Treatment of Intrabony Defects Associated with lnterradicular Root Proximity/Fusion in Molar Furcations

根岔治療對牙周病醫師而言一直是重大的挑戰，其原因包括不論是以傳統的骨修整術，瓣膜根尖移動術或牙周再生，在效果上都有其不可預期性。所以當第一大臼齒拔除後，因為贗復的原因必須留下第二大臼齒時，除了以手術或非手術清創，以盡力維持見況外，實無其積極靠的方法。而長久以來牙根切除術亦被認為適於用在牙根合併或緊鄰的情形。本文嘗試應用牙根切除術，治療根岔處垂直骨缺損並加上牙根合併或緊鄰之病例，在不借助任何牙周再生材料的情形下，短期追蹤後，發現牙根切除後之牙本質斷面，並無礙於牙周之癒合，並可穫致滿意的結果。故而提出此病例報告，建議在慎選病例的條件下，牙根切除術對牙根合併或緊鄰之病例，並非絕對的禁忌。

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並列摘要

To treat Conation involvement is a crucial challenge to periodontists, not only because of the limitation in pocket reduction by osteoplasty and apically positioned flap, but also because of the unpredictability In regenerative approaches. Therefore, if the first molar is absent and the second molar has to be retained strategically for prosthetic reasons, very few alternatives besides nonsurgical/surgical debridement can be taken in treating the furcation of the second molar, where the interradicular root proximity and fusion frequently occur. On the other hand, root amputation/hemisection has long been considered a contraindication in treating furcations with two close roots; however, this impression is only empirical. A series of clinical cases involved in the treatment of intrabony defects associated with interradicular root proximity and fusion by root amputation/hemisection has been reported. Without any help of regenerative material, thorough root debridement and pocket reduction were attained. Based on these cases, we suggested that the cut surface created by odontoplasty during root amputation was compatible for periodontal healing and the extraction socket provided striking potential for defect repair. We re-examined the clinical feasibility and benefit of treating intrabony defects associated with interradicular root proximity and fusion in molar furcations by root amputation/hemisection, and suggested that its role should be favorably reconsidered on case basis. The short term success in periodontal and prosthetic aspects needed to be further evaluated at long-term follow-up.

並列關鍵字

furcation ； interradicular root proximity ； amputation

國際替代計量

Treatment of Intrabony Defects Associated with lnterradicular Root Proximity/Fusion in Molar Furcations

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