Improvement of Visiting Dental Care System in Dental-Medically Underserved Islands

丰岛村由位于日本西南海上的七个孤岛组成，也是牙科医疗服务不足的地区。由于乘坐轮船到最近的牙科诊所需要8个多小时，居民很难获得足够的牙科服务。此外，居民的老龄化使他们更难以走出岛屿去看牙医。因此，他们期望每年进行两次牙科检查。然而，由于牙科工作人员无法在一个岛上停留2天以上，而且进行常规治疗的器械和材料不足，以往的修复治疗大多是临时和临时的。在本研究中，我们开发了一些新的修复治疗方法，并对其进行了临床评估，以提高牙科就诊质量，延长修复体的寿命。评价的方法如下：1。用于修复活动义齿的加固系统、现成的搭扣和粘接修复树脂。2. 空气颗粒研磨用粉盒式和便携式喷砂机。3. 金属核基牙的表面处理，以加强更换后冠的固位。4. 新型粘接树脂牙本质涂层。5. 使用新型间接复合材料的无金属修复。6. 树脂粘接固定局部义齿采用复合义齿桥。7. 治疗器械的安全性和功能性运输。根据结果，发现这些方法对于在牙科医疗服务不足的岛屿上进行牙科护理是有效的。建议这些方法和材料可用于城市地区的牙科就诊。

Toshima Village consists of seven isolated islands located on southwest sea of Japan and it is also dental-medically underserved area. The residents are inconvenienced to receive sufficient dental service since it takes more than 8 hours by ship to visit the closest dental clinic. Additionally, aging of residents makes it more difficult for them to go out islands and see a dentist. Therefore, they expect a visiting dental care that is performed two times a year. However, most of prosthodontic treatments in previous cares have resulted in temporary and interim ones because dental staff could not stay at one island for more than 2 days, and instruments and materials were insufficient to do conventional treatments. In this study, some new prosthodontic treatment methods were developed and evaluated clinically to improve the quality of visiting dental care and enhance the longevity of restorations. The methods evaluated were as follows: 1. Reinforcing systems, ready-made clasps and adhesive repair resins for repairing removable denture. 2. Air-particle abrasion with cartridge-type and portable sandblaster. 3. Surface treatment of abutment tooth with metal-core to enhance retention of replaced crown. 4. Dentin coating with new bonding resin. 5. Metal-free restorations using new indirect composites. 6. Resin-bonded fixed partial denture using composite denture teeth pontic. 7. Safety and functional transportation of instruments for treatment. Based upon the results, it was found that these methods were effective for visiting dental care in dental-medically underserved islands. It was also suggested that these methods and materials could be available for visiting dental care in urban area.