- 期刊
拔牙後及時施行引導組織再生術以保留齒槽嵴－病例報告
Ridge Preservation and Augmentation using Guided Tissue Regeneration Immediately after Tooth Extraction-A Case Report
摘要
當自然牙無法保留時，經拔除後齒槽嵴會迅速地從舌側和根尖向開始骨質吸收，致使殘存骨嵴的高度和寬度減少，而影響日後補綴物設計與美觀，或因骨量不足以承受牙科植體的種植。為了重建植體周圍骨缺隕，近來常配合引導組織再生術（guided tissue regeneration, GTR），利用再生膜隔開牙齦纖維細胞，穩定骨缺處血塊，引導周圍的骨細胞進入骨缺隕處，以達骨嵴加寬、加高，以利將來贋復補綴物與牙科植體種植的進行。本病例報告，在拔牙後立即利用GTR進行拔牙槽骨嵴保存手術，5－6星期後先拆去已露出的再生膜，等殘存骨嵴成熱穩定時，再進行植體植入，以確保拔牙槽嵴的骨架，使將來植體植入時有足夠骨密合度，增加植體的成功率，本文同時探討牙科植體植入的時機，再生膜的露出是否影響骨再生的效果和骨移植材的選擇。
並列摘要
Alveolar ridge resorbs quickly from lingual and apical side right after tooth extraction. Consequently, it reduces the height and width of residual ridge, and makes difficulty for dental implantation. Recently, the guided tissue regeneration (GTR) technique has been successfully developed for exclusion of gingival fibroblasts to guide bone cells into the bony defect to improve the quality and quantity of residual ridge for dental implantation. This article reports a case using GTR technique for preservation and augmentation of alveolar ridge immediately after tooth extraction. The barrier membrane was removed after 5-6 weeks and two dental implants were placed eleven months later, waiting for the maturity of new growth alveolar bone. Finally, the dental prosthesis was constructed and followed up to one year. The clinical and radiographic data look satisfactory. In addition, this article will discuss timing of dental implantation, exposure of barrier membrane and selection of bone grafts.