拔牙齒槽脊周圍軟硬組織體積變化之臨床測量及放射影像學結果：文獻回顧

Clinical and Radiographic Measurement of the Dimensional Change of Hard and Soft Tissue Around Extraction Socket: A Literature Review

鄭家典(Chia-Dan Cheng) ； 陳美筑(Mei-Zhu Chen) ； 陳筱涵(Siao-Han Chen) ； 陳穎吾(Ying-Wu Chen) ； 黃仁勇(Ren-Yeong Huang) ； 宋承恩(Chen-En Sung) ； 江正陽(Cheng-Yang Chiang) ； 鄭琬蒨(Wan-Chien Cheng)

《臺灣牙周病醫學會雜誌》 28卷1期 (2023/05) Pp. 11-23

https://doi.org/10.6121/TAP.202305_28(1).0002

摘要

在牙齒移除後，齒槽脊會隨之產生硬組織及軟組織的變化，進而導致未來重建的困難。能了解這些體積的變化程度，及影響變化量的因子，才能夠提供患者更精準的治療計畫。在文獻回顧中可以從解剖及組織學結構發現，在拔完牙後，接近牙齒的束狀骨會因為缺乏來自牙周韌帶的血液供應而產生大量的吸收，此種現象在本身頰側骨就較薄的前牙區則更為明顯。針對拔牙後的軟硬組織變化量，透過資料庫進行關鍵字文獻搜索，可以得知在拔完牙後，水平向大約會喪失50%的寬度，垂直向喪失量則大約會在20%以內，頰側的垂直喪失量會大於舌側；之於影響變化量的因子，與組織學的發現相同地，拔完牙後頰側骨的厚度會有顯著的影響。而軟組織在拔完牙後，厚度會輕微增加，也造成整體輪廓的變化並不會如硬組織明顯。本篇文獻回顧能提供對於拔牙後軟硬組織變化更完整的資訊，使醫師在進行治療計畫時可以有更多的資訊作為參考。

關鍵字

拔牙 ； 齒槽脊 ； 體積變化

並列摘要

Following tooth extraction, the hard and soft tissue of the alveolar ridge will undergo dimensional changes, which can complicate future rehabilitation. Understanding the magnitude of the changes can be helpful in providing a more precise treatment plan for the patients. Reviewing previous literature regarding the anatomic and histologic structure of the extraction socket, it can be found that a large amount of bundle bone resorption will take place after extraction due to loss of blood supply from the periodontal ligament. The phenomenon is more pronounced in the anterior region which is largely composed of bundle bone. A literature search was conducted on the topic of the post-extraction dimensional change of the hard and soft tissue through online database. It can be summarized that, after extraction, the horizontal dimensional change amounts to 50% loss of the original ridge width while vertical reduction is no more than 20% with buccal side losing more height than lingual. Considering the factors affecting the dimensional change, in accordance with histologic findings, the baseline thickness of the buccal bone plate of the extraction socket is related to the amount of resorption. After extraction, the thickness of soft tissue around the socket will slightly increase which can compensate for the loss of hard tissue, leading to less apparent change of the ridge contour. The present literature review can provide a better understanding of the post-extraction changes of both soft and hard tissue, which will benefit clinicians in treatment planning before tooth extraction.

並列關鍵字

tooth extraction ； alveolar ridge ； periodontal atrophy