PURPOSE: . This study evaluated the fracture resistance of premolar screwretained implant-supported hybrid abutment crowns (HACs) fabricated from different monolithic restorative materials following artificial aging. MATERIALS AND METHODS: . Forty-four titanium implant analogs were restored with HACs fabricated from four materials: 5 mol% yttria-partially stabilized monolithic zirconia (ST), strength-gradient multilayered zirconia (YM), lithium disilicate ceramic (LD), and resin composite containing dispersed nanoparticles (CM) (n = 11 per group). All specimens were subjected to thermocycling (10,000 cycles) and mechanical loading (1.2 million cycles) to simulate 5 years of clinical service.Fracture resistance was evaluated under compressive loading, and failure modes were analyzed using optical microscopy and scanning electron microscopy.Statistical analysis was performed using the Kruskal-Wallis and Steel-Dwass tests (α = 0.05). RESULTS: . Significant differences were found among all groups (P = 0.00033-0.0022). The YM group exhibited the highest median fracture resistance (2.06 kN, IQR: 2.00 – 2.60 kN), followed by ST (1.74 kN, IQR: 1.69 – 1.80 kN), LD (1.29 kN, IQR: 1.14 – 1.41 kN), and CM (0.87 kN, IQR: 0.79 – 0.92 kN). All specimens survived the artificial aging protocols. Distinct fracture patterns were observed depending on the restorative material, with zirconia-based groups showing more favorable resistance than resin composite. CONCLUSION . All tested HACs exhibited fracture resistance values exceeding maximum bite forces, supporting their clinical applicability. Strength-gradient multilayered zirconia demonstrated superior reliability after simulated 5-year aging, emphasizing its structural advantage and broader safety margin compared with other restorative materials.

[Purpose]We report a case concerning 5 months of left elbow and knee joint pain thought to be caused by repetitive use at work. Symptoms were improved successfully (checked by M-test) by a single acupuncture treatment.
[Case]We used acupuncture to treat a 50-year-old woman who visited our Acupuncture and Moxibustion Centerwith complaints of increasing elbow and knee joint pain in the left side. Since 4 months ago, her job involved frequent stair-climbing while carrying an 18-liter can of cooking oil. The soft tissues seemed to be damaged and caused pain due to the repeated lifting of heavy cans at work. Acu-points were decided by M-Test to check limitations of movement, which identified damaged regions and provided feedback for optimal treatment. According to the specific operations of the patient's work, we identified limited movements of left-elbow joint flexion-extension, left-shoulder joint extension, and left hip joint inner rotation and external gyration. These were regarded as target motions for the treatment. Her Visual Analog Scale (VAS) scores before treatment were 90 mm in the left elbow and 80 mm in the left knee. Despite only a single round of acupuncture treatment, the respective values dropped to 18 mm and 15 mm.
[Consideration and Conclusion]The limited movement identified by M-Test could expose the affected areas and help in treating the appropriate acu-points. Therefore, acupuncture using M-Test might improve painful motions of the body.

Nobody studies economic evaluation of acupuncture and moxibustion in Japan. To establish a method of economic evaluation of acupuncture and moxibustion, we introduced case study of economic evaluation of acupuncture and moxibustion at work. In addition, we examined a course of study that annex economic evaluation to a study of acupuncture and moxibustion. This manuscript introduces two case studies of economic evaluation and essential points of economic evaluation.

Objective : To research reports of economic analysis of acupuncture therapy.
Method : Searches were performed in Medline for reports of cost description, economic, randomized controlled trial, cost effectiveness, or cost benefit. Studies were included if they reported original data from any form of standard economic analysis.
Results : A total of 15 papers was found. These studies were investigated as follows : angina pectoris, carpal tunnel syndrome, stroke, knee osteoarthrosis, low back pain, musculoskeletal disease, migraine, acupuncture analgesia. On the other hand, only one paper was found in Japan.
Conclusion : Almost studies were noncntrolled trial, non-rigorous and retrospective studies. In future there is a need for high quality and rigorous studies of the cost and benefits of acupuncture.

We employed the Meridian Test to study the effects of acupuncture on m otor organ diseases and medical expenses of workers in a company, where health promotion is a priority. Our two-month trial was done at one factory which employs mainly physical labor workers. Acupuncture treatments were given for pain in the neckshoulder, knee and lumbar regions. After 8 weeks of our treatment, 83% of neck-shoulder pain cases, 77% of lumbar pain cases, and 88% of knee pain cases reported that their pain was reduced more than 50%. The results of a mental test (POMS test) showed a significant decrease in tension, depression, anger, fatigue and mental confusion. In terms of acupuncture treatment, numbers of visits to conventional hospitals were significantly decreased and average medical expenses were reduced to about 30%. These reductions continued for the next 3 months. Acupuncture treatment using the Meridian Test could benefit corporations where health promotion of workers is an urgent priority.