- 期刊
牙周病整體治療病例報告及文獻回顧
Periodontal Full Treatment Case Report and Literature Review
摘要
下顎阻生第三大臼齒常和鄰近的第二大臼齒遠心側牙周破壞有關，拔除阻生齒後的處理影響著第二大臼齒的預後。本病例報告提出一位47歲罹患慢性牙周炎的男性，前牙深咬且全口有咬合面磨耗，右下顎第三大臼齒為阻生齒合併第二大臼齒遠心側牙周破壞，下顎正中門齒缺牙。基本牙周治療後，患者開始配戴咬合板。左下及右下第二大臼齒施行牙周再生手術，放置生物活性玻璃合併可吸收再生膜，下顎正中門齒缺牙區置入非埋入性單一植體合併骨再生手術後，製作兩固定式牙冠，後續進行游離牙齦移植。術後一年的追蹤，再生手術區域有顯著獲得臨床附連與放射線檢查骨充填，植牙區軟組織與骨嵴位置穩定無發炎現象。經由完整的牙周病及植牙治療並密切注意其咬合負重，病患恢復整體牙周健康及穩定的植牙效果。
並列摘要
Periodontal destruction at the distal surface of mandibular second molars is often related to impacted third molars. Treatments of the distal surface of the adjacent second molars immediately after extraction of impacted third molars may improve healing and have better prognosis. This paper reported the periodontal management of a 47-year-old chronic periodontitis male with deep anterior overbite and full mouth occlusal attrition who had lower right third molar impaction combined with periodontal defect over distal surface of the adjacent second molar and had missing of lower central incisors. In addition to conventional periodontal treatment and occlusal bite plate, surgeries consisting of guided tissue regeneration using bioactive glass grafting and resorbable membrane were performed to periodontal defects. A single implant simultaneously with guided bone regeneration was performed in lower central incisor area. Furthermore, free gingival graft was applied to the implant site. Postoperative One-year examination revealed gain of clinical attachment level and bone fill over osseous grafting sites. The implant site showed bone fill and stable soft tissue condition and crestal bone level without inflammation. The overall periodontal health was improved and with close attention to occlusal load stable implant outcome was achieved