- 期刊
局部型侵犯性牙周炎病例報告及文獻回顧
Localized Aggressive Periodontitis: A Case Report and Literature Review
摘要
侵犯性牙周炎的特色為快速的牙周附連及骨喪失，主要發生於年輕的病患，然而年紀稍長的病患也可能罹患此疾病。侵犯性牙周炎的發生率比慢性牙周炎低，治療的方式也有差異性，乃因局部型侵犯性牙周炎與Aggregatibacter actinomycetemcomitans菌密切相關，由於研究指出此細菌會穿入牙周組織中，因此治療上除了採取機械性清創外，也有學者建議合併服用抗生素。本文提出一位17歲罹患局部型侵犯性牙周炎之病例，臼齒區可見嚴重的牙周破壞，一次性進行牙齦下牙結石清潔與牙根整平後合併給予抗生素治療，然後在上下顎臼齒區施以自體骨移植與引導組織再生手術。經過一年追蹤，臼齒區之骨內缺損與根叉處有顯著的臨床附連增加與放射線骨充填情形。這個病例顯示局部型侵犯性牙周炎患者之嚴重的牙周破壞處可透過機械性清創合併抗生素與牙周再生手術治療得到成功的治療。
並列摘要
Aggressive periodontitis is characterized by a rapid loss of clinical attachment and bone. This disease mainly affects young adults, although older age groups may also be involved. The prevalence of this type of periodontitis is lower than that of chronic periodontitis, but various treatment modalities do exist for these patients. There is a close association between localized aggressive periodontitis (LAgP) and the presence of ＂Aggregatibacter actinomycetemcomitans＂; furthermore, bacterial invasion of the periodontal tissue has been reported to occur in cases with LAgP. Thus systemic antibiotic medication can be used as an adjunctive therapy to mechanical debridement and is frequently proposed for these patients.In this paper, a 17-year-old LAgP case who was suffering from severe periodontal destruction over the molar areas was treated by scaling and root planing in single visit, which was then followed by administration of systemic antibiotics. Osseous grafting procedures and guided tissue regeneration were further performed later in the maxillary and mandibular molar areas. At the one-year postoperative follow-up, it was revealed that there was a significant gain in clinical attachment level and this was accompanied by radiographic bone fill of the intrabony and furcation defects affecting the molar teeth. This case report demonstrates that a LAgP patient with extensive periodontal destruction can be treated successfully by mechanical debridement, antibiotic adjunct therapy and regenerative periodontal therapy.