ 㻠㻞䚸㻟㻝 䜢 㻯㻾 ಟ᚟䐢㻠㻝 ᢤṑᚋ▹ṇ἞⒪䚸䜢ᥦ♧䛧඼䚻䛾䝯䝸䝑䝖䚸䝕䝯䝸䝑䝖䜢䜎䛸䜑䛯⾲䚸ᢤṑᚋ䛾ண ᶍᆺ䜢స〇䛧ㄝ᫂䜢⾜䛳䛯䚹᭶ 㻝 ᅇ䛾་⒪㠃᥋䜢」ᩘᅇ⾜䛔ᝈ⪅䛸ඹ䛻἞⒪᪉㔪䜢Ỵᐃ䛧䛯䚹㻌㻌䛆⪃ᐹ䛇㻌௒ᅇ䛾⑕౛䛷䛿ᝈ⪅䛜⮬㌟䛷Ỵ䜑䛯஦䛻⣡ᚓฟ᮶䜛䜘䛖᫬㛫䜢䛛䛡་⒪㠃᥋䜢⾜䛔ᝈ⪅䛾䝘䝷䝔䜱䝤䜔䝺䝕䜱䝛䝇䛻ྜ䛳䛯䝃䝫䞊䝖䛩䜛஦䜢ᚰ᥃䛡䛯䚹୙‶䜔ᝎ䜏䛿඼䚻䛾ᝈ⪅䛜ᣢ䛳䛶䛚䜚䛭䛾ᝈ⪅⮬㌟䛻ྜ䛳䛯་⒪㠃᥋䜔἞⒪䛜㔜せ䛷䛒䜛஦䚸ྠ䛨ᝈ⪅䛷䛒䛳䛶䜒䝺䝕䜱䝛䝇䛻䜘䜚ᝈ⪅䛾⪃䛘䜔Ỵᐃ䛻ኚ໬䛜䛒䜛஦䜢Ꮫ䜆஦䛜ฟ᮶䛯䚹㻌

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䝫䝇䝍䞊Ⓨ⾲㻌 㻼㻙㻞㻠㻌㻌἞⒪⏝⩏ṑ䜢⏝䛔䛶㢡఩䛾ಟṇ䜢ヨ䜏䛯୍⑕౛㻌
A Case Report on Treatment Denture application to reposition of the Mandibular Position㻌䕿Ḉ஭▱ᕫ䠍㻕㻘㻌 ▼ᓮ⿱Ꮚ䠎㻕㻘㻌 ୰ᓥ㈗Ꮚ䠎㻕㻘㻌 ఀ⸨ᬕỤ䠎㻕㻘㻌 ዠᮧᬸ᪦䠎㻕㻘㻌 ⸨஭つᏕ䠎㻕㻌᪂₲኱Ꮫ་ṑᏛ⥲ྜ⑓㝔㻌 ◊ಟṑ⛉་䠍㻕㻘㻌 ᪂₲኱Ꮫ་ṑᏛ⥲ྜ⑓㝔ṑ⛉⥲ྜデ⒪㒊䠎㻕㻌䕿Sakurai Tomoki1), Ishizaki Hiroko2), Nakajima Takako2), Itou Harue2), Okumura Nobuaki2), Fujii Noritaka2)
Trainee Dentist, Niigata University Medical and Dental Hospital1)
General Dentistry and Clinical Education Unit, Niigata University Medical and Dental Hospital2)䛆⥴ゝ䛇㻌㛗ᮇⓗ䛺⤒㐣䜢㎺䛳䛶ညྜ㧗ᚄ䛜పୗ䛧䛶䛔䜛ᝈ⪅䛻ᑐ䛧䚸ညྜᣲୖ䜢ヨ䜏䛯⑕౛䛻䛴䛔䛶ሗ࿌䛩䜛䚹㻌䛆⑕౛䛇㻌ᝈ⪅䠖㻢㻤 ṓ㻌 ዪᛶ㻌 ୖ㢡 㻷㼑㼚㼚㼑㼐㼥䊡⣭ 㻞 㢮㻌 ୗ㢡 㻷㼑㼚㼚㼑㼐㼥䊠⣭㻌 㻱㼕㼏㼔㼚㼑㼞㻮㻠㻌ᖹᡂ㻞㻟ᖺ㻤᭶䚸ୗ㢡⩏ṑ䛾ჶ䜏ྜ䜟䛫䛜ᝏ䛟ṑ⫗䛜③䜐䛣䛸䜢୺ッ䛻ᙜ⛉ཷデ䚹ึデ᳨ᰝ᫬ᢤṑ㐺ᛂṑከᩘ䛒䜛䜒䚸ᝈ⪅䛾ᕼᮃ䛻䜘䜚ྍཬⓗ䛻ಖᏑ䛧䚸ୖୗ㢡⩏ṑ䜢〇స䚹䛭䛾ᚋ䚸ṧᏑṑ䛾⑕≧ฟ⌧䛻䜘䜚ḟ䚻䛸ᢤṑ䞉ṧ᰿ୖ䜈䛾ቑṑಟ⌮䜢⾜䛳䛯䛜䚸ୖ㢡๓ṑ㒊䛾䜽䝸䜰䝷䞁䝇䛜ᑠ䛥䛟⩏ṑ䛾◚ᢡ䚸ಟ⌮䜢⧞䜚㏉䛧䛶䛔䛯䚹ᖹᡂ㻞㻡 ᖺ㻣 ᭶䚸㻏㻠㻠 䛜ṑ᰿◚ᢡ䛧ಖᏑ୙ྍ䛸ุ᩿䛧ᢤṑ䛸䛺䛳䛯䚹䛣䜜䜢ᶵ䛻 㻱㼕㼏㼔㼚㼑㼞㻯㻝 䜈䛸⛣⾜䛧䚸ୖ㢡⩏ṑ䛾◚ᢡ䛾᪤ 䛸ୖ㢡๓ṑ䛻✺䛝ୖ䛢䞉ືᦂ䛜䛒䜛䛣䛸䛛䜙䚸⌧⩏ṑ䜢἞⒪⏝⩏ṑ䛸䛧䛶฼⏝䛧ညྜᣲୖ䜢⾜䛳䛯䚹䛭䛾ᚋ䚸⩏ṑ䛾Ᏻᐃ䛜ᚓ䜙䜜䚸㢡㛵⠇⑕≧➼ၥ㢟䛜⏕䛨䛺䛡䜜䜀䚸䛭䛾㢡఩䛷᪂⩏ṑ䜢〇స䛩䜛䛣䛸䛸䛧䛯䚹㻌䛆⪃ᐹ䛇㻌ᮏ⑕౛䛿䚸ୖ㢡⮻ṑ䛜᣿ฟ䛧䛶䛚䜚䚸ညྜᖹ㠃䛜஘䜜䚸ညྜ᫬䛻⮻ṑ㒊䛜᥋ゐᚋ䛻ୗ㢡䛜๓᪉䛻⁥䛳䛶ኚ఩䛧䛶䛔䛯䚹䛭䛾䛯䜑 㻱㼕㼏㼔㼚㼑㼞㻯㻝 䜈䛸⛣⾜䛧䛯ᶵ఍䛻㢡఩䜢ಟṇ䛩䜛䛣䛸䜢ඃඛ䛧䛯䚹㢡఩䜢ಟṇ䛩䜛᪉ἲ䛸䛧䛶䚸䛩䛠䛻᪂⩏ṑ䜢〇స䛩䜛᪉ἲ䛸⌧⩏ṑ䜢἞⒪⏝⩏ṑ䛸䛧䛶ಟṇ䛩䜛᪉ἲ䛾䠎䛴䜢᳨ウ䛧䛯䚹௒ᅇ䚸ညྜ䛾ᣲୖ㔞䛜኱䛝䛟䛺䜛䛣䛸䛜ண᝿䛥䜜䚸⤒㐣ほᐹ䛧䛺䛜䜙㢡఩䜢ᶍ⣴䛷䛝䜛䜘䛖䚸䝏䜵䜰䝃䜲䝗䛷༶᫬ಟṇ䛜ྍ⬟䛺⌧⩏ṑ䜢἞⒪⏝⩏ṑ䛸䛧䛶ಟṇ䛩䜛᪉ἲ䜢㑅ᢥ䛧䛯䚹䛺䛚䚸㢡఩䛿඲㒊ᗋ⩏ṑ䛾ညྜ᥇ᚓ䛻‽䛨䛶Ỵᐃ䛧䛯䚹ᮏ⑕౛䜢⤒㦂䛧䚸ணᚋ䛜୙Ᏻ䛺ṧᏑṑ䛾⤒㐣䜢ண 䛧䛴䛴㻝 ཱྀ⭍䜢㛗ᮇ䛻䜟䛯䜚἞⒪䞉⟶⌮䛩䜛䛣䛸䛾㞴䛧䛥䜢ᐇឤ䛧䛯䚹㻌
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䝫䝇䝍䞊Ⓨ⾲㻌 㻼㻙㻞㻡㻌㻌㔜ᗘᗈỗᆺ៏ᛶṑ࿘⅖ᝈ⪅䛾ṑ࿘἞⒪䛻⣽⳦᳨ᰝ䜢⏝䛔䛯୍⑕౛㻌
A case report of the periodontal therapy on the patient with severe generalized chronic periodontitis using bacteriologicalexamination.
䕿℩㔝ᩥ 㻝㻕㻌㻘㻌 ᒣ⏣࿴ᙪ 㻞㻕㻘㻌 ℩㔝ᜨ⾰ 㻞㻕㻘㻌 ㇂ཱྀዉኸ 㻞㻕㻘㻌 ఀἼᖾస 㻞㻕㻘㻌 ᱝᑿ㝧௓ 㻞㻕㻘㻌 ⡿⏣㞞⿱ 㻟㻕㻘㻌 ᘅ⸨༟㞝 㻞㻕㻌 㻌⚟ᒸ་⒪▷ᮇ኱Ꮫᑓᨷ⛉䠍䠅㻘㻌 ⚟ᒸṑ⛉኱Ꮫ⥲ྜṑ⛉Ꮫㅮᗙ⥲ྜṑ⛉Ꮫศ㔝 㻞㻕㻘㻌 㻌⚟ᒸṑ⛉኱Ꮫཱྀ⭍་⒪䝉䞁䝍䞊䠏䠅㻌‫ۑ‬Aya Seno1), Kazuhiko Yamada2), Kei Seno2), Nao Taniguchi2), Yosuke Masuo2), Masahiro Yoneda3),
Takao Hirofuzi2)
Fukuoka College of Health Science1), Department of Conservative Dentistry, Fukuoka Dental College2)
Center for Oral Diseases3), Fukuoka Dental College࠙⥴ゝࠚ 㔜ᗘṑ࿘⅖࡟⨯ᝈࡋ࡚࠸ࡿᝈ⪅ࡣࠊညྜࡸ⿵⥛≀࠶ࡿ࠸ࡣ⏕ά⩦័࡞࡝ࡢⅬ࡛ከࡃࡢၥ㢟ࢆᢪ࠼࡚࠾ࡾࠊ἞⒪ᮇ㛫ࡶ㛗ᮇ࡟ཬࡪࡇ࡜ࡀከ࠸ࠋ௒ᅇࠊ㔜ᗘṑ࿘⅖ᝈ⪅࡟ᑐࡋࠊ⣽⳦᳨ᰝࢆά⏝ࡋ⣽⳦ᩘࡢῶᑡࢆ἞⒪ࡢ┠ᶆ࡟ᤣ࠼ࡿࡇ࡜࡛ࠊ
἞⒪ᮇ㛫ࡀ㛗ᮇ࡟ཬࢇࡔ࡟ࡶ࠿࠿ࢃࡽࡎࠊᝈ⪅ࡢࣔࢳ࣮࣋ࢩࣙࣥࢆ㧗ࡃ⥔ᣢࡍࡿࡇ࡜ࡀ࡛ࡁࠊⰋዲ࡞⤖ᯝࢆᚓࡓ⑕౛࡟
ࡘ࠸࡚ሗ࿌ࡍࡿࠋ
࠙⑕౛ࡢᴫせࠚᝈ⪅㸸69 ṓዪᛶ ึデ᪥㸸2012.4.18
୺ッ࣭⌧⑓Ṕ㸸ୖࡢᕪࡋṑࡀࢢࣛࢢࣛࡍࡿࠋ඲యⓗ࡞ṑ⫗ࡢ⭘⬽ࠋ᪤ Ṕ㸸≉グ஦㡯࡞ࡋࠋ㠀ႚ↮⌧⑕㸸ṑ㛫㒊࠾ࡼࡧ⮻ṑ⯉ഃṑ㢕㒊࡟ࣉ࣮ࣛࢡࡢ௜╔ࡀከ㔞࡟࠶ࡾࠊṑ⫗⦕ୗṑ▼ࢆㄆࡵࡓࠋࣞࣥࢺࢤࣥᡤぢ࡛ࡣ࡯ࡰ඲㢡ⓗ࡟Ỉᖹⓗ㦵྾཰ࡀ㐍ࡳࠊ㒊ศⓗ࡟ᆶ┤ᛶ㦵Ḟᦆࠊ᰿ศᒱ㒊⑓ኚࢆㄆࡵࡓࠋ
࠙἞⒪᪉㔪ࠚ
ṑ࿘⑓⣽⳦᳨ᰝࢆ⾜ࡗ࡚ࠊ⣽⳦ᩘࡢῶᑡࢆ἞⒪ࡢ┠ᶆ࡟ࡍࡿࡇ࡜࡛ᝈ⪅ࡢࣔࢳ࣮࣋ࢩࣙࣥࢆ࠶ࡆࠊཱྀ⭍ΎᤲᣦᑟࠊSRP
ࢆ⾜࠺ࡇ࡜࡟ࡋࡓࠋ
࠙⤖ᯝ࡜⪃ᐹࠚ
἞⒪㛤ጞ࡟ඛ❧ࡕࠊ㏻ἲࡢṑ࿘⤌⧊᳨ᰝ࡟ຍ࠼⣽⳦᳨ᰝࢆᐇ᪋ࡋࡓࠋࡇࡢ⤖ᯝࢆᝈ⪅࡟ᥦ♧ࡋ┠ᶆタᐃࢆ᫂☜࡟♧ࡋࡓࡇ࡜ࡀࠊṑ࿘⑓ࡀ⣽⳦ឤᰁ⑕࡛࠶ࡿࡇ࡜࡟ᑐࡍࡿ⌮ゎࢆຓࡅ✚ᴟⓗ࡟ࢭࣝࣇࢣ࢔࡟ྲྀࡾ⤌ࡴጼໃࢆసࡾୖࡆࡓࠋࡑࡢ
⤖ᯝࠊṑ࿘ᇶᮏ἞⒪ࡀ㛗ᮇ࡟ཬࢇࡔ࡟ࡶ࠿࠿ࢃࡽࡎࠊṑ࿘἞⒪ࢆᡂຌ࡟ᑟࡃࡇ࡜ࡀ࡛ࡁࡓせᅉ࡜⪃࠼ࡿࠋ
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䝫䝇䝍䞊Ⓨ⾲㻌 㻼㻙㻞㻢㻌㻌㻼㻻㻿 䜢ᇶ┙䛸䛧䛯ᗈỗᆺ㔜ᗘṑ࿘⅖䛾デ᩿䛸἞⒪ィ⏬㻌
Diagnosis and treatment planning for generalized severe periodontitis based on POS㻌䚽ྂᕷ㝯 㻝㻌㻕㻘㻌 㛵ၨ௓ 㻞㻌㻕㻘㻌 㰻⸨㑥Ꮚ 㻞㻌㻕㻘㻌 ➉ෆ⩏┿ 㻞㻌㻕㻘㻌 ྂᆅ⨾ె 㻞㻌㻕㻘㻌 ⣬ᮏ⠜ 㻞㻌㻕㻌᪥ᮏ኱ᏛṑᏛ㒊௜ᒓṑ⛉⑓㝔⥲ྜデ⒪⛉ 㻝㻕㻘㻌 㻌 ᪥ᮏ኱ᏛṑᏛ㒊㝃ᒓṑ⛉⑓㝔⣔༞┤ᚋ◊ಟศ㔝 㻞㻌㻕㻌
䚽Takashi Furuichi 1 ), Keisuke Seki2 ),Kuniko Saito 2 ), Yoshimasa Takeuchi2 ), Mika Furuchi2 ), Atsushi Kamimoto2 ),Nihon University School of Dentistry Dental Hospital 1 ),Nihon University School of Dentistry Dental Hospital General Practice Residency 2 )㻌䛆䛿䛨䜑䛻䛇㻌
௒ᅇ䚸⮻ṑ㒊䛾ညྜᔂቯ䜢క䛖㔜ᗘṑ࿘⅖䛻ᑐ䛧䛶 㻼㻻㻿 䛻ᇶ䛵䛔䛯デᰝ䞉デ᩿䜢⾜䛳䛯ᚋ䚸἞⒪ィ⏬䜢❧᱌䛧䛯䛾䛷䛣䜜䜢ሗ࿌䛩䜛䚹㻌䛆ึデ䛇㻌ᝈ⪅䠖㻢㻥 ṓ䚸ዪᛶ䚹㻞㻜㻝㻟 ᖺ㻢 ᭶᮶㝔䚹୺ッ䠖ྑୗ䛾๓ṑ䛾ṑⱼ䛻㐪࿴ឤ䛜䛒䜛䚹⌧⑓Ṕ䠖㻝 㐌㛫⛬๓䛛䜙ྑୗ๓ṑ䛾ṑⱼ䛜③䜏ᙜ㝔ཷデ䚹඲㌟⑌ᝈ䠖⢾ᒀ⑓䚹㻌䛆デᰝ䞉᳨ᰝᡤぢ䛇㻌⌧ᅾṑ䛿 㻝㻢 ṑ䚸⌧⾜䛾ୖ㢡⩏ṑ䛿ⴭ䛧䛟㐺ྜ୙Ⰻ䛷䛒䛳䛯䚹඲㢡ⓗ䛻ṑ⫗䛾Ⓨ㉥䚸⭘⬽䜢ㄆ䜑䝥䝷䞊䜽䝁䞁䝖䝻䞊䝹䛿୙Ⰻ䚸㻮㻻㻼䛿㻞㻥㻌㻑䛷䛒䛳䛯䚹㼄⥺ᡤぢ䛷䛿඲㢡ⓗ䛻㧗ᗘ䛺Ỉᖹᛶ䛾㦵྾཰䜢ㄆ䜑䚸≉䛻㻟㻝䚸㻠㻝䚸㻠㻞䚸㻝㻣䛷䛿ᆶ┤ᛶ䛾㦵྾཰䜢ㄆ䜑䛯䚹ྛ✀デᰝ䛾⤖ᯝ䜘䜚 㻝㻣䚸㻟㻝䚸㻠㻝䚸㻠㻞 䜢ಖᏑ୙⬟䛸䛧䛯䚹㻌䛆デ᩿䛇㻌⮻ṑ㒊䛾ညྜᔂቯ䜢క䛳䛯ᗈỗᆺ㔜ᗘ៏ᛶṑ࿘⅖㻌䛆἞⒪ィ⏬䛇㻌㻌 ≉䛻ୖ㢡ྑഃ⮻ṑ㒊䛾᣿ฟ䛜኱䛝䛔䛯䜑䚸ಖᏑ䛾ྍྰ䜢ุ᩿䛩䜛┠ⓗ䛷᭱⤊⿵⥛⿦⨨䜢ண᝿䛧⥲⩏ṑ䝍䜲䝥䛾デ᩿⏝䝽䝑䜽䝇䜰䝑䝥䜢స〇䛧䛯䚹ṑ࿘ᇶᮏ἞⒪䛿 㼀㻮㻵䚸䝇䜿䞊䝸䞁䜾䛚䜘䜃 㻿㻾㻼䚸ឤᰁ᰿⟶἞⒪䚸ணᚋ୙Ⰻṑ䛾ᢤṑ䚸䝥䝻䝡䝆䝵䝘䝹䝺䝇䝖䝺䞊䝅䝵䞁䛾⿦╔䜢⾜䛖䚹෌ホ౯ᚋ 㻠㻌㼙㼙 ௨ୖ䛾ṑ࿘䝫䜿䝑䝖䛜Ꮡᅾ䛧䛯㒊఩䛻ᑐ䛧ṑ࿘እ⛉ᡭ⾡䜢⾜䛖䚹ཱྀ⭍ᶵ⬟ᅇ᚟἞⒪䛷䛿ୖ㢡䛿䜸䞊䝞䞊䝕䞁䝏䝱䞊䚸ୗ㢡䛿䜽䝷䜴䞁䛚䜘䜃䝤䝸䝑䝆䛻䜘䜚⿵⥛䛧䚸㻿㻼㼀 䜈⛣⾜䛩䜛䚹㻌䛆἞⒪⤒㐣䛇㻌㻌 ⌧ᅾ䜎䛷䛻ୗ㢡䛾ணᚋ୙Ⰻṑ䜢ᢤṑ䚸୙㐺ྜಟ᚟≀䛾᧔ཤ䛚䜘䜃ឤᰁ᰿⟶἞⒪䜢⾜䛳䛯䚹┠ୗୗ㢡䛾䝥䝻䝆䝵䝘䝹䝺䝇䝖䝺䞊䝅䝵䞁䛾ㄪᩚ䜢㐍䜑䛶䛚䜚䚸ୖ㢡䛾἞⒪⏝⩏ṑ䜢స〇䛧䛶䛔䜛䚹㻌䛆⪃ᐹ䞉䜎䛸䜑䛇㻌㻌 㻌 㻌 㻼㻻㻿 䛻ᇶ䛵䛝ᢳฟ䛥䜜䛯୺䛺ၥ㢟Ⅼ䛿䚸䐟⮻ṑ㒊䝞䞊䝔䜱䜹䝹䝇䝖䝑䝥䛾ᔂቯ䚸䐠㗑≧ညྜ䚸䐡㐺ྜ୙Ⰻ䛾ୖ㢡⩏ṑ䛷䛒䛳䛯䚹἞⒪ィ⏬❧᱌䛻㝿䛧デ᩿⏝䝽䝑䜽䝇䜰䝑䝥䜢〇స䛩䜛䛣䛸䛿䚸᭱⤊⿵⥛≀䛾ண 䛸䚸ᝈ⪅䜈䛾෇⁥䛺἞⒪ィ⏬䛾ㄝ᫂䚸䝰䝏䝧䞊䝅䝵䞁䛾ྥୖ䛻⧅䛜䜛᭷ຠ䛺ᡭẁ䛷䛒䛳䛯䚹㻌
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䝫䝇䝍䞊Ⓨ⾲㻌 㻼㻙㻞㻣㻌㻌ညྜ㧗⤒䛾ቑຍ䛻క䛖ညྜᨭᣢ䛸䜰䞁䝔䝸䜰䝹䜺䜲䝎䞁䝇䛾෌ᵓᡂ䜢ᅗ䛳䛯䠍⑕౛㻌
A Case of reconstruction of occlusal support and anterior guidance with increasing occlusal vertical dimension㻌䕿ᐅ㔝ᗙ⧊ᜨ㻘㻌 ụ⏣ள⣖Ꮚ㻘㻌 㛗㇂ᕝ⠜ྖ㻌᫛࿴኱ᏛṑᏛ㒊㻌 ṑ⛉ಖᏑᏛㅮᗙ㻌 ⥲ྜデ⒪ṑ⛉Ꮫ㒊㛛㻌‫ۑ‬Orie Ginoza, Akiko Ikeda, Tokuji Hasegawa
 Department of Conservative Dentistry, Division of Comprehensive Dentistry, Showa University School of Dentistry㻌䛆⥴ゝ䛇㻌⮻ṑ㒊ညྜᨭᣢ䛾႙ኻ䛿ୗ㢡఩䜢ኚ໬䛥䛫䚸࿪ᄮ➽䛾⥭ᙇ䜢ቑ䛧䚸䜰䞁䝔䝸䜰䝹䜺䜲䝎䞁䝇䛾᮲௳䜢኱䛝䛟ኚ䛘䛶䛧䜎䛖䚹௒ᅇ䚸ୖ㢡⮻ṑ㒊ேᕤṑ䛾㐣ᗘ䛾ᦶ⪖䛻䜘䜚๓ṑ㒊䛻ညྜᛶእയ䜢ᘬ䛝㉳䛣䛧䛶䛔䛯⑕౛䛻ᑐ䛧ညྜᨭᣢ䛾ᅇ᚟䜢ඃඛ䛧䚸䜰䞁䝔䝸䜰䝹䜺䜲䝎䞁䝇䛾෌ᵓᡂ䜢ᅗ䛳䛯⑕౛䛻䛴䛔䛶ሗ࿌䛩䜛䚹㻌䛆⑕౛䛇㻌ึデ᫬ 㻢㻥 ṓ⏨ᛶ䚹ṧᏑṑ䛿䠏䠉䠑䚸䠔䠉䠔䛷䛒䜚䚸ୖ㢡䛻䛿୧ഃ㐟㞳➃⩏ṑ䛜⿦╔䛥䜜䛶䛔䛯䛜䚸㖋ṑ䛸䛺䛳䛶䛔䛯䠏䛾ṑෙ◚ᢡ䜢୺ッ䛻᮶㝔䛧䛯䚹⹫⾑ᛶᚰ⑌ᝈ䜔⏕ά⩦័⑓䜢᭷䛧䛶䛔䜛䛜䚸䝁䞁䝖䝻䞊䝹Ⰻዲ䛷䛒䜛䚹ேᕤṑ䛾ⴭ䛧䛔☻⪖䛻䜘䜛ညྜ㧗⤒䛾పୗ䛛䜙䚸ୖ㢡๓ṑ㒊䛾䜶䝑䜽䝇⥺ᡤぢ䛷䛿ညྜᛶእയ䛜ཎᅉ䛸ᛮ䜟䜜䜛ᆶ┤ⓗ㦵྾཰䛜ㄆ䜑䜙䜜䛯䚹㻌䛆デ᩿ཬ䜃἞⒪᪉㔪䛇㻌䠏䛿⩏ṑ䛾ேᕤṑᦶ⪖䛻క䛖ညྜ㧗ᚄ䛾పୗ䛛䜙እയ䜢ᘬ䛝㉳䛣䛧䛯⤖ᯝ䚸ṑෙ◚ᢡ䜢⏕䛨䛯䜒䛾䛸デ᩿䛧䛯䚹䜎䛯䚸௚䛾ୖ㢡ṧᏑṑ䛻䛴䛔䛶䜒ညྜᛶእയ䛜ཎᅉ䛸ᛮ䜟䜜䜛㧗ᗘ䛾ᆶ┤ⓗ㦵྾཰䜔ṑ㉁䛾◚ᢡ䛜ㄆ䜑䜙䜜䛯䛣䛸䛛䜙䚸ேᕤṑ䛻༶᫬㔜ྜ䝺䝆䞁䜢ῧຍ䛩䜛䛣䛸䛷䚸㐺ษ䛺ညྜ㧗ᚄ䜢௜୚䛧⮻ṑ㒊ညྜᨭᣢ䛾ᅇ᚟䜢ᅗ䜛䛣䛸䜢ඃඛ䛧䛯䚹䛭䛾ᚋ䚸୺ッ䛷䛒䜛㖋ṑ䜢ྵ䜑䛯ୖ㢡๓ṑ㒊䛻䛿䝥䝻䝡䝅䝵䝘䝹䝺䝇䝖䝺䞊䝅䝵䞁䜢⏝䛔䛺䛜䜙㐺ษ䛺䜰䞁䝔䝸䜰䝹䜺䜲䝎䞁䝇䜢ᶍ⣴䛧䚸ṑ࿘ᇶᮏ἞⒪⤊஢ᚋ䛻᭱⤊⿵⥛䜢⾜䛖䛸䛔䛖἞⒪᪉㔪䜢❧䛶䛯䚹㻌䛆⤖ᯝ䛸⪃ᐹ䛇㻌㻌 ᮏ⑕౛䛷䛿ᪧ⩏ṑ䜢ಟṇ䛧䛶἞⒪⩏ṑ䛸䛧䛶౑⏝䛧䚸㐪࿴ឤ䜢ッ䛘䜛䛣䛸䛺䛟ညྜ㧗ᚄ䛾ᨵၿ䜢㐍䜑䜙䜜䛯䚹⮻ṑ㒊ညྜ䛜Ᏻᐃ䛧䛯ᚋୖ㢡๓ṑ㒊䛻䛿䝤䝸䝑䝆䜢㑅ᢥ䛩䜛䛣䛸䛷䠍ḟ䝇䝥䝸䞁䝖ຠᯝ䜢ᮇᚅ䛧䚸䝥䝻䝡䝅䝵䝘䝹䝺䝇䝖䝺䞊䝅䝵䞁䛾᝟ሗ䛿䜽䝻䝇䝬䜴䞁䝖䜢⾜䛖䛣䛸䛷ṇ☜䛻෌⌧䛥䜜䛯䚹䜰䞁䝔䝸䜰䝹䜺䜲䝎䞁䝇䛸ညྜᨭᣢ཮᪉䛻ၥ㢟䛜䛒䜛ሙྜ䛻䛿ညྜᨭᣢ䛾ᅇ᚟䜢ඃඛ䛧䚸䝥䝻䝡䝅䝵䝘䝹䝺䝇䝖䝺䞊䝅䝵䞁䜢⏝䛔䛶䜰䞁䝔䝸䜰䝹䜺䜲䝎䞁䝇䜢ᶍ⣴䛩䜛䛣䛸䛜ຠᯝⓗ䛷䛒䜛䛸⪃䛘䜙䜜䛯䚹㻌
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䝫䝇䝍䞊Ⓨ⾲㻌 㻼㻙㻞㻤㻌㻌ᨭྎ⠏㐀䛛䜙䜽䝷䜴䞁⿦╔䜎䛷䛾඲䛶䛾⮫ᗋ䛚䜘䜃ᢏᕤ᧯స㻌A Case report of prosthetic treatment with cast post core and cast crown handled by a dental intern䕿⚟⏣ె⧊䠍㻕㻘ᡞᮌ㻌 ᪂ 㻝㻕㻘⸨ཎ㻌 ༓ᬗ䠍㻕㻘ྂᆅ⨾ె 㻞㻕㻘➉ෆ⩏┿ 㻞㻕㻌㻘㰻⸨㑥Ꮚ 㻞㻕㻘㛵㻌 ၨ௓ 㻞㻕㻘⣬ᮏ㻌 ⠜ 㻞㻕㻌᪥ᮏ኱ᏛṑᏛ㒊௜ᒓṑ⛉⑓㝔㻌㻌㻘᪥ᮏ኱ᏛṑᏛ㒊㝃ᒓṑ⛉⑓㝔⣔༞┤ᚋ◊ಟศ㔝 㻞㻌㻌
ࠐKaori Fukuda1), Arata Toki1), Chiaki Fujiwara1), Mika Furuchi2), Yoshimasa Takeuchi2), Kuniko Saito2), Keisuke Seki2),
Atsushi Kamimoto2)
Nihon University School of Dentistry Dental Hospital1),
Nihon University School of Dentistry Dental Hospital General Practice Residency2)䛆⥴ゝ䛇㻌඲㒊㔠ᒓෙཬ䜃⠏㐀య⬺㞳䛷᮶㝔䛥䜜䛯ᝈ⪅䛻ᑐ䛧䚸ᨭྎ⠏㐀䛛䜙඲㒊㔠ᒓෙ⿦╔䜎䛷䛾⮫ᗋ䛚䜘䜃ᢏᕤ᧯స䜢⾜䛳䛯䚹⮫ᗋ䛸ᢏᕤ䛾᧯స䜢㏻䛨䛶⩦ᚓ䛧䛯Ⅼ䛻䛴䛔䛶ሗ࿌䛩䜛䚹㻌䛆⑕౛䛾ᴫせ䛇㻌ᝈ⪅䛿 㻞㻞 ṓ⏨ᛶ䚹ୗ㢡ᕥഃ➨஧ᑠ⮻ṑ䛾඲㒊㔠ᒓෙ䛚䜘䜃⠏㐀య⬺㞳䛷᮶㝔䛧䛯䚹඲㒊㔠ᒓෙ䛿 㻟 ᖺ๓䛻᯾ṑ⛉་㝔䛷⿦╔䛥䜜䚸㻟 ᪥๓䛻⬺㞳䛧䛯䚹ᝈṑ䛻ᡴデ③䛺䛹䛾⮫ᗋ⑕≧䛿䜏䜙䜜䛺䛔䚹ឤᰁ᰿⟶ฎ⨨ᚋᨭྎ⠏㐀䜢⾜䛔䚸඲㒊㔠ᒓෙ䜢⿦╔䛩䜛ィ⏬䛸䛧䚸඲䛶䛾ᢏᕤ᧯స䜢ᣦᑟ་䛸ᢏᕤኈ䛾ᣦᑟ䛾ୗ䚸⮬㌟䛷⾜䛳䛯䚹㻌䛆἞⒪ෆᐜ䛇㻌㻌 ឤᰁ᰿⟶἞⒪㛤ጞ䛛䜙 㻞 㐌㛫ᚋ䛻᰿⟶඘ሸ䚸❐Ὕᙧᡂ䛚䜘䜃༳㇟᥇ᚓ䜢⾜䛔䚸㗪㐀య䛻䜘䜛⠏㐀䜢⾜䛳䛯䚹ᝈṑ䛿㐲ᚰᐤ䜚䛻᳜❧䛧䛶䛔䜛䛯䜑䚸㐲ᚰ㍈㠃䛾๐㝖䜢ከ䜑䛻䛩䜛䛣䛸䛷䚸⿦╔䛩䜛඲㒊㔠ᒓෙ䛾ཌ䜏䜢☜ಖ䛧䛯䚹⠏㐀ᚋ䚸䝥䝻䝡䝆䝵䝘䝹䝺䝇䝖䝺䞊䝅䝵䞁䜢⿦╔䛧䚸㻞 㐌㛫ᚋ䛻⢭ᐦ༳㇟᥇ᚓ䜢⾜䛳䛯䚹ṑᆺྍ᧔ᘧᶍᆺୖ䛷䜝䛖ᆺᙧᡂ䛧䚸㻝㻞㻌 㻑㔠㖟䝟䝷䝆䜴䝮ྜ㔠䛻䛶㗪㐀䜢⾜䛳䛯䚹᏶ᡂ䛧䛯඲㒊㔠ᒓෙ䛿ヨ㐺ᚋ䛻௬╔䛧䚸㻝 㐌㛫ᚋ䛻ྜ╔䛧䛯䚹⌧ᅾ䚸⤒㐣䛿Ⰻዲ䛷䛒䜛䚹㻌䛆⤖ㄽ䛚䜘䜃⪃ᐹ䛇㻌୍㐃䛾᧯స䜢㏻䛨䛶Ẽ䛵䛔䛯䛣䛸䜢௨ୗ䛻♧䛩䚹⠏㐀య䛻䛴䛔䛶䛿䚸᏶ᡂ䛩䜛඲㒊㔠ᒓෙ䛾ᙧែ䜢᝿ᐃ䛩䜛䛣䛸䛜㔜せ䛷䛒䜛䚹䛭䜜䛿䚸ᑐည㛵ಀ䚸ᝈṑ䛾᳜❧఩⨨䚸೫ᚰ㐠ື᫬䛾ᑐྜṑ䛸䛾㛫㝽䚸㞄ᅾṑ䛸䛾㊥㞳➼䜢⪃៖䛧䚸඲㒊㔠ᒓෙ䛾ཌ䜏䜢☜ㄆ䛩䜛䛯䜑䛷䛒䜛䚹䜎䛯㔠ᒓෙ䛾䜝䛖ᆺᙧᡂ䜢⾜䛔ண䜑ᝈṑ䛾᥋ゐ≧ែ䜢▱䜛䛣䛸䛷䚸ཱྀ⭍ෆ䛷䛾᪋⾡᫬㛫䜢▷⦰䛩䜛䛣䛸䛜䛷䛝䛯䚹㻌
㧗㱋໬䛜㐍䜐䛻క䛔⿵⥛἞⒪䛾䝙䞊䝈䜒ቑຍ䛩䜛䛸ண 䛥䜜䜛䚹䜘䜚Ⰻ䛔⿵⥛⿦⨨䜢〇స䛩䜛䛻䛒䛯䜚䚸ṑ⛉་ᖌ䛿ᢏᕤኈ䛻ᝈ⪅ᅛ᭷䛾᝟ሗ䜢ఏ䛘䚸ᣦ♧䛩䜛ᚲせ䛜䛒䜛䚹ᢏᕤ᧯స䜢య㦂䛩䜛䛣䛸䛷䚸⮫ᗋ䛻䛚䛡䜛ὀព஦㡯䜢Ꮫ䜆䛰䛡䛷䛺䛟䚸ᢏᕤኈ䜈䛾ⓗ☜䛺ᣦ♧䜒⾜䛔䜔䛩䛟䛺䜚䚸䝏䞊䝮་⒪䛾ྥୖ䛻䜒䛴䛺䛜䜛䛸ᛮ䜟䜜䛯䚹㻌
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䝫䝇䝍䞊Ⓨ⾲㻌 㻼㻙㻞㻥㻌㻌ᝈ⪅୰ᚰ䛾་⒪䜢ᐇ㊶䛩䜛Ⅽ䛻ᝈ⪅䛾ゎ㔘䝰䝕䝹䜢ᘬ䛝䛰䛩䛣䛸䜢┠ⓗ䛸䛧䛯䝒䞊䝹䜢౑⏝䛧䛯⑕౛㻌
A case of using tool aiming at leading the patient's explanatory model in order to practice patient-centered dental treatment㻌䕿ᒣᙧ࿴ᘯ 㻝㻕㻘㻌 ὸぢᣅဢ 㻝㻕㻘㻌 ⚄㈡⫕Ꮚ䠎䠅㻘㻌 ᱓㏕⩧Ꮚ䠎䠅㻘㻌 ຾㒊┤ே 㻝㻕㻘㻌 㛗㇂ᕝ⠜ྖ 㻝㻕㻌᫛࿴኱ᏛṑᏛ㒊㻌 ṑ⛉ಖᏑᏛㅮᗙ㻌 ⥲ྜデ⒪ṑ⛉Ꮫ㒊㛛 㻝㻕㻘㻌 ᫛࿴኱ᏛṑᏛ㒊㻌 Ꮫ⏕䠎䠅㻌
䕿Kazuhiro Yamagata, Takuya Asami, Hatsuko Kamiga, Shoko Kuwasako, Naoto Katsube, Tokuji Hasegawa
Department of Conservative Dentistry, Division of Comprehensive Dentistry, Showa University School of Dentistry1),
Showa University School of Dentistry2)䛆⥴ゝ䛇㻌⥲ྜデ⒪䜢ᡂຌ䛥䛫䜛䛯䜑䛻䛿ཱྀ⭍ෆ඲య䛾ၥ㢟䛻ᑐ䛩䜛せᅉ䛾㝖ཤ䜢ྵ䜑ᝈ⪅䜢඲ேⓗ䛻ᤊ䛘἞⒪䛩䜛䛣䛸䛜㔜せ䛷䛒䜛䚹㻌
ᮏሗ䛷䛿䚸ᝈ⪅᝟ሗ䜰䞁䜿䞊䝖䛻䜘䜚䚸᭷ຠ䛺་⒪᝟ሗ䠄ညྜ⩦Ⓑ䠅䜢ᚓ䜛䛣䛸䛜䛷䛝䛯䛣䛸䛷䚸ಟ᚟≀⬺㞳䛻ᑐ䛧䛶༑ศ䛺䜶䝡䝕䞁䝇䛻ᇶ䛵䛔䛯ᝈ⪅ㄝ᫂䜢ᐇ᪋䛧䚸㐺䛧䛯ಟ᚟≀䜢㑅ᢥ䛧䛯⑕౛ሗ࿌䛛䜙䚸⥲ྜデ⒪䜢⪃ᐹ䛩
䜛䚹㻌
䛆⑕౛䛇㻌
ᝈ⪅䛿 㻞㻣 ṓዪᛶ䚸③䛛䛳䛯ṑ䛾἞⒪䛾⥆䛝䜢䛧䛶ḧ䛧䛔䛣䛸䜢୺ッ䛸䛧䛶᮶㝔䛧䛯䚹㻌㏆ᡤ䛾ṑ⛉䛻䛶୺ッ䛾ྑୗ㻤䛾㱘⼃䛻ᛂᛴฎ⨨䛸䛧䛶௬ᑒ䜢䛧䚸ྑୖ㻢㻘㻣㻌 ᕥୗ㻢䛾䊠⣭❐Ὕ䜲䞁䝺䞊䛾⬺㞳䛻ᑐ䛧௬ᑒ䛥䜜䛯≧ែ䛷䛒䛳䛯䚹ึ᪥䛿ཱྀ⭍ෆデᰝ䜢ᐇ᪋䛧䚸ᝈ⪅䛾ཷデືᶵ➼䜢䜘䜚Ⰻ䛟ᢕᥱ䛩䜛┠ⓗ䛷ᝈ⪅᝟ሗ䜰䞁䜿䞊䝖䜢Ώ䛧䚸⮬Ꮿ䛻䛶ゎ⟅䛧䛶䜒䜙䛳䛯䚹䛩䜛䛸䚸㉳ᗋ᫬䛾㢡䛾⑂䜜䜢ッ䛘䛶䛔䜛䛣䛸䛜ᝈ⪅᝟ሗ䜰䞁䜿䞊䝖䛾グ㍕䛛䜙ศ䛛䛳䛯䚹䛭䛣䛷䛥䜙䛻ヲ⣽䛻ཱྀ⭍ෆデᐹ䜢ᐇ᪋䛧䛯䛸䛣䜝඲㢡ⓗ䛻ṑ⫗⅖䛾≧ែ䛷๓ṑ㒊䛻㦵Ḟᦆ䛜⏕䛨䛶䛚䜚䚸ᆶ┤ⓗ䛺㦵྾཰䜔ṑ᰿⭷⭍䛾ᣑ኱䛜ぢ䜙䜜ཱྀ⭍ෆᡤぢ䛸䛧䛶䜒㦵㝯㉳䛜䜏䜙䜜䜛䛣䛸䛜᫂䜙䛛䛻䛺䜚䚸ညྜ⩦Ⓑ䛜ᙉ䛟␲䜟䜜䛯䚹㻌䛆デ᩿䚸἞⒪᪉㔪䛇㻌ṑ࿘ᇶᮏ἞⒪⤊஢ᚋ䚸ညྜ⩦Ⓑ䛻ᑐ䛧ᬯ♧⒪ἲ䜢⾜䛳䛶ᝈ⪅䛾⮬ぬ⑕≧䛜㍍ῶ䛧䛯䛣䛸䜢☜ㄆ䛧䛶䛛䜙୺ッ䛷䛒䜛ྑୗ 㻤 䛾௬ᑒ㝖ཤ䛧㱘⼃㝖ཤᚋ 㻯㻾 ಟ᚟䜢⾜䛔䚸䛭䛾ᚋ䚸䊠⣭❐Ὕ䜲䞁䝺䞊⬺㞳㒊ศ䛻ᑐ䛧 㻯㻾 ඘ሸ䜢⾜䛳䛯䚹ṑෙಟ᚟䛻䜘䜛ညྜᅇ᚟ᚋ䚸ᚲせ䛜䛒䜜䜀ᝈ⪅䛸┦ㄯ䛾ୖ䝘䜲䝖䜺䞊䝗స〇䜢⪃䛘䛶䛔䜛䚹㻌䛆⤖ᯝ䛸⪃ᐹ䛇㻌デᰝデ᩿䛻䜘䜚ᚓ䛯᝟ሗ䛛䜙せᅉ䚸἞⒪᪉㔪䜢ᢳฟ䛩䜛䛰䛡䛷䛿䛺䛟䚸ᝈ⪅䛾ཱྀ⭍ෆ䛻ᑐ䛩䜛Ẽᣢ䛱䜢⌮ゎ䛩䜛䛣䛸䛜㔜せ䛷䛒䜛䚹㐺ᐅ䚸ᝈ⪅᝟ሗ䜰䞁䜿䞊䝖䜢ే⏝䛩䜛䛺䛹䛧䛶ᝈ⪅᝟ሗ⫈ྲྀ䛾ᶵ఍䜢䜘䜚ከ㠃ⓗ䛻䛩䜛䛣䛸䛷ᝈ⪅୰ᚰ䛾་⒪䜢ᒎ㛤䛩䜛䛣䛸䛜䛷䛝䚸⥲ྜ἞⒪䜢ᡂຌ䛻㏆䛵䛡䜛䛸⪃ᐹ䛧䛯䚹㻌 㻌 㻌 㻌 㻌 㻌 㻌 㻌
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䝫䝇䝍䞊Ⓨ⾲㻌 㻼㻙㻟㻜㻌㻌᫛࿴኱Ꮫṑ⛉⑓㝔⥲ྜデ⒪ṑ⛉䛻䛚䛡䜛⮫ᗋᐇ⩦㻌䠉୰➼ᗘṑ࿘⅖ᝈ⪅䛻ᑐ䛩䜛඲ேⓗ䛺䝸䝇䜽ホ౯䛻䜘䜛⥲ྜデ⒪ィ⏬❧᱌䠉
Comprehensive Dental Practice in Comprehensive Dentistry, Showa University Dental Hospital㸫Comprehensive dental treatment planning by holistic risk assessment to patient with moderate periodontitis㸫䕿⃝㇂♸኱ 㻝䠅㻘㻌 㰻⸨၏ 㻝䠅㻘㻌 ᒣᙧ࿴ᘯ 㻞㻕㻘㻌 ຾㒊┤ே 㻞㻕㻘㻌 㛗㇂ᕝ⠜ྖ 㻞㻕㻌᫛࿴኱ᏛṑᏛ㒊㻌 Ꮫ⏕ 㻝䠅㻘㻌 ᫛࿴኱ᏛṑᏛ㒊㻌 ṑ⛉ಖᏑᏛㅮᗙ㻌 ⥲ྜデ⒪ṑ⛉Ꮫ㒊㛛 㻞㻕㻌
䕿Yuta Sawatani, Yui Saito, Kazuhiro Yamagata, Naoto Katsube, Tokuji Hasegawa
Showa University School of Dentistry1)
Department of Conservative Dentistry, Division of Comprehensive Dentistry, Showa University School of Dentistry2)㻌䛆⥴ゝ䛇㻌㻌 ⥲ྜデ⒪ṑ⛉䛻䛚䛡䜛⮫ᗋᐇ⩦䛷䛿䚸⑌ᝈ䛾せᅉ䛻䜎䛷ゝཬ䛧䛯἞⒪ィ⏬❧᱌䜢ㄢ䛫䜙䜜䜛䚹୰➼ᗘ䛾ṑ࿘⅖䜢᭷䛩䜛ᝈ⪅䛻ᑐ䛧䛶⥲ྜ἞⒪ィ⏬❧᱌䛧䛯䛣䛸䛷䚸⑌ᝈ䜢ቑᝏ䛥䛫䜛䝸䝇䜽ホ౯䛾㔜せᛶ䜢Ꮫ䜉䛯䛾䛷ሗ࿌䛩䜛䚹㻌䛆⑕౛䛇㻌㻌 ᝈ⪅䛿 㻣㻡 ṓዪᛶ䚸୍㐌㛫๓䛛䜙㣗∦ᅽධ䛻క䛖ṑⱼ䛾③䜏䛸ညྜ③䜢୺ッ䛻᮶㝔䛧䛯䚹ṑ⛉䜈䛾ཷデ䛿 㻝㻡 ᖺ௨ୖ䛺䛛䛳䛯䚹㻼㻯㻾 䛿 㻥㻥䠂䚸䛻 㻠㼙㼙 ௨ୖ䛾ṑ࿘䝫䜿䝑䝖䚸㻢㻌㻣 䛻䛿 㻞 ᗘ䛾ືᦂ䚸㻤 䛻㱘❐䚸㻢㻣 㛫䛻䝁䞁䝍䜽䝖୙Ⰻ䜢ㄆ䜑䛯䚹䜎䛯䚸ཱྀ⵹㝯㉳䚸ୗ㢡㝯㉳䛜䜏䜙䜜䚸ᝈ⪅䛿䝤䝷䜻䝅䝈䝮䜢⮬ぬ䛧䛶䛔䛯䚹䜶䝑䜽䝇⥺෗┿䛷䛿䚸඲㢡ⓗ䛻ṑ᰿ 㻝㻛㻟 ௨ୖ䛾ṑᵴ㦵྾཰䚸㻤㻌㻣 䛻䛿᰿㠃㱘⼃ᵝ㏱㐣ീ䚸㏆ᚰṑᵴ㦵䛻䛿ᆶ┤ᛶ㦵྾཰䚸㻟 䛻䛿䜹䝑䝥≧㦵Ḟᦆ䜢ㄆ䜑䛯䚹㻌䛆デ᩿ཬ䜃἞⒪᪉㔪䛇㻌㻌 ୺ッ䛿㻤㻌㻣䛾ᛴᛶṑ࿘⅖䛷䛒䜚䚸䝁䞁䝍䜽䝖୙Ⰻ䛻䜘䜛㣗∦ᅽධ䚸䝥䝷䞊䜽䝁䞁䝖䝻䞊䝹୙Ⰻ䚸䝥䝷䞊䜽䝸䝔䞁䝅䝵䞁䝣䜯䜽䝍䞊䛸䛧䛶䛾᰿㠃㱘⼃䛸ṑ▼䚸ᕥഃ⮻ṑ㒊䛾᪩ᮇ᥋ゐཬ䜃ည㢌ᖸ΅䚸ཱྀ⭍⩦Ⓑ䛸⑌ᝈ䛻ᑐ䛩䜛ᝈ⪅䛾↓㛵ᚰ䛻䜘䜚ṑ࿘⅖䛜ቑᝏ䛧䛯䛸デ᩿䛧䛯䚹㻌
἞⒪᪉㔪䛸䛧䛶⑌ᝈ䛻ᑐ䛩䜛⌮ゎ䜢ಁ䛧ཱྀ⭍⾨⏕≧ែ䛾ᨵၿ䛻ດ䜑䚸ညྜㄪᩚ䜢⾜䛔䚸ᨵၿ☜ㄆᚋ䛻ညྜᨭᣢ䜢⪃៖䛧䛯ᬻ㛫⿵⥛䚸䛭䛧䛶᭱⤊⿵⥛䜈䛾⛣⾜䜢ィ⏬䛧䛯䚹㻌䛆⤖ᯝ䛸⪃ᐹ䛇㻌㻌 ⥭ᛴฎ⨨䛸䛧䛶ṑ⫗䛻ᑐ䛩䜛ᾘ⅖ฎ⨨䚸ညྜㄪᩚ䜢⾜䛳䛯ᚋ䚸ṑ࿘⅖䛾ቑᝏᅉᏊ䛻䛴䛔䛶༑ศ䛻᳨ウ䛫䛪䛻䚸ṑ▼䛾㝖ཤ䜢ඃඛ䛧䛯἞⒪䜢⥆䛡䛯䛸䛣䜝䚸ṑ࿘⅖䛾ᛴᛶ໬䜢⧞䜚㏉䛧䛯䚹䛭䛣䛷䚸ᝈ⪅䛾ṑ࿘⅖䛻㛵䛩䜛ቑᝏᅉᏊ䜢඲䛶ᢳฟ䛧䚸㔜せᗘ䛸⥭ᛴᗘ䜢஧ḟඖᒎ㛤䛥䛫᳨ウ䛧䛯⤖ᯝ䚸䜎䛪ညྜㄪᩚ䚸䝥䝷䞊䜽䝁䞁䝖䝻䞊䝹䛾ᨵၿ䛻ḟ䛔䛷䚸䝥䝷䞊䜽䝸䝔䞁䝅䝵䞁䝣䜯䜽䝍䞊䠄㱘⼃䚸୙Ⰻ⿵⥛≀䚸ṑ▼䠅䛾㝖ཤ䚸᭱ᚋ䛻ཱྀ⭍⩦Ⓑ䛾ᨵၿ䛾㡰䛻἞⒪䜢⾜䛖ィ⏬䜢෌❧᱌䛧䛯䚹㻌௒ᅇ䚸୰➼ᗘṑ࿘⅖䜢᭷䛩䜛ᝈ⪅䛾἞⒪ィ⏬❧᱌䛻䜘䜚䚸䝸䝇䜽ホ౯䛸䝸䝇䜽䝁䞁䝖䝻䞊䝹䛾㔜せᛶ䜢Ꮫ䜉䛯䚹㻌
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䝫䝇䝍䞊Ⓨ⾲㻌 㻼㻙㻟㻝㻌㻌་⒪㠃᥋䛻䛚䛔䛶ᛴᛶᬛṑ࿘ᅖ⅖䛸デ᩿䛩䜛䛯䜑䛻᭷ຠ䛺ゝㄒ᝟ሗ䛻䛴䛔䛶㻌The medical/dental interview for diagnosis of acute pericoronitis㻌䕿ఀ⸨Ꮥဢ㻝䠅㻘㨣ሯ༓⤮㻞䠅㻘㫽㉺㙾௦㻝䠅㻘⏕⏣᭷ᶞᏊ㻝䠅㻘Ọᯇᾈ㻞㻕㻘ᮌᑿဴᮁ㻞䠅㻌஑ᕞṑ⛉኱Ꮫ㻌 ṑᏛ㒊㻌 ṑᏛ⛉㻌 䠑ᖺ⏕㻝㻕䚸஑ᕞṑ⛉኱Ꮫ㻌 ⥲ྜデ᩿Ꮫศ㔝㻞㻕㻌
䕿Takaya Ito1), Chie Onizuka2), Akiyo Torigoe1), Yukiko Ikuta1), Hiroshi Nagamatsu2), Tetsuro Konoo2)
Kyushu Dental University, Division of Comprehensive Dentistry1),
Department of Oral Functions, Kyushu Dental University2)䛆┠ⓗ䛇㻌 㻌⮫ᗋᡤぢ䜔䜶䝑䜽䝇⥺෗┿ᡤぢ䜢㝖䛔䛯་⒪㠃᥋䛷཰㞟䛧䛯᝟ሗ䛾䜏䛷デ᩿䛷䛝䜛⑕౛䛿ᛴᛶᬛṑ࿘ᅖ⅖䛷䛿㻥㻞㻚㻥䠂䛻䛾䜌䜛䛸䛔䛖ඛ⾜◊✲㻝㻕䛜䛒䜛䜘䛖䛻䚸་⒪㠃᥋䛿デ᩿䝥䝻䝉䝇䛻኱䛝䛺ព⩏䜢ᣢ䛳䛶䛔䜛䚹௒ᅇ䛾◊✲䛾┠ⓗ䛿䚸་⒪㠃᥋䜢⾜䛖㝿䛻ᛴᛶᬛṑ࿘ᅖ⅖䛸䛔䛖デ᩿䛻⮳䜛䛯䜑䛻䛹䛾䜘䛖䛺᝟ሗ䛻ὀព䜢ᡶ䛘䜀Ⰻ䛔䛾䛛᫂䜙䛛䛻䛩䜛䛣䛸䛷䛒䜛䚹㻌䛆᪉ἲ䛇㻌 㻌஑ᕞṑ⛉኱Ꮫ㝃ᒓ⑓㝔䛾◊ಟṑ⛉་䠄௨ୗ◊ಟ་䠅㻣㻞ྡ䛸ཱྀ⭍እ⛉ᡤᒓṑ⛉་䠄௨ୗཱྀ⭍እ⛉་䠅㻤ྡ䛻䚸ᛴᛶᬛṑ࿘ᅖ⅖䛸䛔䛖デ᩿䛻⮳䜛䛯䜑䛻ᚲせ䛺་⒪㠃᥋䛾᝟ሗ䛻䛴䛔䛶䛾㑅ᢥᘧ䜰䞁䜿䞊䝖ㄪᰝ䜢⾜䛳䛯䚹䜰䞁䜿䞊䝖䛷䛿㻞㻜㡯┠䛛䜙ḧ䛧䛔᝟ሗ䜢㻝㻜㡯┠㑅䜀䛫䚸䛭䛾㻝㻜㡯┠䛻ඃඛ㡰఩䜢䛴䛡䛥䛫䚸䛭䛾㡰఩䜢䝫䜲䞁䝖໬䛧䛯䚹㻌䛆⤖ᯝ䛇㻌 㻌◊ಟ་䛷䛿䚸ᛴᛶᬛṑ࿘ᅖ⅖䛸䛔䛖デ᩿䛻⮳䜛䛯䜑䛻㔜せ䛷䛒䜛᝟ሗ䛿䚸䝫䜲䞁䝖䛾㧗䛔㡰䛻䛂ዟṑ䛾ṑⱼ䛜⭘䜜䛶䛔䜛䛃䚸䛂య 䛜ᖹ⇕䜘䜚䠍ᗘ௨ୖ㧗䛔䛃䚸䛂䝈䜻䝈䜻䛸ዟṑ䛜③䜐䛃䚸䛂ཱྀ䜢㛤䛡䜛䛣䛸䛜㎞䛔䛃䚸䛂䝸䞁䝟⠇䛜⭘䜜䛶䛔䜛䛃䛷䛒䛳䛯䚹䛭䜜䛻ᑐ䛧䚸ཱྀ⭍እ⛉་䛷䛿䛂ዟṑ䛾ṑⱼ䛜⭘䜜䛶䛔䜛䛃䚸䛂ႃ䛜⭘䜜䛶䛔䜛䛃䚸䛂ཱྀ䜢㛤䛡䜛䛣䛸䛜㎞䛔䛃䚸䛂ၚ䜢㣧䜏㎸䜐䛸③䛔䛃䚸䛂ṑ䛜ᇙ䜒䜜䛶䛔䜛䛃䛷䛒䛳䛯䚹㻌䛆⪃ᐹ䛇㻌 㻌ᛴᛶᬛṑ࿘ᅖ⅖䛿䚸᪩ᮇẁ㝵䛷䛿ᬛṑ㒊䜢୰ᚰ䛸䛩䜛⑊③䜔⭘⬽䛜㉳䛣䜛䛜䚸㐍⾜䛧䛶⅖⑕䛜㢋ഃ䛻Ἴཬ䛩䜛䛸ᢿື③䜢࿊䛧䚸᭦䛻䛿㧗ᗘ䛺㛤ཱྀ㞀ᐖ䜢ᘬ䛝㉳䛣䛩䚹䜎䛯䚸⅖⑕䛜⯉ഃ䛛䜙ဗ㢌᪉ྥ䜈䚸䛭䛧䛶⯉ୗ㝽䜔㢡ୗ㝽䛻䜎䛷Ἴཬ䛩䜛䛸䚸ᄟ
ୗ③䚸㛤ཱྀ㞀ᐖ䚸䜎䛯ဗ㢌㒊䛾Ⓨ㉥⭘⬽䛺䛹䛾⑕≧䜢ᘬ䛝㉳䛣䛩䛣䛸䛜ከ䛔䚹㻌ᬛṑ࿘ᅖ⅖䛸デ᩿䛩䜛䛯䜑䛻䛿䚸◊ಟ་䛷䛿䚸⅖⑕⑌ᝈ䛾஬኱ᚩೃ䛻㛵㐃䛧䛯᝟ሗ䛜ඃඛ㡰఩䛸䛧䛶ୖ఩䜢༨䜑䛯䛜䚸ཱྀ⭍እ⛉་䛷䛿䚸⑕≧䛜ᝏ໬䛧䛯≧ែ䚸⅖⑕䛜⯉ୗ㝽䜔㢡ୗ㝽䛺䛹䛻Ἴཬ䛧䛯≧ែ䜢᝿ᐃ䛧䛯᝟ሗ䜢㔜せど䛧䛶䛔䜛䛣䛸䛜䜟䛛䛳䛯䚹㻌䛆ᘬ⏝ᩥ⊩䛇㻌
䠍䠅ᰩཎ┤அ㻘㻌 ᗉྖ㻌 ᠇᫂௚䠖ṑ③䛻㛵䛩䜛デ᩿Ꮫⓗ◊✲䠄㼂㻵㻵䠅㻌 ṑ③デ᩿䛻䛚䛡䜛ၥデ䛾㔜せᛶ㻌 ᪥ᮏཱྀ⭍デ᩿Ꮫ఍㞧ㄅ㻌➨㻝㻤ᕳ㻌 ➨㻞ྕ㻞㻠㻞㻙㻞㻞㻠㻘㻞㻜㻜㻡㻌

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䝫䝇䝍䞊Ⓨ⾲㻌 㻼㻙㻟㻞㻌㻌᫛࿴኱Ꮫṑ⛉⑓㝔⥲ྜデ⒪ṑ⛉䛻䛚䛡䜛⮫ᗋᐇ⩦㻌䠉䜶䝡䝕䞁䝇䛻ᇶ䛵䛟἞⒪ィ⏬❧᱌䠉㻌Comprehensive Dental Practice in Comprehensive Dentistry, Showa University Dental HospitalʊComprehensive dental treatment planning based on evidenceʊ㻌䕿㨣୸⨾⳯Ꮚ 㻝䠅㻘㻌 ➟ཎ⏤㤶 㻝䠅㻘㻌 ྜྷ✚⮫ኴ㑻 㻞㻕㻘㻌 ຾㒊┤ே 㻞㻕㻘㻌 㛗㇂ᕝ⠜ྖ 㻞㻕㻌᫛࿴኱ᏛṑᏛ㒊㻌 Ꮫ⏕ 㻝䠅㻘㻌 ᫛࿴኱ᏛṑᏛ㒊㻌 ṑ⛉ಖᏑᏛㅮᗙ㻌 ⥲ྜデ⒪ṑ⛉Ꮫ㒊㛛 㻞㻕㻌
䕿Minako Onimaru, Yuka Kasahara, Rintaro Yoshizumi, Naoto Katsube, Tokuji Hasegawa
Showa University School of Dentistry1),
Department of Conservative Dentistry, Division of Comprehensive Dentistry, Showa University School of Dentistry2)䛆⥴ゝ䛇㻌᫛࿴኱ᏛṑᏛ㒊䛷䛿Ꮫ⏕䛻ᑐ䛧䛶䚸ṑ⛉་ᖌ䛸䛧䛶䛾㈐ົ䜢⮬ぬ䛧䝥䝻䝣䜵䝑䝅䝵䝘䝹䛸䛧䛶䚸▱㆑䚸ᢏ⾡䛸䜒䛻⮬䜙䛾◊㛑䛻ᑓᚰ䛧䚸㧗䛔⾜ືᇶ‽䜢䜒䛳䛯ᑓ㛛ᐙ䜢⫱ᡂ䛧䛶䛔䜛䚹䛣䛖䛧䛯ᩍ⫱┠ᶆ䛛䜙䚸⥲ྜデ⒪ṑ⛉䛷䛿Ꮫ⏕䛜⮬䜙་⒪㠃᥋䜢⾜䛔἞⒪ィ⏬❧᱌䛧ᝈ⪅䛻஢ᢎ䜢ᚓ䜛䜎䛷䛾䝥䝻䝉䝇䜢ᐇᆅ䛩䜛䜘䛖ᮏᖺᗘ䜘䜚⮫ᗋᐇ⩦䜢ᨵኚ䛧䛯䚹㻌㻌 ᮏሗ䛷䛿䚸⥲ྜデ⒪ṑ⛉䛾⮫ᗋᐇ⩦䛻䛚䛔䛶䚸䜶䝡䝕䞁䝇䛻ᇶ䛵䛔䛯ṑ⛉་⒪䛾ᐇ㊶䜢┠ⓗ䛸䛧䛯⥲ྜ἞⒪ィ⏬❧᱌䜢⾜䛳䛯䛾䛷ሗ࿌䛩䜛䚹㻌䛆⑕౛䛇㻌ᝈ⪅䛿ึデ᫬ 㻢㻢 ṓ䛾⏨ᛶ䚸㝡ᮦ↝䛝௜䛡㗪㐀ෙ㻔௨ୗ 㻹㻮 䛸䛩䜛㻕⬺㞳䜢୺ッ䛻᮶㝔䛧䛯䚹ᙜヱ⿵⥛≀䛿 㻡㻜 ᖺ⛬๓䛻⿦╔䛧䚸୍ᖺ๓䛻⬺㞳䛻Ẽ䛵䛔䛯䛜ᨺ⨨䛧䛶䛔䛯䚹䜎䛯䚸௙஦䛾㒔ྜ䛻䜘䜚 㻟 䜹᭶ᚋ䛻἞⒪䜢୍᫬୰᩿䛧䛺䛡䜜䜀䛺䜙䛺䛛䛳䛯䚹㻌୺ッ䛾㻌 㻌 㻡 䛿 㻹㻮 ⬺㞳䚸㻠㻌 㻌 㻢 䛾 㻹㻮 ◚ᦆ䚸ኳ↛ṑ䛾 㻡㻝㻌 㻌 㻠㻢 䛻ည㢌䛾୍㒊◚ᢡ䛜䜏䜙䜜䛯䚹䜎䛯䚸๓ṑ㒊䛻ည⪖䚸ཱྀ⵹㝯㉳䚸ୗ㢡㝯㉳䚸㢋ᅽ⑞䛸⯉ᅽ⑞䚸䜶䝑䜽䝇⥺䜘䜚୰⛬ᗘ䛾㦵྾཰䛸ṑ᰿⭷⭍䛾ᣑ኱䜢ㄆ䜑䚸䝤䝷䜻䝅䝈䝮䛜␲䜟䜜䛯䚹㻌἞⒪᪉㔪䛸䛧䛶ṑ࿘⑓䛾㐍⾜䛸᰿㠃䜹䝸䜶䝇䛾ண㜵䜢┠ⓗ䛸䛧䛯ཱྀ⭍⾨⏕ᣦᑟ䜢⾜䛔䚸㻟 䛛᭶ᚋ䛾୰᩿䜎䛷䛻㻌 㻡䚸䛭䛾ᚋ㻠㻌 䛸 㻢㻌 䛾෌⿵⥛䜢⾜䛖䛣䛸䛸䛧䛯䚹㻌἞⒪ィ⏬❧᱌䛻䛚䛔䛶䛄䝤䝷䜻䝅䝈䝮䛾䛒䜛ᝈ⪅䛻 㻹㻮 䛷⿵⥛䛩䜛䛸㔠ྜ㔠䛻ẚ䜉䛶๭䜜䛯䜚䛧䛺䛔䛾䛛䛅䛸䛔䛖⮫ᗋⓗ␲ၥ䛜⏕䛨䛯䚹ᩥ⊩᳨⣴䛻䜘䜚㔠ྜ㔠඲㒊㗪㐀ෙ䛸 㻹㻮 䛷䛾⮫ᗋⓗணᚋ䛻ᕪ䛿ㄆ䜑䜙䜜䛺䛔䛸䛔䛖ሗ࿌䛜䛒䛳䛯䛜䚸䝤䝷䜻䝅䝈䝮䛾䛒䜛ᝈ⪅䛻䛿㻹㻮䛿⚗ᚷ䛸䛩䜛᭩ぢ䜒䜏䜙䜜䛯䚹ᮏ⑕౛䛿᪤Ꮡ䛾㻹㻮䛾◚ᢡ䛜䛒䜚䚸ᝈ⪅䛜ᑂ⨾ᛶ䜢㔜せど䛧䛶䛔䛺䛛䛳䛯䛯䜑 㻹㻮 䛷䛿䛺䛟䚸඲㒊㗪㐀ෙ䜢㑅ᢥ䛩䜛䛣䛸䛸䛧䛯䚹㻌䛆⤖ᯝ䛚䜘䜃⪃ᐹ䛇㻌㔠ྜ㔠඲㒊㗪㐀ෙ䛾⿦╔䛻䜘䜚ᝈ⪅䛾‶㊊䜢☜ㄆ䛧䛯䚹᭱Ⰻ䛾䜶䝡䝕䞁䝇䚸ᝈ⪅䛾ᕼᮃ䛸ᥦ౪ྍ⬟䛺⮫ᗋ⾡ᘧ䛛䜙ពᛮỴᐃ䛧἞⒪ィ⏬❧᱌䛩䜛䛣䛸䛾㔜せᛶ䜢Ꮫ䜉䛯䚹㻌
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䝫䝇䝍䞊Ⓨ⾲㻌 㻼㻙㻟㻟㻌㻌་⒪㠃᥋䛻䛚䛡䜛㠀ゝㄒ䝁䝭䝳䝙䜿䞊䝅䝵䞁䛾ᙺ๭㻌 㻌 㻌 㻌 㻌 䠉䛂䛖䛺䛪䛝䛃䛸䛂㛫䛃䛻䛴䛔䛶䠉㻌
Role of the nonverbal communication in the medical/dental interview䕿㫽㉺㙾௦㻝䠅㻘⏕⏣᭷ᶞᏊ㻝䠅㻘㨣ሯ༓⤮㻞䠅㻘ఀ⸨Ꮥဢ㻝䠅㻘Ọᯇᾈ㻞㻕㻘ᮌᑿဴᮁ㻞䠅㻌஑ᕞṑ⛉኱Ꮫ㻌 ṑᏛ㒊㻌 ṑᏛ⛉㻌 䠑ᖺ⏕㻝㻕㻘஑ᕞṑ⛉኱Ꮫ㻌 ⥲ྜデ᩿Ꮫศ㔝㻞㻕㻌䕿Akiyo Torigoe1), Yukiko Ikuta1), Chie Onizuka2), Takaya Ito1), Hiroshi Nagamatsu2) , Tetsuro Konoo2)

Kyushu Dental University, Division of Comprehensive Dentistry1),
Department of Oral Functions, Kyushu Dental University2)䛆┠ⓗ䛇㻌㻯㼛㼔㼑㼚㻌 㻯㼛㼘㼑 䛿་⒪㠃᥋䛾┠ⓗ䛸䛧䛶䚸་⒪᝟ሗ䛾཰㞟䚸ಙ㢗㛵ಀ䛾ᵓ⠏䚸ᝈ⪅ᩍ⫱䛸ືᶵ䛵䛡䜢ᣲ䛢䛶䛔䜛䚹ᝈ⪅䛾་⒪⪅䛻ᑐ䛩䜛ಙ㢗ᗘ䛜㧗䛟䛺䜛䛯䜑䛻䛿䚸䛣䜜䜙䛾་⒪㠃᥋䛾┠ⓗ䛜㐩ᡂ䛥䜜䜛䛣䛸䛜ᚲせ䛷䛒䜛䛸ᛮ䜟䜜䜛䚹䝁䝭䝳䝙䜿䞊䝅䝵䞁䛾 㻢㻡䠂䛿㠀ゝㄒ䛻䜘䛳䛶ఏ䛘䜙䜜䛶䛔䜛䛸䛥䜜䛶䛔䜛䛣䛸䛛䜙䚸㠀ゝㄒ䝁䝭䝳䝙䜿䞊䝅䝵䞁䛜ಙ㢗㛵ಀ䛾☜❧䛻୚䛘䜛ᙳ㡪䛿኱䛝䛔䛸⪃䛘䜙䜜䜛䚹ᮏ◊✲䛾┠ⓗ䛿㠀ゝㄒ䝁䝭䝳䝙䜿䞊䝅䝵䞁䚸䛭䛾䛺䛛䛷䜒≉䛻䛂䛖䛺䛪䛝䛃䛸䛂㛫䠄䜎䠅䛃䛻ὀ┠䛧䚸䛣䜜䜙䛾䝍䜲䝭䞁䜾䛾┦㐪䛜་⒪㠃᥋䛻୚䛘䜛ᙳ㡪䛻䛴䛔䛶䛭䜜䛮䜜᫂䜙䛛䛻䛩䜛䛣䛸䛻䛒䜛䚹㻌䛆᪉ἲ䛇㻌䠄ᐇ㦂䐟䠅ᝈ⪅㻙ṑ⛉་ᖌ䛾ึデ᫬་⒪㠃᥋䜢᝿ᐃ䛧䚸ṑ⛉་ᖌ䛾䛂䛖䛺䛪䛝䛃䛾⟠ᡤ䛾䜏␗䛺䜛䠏䛴䛾ື⏬䜢సᡂ䛧䛯䚹㻌䠄ᐇ㦂䐠䠅ᝈ⪅㻙ṑ⛉་ᖌ䛾ึデ᫬་⒪㠃᥋䜢᝿ᐃ䛧䛯䚸ᝈ⪅䛾Ⓨヰ䛻ᑐ䛧䛶ṑ⛉་ᖌ䛾ᛂ⟅䜢㛤ጞ䛩䜛᫬㛫䠄䛂㛫䛃䠅䛾䜏䛜␗䛺䜛㡢※䜢సᡂ䛧䛯䚹㻌䠄ᐇ㦂䐟䛚䜘䜃䐠䠅Ꮫ⏕䛚䜘䜃ᕷẸ䜢ᑐ㇟䛸䛧䛯㑅ᢥᘧ䜰䞁䜿䞊䝖ㄪᰝ䜢⾜䛳䛯䠄䐟䛿㻥㻞ே䚸䐠䛿㻝㻜㻠ே䠅䚹䐟䛷䛿䚸ື⏬䛾ど⫈⪅䛻ᑐ䛧䚸ຠᯝ䛾䛒䜛䛂䛖䛺䛪䛝䛃䛻䛴䛔䛶㡰఩䜢䛴䛡䛥䛫䛯䚹䐠䛷䛿䚸఍ヰ䛾䛂㛫䛃䛜⮬↛䛷䛒䜛䛛ホ౯䛩䜛䛸䛔䛖䜰䞁䜿䞊䝖ㄪᰝ䜢⾜䛳䛯䚹㻌䛆⤖ᯝ䛇㻌䐟䛂ᝈ⪅䛜ヰ䛧ጞ䜑䛯┤ᚋ䛃䛜䚸ዲ䜎䛧䛔䛂䛖䛺䛪䛝䛃䛾⟠ᡤ䛷䛒䜛䛸䛔䛖ᅇ⟅䛜᭱䜒ከ䛟 㻡㻣 ྡ䛷䛒䛳䛯䚹䐠᭱䜒⮬↛䛷䛒䜛䛸ឤ䛨䜛఍ヰ䛾䛂㛫䛃䛿䠍⛊䛷䛒䛳䛯䚹ḟ䛿 㻜㻚㻡 ⛊䛷䛒䛳䛯䚹㻌䛆⪃ᐹ䛇㻌ᝈ⪅䛾఍ヰ㛤ጞ᫬┤ᚋ䛾䛂䛖䛺䛪䛝䛃䛾ホ౯䛜㧗䛛䛳䛯䛾䛿䚸ᝈ⪅䛜ṑ⛉་ᖌ䛻⪺䛔䛶䜒䜙䛘䛶䛔䜛䛸ឤ䛨䜔䛩䛔䛯䜑䛰䛸⪃䛘䜙䜜䜛䚹䜎䛯䚸ᝈ⪅䛜⑕≧䜢ッ䛘䛯ᚋ䛻ṑ⛉་ᖌ䛜ᛂ⟅䜢㛤ጞ䛩䜛᫬㛫䛿䠍⛊䛜᭱䜒ホ౯䛜㧗䛟䛭䜜䜘䜚▷䛟䛶䜒㛗䛟䛶䜒ホ౯䛜ୗ䛜䜛䛣䛸䛜䜟䛛䛳䛯䚹䛣䛾䛣䛸䛛䜙఍ヰ䛾ᛂ⟅㛤ጞ᫬㛫䛻䜘䜚ᝈ⪅䛾༳㇟䛜␗䛺䜛䛣䛸䛜♧၀䛥䜜䛯䚹㻌
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