Root Coverage with Laterally Positioned Pedicle Flap and Subepithelial Connective Tissue Graft on Localized Severely Denuded Root Surface after Surgical Orthodontic Treatment in Cleft Lip and Palate: A Case Report

使用側向移位翻瓣術合併上皮下結締組織移植體治療矯正及正顎手術後之局部嚴重牙根裸露：病例報告

王淵民(Yuan-Min Wang) ； 朱毓仁(Yuh-Ren Ju) ； 柯雯青(Ellen Wen-Ching Ko) ； 潘惠玲(Whei-Lin Pan) ； 陳朝寶(Chiu-Po Chan) ； 張軒棠(Jasmine Shiuan-Tang Chang)

《中華民國齒顎矯正學雜誌》 26卷1期 (2014/03) Pp. 41-48

https://doi.org/10.30036/TJO.201403_26(1).0004

摘要

一位具唇腭裂病史之27歲女性，於正顎手術及矯正治療後，在右上顎第一小臼齒頰側罹患牙齦嚴重萎縮、齒根裸露，口內頰側前庭亦可見疤痕組織於多處形成。由於和鄰牙之間並無齒間骨質喪失且有足夠的附連牙齦組織，本病例於是選擇使用側向移位翻瓣術合併上皮下結締組織移植體來做牙根覆蓋，術後一年仍有百分之百的牙根覆蓋率。於臨床文獻中，尚無應用側向移位翻瓣術合併上皮下結締組織移植體來治療正顎手術後局部嚴重牙齦萎縮之病例，本病例的治療成果顯示此術式應用在該類患者上能得到良好的長期預後及可預測性。

關鍵字

唇腭裂 ； 牙齦萎縮 ； 側向移位翻瓣術 ； 牙根覆蓋 ； 上皮下結締組織移植體 ； 正顎手術

並列摘要

A 27-year-old female patient with secondary cleft deformity and malocclusion was initially treated with reconstructive surgery. However, localized severely gingival recession on the upper right first premolar and massive scar tissue over the buccal vestibular area were formed after the surgical orthodontic treatment. The surgical technique of choice in this patient was laterally positioned pedicle flap (LPF) combined with subepithelial connective tissue graft (SCTG) because of the area adjacent to the recession defect showed a great amount of attached gingiva and without interproximal bone loss. The complete root coverage in the surgical site was observed one year later. To the best of our knowledge, there is no report available on the application of LPF combined with SCTG to treat gingival recession after surgical orthodontic treatment and the result of this report demonstrates the possibility of predictable root coverage and clinical attachment gain.

並列關鍵字

cleft lip and palate ； gingival recession ； laterally positioned pedicle flap ； root coverage ； subepithelial connective tissue graft ； surgical orthodontic treatment